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    extended bleeding?
    An_248977 posted:
    I'm a t 45 year old woman with regular 4 day periods. As of late tho, I've been bleeding very lightly for as many as 6 or 7 days after the "cycle" ends. No cramps, pain, etc . ..Thoughts?
    Jane Harrison Hohner, RN, RNP responded:
    Dear An: The most common reason for a menstrual pattern like you have described is hormonal changes from either missed ovulations or decreased progesterone production. 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 and release of an egg.. 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—which can appear as a missed/late period. Alternatively, the built up lining can begin to shed on its own creating erratic bleeding patterns which are usually "too-light" or super heavy and prolonged. Even if ovulation occurs, as we age, progesterone production goes into decline leading to a more thickened lining..

    There can be many things which influence ovulation: low thyroid problems, pituitary problems, ovarian cysts, physical stressors (eg sudden increases in exercise, crash dieting), emotional stressors (problems with parents or partner, finances), increased body weight, anorexia, rotating shifts at work, etc. Certainly as one approaches menopause ovulations can be more infrequent, too.

    Lastly one may have some physical changes within the uterus itself (eg fibroids or polyps) which can prompt erratic bleeding. Given that you are having 10 or 11 days of some kind of bleeding per month it is wise to see your GYN or clinic for follow up. They may want to do a vaginal ultrasound to assess the lining's thickness (missed ovulations) or any irregular countours (fibroids or polyps). An ultrasound should be able to image an ovarian cysts. Additionally, a biopsy of the lining of the uterus (endometrial biopsy) can rule the presence of any abnormal cells and can sometimes yield fragments of polyps of the lining.


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