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Your average period lasts anywhere from three to seven days, and most women who have them don't exactly relish those. What if your period has gone on longer than a week, and in some cases even way longer — as in multiple weeks or even months, though? You're in period hell, and you need to get to the bottom of what's causing it. 

The medical term for either really heavy periods (in which you need to change pads or tampons every two hours or even more often) or really long periods (anything longer than a week) is menorrhagia. Menorrhagia has multiple possible causes, and we'll discuss them here. 

Menorrhagia: The Symptoms

Besides really long and/or heavy menstrual periods, you may also notice:

  • The passing of large clots.
  • Pain, and maybe pain severe enough to stop you from doing everyday stuff.
  • Fatigue. 
  • Shortness of breath. 
  • The bleeding may be so severe that you have to use multiple methods to collect your menstrual flow, such as a menstrual cup as well as pads, and even doing that, your periods may still interfere with your daily life. 

Causes Of Menorrhagia

A slew of different things can cause menorrhagia, but they ultimately boil down to three broad causes — hormonal, uterine, and other. The specific options include:

  • Polycystic Ovary Syndrome, an endocrine disorder that causes excessive androgen ("male hormone") levels, frequently insulin resistance, and multiple ovarian cysts. It is associated with obesity, as well. Both insulin resistance and obesity can also lead to menorrhagia on their own. 
  • Anovulation. Not ovulating, which is more common in very young women, can cause prolonged periods. 
  • Uterine fibroids or polyps. Fibroids are benign uterine tumors, while polyps are small growths within the uterine lining. 
  • Adenomyosis. A bit like its more well-known "cousin" endometriosis, it is a condition in which uterine lining (the endometrium) invades the muscular wall of your uterus. 
  • Uterine or cervical cancer.
  • Birth-control related bleeding, which is more frequently caused by a copper intrauterine device (Paragard in the US). 
  • Bleeding disorders such as platelet function disorder. 
  • Medications, like anticoagulants and hormone-containing therapies, can cause heavy and prolonged menstrual bleeding as well. 

A further option is the possibility that you are not really experiencing a menstrual period, but rather a miscarriage or bleeding associated with pregnancy. Women who have any chance at all of being pregnant should seek prompt medical care. This also, however, holds true for everyone else with prolonged periods. As the spectrum of possibilities above (and those weren't even all possible causes of menorrhagia!) should tell you, you are more than warranted in seeking out advice from your OBGYN as soon as possible — your long periods could be more than just a pain in the neck. Regardless of cause, they also place you at risk of developing anemia. 

What Now?

When you see your OBGYN, you can expect a physical exam and a chat about your medical history and any medications you may use. Along with that, your doctor may wish to perform a Pap smear, blood tests, an ultrasound, and even take an endometrial biopsy if they believe it is necessary. Treatment depends on the cause of your prolonged periods, obviously, but it can consist of medication (from ibuprofen to birth control pills) or surgery (from an endometrial ablation to a hysterectomy in severe cases). 

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