The longer than normal period can cause concern in women, since it is sometimes an indicator of some pathology or alteration in the reproductive system. Discover its most frequent causes.
For many years, menstruation has been a taboo in society. This has caused a great lack of knowledge of the variety and richness that the menstrual cycle implies. So much so that when the period lasts longer than normal, it is always scary, but it does not have to be pathological every time.
The mean duration of bleeding ranges from 4 to 8 days, but varies depending on the population studied. However, some women do not meet this criterion, as they have a longer or shorter period than usual. Why can these changes occur? Read on to find out.
When is the period considered longer than normal?
First of all, it is necessary to distinguish the type of vaginal bleeding and whether it is linked to menstruation. Depending on the stage of the menstrual cycle in which the bleeding occurs, we can rule out whether it is an alteration of the period or not.
To know if menstruation is within normality, we must keep track of our cycle, the duration and amount of bleeding. Depending on these characteristics, we have different alterations:
- Eumenorrhea: it is when menstruation has a duration and quantity that places it within the average. That is, it lasts between 4-8 days with a flow of 80 milliliters.
- Hypermenorrhea:Â menstrual bleeding occurs in excessive amounts in terms of volume, exceeding 80 milliliters.
- Polymenorrhagia:Â the duration is excessive, for more than 8 days.
- Proiomenorrhea: this is an alteration that changes the total days of the cycle, making them short, below 28 days between one menstruation and another.
Therefore, if we see that the bleeding days are lengthened by more than 8, we will be facing a polymenorrhagia. However, this variation is almost always accompanied by excessive bleeding, which changes the medical definition of menorrhagia.
Causes of a longer period than normal
When a menstrual flow occurs with a duration and abundance that is different from the previous ones that we have had, we must go to the gynecologist for a clinical examination. The possible causes of the disorder are divided into two large groups that we will discuss now.
Organic causes
When the cause of a longer than normal period can be seen in the physical exam performed by the gynecologist or in complementary tests, such as an ultrasound, it means that it is organic. There are several responsible anomalies, such as the following:
- Iatrogenic: menstrual disturbances are caused by a medical procedure or medication. The most common are hormonal contraceptives, since they alter the menstrual cycle and the functioning of estrogens and progestogens. In addition, other iatrogenic causes are psychotropic drugs and antiplatelet drugs.
- Trauma and presence of foreign bodies in the vaginal canal
- Infections: they can generate alterations in the structure of the uterus, such as adhesions, which prevent proper emptying of the bleeding. The most frequent are usually those of sexual transmission.
- Benign or malignant organic pathology: the organ that detaches and causes bleeding is called the endometrium and is a layer of the uterus. Sometimes, there may be a benign abnormal growth, as is the case with fibroids; or malignant, such as endometrial tumors.
Hormonal causes
On the other hand, there is a group of causes that alter hormonal functioning and have an impact on the entire organism:
- Hyperestrogenism: in a healthy and normal menstrual cycle, estrogens generate the proliferation of the endometrium which will then fall. But, at a certain point, progesterone comes into play, which inhibits the growth of this layer. In hyperestrogenism, estrogens roam freely without progesterone regulation, causing heavier and longer-lasting bleeding.
- Endocrinopathies: thyroid disorders and an increase in prolactin can cause menorrhagia.
- Coagulopathies: These are blood disorders in which the components of blood aggregation, such as platelets or clotting factors, are altered. This causes the blood to take longer to clot.
Functional causes
Functional causes are the most frequent and only between 10-20% are organic causes, such as those described above. However, they must be discarded yes or yes because they have a specific treatment.
Excessive and long-lasting functional bleeding is usually due to a malfunction of the hypothalamic pituitary-ovarian axis. This axis regulates estrogens and progestogens so that they can be at adequate levels, depending on the stage of the menstrual cycle.
Many times, this malfunction is due to the immaturity of the system. For this reason, it usually occurs in young people, specifically in adolescents. It leaves no mark on the medical tests that are performed and the only thing that can be done is to try to control hormone levels with medication.
When should I be concerned?
First of all, you have to rule out whether the longer cycle is part of normal for a woman or not. As we discussed at the beginning, the length and amount of the period is an individual characteristic.
If the bleeding has lasted more than 8 days for years and there have been no signs or symptoms of illness, it may be completely normal and healthy. We do not always have to be within the population mean.
On the other hand, if in each cycle the duration of menstruation has been less than 8 days and, suddenly, it lengthens, you have to be vigilant. It can mean that there is a hormonal alteration or some pathology that is in the reproductive system. This is the time for a medical consultation.
