I was told in middle school health class that your period should last between two and seven days. But I very quickly learned this was just the ideal situation for most people — not what everyone actually experiences. My first period lasted nine days. So, how long should your period last? And if it lasts more than a week, how do you know if there's a cause for concern or if you just have a longer-than-average period?
It is possible that a long period is just normal for you, as long as you're not experiencing any troublesome symptoms. However, all the blood loss resulting from long periods can lead to anemia, Salli Tazuke, MD, co-medical director with CCRM San Francisco, tells Bustle. If you've always had a long period, there's probably nothing wrong, but you should get a blood count to make sure you're not anemic. Getting enough iron from supplements or foods like spinach, red meat, and poultry can help prevent anemia.
If this is new for you, though, you should talk to your doctor. There could be an underlying issue. The reason your period lasts more than a week depends on whether it has always been that long or has suddenly gotten longer, Dr. Tazuke says. Here's what it could be in each situation.
If It's New:
If it only happens once, a long period could be a result of an early miscarriage, Dr. Tazuke says. You may also notice vaginal bleeding or spotting, abdominal pain or cramping, and/or fluid or tissue exiting your vagina if you're having a miscarriage. It could also be a tubal pregnancy, also known as an ectopic pregnancy, which occurs outside the uterus, Dr. Tazuke adds. Ectopic pregnancies can also lead to pelvic pain and typical pregnancy symptoms. See a doctor to rule out these possibilities.
2. A Missed Period
If you miss a period, your next one may be longer than usual because your uterine lining has spent a long time building up, Dr. Tazuke says. The causes of a missed period include stress, sleep disturbances, and changes in weight.
Medications intended to avoid blood clotting can also affect your menstrual blood, Dr. Tazuke says. Pain relievers like aspirin, or ibuprofen can also have this effect on some people, as can birth control pills and IUDs. "'Breakthrough bleeding' is the name of the common side effect from birth control pills, and it can last especially when you first start taking the pill," reproductive endocrinologist Aimee Eyvazzadeh, MD, tells Bustle.
If It's Always Been That Way:
1. Excessive Bleeding
Some people are genetically more prone to bleeding, Dr. Tazuke says. If this is the case with you, you might also notice that you bruise or bleed easily on other parts of your body. This requires treatment, so see a doctor about it.
In Either Situation:
1. Uterine Fibroids
Fibroids are benign tumors on the uterus made of muscle cells and connective tissue. Seventy to 80 percent of women get fibroids before age 50, and most don't even notice them. One sign of fibroids is a heavy or long-lasting period, Dr. Tazuke says. Others include frequent urination, an enlarged abdomen, and pain during sex.
Most fibroids don't have to be treated, but if you have some of these symptoms and they're bothering you, you can go to a doctor for an ultrasound to see if you have fibroids, and they can be treated with pain relievers, hormonal medication, or, in severe cases, surgery.
Polyps are another kind of uterine growth that can cause long or heavy periods, Dr. Tazuke says. They come from overgrowth of the uterus's lining, and they're sometimes cancerous but usually benign. Postmenopausal people are most likely to get them, though it's possible for younger people to as well. Like fibroids, these don't always require treatment, but they can be treated with hormonal medications or surgical removal.
3. Ovarian Cysts
Ovarian cysts are growths on the ovaries that most women have at some point. Sometimes they cause pain or rupture, and sometimes they go away before you even feel them. They don't always affect your period, but they may go along with hormonal changes that can throw off your period. Ovarian cysts could also be a sign of polycystic ovary syndrome (PCOS), whose symptoms include missed periods, making the next period long.
"Cysts don't always have to mean cancer. Don't let your google search freak you out," Dr. Eyvazzadeh says. "A simple ultrasound and blood panel can diagnose the problem quickly so you can have a good treatment and plan for follow-up with your doctor."
So, your long periods could mean a huge number of things. See your doctor just to make sure everything's OK, but don't worry, as most causes aren't serious. "Simple blood tests and an ultrasound can guide your doctor re: why you're bleeding," Dr. Eyvazzadeh msays. "Don't wonder and get worried unnecessarily about something that could be easy to treat."
This post was originally published on December 1, 2017. It was updated on June 7, 2019.