What Is And Isn’t Spotting
It’s common for people to refer to any bleeding outside of a period as spotting. However, spotting, breakthrough bleeding, and other issues differ in the timing and amount of bleeding.
- Spotting: This includes just a red tinge on the toilet paper or a drop or two in your underwear. Medically, it’s considered spotting if it’s outside of your period and doesn’t generally require you to use a pad or tampon.
- Light bleeding: This type of bleeding occurs just before or after your period and isn’t technically spottingit’s considered part of your period.
- Breakthrough bleeding: Mid-cycle bleeding is heavier than spotting.
Your Body’s Gearing Up For Menopause
Oh yes, simply getting older can mess with your period. Menopause, which technically means you’ve gone 12 or more months without a period, hits women around age 50. However, your body starts the natural decline in hormones that leads up to menopause as early as 35, says Christiane Northrup, MD, author of Womens Bodies, Womens Wisdom.
When this happens, you may notice your periods getting longer or shorter, your cycle becoming more random, and other slight changes in your menstruation.
If you’ve ruled out everything else, and you’re in your mid- to late-30s, your prolonged periods might simply be due to the natural process of aging. There is, however, such a thing as early menopause, which can affect women even in their twenties. So talk to your doctor if this runs in your family or if you’re showing other signs of menopause, like a low sex drive or insomnia.
How Is Menorrhagia Treated
Treatment for menorrhagia depends on how serious the bleeding is, the cause of the bleeding, your health, age, and medical history. Also, treatment depends on your response to certain medicines and your wants and needs. You may not want to have a period at all, or just want to reduce the amount of bleeding. In addition, your decision to get pregnant or not will affect what treatment you choose. If you do not have anemia, you can choose to not have treatment.
Common treatments include:
- Hormone therapy to reduce bleeding
- Desmopressin nasal spray to stop bleeding for certain bleeding disorders
- Antifibrinolytic medicines to reduce bleeding
- Dilation and curettage to reduce bleeding by removing the top layer of uterus lining
- Operative hysteroscopy to remove fibroids and polyps and remove lining of uterus
- Endometrial ablation or resection to remove all or part of the lining of the uterus
- Hysterectomy to surgically remove the uterus and you will stop having your period
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Your Treatment Options Summarised
Oral contraceptive pill
POP or mini-pill
It Could Be Due To Pcos
PCOS or Polycystic ovarian syndrome is one of the main culprits behind almost every menstrual irregularity including prolonged periods. This is a condition where several cysts are developed inside the ovary of women that leads to hormonal imbalance. Due to this hormonal imbalance, your body doesnt get a proper signal to produce the right amount of eggs and relies at the right time.
It can be from the beginning. Even, some women with PCOS will have periods after a gap of three months as well. If you have high body weight, excessive hair growth and thyroid issues with your prolonged periods then chances are high that PCOS is the culprit. You need to take proper medical help for proper diagnosis and remedy.
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If You Have Just Started Taking Certain Medication
There are certain sorts of medicines that can create havoc inside your body and whack your hormones. If you have just started medications for issues like thyroid and blood-thinning, then there are chances of having longer periods. These medications disturb the hormone levels by leaps and bounds and disturbed hormone levels mean longer periods.
Your Hormones Are Out Of Whack
Polycystic ovarian syndrome , an underactive or overactive thyroid, and other disorders that mess with your sex hormone levels can cause long, heavy, or irregular periods, says Ross. If your period is abnormal or has changed significantly, you may want to see an endocrinologist to test for these conditions.
Diagnosis Of Painful Periods And Heavy Bleeding
UT Southwesterns experienced gynecologists conduct a thorough evaluation, which includes a:
- Physical exam
- Review of personal medical history, including details of the patients menstrual cycle
- Discussion of symptoms
Patients should bring information about the dates and lengths of their last several periods. For sexually active patients, a pelvic exam will be performed to check for infections and to examine the cervix.
To diagnose heavy bleeding and painful periods, our doctors usually recommend one or more tests, such as:
- Blood tests to look for signs of iron deficiency, thyroid disorders, or blood-clotting abnormalities
- Ultrasound: Diagnostic tools that use sound waves to produce images of the pelvic organs. Used to look for any abnormalities
- Pap smear: Sample of cells from the cervix that are examined under a microscope for infection or changes that can lead to cancer or already are cancerous
- Endometrial biopsy: A test that samples a small amount of endometrial tissue for examination under a microscope
- Magnetic resonance imaging scans: Equipment that uses a large magnet and radio waves to produce detailed images of pelvic organs
Based on the results of these tests, we might recommend further testing, such as:
You Had An Early Miscarriage
Early miscarriages are much more common than you may realize. Up to half of all pregnancies end in miscarriage, often before the woman even realizes she was pregnant, according to the .
Sometimes the only sign is an extra-heavy or long period. Your menstrual cycle length should return to normal within one to two cycles if it stays abnormally long after three cycles, call your doctor, Dr. Toth says.
About one in 100 women suffer from repeat miscarriages, so it’s important to rule out a condition that affects fertility, like endometriosis.
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Female Bleeding: When Should You See A Doctor
Thankfully, most of the time your period will come and go without causing much fuss. But what about those times when your cycle gets thrown out of whack and you have abnormal bleeding? Should you be concerned?
Every woman is different when it comes to her cycle. However, when period changes happen such as a heavier or lighter flow than usual or timing abnormalities it can be hard to decide if you need to call your doctor or if what youre experiencing is in the range of normal.
Its a good idea to always track your menstrual cycles, including how heavy your flows are, how long they last and how many tampons or pads you use during a single cycle. This information can be useful for your doctor.
We spoke to INTEGRIS Health OB-GYN Dr. Elise Schrop to get her insights on a scary topic. What causes abnormal bleeding, just what is abnormal anyway, and when should you consult your doctor?
“Abnormal bleeding is a very common problem for women,” Dr. Schrop says. “In fact, about a third of office visits to the gynecologist are for abnormal bleeding. It can happen to women of all ages but most commonly occurs in the first several years after a young woman starts having a period and as women start to make the transition to menopause.”
When A Hysterectomy Is Needed
It was a hysterectomy that eventually improved Beth’s endometriosis. Her doctor gave her two options: a “D and C” or a hysterectomy.
Harris chose the “D and C” first. But when it didn’t help much, she consulted with her doctor and decided to go ahead with the hysterectomy. The results? “My lifestyle improved drastically, my physical strength went up, and I felt back to normal.”
Not all women recover easily from a hysterectomy, however. A woman should make the decision only after a thorough discussion with her doctor.
Fortunately, most menstrual-bleeding abnormalities are the result of benign conditions, says Roberson, and can be treated without surgery.
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How Is Menorrhagia Managed
To manage menorrhagia, some women stay home on days when they are bleeding heavily. Others leave the house if they know a bathroom will be nearby. Also, it is a good practice to keep pads and/or tampons in your purse or at work. Wearing dark pants or skirts can help if you are worried about stains on light-colored clothing. Additionally, you can use a waterproof sheet on your mattress to prevent stains.
Why Am I Having Periods That Last For Weeks
Most womens menstrual flow lasts a few days, often up to a week. Sometimes, however, women may have periods that last much longer, like having a period for 3 weeks. If a womans period is prolonged, irregular, or excessively heavy, it is called menorrhagia. This is a condition that may be controlled with the use of hormones or birth control therapy, or it may be a warning sign of a more serious, underlying health issue.
Causes of Prolonged Menstrual Bleeding
A womans entire menstrual cycle usually takes 21-35 days to complete. Young girls who have just started having periods or older women nearing menopause may notice variations of that schedule. The fluctuation of hormone levels, particularly estrogen, is often the cause for these inconsistencies. This is not abnormal for females in these age groups.
Another cause for prolonged periods may be dysfunctional uterine bleeding . DUB is a hormone dysfunction that may happen any time during a womans reproductive years, but it is most commonly found in women over 40. This condition is often successfully treated with hormones such as estrogen or progesterone. A combination of these two hormones may be prescribed in the form of birth control pills which act not only as contraceptives but also regulate the production of female hormones.
Other causes for long-lasting periods can include:
Fibroids, benign growths on the uterine wall
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Hormone And Ovulation Changes
Changes to your hormones or ovulation may cause a long period. You may notice hormonal changes when you first get your period during puberty or in perimenopause. You may also experience a hormonal imbalance from different health conditions, such as thyroid disorders or polycystic ovary syndrome.
If your hormones arent at a normal level or if your body doesnt ovulate during your menstrual cycle, the uterine lining can become very thick. When your body finally sheds the lining, you may experience a period thats longer than normal.
Long Periods & The Menstrual Cycle
Menstruation, whether in the form of a normal or long period, is only part of a woman’s menstrual cycle. The menstrual cycle is the process during which a woman’s ovaries produce eggs, release those eggs, and, in the absence of fertilization , results in a period approximately once a month. In other words, there’s a lot going on within the body before, after and during menstruation, much of which varies depending on the cycle and the person.
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Youre Actually Pregnant And Have Placenta Previa
This type of heavy vaginal bleeding is actually unrelated to a period, though you might think it is one if you don’t yet know you’re pregnant. Placenta previa is a condition that happens during pregnancy where the placenta covers the cervix, explains Dr. Horton.
Patients will usually have heavy vaginal bleeding throughout their pregnancy and will need to deliver their baby by C-section. Take a pregnancy test and see your doctor to figure out the best treatment method.
What Treatments Are Available For Prolonged Menstrual Bleeding
Many causes of prolonged bleeding can be treated with birth control pills of estrogen and progesterone. This not only provides contraception, it can regulate hormone production and so treat bleeding caused by hormones. Birth control pills generally decrease the overall amount of flow and so should lessen the length of your period, Thielen says.
In some cases, such as for endometrial hyperplasia, the hormone progestin may be prescribed alone.
Other medicines may also be used. Lysteda is a prescription drug that treats heavy menstrual bleeding. It comes in a tablet and is taken each month at the start of the menstrual period.
Prolonged bleeding caused by uterine fibroids can be treated with medication or with minimally invasive procedures such as endometrial ablation or laparoscopic surgery . In severe cases an abdominal myomectomy or a hysterectomy may be recommended.
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How Might Your Doctor Diagnose A Long Period
Your doctor will ask how often you get your period, how many days it lasts, and do you have bleeding in between your period or after sex, says Jodie Horton, MD, an ob-gyn in Oakton, Virginia, and chief wellness advisor for Love Wellness. Other important clues to determine what is causing your abnormal uterine bleeding is how heavy your periods are, what medications youre taking, if youve been tested for sexually transmitted infections and are up to date on your Pap smears. So you’ll want to know that info before your visit.
Your doctor may perform a pelvic exam to evaluate the cervix and the size and regularity of the uterus, as well as a pelvic ultrasound or hysteroscopy to see inside your cervix, uterus, fallopian tubes, and ovaries for any abnormalities.
It sounds scary, but most causes of prolonged menstrual bleeding aren’t a big deal and can be fixed or improved with the help of your doctor, Dr. Toth notes. And you deserve to have a normal period that doesn’t totally suck.