The period is sticky and hot. During such a difficult period, some girls’ aunts have been for another half a month, sweating and bleeding on a hot day, and they are too weak.
What the hell is going on here, is there something wrong with the body?
Image source: Zhanku Hailuo
We all know that a normal menstrual period lasts from 2 to 8 days. In a normal menstrual cycle, menstruation occurs every 21 to 35 days. If the menstrual period lasts for more than a week, or even drags on for half a month, it means that the menstrual period is prolonged [1].
Prolonged periods are not uncommon, accounting for more than 15 percent of gynecological outpatients [2].
Then what is the relationship between prolonged menstruation and can it heal itself? To what extent do you need to see a doctor? This is what we need to know.
Mainly related to the following factors:
1. Tired, stressed, and in a bad mood
Many working parties and student parties have indicated that menstrual periods may be prolonged when rushing to deadlines or preparing for exams.
In fact, mental factors have a greater impact on endocrine and menstruation than we think. Studies have shown that negative emotions such as tension, anxiety, depression, and anger can stimulate the neuroendocrine system and lead to irregular menstruation [3].
As long as you adjust your mood, work and rest in time, your menstrual period will return to normal after a stressful period.
2. Endocrine disorders
Luteal insufficiency
The corpus luteum is the yellow “flower” in the picture above. In the big company of the uterus, the corpus luteum is responsible for secreting progesterone. When the corpus luteum goes off work, progesterone withdraws, and the endometrium loses nourishment and falls off, forming menstruation.
When the corpus luteum is insufficiency, it will not secrete progesterone properly, and a small amount of endometrial shedding occurs in advance, resulting in a small amount of bleeding before normal menstruation occurs. If there is a bit of bleeding before the menstrual cramps, and the dripping after the menstrual cramps drags on for a long time, it may be related to luteal insufficiency [4].
Irregular shedding of endometrial lining
When the corpus luteum is not fully atrophied, it will keep producing progesterone, causing irregular shedding of the lining of the uterus, leading to prolonged menstrual periods. If the menstrual period is as long as 9 to 10 days, and the amount of bleeding increases, it may be related to irregular endometrial shedding [5].
3. Adenomyosis
Main manifestations include increased menstrual flow, prolonged menstrual periods and progressively worsening dysmenorrhea. The pain is located in the middle of the lower abdomen. It starts 1 week before menstruation and continues until the end of menstruation. The menstrual volume of adenomyosis is usually more than 80ml. More intuitively, it means that the menstrual blood volume is very large every day of the menstrual period, and a whole sanitary napkin can be soaked in about 1 to 2 hours.
4. Anovulatory Abnormal Uterine Bleeding
Anovulatory abnormal uterine bleeding may be due to irregular periods of bleeding and prolonged bleeding. Commonly seen in adolescence and menopause transition period, it is caused by neuroendocrine system disorders or abnormal follicle development [4].
5. Other gynecological related diseases
Cervical polyps are also a common cause of prolonged menstrual periods, and some people are also accompanied by intermenstrual bleeding. Pelvic inflammatory disease, endometriosis, endometrial polyps, and uterine fibroids may all have prolonged periods and increased menstrual flow. And uterine fibroids may also have symptoms such as increased leucorrhea, mass in the lower abdomen, bulging in the lower abdomen, and back pain.
6. IUD
Prolonged menstruation and other irregular bleeding are the most common clinical complications of IUDs, often occurring within one year of IUD placement [6]. caused by oppression. Those who have had prolonged menstrual periods should be checked and treated in time. If bleeding occurs after a few days of placement, seek medical attention immediately.
Image source: Zhanku Hailuo
7. Whole body coagulation phaseDiseases
Coagulation disorders, abnormal platelet count and function, severe liver disease, long-term use of anticoagulant drugs, and abnormal blood vessel wall diseases can also lead to prolonged menstrual periods [7].
In fact, you don’t need to be nervous when you find that your menstrual period is prolonged. If the blood volume is not large, for example, after the third day of the menstrual period, the amount becomes less, and the dripping will not be clean until about 10 days. It is recommended to observe it for two or three months. . Adjust your lifestyle during this period to see if your periods return to normal. If prolonged menstrual period occurs more than 3 times in half a year, it is recommended to go to the gynecology or gynecological endocrinology department in time.
Another condition that requires immediate medical attention is when the bleeding is prolonged and heavy. This can easily lead to excessive blood loss and anemia, which should be taken seriously and seek medical attention immediately.
According to the various etiologies analyzed above, the causes are investigated from cervical lesions, endometrial lesions, other pelvic lesions, gynecological endocrine aspects, systemic lesions, etc. can be treated.
Not all menstrual prolongations are necessarily ill, and even pathological prolongation generally has a good prognosis. Pay attention to maintaining a healthy diet and a good mood in life, so that my aunt can come without pain and leave happily.
Reviewer: Liu Haifang| Deputy Chief Physician, Department of Obstetrics and Gynecology, Huashan Hospital Affiliated to Fudan University
References
[1] China Association of Traditional Chinese Medicine. Guidelines for the diagnosis and treatment of common gynecological diseases in traditional Chinese medicine [M]. China Traditional Chinese Medicine Press, 2012.
[2] Du Huilan, Yang Yupei, World Federation of Chinese Medicine Societies, Chinese Association of Chinese Medicine. International Chinese Medicine Clinical Practice Guidelines for Menstrual Extension (2019-10-11) [J]. World Chinese Medicine ,,:1-5.
[3] Shen Kejia, Shen Zuo Qin Xuan, Liu Biyuan, Fu Lingmei, Xiong Jie. Study on the establishment of mouse models of premature ovarian failure and ovarian hyporesponsiveness by chronic immobilization stress[J] ]. China Medical Herald, 2017, 14(17): 19-22.
[4] Yu Qi, Deng Shan. Xiehe Gynecological Endocrinology Manual. Beijing: People’s Health Publishing House, 2018.
[5] Xie Xing, Kong Beihua, Duan Tao. Obstetrics and Gynecology (9th Edition). Beijing: People’s Health Publishing House, 2018.
[6] Tang Liangli, Liu Shuwen. Complications and prevention of intrauterine device [J]. Chinese Journal of Practical Gynecology and Obstetrics, 2001(09):13-15.
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[7] Lu Meiqiu, Zhao D, Yang Xin. Advances in the diagnosis and treatment of abnormal uterine bleeding caused by systemic coagulation-related diseases [J]. Chinese Journal of Obstetrics and Gynecology, 2019, 20(02): 190-192.
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