Is It Normal for Menstrual Cycle to Last 18 Days? Expert Insights

Is it normal for menstruation to last 18 days?

Hello Dr.
Wei,
I would like to ask for your assistance with the following issues, thank you! I started my menstrual cycle in mid-April, but it has been irregular and persistent until mid-May.
During this time, in addition to the irregular spotting, I have experienced an increase in menstrual flow and the presence of blood clots.
Is this normal? My menstrual cycles typically last about 5 days, and they often come every two months or even longer.

About three years ago, I underwent laparoscopic surgery to address severe ovarian adhesions, endometriosis, and dysmenorrhea, which included adhesiolysis and the removal of an endometrioma, along with a nerve block procedure for pain relief.
After the surgery, I experienced irregular menstrual cycles for over a year, during which I did not menstruate at all.
Blood tests indicated that I had polycystic ovary syndrome (PCOS), and I was prescribed birth control pills to regulate my cycles for about three months.
However, I continued to experience irregularities and delayed cycles.
When I consulted the surgeon about this, he mentioned that it was not a concern whether I menstruated or not, so I did not pay much attention to it.
However, the recent experience of having my menstrual cycle last for 18 days has made me question whether I should see a doctor again.
I had sexual experiences about five years ago, but I have not had any sexual relationships since then.
Additionally, both my mother and aunt passed away from cervical cancer.
I am currently 30 years old; can the health department cover the cost of a Pap smear for me?
Could my current situation be related to the issues I faced over three years ago? During a check-up over two years ago, uterine fibroids were also discovered.
Although the surgeon mentioned that my condition could recur, could it happen so soon? Or could there be other underlying issues?

Doris, 30~39 year old female. Ask Date: 2001/05/31

Dr. Wei Fumao reply Obstetrics and Gynecology

If menstruation is irregular in April, especially if there was little or no period in February or March, it could indicate an abnormality.
However, there are other conditions that can cause this, so please consult a gynecologist for an examination.
A Pap smear is covered by health insurance regardless of whether you are 30 years old, as long as the physician deems it necessary.
For issues related to gynecological fibroids and endometriomas, it is best to return to the original surgeon for evaluation.

Reply Date: 2001/05/31

More Info

Experiencing a menstrual cycle that lasts for 18 days can be concerning, especially if your typical cycle is around 5 days. It is essential to understand that various factors can influence menstrual cycles, including hormonal imbalances, underlying medical conditions, and lifestyle factors. Given your history of ovarian adhesions, chocolate cysts, and previous surgeries, it is crucial to approach this situation with careful consideration.

Firstly, prolonged menstrual bleeding, known as menorrhagia, can occur due to several reasons. In your case, the presence of blood clots and the gradual increase in bleeding may indicate a disruption in your hormonal balance or the presence of uterine abnormalities, such as fibroids or polyps. Since you have a history of endometriosis and ovarian issues, these conditions could contribute to irregular bleeding patterns.

It is also important to note that your previous surgeries may have impacted your reproductive system's normal functioning. Adhesions can lead to changes in the anatomy of the reproductive organs, potentially causing irregularities in menstrual cycles. Additionally, the hormonal treatments you received in the past may have long-term effects on your menstrual health.

Given your family history of cervical cancer, it is prudent to be proactive about your reproductive health. Regular screenings, such as Pap smears, are essential for early detection of any abnormalities, including cervical cancer. In many countries, health departments provide financial assistance for these screenings, especially for individuals at higher risk. It would be beneficial to check with your local health department regarding coverage for cervical screening tests.

Considering your current symptoms, it is advisable to consult a healthcare professional. A thorough evaluation, including a pelvic examination and possibly imaging studies like an ultrasound, can help identify any underlying issues contributing to your prolonged menstrual cycle. Blood tests may also be necessary to assess hormone levels and rule out conditions such as thyroid disorders or clotting issues.

In summary, while it is not typical for a menstrual cycle to last 18 days, it can occur due to various factors, particularly in individuals with a history of reproductive health issues. Given your medical history and family background, seeking medical advice is crucial. Early intervention can help manage any potential complications and ensure your reproductive health is monitored effectively. Remember, your health is a priority, and addressing these concerns with a healthcare provider will provide you with the best guidance moving forward.

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