Having a period that lasts longer than seven days or a period that is especially heavy was previously called menorrhagia. But to avoid confusion about whether menorrhagia could refer to a period that is heavy, long, or both, the International Federation of Gynecology and Obstetrics1 has recommended referring to the above as “abnormal uterine bleeding” (or more specifically, “heavy menstrual bleeding,” depending on the symptoms) and advises doctors to instead determine and specify the cause for the either prolonged or excessive menstrual bleeding whenever possible, says obstetrician-gynecologist Kara McElligott Park, MD, MPH, medical advisor at fertility company Mira.
Uterine bleeding related to your period can fluctuate in frequency, duration, regularity, and volume.
Note that uterine bleeding related to your period can fluctuate over time in frequency, duration, regularity, and volume, and any changes therein can be considered abnormal for you, says Dr. Park. From a medical standpoint, lengthy period bleeding (including a period that lasts longer than a week) or heavy menstrual bleeding (typically defined as any bleeding that soaks through one or more tampons or pads every hour) is considered abnormal uterine bleeding. That said, any change in your period that involves more bleeding or bleeding that lasts longer than usual for you and that interferes with your comfort and ability to function is worth investigating, says Dr. Park.
Below, you’ll find some of the reasons why your period might last longer than a week or be especially heavy, when you should check in with your doctor, and how to deal with long periods, according to OB/GYNs.
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How common is a long or heavy period, and can this ever be normal?
If you’re one of those menstruators who dreads their marathon-length, super tampon-soaking periods, you are far from alone. The Centers for Disease Control (CDC) estimates that 10 million people in the U.S. experience heavy menstrual bleeding per year, so that’s one in every five people who menstruate.
Having a period that’s particularly long does not automatically or necessarily mean that your period is abnormal; normal menstrual cycles range from 21 to 35 days, and some people do regularly bleed for anywhere from three to eight days, says obstetrician-gynecologist Gunvor Ekman Ordeberg, MD, co-founder of DeoDoc Intimate Skincare.
It’s also important to normalize changes in your period during different seasons of life. When someone first gets a period, it can take the body a number of cycles to become consistent, says Dr. Park, who also notes that postpartum and perimenopause are two common times for experiencing big (and totally normal) fluctuations in period length and flow.
Overall, it’s the total amount of bleeding that’s happening (over however many period days your menstrual cycle contains) that can make the difference between normal and abnormal, says Dr. Ordeberg. If you have heavy bleeding (as in, soaking through a pad or tampon an hour) for longer than seven days, it’s likely going to have an impact on your daily life, and in that case, it’s worth looking into underlying causes and solutions to help reduce the flow, she says.
4 most common causes of periods that last longer than a week
1. Uterine fibroids or polyps
You may have heard more about uterine fibroids (or benign tumors that grow on the walls of the uterus) in recent years, thanks to the introduction of new bills to fund (long overdue) fibroid research and the approval of the first oral treatment for fibroid-related heavy menstrual bleeding in 2020. These tumors—which may occur in up to 60 percent of Black women by age 352—can contribute to irregular or heavy periods, says Dr. Ordeberg, among other symptoms like pelvic pain, constipation, frequent urination, or pain during sex.
Polyps are typically smaller growths that situate themselves inside the uterus and may also cause especially heavy periods, according to Dr. Ordeberg. Sometimes, these growths are a factor in painful, heavy, or otherwise abnormal menstrual bleeding patterns, but other times, they do not cause any significant or noticeable symptoms.
2. A copper IUD
One common side effect of using a copper, non-hormonal IUD as a contraceptive method is heavier, more painful periods, especially when it is first inserted, Dr. Ordeberg says.
You could also experience bleeding or spotting between periods with a copper IUD3 because of the mechanism through which the IUD works; it creates an inflammatory response to repel sperm and eggs and prevent pregnancy, but such inflammation can also worsen menstrual bleeding or associated cramps.
3. Emergency contraception, abortion, pregnancy loss, or childbirth
An extra-long or extra-heavy period could also be a temporary response to other reproductive-health changes. For example, if you’ve just used an emergency contraception pill, your cycle might be irregular, and it may take four to six weeks for it to return to your previous norm, explains Dr. Park.
If you’ve experienced a pregnancy recently, whether it ended in abortion, pregnancy loss, or a live birth, you can also expect for menstrual bleeding to be different for a while afterward. “After any pregnancy, it is normal to have absent, irregular, or heavier bleeding for several weeks,” says Dr. Park. “However, if bleeding is very heavy for more than three or four days [after childbirth or pregnancy loss], I recommend patients be seen by a medical professional sooner rather than later.”
4. Hormonal imbalance
Sometimes, having an abnormally high amount of androgen hormones (like testosterone) can cause heavy or irregular periods, says Dr. Park. Such a hormonal imbalance is often the result of a condition called polycystic ovarian syndrome (PCOS), which involves multiple cysts growing on the ovaries. In someone with PCOS, menstrual cycles can be particularly unpredictable or infrequent, meaning that when they do happen, they can come on especially heavy.
A temporary imbalance of hormones can also happen because of stress, depression, or disordered eating and the ovaries not receiving the necessary hormonal stimulation for ovulation, explains Dr. Ordeberg. This could trigger an irregular menstrual cycle, including months during which you don’t have a period or bleed at all. “However, the estrogen levels present still contribute to the thickening of the endometrium, or uterine lining,” says Dr. Ordeberg. So whenever that thickened uterine lining does shed and a period occurs, it might end up lasting longer and including a heavier flow than usual.
When to see a doctor about a period that lasts longer than a week
“It is never wrong to seek care if you are unsure about heavy period bleeding,” especially if you are worried about how your periods are impacting your life, says Dr. Park. In particular, Dr. Ordeberg says it’s a good idea to seek care if:
- You’re regularly bleeding heavily for longer than seven days
- You’re regularly bleeding through a pad or tampon in an hour or less
- You’re waking up to change your menstrual products once or more during the night
- You have consistent large blood clots during your period
- You have particularly painful periods or are experiencing fatigue during your periods that impedes your daily functioning
Having any of these symptoms does not automatically mean there is something seriously wrong with your cycle—but any of these could point to an underlying health concern and is likely causing you some level of discomfort that may be able to be resolved with treatment from a doctor. (If you can’t get an in-person appointment on the books right away, telehealth is worth a try to get a preliminary assessment before the physical exam, says Dr. Park.)
Your doctor might run a test for anemia (which can happen with excessive blood loss), check your hormone levels, and/or do a pelvic exam to find out more information about the root cause underlying the abnormal uterine bleeding.
How to deal with a long or heavy period
1. Track the length of your periods over time
Tracking your periods over time for length, amount of bleeding, and associated symptoms (like intense cramps) can help a medical provider decipher and diagnose exactly what’s going on. Bring that record of your recent periods, either in an app or on paper, to an appointment where you plan to discuss any recent or persistent abnormalities.
If you feel unsafe using a period tracking app due to data privacy concerns in the wake of Roe v. Wade being overturned, try downloading a menstrual diary that doesn’t ask for an email address, Dr. Park suggests. One important thing to jot down is the number and types of pads, tampons, discs, or menstrual cups you’ve used each time your period hits and how saturated they were during your cycle, she adds.
2. Take ibuprofen
Your doctor might recommend taking a non-steroidal anti-inflammatory drug (NSAID), like ibuprofen (aka Advil), while you have your period. “This may reduce the total amount of blood loss during a period,” says Dr. Park. Taking it regularly throughout your period may also cut back on cramps, pelvic pain, and other muscle aches.
3. Try a hormonal birth control option (with the recommendation of a doctor)
You shouldn’t self-evaluate and start a new over-the-counter (or prescription) birth control method without first touching base with an OB/GYN or sexual health care provider, but a medical professional may recommend hormonal birth control (including birth control pills or a patch, ring, or hormonal IUD) to help resolve heavy or prolonged menstrual bleeding or ameliorate associated symptoms.
“Many different methods of birth control regulate hormones and can even out or reduce flow, or temporarily remove the need for a period,” says Dr. Park.
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- Munro, Malcolm G et al. “The FIGO classification of causes of abnormal uterine bleeding in the reproductive years.” Fertility and sterility vol. 95,7 (2011): 2204-8, 2208.e1-3. doi:10.1016/j.fertnstert.2011.03.079
- Uimari, Outi et al. “Uterine Fibroids (Leiomyomata) and Heavy Menstrual Bleeding.” Frontiers in reproductive health vol. 4 818243. 4 Mar. 2022, doi:10.3389/frph.2022.818243
- Godfrey, Emily M et al. “Treatment of bleeding irregularities in women with copper-containing IUDs: a systematic review.” Contraception vol. 87,5 (2013): 549-66. doi:10.1016/j.contraception.2012.09.006