Menstruation is a natural and important part of a woman’s reproductive system. It reflects the body’s preparation for potential pregnancy and the shedding of the uterine lining when pregnancy does not happen. A typical menstrual period usually lasts between 3 and 7 days though it can vary at times. The menstrual cycles can be longer or shorter than ‘normal’. If it goes beyond the seventh day, you may wonder why your period won’t stop. Long periods may have to do with health conditions, including Polycystic Ovary Syndrome or PCOS. Read on to know the causes of long periods and what to do about it.

What is menstruation?

Menstruation is the monthly process in which the body of a woman sheds the lining of the uterus (endometrium) when pregnancy does not happen, says obstetrician and gynaecologist Dr Chetna Jain. This process is a part of the menstrual cycle, which prepares the body for potential pregnancy each month. A normal menstrual cycle for most women ranges from 21 to 35 days, but 14 to 25 percent of women have irregular menstrual cycles, as per Eunice Kennedy Shriver National Institute of Child Health and Human Development. This means the menstrual cycles are shorter or longer than normal. They may even be heavier or lighter than normal menstrual bleeding or are experienced with other problems, like period cramps.

Why do some women experience long periods?

There are several reasons why some women may experience periods that are longer than usual. Here are some of the reasons:

1. Hormonal imbalance

The menstrual cycle is regulated by two main hormones — estrogen and progesterone. These two need to be in balance for the menstrual cycle to function properly. Estrogen helps to build up the endometrial lining during the first half of the menstrual cycle. Progesterone on the other hand, helps to maintain the endometrial lining in the second half of the cycle and prepares it for a potential pregnancy. When these hormones are out of balance, the endometrial lining may become overly thick, resulting in heavier and longer periods.

2. Polycystic Ovary Syndrome (PCOS)

PCOS is a common endocrine disorder where the ovaries produce higher levels of androgens (male hormones), says the expert. When this happens, it can prevent regular ovulation, causing the endometrium to continue growing and result in prolonged or irregular periods.

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3. Uterine fibroids

Uterine fibroids are growths in the uterus, but are non-cancerous. They can increase the surface area of the uterine lining, leading to longer menstrual bleeding. The fibroids themselves can also cause increased blood flow.

4. Endometriosis

It is a health condition where tissue similar to the uterine lining, grows outside the uterus. This ectopic tissue responds to hormonal changes and bleeds during menstruation, leading to longer periods and significant pain.

5. Pelvic Inflammatory Disease (PID)

PID is an infection of the reproductive organs. Chronic inflammation and scarring from Pelvic Inflammatory Disease can interfere with normal uterine function, leading to irregular and extended menstrual bleeding, says Dr Jain.

6. Intrauterine Device (IUD)

Some types of intrauterine devices, particularly copper IUDs, can initially cause heavier and longer periods. This is usually a side effect during the first few months after insertion as the body adjusts to it.

7. Thyroid disorders

Both hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) can disrupt menstrual cycles. Thyroid hormones regulate many body functions, including the menstrual cycle. Imbalances can lead to irregularities, including extended periods.

8. Blood clotting disorders

Bleeding disorder like Von Willebrand disease, which is caused by low levels of clotting protein in the blood, impair the blood’s ability to clot properly. This can lead to heavier menstrual bleeding that lasts longer than usual.

9. Medications

Certain medications, such as blood thinners (anticoagulants), hormonal therapies, and some anti-inflammatory drugs, can interfere with normal blood clotting or hormonal balance. This can result in prolonged menstrual bleeding, says the expert.

10. Miscarriage

Miscarriage or an early pregnancy loss can lead to prolonged bleeding. During miscarriage, the body expels the pregnancy tissue. This can take time and lead to extended menstrual-like bleeding.

11. Stress and lifestyle factors

High stress levels, significant weight changes, and too much exercise can disrupt the hormonal balance in the body. This can interfere with the regularity and duration of menstrual cycles, potentially leading to extended periods.

12. Chronic conditions

Chronic illnesses such as diabetes and diseases of the liver or kidneys can affect the body’s overall health, including the menstrual cycle. These conditions can lead to hormonal imbalances and affect menstrual duration and regularity.

What to do if period won’t stop?

Managing prolonged periods involves addressing the underlying cause, if known, and making lifestyle adjustments. Here are some tips –

1. Medical treatment

Hormonal Therapy: Depending on the underlying condition, your doctor may prescribe birth control pills, hormonal patches, or hormonal intrauterine devices to regulate hormone levels and menstrual cycles.
Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help reduce menstrual cramps and heavy bleeding. Antifibrinolytic medications such as tranexamic acid can also be prescribed to reduce excessive bleeding.

2. Treat underlying conditions

PCOS: Treatment may include lifestyle changes (diet, and exercise), hormonal contraceptives, and medications like metformin to regulate insulin levels, says the expert.
Thyroid Disorders: Thyroid hormone replacement therapy for hypothyroidism or medications to regulate thyroid function for hyperthyroidism.
Uterine fibroids or Endometriosis: Treatment options range from medications to surgery (e.g., myomectomy for fibroids, and laparoscopic excision for endometriosis).
Pelvic Inflammatory Disease (PID): Antibiotics to treat the underlying infection causing PID.
Bleeding Disorders: Treatment may involve medications to promote blood clotting or transfusions in severe cases.

3. Lifestyle changes

Maintain a healthy weight: Obesity or being overweight can lead to hormonal imbalances. Adopting a balanced diet and regular exercise routine can help regulate hormone levels.
Reduce stress: Practice stress management techniques such as yoga, or meditation, or engage in hobbies that promote relaxation.
Healthy sleep habits: Aim for regular sleep patterns and sufficient sleep each night to support overall hormone balance.
Limit alcohol and caffeine: These drinks can disrupt hormone levels and exacerbate menstrual irregularities.

4. Nutritional support

Iron-rich foods: Consume foods rich in iron (e.g., leafy greens, lean meats, and beans) to prevent anemia caused by heavy menstrual bleeding.
Hydration: Drink plenty of water to stay hydrated, which supports overall health and may help alleviate bloating and period cramps.

There are times when periods may last longer than 7 days, but if it happens consistently, you should see a doctor. It may be due to an underlying condition and that’s why prompt medical evaluation is essential.