Prolonged Menstrual Bleeding: Causes and Concerns - Obstetrics and Gynecology

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Prolonged menstrual bleeding, also known as menorrhagia, can be a concerning symptom for many women. It is defined as menstrual bleeding that lasts longer than seven days or is excessively heavy. When a woman experiences menstrual bleeding that lasts more than 14 days, as you described, it is essential to consider various potential causes and seek medical evaluation.

There are several reasons why prolonged menstrual bleeding may occur. Some common causes include:
1. Hormonal Imbalances: The menstrual cycle is regulated by hormones, and any imbalance can lead to prolonged bleeding. Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can disrupt normal hormonal function.

2. Uterine Fibroids: These are non-cancerous growths in the uterus that can cause heavy and prolonged menstrual bleeding. They can vary in size and number, leading to different symptoms.

3. Endometrial Polyps: Similar to fibroids, these are growths on the lining of the uterus that can cause irregular bleeding.

4. Adenomyosis: This condition occurs when the tissue that normally lines the uterus grows into the muscular wall of the uterus, leading to heavy and painful periods.

5. Coagulation Disorders: Some women may have underlying bleeding disorders that affect their ability to clot blood properly, leading to prolonged bleeding.

6. Medications: Certain medications, especially anticoagulants or hormonal treatments, can affect menstrual bleeding patterns.

7. Infections: Pelvic inflammatory disease (PID) or other infections can lead to abnormal bleeding.

8. Pregnancy-Related Issues: In some cases, prolonged bleeding may be related to pregnancy complications, such as miscarriage or ectopic pregnancy.

Regarding your concern about whether having intercourse during your menstrual period could have influenced the prolonged bleeding, it is generally not a direct cause of menorrhagia. However, if there was any trauma or irritation to the cervix or uterus during intercourse, it could potentially lead to some bleeding. It’s also possible that the hormonal changes associated with your menstrual cycle could be contributing to the prolonged bleeding.

Given that you have experienced this issue for more than 14 days and have a history of heavy menstrual bleeding, it is crucial to consult with a healthcare provider. They may recommend a thorough evaluation, which could include:
- A physical examination and pelvic exam.

- Blood tests to check for anemia or hormonal imbalances.

- Imaging studies, such as an ultrasound, to assess for fibroids or polyps.

- A biopsy of the endometrial lining if necessary.

Treatment for prolonged menstrual bleeding will depend on the underlying cause. Options may include hormonal therapies, medications to help reduce bleeding, or surgical interventions if structural issues like fibroids or polyps are present.

In conclusion, while prolonged menstrual bleeding can be alarming, understanding the potential causes and seeking timely medical advice is essential for proper diagnosis and treatment. If you have any additional symptoms, such as severe pain, dizziness, or signs of anemia (like fatigue or pallor), it is even more critical to seek immediate medical attention. Your health and well-being should always be a priority, and addressing these symptoms early can lead to better outcomes.