From the Guidelines
A menstrual period lasting longer than 7 days is generally considered too long and may warrant medical attention. Most normal periods last between 3-7 days, with the average being about 5 days, as suggested by the latest guidelines 1. If you're experiencing bleeding that continues beyond a week, especially if this is a new pattern for you, you should consult with a healthcare provider. Heavy or prolonged bleeding (menorrhagia) can lead to iron deficiency anemia and may indicate underlying conditions such as uterine fibroids, polyps, hormonal imbalances, endometriosis, or in rare cases, precancerous or cancerous conditions.
Some key points to consider when evaluating prolonged menstrual bleeding include:
- The patient's medical history and treatment goals, as outlined in the 2024 U.S. Selected Practice Recommendations for Contraceptive Use 1
- The potential need for further testing, such as ultrasounds or endometrial biopsies, depending on the patient's specific situation and age
- The possibility of underlying health conditions, such as interactions with other medications, sexually transmitted infections, pregnancy, thyroid disorders, or new pathologic uterine conditions (e.g., polyps or fibroids), which should be considered and treated if found 1
While waiting for medical evaluation, you can track your bleeding patterns, noting the number of pads or tampons used and any associated symptoms like pain or clotting. Over-the-counter NSAIDs like ibuprofen (400-600mg every 6-8 hours) may help reduce flow and manage discomfort temporarily, as suggested by the guidelines for managing bleeding irregularities while using contraception 1. Your doctor might recommend hormonal treatments such as birth control pills, progesterone therapy, or a hormonal IUD to regulate periods.
It's essential to prioritize your health and seek medical attention if you experience prolonged or heavy menstrual bleeding, as early diagnosis and treatment can significantly improve outcomes and quality of life 1.
From the Research
Definition of a Normal Menstrual Period
A normal menstrual period typically lasts between 3 to 7 days, with an average blood loss of 30-40 milliliters [ 2 ]. However, the duration and amount of bleeding can vary significantly from woman to woman.
What is Considered Too Long for a Menstrual Period
Menstrual bleeding that lasts longer than 7 days is considered prolonged [ 3 ]. Heavy menstrual bleeding (HMB) is defined as menstrual blood loss exceeding 80 milliliters per cycle [ 4 ].
Factors that Can Affect Menstrual Period Length
Several factors can influence the length of a menstrual period, including:
- Hormonal changes
- Uterine abnormalities
- Medical conditions, such as thyroid disorders or polycystic ovary syndrome (PCOS)
- Certain medications, such as anticoagulants or hormone replacement therapy
Treatment Options for Heavy Menstrual Bleeding
Treatment options for HMB include:
- Tranexamic acid, which has been shown to reduce menstrual blood loss by 26%-60% [ 2 ]
- Non-steroidal anti-inflammatory drugs (NSAIDs), which can reduce prostaglandin levels and alleviate symptoms [ 4 ]
- Oral contraceptives, which can help regulate menstrual cycles and reduce bleeding [ 5 ]
- Surgical interventions, such as endometrial ablation or hysterectomy, may be considered in severe cases [ 2 ]
Reducing Menstrual Period Length
Some treatments, such as danazol, have been shown to reduce the duration of menstruation [ 4 ]. However, the effectiveness of these treatments can vary depending on individual circumstances. In a pilot study, oral tranexamic acid was found to be as effective as combined oral contraceptives in reducing menstrual blood loss and improving quality of life in adolescents with heavy menstrual bleeding [ 5 ].