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Headaches and Longer Periods
An_248390 posted:
For the last 6-12 months my period has been lasting 10 days and I have been experiencing migraines at the beginning and end of my period to. I am about to turn 31. I don't know if I am going through hormonal changes or what the deal is. Has anybody experienced this?
Jane Harrison Hohner, RN, RNP responded:
Dear An: Generally speaking a menstrual period which lasts longer than seven days is considered out of the range of normal--especially if it is a sudden development. Yes, I would concur that a hormonal change is a possible culprit for prolonged flows.

There are two major reasons for very prolonged/heavy periods: hormonal and what I call "structural". "Structural" means when excessive bleeding is due to actual problems within the cavity or walls of the uterus. Some examples of this would include fibroids of the uterus, endometriosis of the muscular wall of the uterus ("adenomyosis"), infections of the lining of the uterus, polyps of the uterine lining, or even uterine cancer.

Hormonal causes are usually linked to missed or erratic ovulations. As you may know, in a normal cycle, estrogen is produced all month. Estrogen is responsible for building up the lining of your uterus so you have something to shed each month. In a normal cycle, progesterone production increases following ovulation. Progesterone "stabilizes" the uterine lining in preparation for a possible implantation of a new pregnancy. If you are not pregnant that month the levels of estrogen and progesterone fall, triggering the release of the uterine lining—your period.

So, if you do not ovulate, the estrogen build up of the lining continues, but without the usual ovulation associated progesterone. Thus, the hormone levels don't decline, and the lining stays up inside the uterus as a missed/late period. Alternatively the lining can begin to shed under its own weight producing prolonged bleeding.

Causes for not ovulating are multifold: thyroid problems, pituitary problems, ovarian cysts, physical stressors (eg sudden increases in exercise, crash dieting), emotional stressors (problems with partners or boyfriends/girlfriends, finances), increased body weight, anorexia, rotating shifts at work, etc.

Menstrual migraines have been purported to have a hormonal cause. There are some studies which suggest that lowered estrogen levels can trigger a migraine. A common time for this to occur is about 48 hours prior to the onset of flow, After menstruation estrogen levels are beginning to rise.

Bottom line, both the prolonged bleeds and migraine headaches should be evaluated. You can start with your GYN, MD, or even a local family planning clinic. They should be able to give you a more exact cause for the recently prolonged bleeding pattern.


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