What causes prolonged periods in young females?

Question

Hello doctor,

I am a 21-year-old female, 5 feet 7 inches tall, and weigh 49 kilograms (108 pounds). My period has been going on for about two to three weeks. The flow varies; sometimes it is normal, and other times it is very light. I am not experiencing any severe pain, but I am a bit concerned because this is not usual for me. I am also not taking any medications or birth control pills.

Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

Thank you for sharing these details. It is good that you are paying attention to your menstrual cycle. A period lasting two to three weeks, even if the flow is light or varies, is not considered normal and should be evaluated, especially since the duration is not typical for you.

There are several possible causes. One is a hormonal imbalance, which can be triggered by factors such as stress, sudden changes in weight, being underweight (your body mass index is approximately 17.2), or poor nutrition. Conditions like thyroid dysfunction or polycystic ovary syndrome (PCOS) can also disrupt hormone levels and lead to prolonged or irregular bleeding.

Another possibility is an anovulatory cycle, where you are not ovulating properly. This can cause the uterine lining to shed irregularly or incompletely, leading to light, extended bleeding. Uterine issues such as polyps, fibroids, or a thin endometrial lining may also result in prolonged spotting or bleeding. Additionally, cervical problems or infections, such as cervicitis (inflammation of the cervix, the lower part of the uterus), can sometimes mimic a light, prolonged period. Although less common at your age, bleeding disorders should also be considered if this pattern continues or if there is a family history of such conditions.

You must see a gynecologist (a medical doctor specializing in the female reproductive system) or a primary care provider. They may recommend a pelvic ultrasound to examine your uterus and ovaries and hormone tests, including estrogen, progesterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, and a thyroid panel. A complete blood count (CBC) may be done to check for anemia, and if you are sexually active, screening for sexually transmitted infections (STIs) might be suggested.

In the meantime, it would be helpful to track your bleeding each day, note the flow, presence of clots, and color. Also, watch for any other symptoms such as fatigue, dizziness, or unintentional weight loss. Make sure you are eating enough and managing your stress levels as best as you can.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.