Menstruation: Is a Two-Month-Long Period Cause for Concern?
Q.
I have been having a period for two months. I went to the doctor but they cannot find anything wrong. Should I worry?
A.
Bleeding for two months is always reason for concern -- and a trip to your gynecologist. There are many, many reasons for such bleeding, ranging from infection to uterine polyps to fibroids to pregnancy to hormone imbalance. Your age plays a role in deciding how to proceed with the investigation, but in general, tests may include any of the following:
CBC (complete blood count). This will show whether you are anemic.
TSH. This blood test evaluates the thyroid gland. An underactive or overactive thyroid may cause abnormal bleeding.
Cultures to detect bacterial infection. Chronic low-grade uterine infection may produce prolonged spotting or bleeding.
Pregnancy test. This is an absolute must-do test for all but the menopausal or women who have had hysterectomies.
Bleeding time. Your doctor may do this and other tests to measure the blood's ability to clot properly. Often women with a clotting abnormality like von Willibrand's disease will give a history of lifelong heavy periods and easy bruising.
Ultrasound. Either a traditional ultrasound or the new saline infusion ultrasound may be done to look for ovarian cysts, fibroids, polyps or a thickened uterine lining.
Endometrial biopsy. The doctor inserts a small catheter into the uterus to obtain a sample of the lining for analysis. This test is done in the office and causes moderate cramping.
D&C. This surgical procedure samples the uterine lining and is more extensive than an endometrial biopsy. It may be combined with a hysteroscopy, a surgical procedure that involves inserting a telescope-like instrument through the cervix to view the uterine cavity.
Sometimes all tests are normal. Prolonged bleeding may be a sign of impending menopause. In this case, using progesterone may help to regulate the bleeding. Obviously, if a particular abnormality is diagnosed, it would be treated specifically. Your gynecologist should be able to determine what tests are needed and perform them.
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