Periods normally start at the age of 11 to 12 and all females have them till menopause which occurs at 45 to 55 years of age. Most females bleed for two to seven days and this duration of bleeding is greatly different for different women. Generally the periods are 28 days apart but there is also great variation among normal women and 24-35 days is an acceptable length of the menstrual cycle.

I've Been Bleeding for Two Weeks, What's Happening?

Period bleeding rarely lasts for more than seven days. There are some reasons due to which you can have a lengthy and prolonged period. The most common one is approaching menopause and at that time there can be bleeding for longer periods of time due to hormonal changes.

The main reasons for prolonged bleeding are:

1. Hormonal Imbalance

The hormones progesterone and estrogen are responsible for regulating the menstrual cycle. Their balance determines the length of the cycle and when due to any reason this balance is disturbed or there is excessive production of any one of these, prolonged bleeding can happen. Hormonal imbalance is the most common cause of prolonged bleeding in premenopausal women.

2. Uterine Fibroids

Another reason for prolonged bleeding is the presence of uterine fibroids. Fibroids are non-cancerous muscle growths or tumors which develop from the uterine muscles. These are extremely common but are generally too small to cause any symptoms and are discovered on ultrasound examination. These can be situated anywhere in the uterine wall and the symptoms which may be experienced when they grow in size are:

• Prolonged periods, lasting for more than seven days
• Excessive bleeding during periods
• A heavy feeling or a feeling of fullness in the pelvis
• Pain in lower abdomen
• Constipation due to pressure on intestines
• Painful intercourse

3. Uterine Polyps

I've been bleeding for two weeks or more now, what can be the reason? In a quarter of women having prolonged periods the reason is a uterine polyp. A uterine polyp is mostly a benign overgrowth of the lining of the uterus. The uterine lining or endometrium overgrows and leads to polyp formation.

These polyps are often non-cancerous but very rarely they undergo malignant changes and can lead to cancer. The symptoms of a uterine polyp are excessive and/or prolonged bleeding. These can lead to bleeding in between the cycles, bleeding after intercourse or bleeding after menopause.

4. Adenomyosis

Adenomyosis is a condition in which the cells of uterine lining are present in the muscular walls of the womb. These displaced cells respond to the hormonal stimuli in the same way as the normal uterine lining or endometrium and proliferate and grow in the same fashion during each menstrual cycle. This abnormal presence of uterine lining can sometimes lead to prolonged bleeding.

Most of the times, adenomyosis is a silent condition and does not lead to any significant symptoms. It can lead to a bulky uterus and you may feel that your lower abdomen is tender to touch or feels fuller.

Other symptoms of adenomyosis are:

• Prolonged periods and heavy or excessive bleeding
• Painful periods, the pain is usually cramp like and can range in severity from mild to severe cramps during periods
• Period pain which gets worse with age
• Uncomfortable or painful intercourse
• Passage of clots during periods

5. Dysfunctional Uterine Bleeding

Irregular or unexpected bleeding is a very common phenomenon and any bleeding outside the normal menstrual cycle is termed as dysfunctional uterine bleeding or DUB. Any abnormal vaginal bleeding comes under this territory and if severe or very frequent, needs to be investigated to rule out any serious underlying condition.

Many women experience this at some point of their life and the question gynecologists hear on daily basis is "I've been bleeding for two weeks now, why is my period not stopping?" or something similar.

The symptoms of dysfunctional uterine bleeding are:

• Abnormally heavy bleeding during periods
• Passage of small or large clots during periods
• Bleeding for more than a week
• Frequent and prolonged periods

6. Other Causes

While most of the times the abnormal bleeding is due to hormonal imbalance sometimes any definitive cause cannot be found. Other reasons for prolonged vaginal bleeding in premenopausal women include:

• Stress
• Going on or off a new brand of contraceptive pills
• Poly cystic ovaries can also lead to hormonal imbalance and can cause prolonged periods.
• Endometriosis is a condition in which the cells of uterine lining are present outside the uterine cavity; it can also result in heavy or lengthy periods.
• Infections like pelvic inflammatory disease.
• Another very important thing to consider is the chance of you being pregnant. If you are bleeding for two weeks, there is a possibility that you could be pregnant and this bleeding might be due to a miscarriage.

I’ve Been Bleeding for Two Weeks, What to Do?

If you are bleeding for a longer than usual time and are concerned, the best thing to do is to discuss it with your doctor. It might be nothing serious but having a medical opinion is the best thing to do in these circumstances.

Here are a few things which can help you to cope with prolonged periods:

1. Lifestyle Changes

• If you get prolonged or irregular periods frequently it is a good idea to keep some extra sanitary pads or tampons available at all times. Put a few in your office drawer, hand bag or in your car so you are always prepared to face an awkward situation.
• Keep a healthy and active lifestyle, exercise and balanced diet can improve hormonal imbalance and reduce stress which are two main reasons for prolonged periods.
• Eat plenty of leafy green vegetables and diets rich in iron to reduce the risk of developing anemia.

2. Alternative Treatment Options

There are many herbal and alternative remedies which are effective to correct hormonal imbalance. These include dong quai and soy. Raspberry leaves help to sooth the cramps while ginseng is very effective to reduce the feeling of fatigue and tiredness.

3. Medication and Surgery

The treatment option for hormonal imbalance is oral contraceptive pills, many other medicines are also available but the best thing is to get expert opinion first for proper diagnosis and appropriate treatment option selection. Rarely surgery is required to correct the conditions like huge fibroids or polyps.