Many women ask, “Is my menstrual cycle normal?” Oftentimes, the answer can depend on a variety of different factors. So, what menstrual cycle is normal and how do you know?
The normal menstrual flow lasts up to seven days, and a woman can lose up to 80 mL of blood flow. Ultimately, what is “normal” is usually the duration of menses a woman has always experienced. Any “change” should prompt an evaluation by a physician, particularly if associated with a problem such as pain, infertility, hot flashes, anemia, or worsening bleeding. However, menses longer than seven days (menorrhagia) is abnormal and should prompt an evaluation by a specialist.
Abnormal or irregular bleeding is now categorized by the acronym “PALM-COEIN” meaning:
- P = polyp; this is a benign overgrowth of the lining of the uterus
- A = adenomyosis; endometriosis located in the muscle of the uterus
- L = leiomyoma; benign tumors of the uterus
- M = malignancy and hyperplasia; cancer of the uterus and pre-cancer of the uterine lining
- C = coagulopathy; bleeding disorders such as von Willebrand’s disease
- O = ovulatory dysfunction; most commonly Polycystic Ovarian Syndrome (PCOS) but other hormonal disorders can cause abnormal bleeding such as elevated prolactin and thyroid disease
- E = endometrial; other abnormalities of the uterine lining such as acute or chronic endometritis (acute infection or chronic inflammation)
- I = iatrogenic (caused by a prior medical treatment)
- N = not yet classified
If your period lasts longer than a week, what could that mean?
In addition to the above, pregnancy should be the first test you obtain since abnormal bleeding can be a sign of impending miscarriage or ectopic pregnancy (a potentially life-threatening pregnancy outside the uterus, usually located in the fallopian tube).
Anti-Müllerian hormone is made by the tiny liquid capsule-like follicles in the ovaries, that house and nourish human eggs. By calculating the amount of AMH the follicles produce, it is thought, fertility specialists can measure the remaining number of eggs a woman has left.
What if your period has always lasted longer than a week?
As mentioned above, if your period flow is not new or associated with symptoms such as pain, infection, infertility, hot flashes, anemia or bleeding disorder, or worsening bleeding, then no management is necessary. However, chronic menstrual bleeding longer than seven days is not normal and is usually associated with anemia as well as one of the above abnormalities. An evaluation is recommended despite this being your “norm.”