Menstruation With Extended and Excessive Bleeding

Q: I am 14 years old and my periods last 2 weeks. I have had my periods since 12 months. Is this normal? They also get heavy in the second week.
– By Laura brown

Reply:

No, this is not normal. Your periods are very prolonged and heavy for your age.

Such a condition is medically called menorrhagia.

What is Menorrhagia?

Heavy bleeding is called menorrhagia. It may be a prolonged bleeding that continues beyond 7 days. Or it may be heavy bleeding requiring more that ten pads a day.

Heavy bleeding definitely needs to be corrected. It may make you anemic (weak), as a lot of blood is lost every month.

Also, such a bleed is a symptom caused by some underlying problem which needs to be detected before it leads to other disturbing problems.

Causes of Prolonged Menses

In young girls, the commonest reason of prolonged periods is any hormonal disturbance.

The female reproductive cycle is mainly controlled by two hormones- estrogen and progesterone.

Estrogen is the first to be secreted during a monthly cycle. It leads to thickening of the uterine endometrium (inner lining), preparing for implantation of the fertilized egg.

After ovulation, progesterone levels rise.

Any imbalance in this process would lead to bleeding disturbances.

Like, if progesterone is not produced in sufficient amounts, estrogen levels stay high leading to prolonged bleeding. This situation is also called dysfunctional uterine bleeding, or DUB.

This may be due to many medical conditions. They include:

  • Dysfunction of the ovaries- Sometimes ovulation does not occur. Consequently, progesterone is not produced.
  • Thyroid problems
  • Pituitary problems

Other Causes of Menorrhagia

Apart from hormonal factors, there can be other reasons of prolonged, heavy bleeds. They are:

  • If you are taking any blood thinning medications like aspirin, the bleed will be long and heavy.
  • Medications like steroids.
  • Excessive use of anti inflammatory medication (such as aspirin)
  • Blood disorders like von Willibrand’s disease, where some clotting factor is absent in the blood. So, any bleeding from the body does not arrest quickly.
  • Lifestyle problems like stress or some abrupt change in diet.
  • Any non-cancerous growth in the uterine cavity, like uterine polyp or fibroid. However, they are commoner in 20- 30’s.

Hormonal problems in teenage girls usually get corrected by themselves. However, if you feel it is not getting better, visit a gynecologist.

You require a thorough checkup and medical evaluation. The cause of your problem needs to be detected.

Your gynecologist may order some tests like:

  • Blood tests- for thyroid, iron count, total blood count
  • Pelvic ultrasound, to check any growth in the uterus.
  • Urinalysis

If it’s a hormonal problem, hormonal medications may be required for some time. Iron supplements can be given to recover the loss due to heavy bleeding.

If there is some other problem, treatment would be accordingly. Most of the conditions leading to your symptom are treatable.

Take Care,

Buddy M.D.

Medical Advice (Q&As) on “Heavy Prolonged Bleeding During Menstrual Periods

  1. Carey

    Dear Doctor,
    I have heavy flow during my period, so much that I have to use two pads per use and change them every 3 hours or so. My period also flows for 8 days. What do you think causes this? Please help.

    Reply
    1. Buddy M.D. Post author

      As you can read above, there are many causes for having a heavy bleeding.

      Let us know your age, any kids, any other symptom, like pain abdomen etc.

      Reply
      1. Carey

        Hey I am 24, I have no kids and I have never had sex. When I have my Period I sweat a lot, get abdominal cramps (in pelvic area), leg pain, back pain and nausea. The pain is so intense that I can’t stay in one place for too long, always have to be moving about. Sometimes lying down the pain is still unbearable so I take (2) 500mg naproxen tabs to cool it. 5 years ago, I had swelling in my feet and abdomen and when I ran I can hear a swishing sound. I couldn’t laugh or cough without pain. I went to do a ultrasound and it detected fluid and that one of my ovaries was BIGGER than the other. Don’t know if that is normal. The specialist said it was nothing to be worried about but the Dr questioned whether it could be Endometriosis. Unfortunately we don’t have the availability of machinery available to perform certain tests in my country. One doctor who recently visited my country from Columbia used a sort of rod like device to scan me and claimed that my ovaries were damaged, I had slight anemia (which I know and that I was suffering from Hyperthyroidism but my GPs don’t think so because I have no Goiter so I don’t know who to believe any more.

        Reply
        1. Buddy M.D. Post author

          Many girls have pain in legs and abdomen during menses. Specify if you have any pain in legs or tummy even otherwise, without menses.

          Also, are your menstrual cycles regular?

          Reply
          1. Carey

            I do not get pain in tummy or legs etc when I do not have my period. No, my period is very irregular. Sometimes it comes 2 weeks early sometimes a week later.

          2. Buddy M.D. Post author

            You need to go for an U/S. There appears to be some pathology in the uterus or ovaries.