Menstruation is really annoying.
When it doesn't come, think it comes. After coming, I hope it will go quickly.
But some aunts don't like to go when they come, is there something wrong with this?
Many sisters have experienced:
In the last few days of menstruation, the amount of light is already very small, and it feels like it should be over immediately, but it drags on until more than a week before it ends;
There are also sisters who menstruate a lot, which lasted for more than a week.
In fact, if the menstrual period exceeds 7 days and does not go away (excluding 7 days), it is an extension of menstruation [1].
The occurrence of this situation may be a reminder to you:
1. Too much pressure lately
Many work parties and student parties have said that there will be prolonged menstruation when rushing to deadlines or preparing for exams.
In fact, the influence of mental factors on endocrine and menstruation is far greater than we think.
Nervousness can cause endocrine disturbances that stimulate dysregulation of hormone secretion from the hypothalamic-pituitary-ovarian axis, leading to menstrual irregularities[1].
As long as you adjust your mood, work and rest and relieve stress in time, menstruation will return to normal on its own.
2. Abnormal ovulation
Insufficient luteal function
The corpus luteum is the yellow "floret" in the picture above, which is transformed from the follicles after ovulation.
Normally, in the large company of the ovaries, the corpus luteum is mainly responsible for secreting estrogen and progesterone after ovulation.
When the corpus luteum leaves work, estrogen and progesterone retreat, and the endometrium loses nourishment and falls off, forming menstruation.
When the luteal body is insufficient, the level of estrogen secretion decreases, and a small amount of endometrial detachment occurs in advance, resulting in a small amount of bleeding before normal menstruation, or the cycle is significantly shortened.
If there is a little drip bleeding before menstruation, and then it drags on for a long time after menstruation, it may be related to the lack of luteal function [1].
Irregular shedding of the endometrium
When the luteal body is atrophied, it will continue to secrete estrogen and progesterone, and there will be irregular shedding of the uterine lining, resulting in a prolonged menstrual period.
If the menstrual period is 9 to 10 days long and the amount of bleeding increases, it may be related to irregular endometrial detachment [2].
3. Anovulation
If the bleeding cycle is irregular and the bleeding time is still long, it may be an anovulatory abnormal uterine bleeding.
Commonly found during puberty and menopause transitions, it is caused by dysfunction of the reproductive endocrine axis or the inability of follicles to develop normally [1].
4. Gynecological organic diseases
Adenomyosis
The main manifestations are increased menstrual flow, prolonged menstruation, and progressively worsening dysmenorrhea. The pain is located in the middle of the lower abdomen and begins 1 week before menstruation and lasts until the end of menstruation.
The menstrual volume of adenomyosis is usually greater than 80ml, more intuitively, that is, the menstrual blood volume of each day during menstruation is very large, and a whole sanitary napkin can be soaked in about 1 to 2 hours.
5. Other reasons
IUD (often occurring within one year of IUD insertion), systemic coagulation-related disorders, or long-term use of anticoagulants [4,5].
This can be done in two cases:
If the blood volume in the late menstrual period is not large, such as the amount of less after the 3rd to 7th day of menstruation, but it has been dripping for more than 10 days before it is clean, it is recommended to observe for two or three months.
During this period, adjust your lifestyle, relieve stress, and observe on your own whether your periods can return to normal. If there is a prolonged period of ≥ 3 times within six months, it is recommended to go to the gynecology or endocrinology department in time.
There is also a situation that requires timely medical treatment, if there is a prolonged menstrual period with an increase in menstrual volume, even if it is once, it is easy to lose too much blood, resulting in anemia, which should be taken seriously and seek medical treatment immediately.
Prolonged menstruation, really don't have to be too anxious. Not all period prolongations are necessarily sick, and even if they are pathological, after treatment, most of them can return to normal.
Pay attention to maintaining a healthy diet, regular work and rest and a good mood in life, so that the aunt can come without pain and walk happily.
Reviewer
Feng Cuiping | Deputy Chief Physician of the Department of Obstetrics and Gynecology, Beijing China-Japan Friendship Hospital
bibliography
Yu Qi,Deng Shan. Concord Gynaecological Endocrinology Manual. Beijing:People's Medical Publishing House,2018.]
Xie Xing,Duan Tao,Kong Beihua. Obstetrics and Gynecology (Ninth Edition)[M].People's Medical Publishing House, 2018.
Pang Qiushi,Cheng Linghui,Wang Jing,Wei Wenwen,Huang Xiuhua,Li Wenwen. Risk factors for prolonged menstruation after caesarean section[J].Journal of Practical Obstetrics and Gynecology,2021,37(11):835-838.
Tang Liangbao,Liu Shuwen. Complications of IUD and its prevention[J].Chinese Journal of Practical Gynecology and Obstetrics,2001(09):13-15.
Lu Meiqiu,Zhao Yang,Yang Xin. Progress 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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