What Causes Long Term Menstrual Bleeding and Abdominal Sensitivity?

A normal monthly menstrual period is enough of an inconvenience. But sometimes a woman may experience monthly cycles where she has heavy bleeding over a long period of time. The bleeding can last for several weeks and can naturally cause some distress. Another problem is a sensitive abdomen during these times. So what causes heavy bleeding and abdominal sensitivity? Is there anything you can do about it? If you have experienced these problems, then here is some information on some of the common causes for your condition.

What Causes A Normal Cycle

This is for anyone out there who may not know how the whole menstruation thing works. The lining of the uterus is called the endometrium. In a normal cycle, the brain produces a hormone called follicle stimulating hormone which causes the egg follicles in the ovary to make estrogen. This causes the endometrium to thicken.

During ovulation, a second hormone called progesterone causes the endometrium to turn spongy. The menstrual period then occurs when the estrogen and progesterone levels fall and the uterus sheds its spongy lining. A normal menstrual cycle lasts for about seven days.

Bleeding Disorders


So what causes prolonged menstrual periods where the bleeding is heavy and lasts longer than seven days? One thing to consider is if you have chronic nosebleeds or problems with your blood failing to clot. If you have any of these symptoms, you may have a bleeding disorder. If so, you should see a doctor for treatment. In a related matter, if you are currently taking anticoagulants and blood thinners for a medical condition, this could be a cause of prolonged menstrual bleeding.


Menorrhagia is a condition where a woman regularly experiences heavy and prolonged menstrual bleeding. The symptoms can be anything from going through a pad or tampon an hour or bleeding for more than a week. Menorrhagia can be caused by a number of things. It can be from changes in hormone levels to blood clotting or even uterus disorders.

Another form of menorrhagaia is called hypermenorrhagia; this is an even heavier form of bleedingm where you go through more than one pad or tampon in an hour.

Other causes of menorrhagia are a thickened endometrium, uterine hyperplasia, uterine or cervical cancer, ectopic pregnancy, thyroid problems, pelvic inflammatory disease, and problems with IUDs.

Ovulation Problems

There could be several reasons for having a prolonged menstrual cycle. Besides a possible bleeding disorder, one cause of a long bleeding period is a problem with your ovaries. If your body does not ovulate, the ovaries will still continue to make estrogen which causes the lining of the uterus to thicken even more. This is often the cause of a late period. When the lining of the uterus finally sheds, it causes heavy bleeding and takes longer to pass through your body.

Ovaries can be affected by a number of things. Stress and anxiety can interfere with how your ovaries function. Luckily, most problems with the ovaries can be solved through medication such as birth control which gets the ovaries regulating on a normal schedule.

Uterus Problems

Another cause of a long bleeding period is problems with the uterus. One such problem is polyps. Endometrial polyps are small growths that appear on the lining of the uterus. These polyps are usually harmless but can cause longer menstrual periods. Polyps occur from long term use of estrogen medication or from excessive build-up of estrogen because of non-ovulation.

Another problem with the uterus is fibroids. Fibroids are classified as leiomyoma or myoma and they grow inside the uterus. Most of the time these fibroids do not cause any symptoms at all but can be a factor in prolonged bleeding. The size of fibroids varies but they generally decrease after menopause.

Adenomyosis is a condition where the lining of the uterus grows into the uterus wall. During a normal menstrual cycle, the endometrium breaks down and flows out of the body. But when the endometrium is part of the muscle wall, some of that broken down tissue may get trapped in the wall. This can lead to heavy and prolonged bleeding as the uterus tries to shed all of the blood. A doctor can tell if you have adenomyosis by performing an ultrasound on your uterus.


If you are over 40, another cause for long periods of menstrual bleeding may be the onset of menopause. It is difficult to tell exactly when menopause hits. The symptoms vary and can come on at different times during a woman’s life. The average age for menopause is anywhere from 47 to 54 years.

The time period immediately before menopause is called perimenopause and it can last up to four years. When this starts, you may experience bouts of heavy bleeding that requires a pad or tampon every hour or you may have bleeding that lasts for more than a week. Other symptoms are hot flashes, mood swings, tiredness, and fatigue.

Causes Of Abdominal Sensitivity

Many women experience increased sensitivity or tenderness in the abdomen area during their menstrual cycle. This is actually pretty common and usually results from the fluctuations in the levels of estrogen and progesterone. If you experience menstrual cramps, this could cause your muscles to become tender. Although tenderness and cramping is normal, you should not be experiencing episodes of intense pain. If so, you should see a doctor.

Another cause, and a more serious one, for abdominal tenderness is a condition called endometriosis. This is where the lining of the uterus also grows on the outside of the uterus. It thickens just like the interior tissue and breaks down when hormone levels drop. But while the broken down endometrium flows out through the cervix, the broken down lining on the outside of the uterus has nowhere to go and can develop into fluid sacks and scar tissue.

Endometriosis can cause not just tenderness but also pain in the abdomen. It can even hinder the ability to get pregnant if enough scar tissue builds up. Only a doctor can diagnose endometriosis.

Medications and Treatments

If you are experiencing constant long periods of menstrual bleeding, there are some things you can do to try to solve the problem. The most common is birth control medication. Birth control pills contain hormones that will help your uterus lining from getting too thick. They can regulate your cycle and also help reduce cramping. If you don’t like the idea of having to remember to take a pill everyday, you can also use a birth control patch.

An Intrauterine Device (or IUD) is a type of birth control that can also put you on a regular cycle. A IUD is a small device about the size of a medicine capsule (but thinner) that is inserted into your uterus through the vagina. They have been proven to be more effective against heavy bleeding, inconsistent menstrual cycles, and pregnancy. However, the side-effects for an IUD is weight gain, bloating, and tenderness in the breasts.

If birth control do not work to control your prolonged bleeding, you might have to consider surgery. There are two types a doctor can perform: a hysterectomy and an endometrial ablation.

A hysterectomy completely removes the uterus. Patients who have this procedure done no longer have periods and can no longer get pregnant. There are risks involved and side effects. Most patients have to go through long term hormone therapy and medication afterward.

Endometrial ablation is a procedure that removes only the lining of the uterus. Pregnancy is not very likely after this type of procedure and it usually stops all menstrual bleeding (although light bleeding and spotting still may occur).