Bleeding for a Month Straight: What Could Be Wrong?

Experiencing bleeding that continues for more than a week, or even a month, can feel unsettling. But you’re not alone. Up to one in four women experience what doctors call abnormal uterine bleeding at some point in their lives.

This isn’t “just a heavy period.” Prolonged bleeding can be your body’s way of signaling a hormonal imbalance, fibroids, or another treatable condition. With the right care, most causes can be managed effectively.

In this guide, we’ll look at the most common reasons why bleeding might persist, when it’s time to reach out to a healthcare provider, and what treatments can help restore your body’s natural rhythm. Remember: your symptoms are worth attention, and caring for your body is an act of strength, not worry.

Bleeding for a Month Straight: What Could Be Wrong?

Understanding Abnormal Uterine Bleeding

When your period lasts for weeks instead of days, it's not just a "heavy period" anymore; it's officially referred to as abnormal uterine bleeding. This condition is actually quite common, affecting up to 25% of women during their reproductive years.

The good news is that most causes of prolonged bleeding are treatable. Hormonal imbalances, benign uterine growths, or temporary disruptions cause the vast majority of abnormal bleeding, and each responds well to targeted treatment. Our bodies aren't perfect machines, and sometimes the systems regulating menstruation just get out of sync.

Here's the difference between normal and abnormal bleeding: a typical period lasts 2-7 days, comes every 21-35 days, and generally follows a predictable rhythm.

Abnormal uterine bleeding looks different:

*You might hear doctors call this condition "menometrorrhagia" - we're sticking with "abnormal uterine bleeding" because it's clearer.

Since hormonal imbalances are among the most common culprits of abnormal uterine bleeding symptoms, tracking your hormones can often pinpoint what's off. The Mira Hormone Monitor measures actual hormone concentrations in your urine using specialized Wands, and can identify issues like low progesterone or elevated estrogen. The Mira App turns this data into detailed charts, giving you and your doctor concrete evidence instead of just descriptions of symptoms.

Common Causes of Bleeding That Lasts for Weeks

Prolonged bleeding typically stems either from hormonal imbalances disrupting your cycle's natural rhythm or structural changes in your uterus interfering with normal shedding. Studies show hormonal causes dominate in women under 40 (accounting for up to 58% of cases), while structural issues like fibroids increase with age, affecting over 50% of women seeking surgical treatment. The good news is that both categories are treatable once identified.

Hormonal Causes (Including Perimenopause)

Hormonal disruptions are the leading cause of prolonged bleeding in younger women. These causes are typically manageable once you know what's going on. Here's what might be disrupting your cycle:

• Irregular or absent ovulation disrupting normal cycles

When ovulation doesn't occur regularly, or at all, your body produces estrogen without the balancing effect of progesterone. This hormonal imbalance allows your uterine lining to continue thickening until it becomes unstable and sheds irregularly, causing unpredictable and often prolonged bleeding episodes.

Irregular ovulation issues can be better understood with hormone tracking and expert coaching, which provides personalized support to help identify and address these complex hormonal patterns.

• Thyroid disorders (hypothyroidism or hyperthyroidism)

Both overactive and underactive thyroid conditions can disrupt your menstrual cycle. Hyperthyroidism often leads to heavier, more frequent periods, while hypothyroidism can cause lighter but irregular bleeding patterns that may extend for weeks.

• Hormonal birth control changes or side effects

Starting, stopping, or switching hormonal contraceptives commonly triggers breakthrough bleeding that can persist for weeks. Progestin-only methods like “the shot,” implant, or hormonal IUD are particularly known for causing unpredictable bleeding patterns.

• Perimenopause and menopause transition

During the years leading up to menopause, declining ovarian function causes dramatic hormonal fluctuations. These changes often cause irregular cycles, sometimes with periods that last weeks or occur more frequently than usual.

Understanding whether your prolonged bleeding stems from perimenopause or another condition requires tracking your hormone levels over time, not just documenting symptoms. The Mira Menopause Transitions Kit works with the free Menopause Transitions Mode in the Mira App (available to users over 35). This specialized mode helps define your menopausal transition stage through FSH testing, tracks changing cycle patterns, and lets you log symptoms like irregular bleeding. After two months of testing, you'll receive a comprehensive hormone report with personalized recommendations and key points to discuss with your doctor.

Gynecological Conditions

Gynecological conditions refer to physical changes in your uterus, such as tissue growths or structural variations that affect how your uterine lining develops and sheds. While these account for most prolonged bleeding cases, they're typically benign and respond well to treatment once identified.

• Uterine fibroids (benign muscular growths)

Fibroids are non-cancerous tumors that develop in or around your uterine wall. They're extremely common, affecting up to 80% of women by age 50, and can cause heavy, prolonged periods.

• Polyps (overgrowth of the uterine lining)

Endometrial polyps are finger-like growths that develop from your uterine lining. While often benign, they can cause irregular bleeding, particularly intermenstrual spotting that may extend your bleeding days.

• Adenomyosis (uterine lining growing into the wall)

Adenomyosis occurs when endometrial tissue develops into your uterine muscle wall, often causing severely painful and prolonged periods. While its exact role in abnormal bleeding patterns isn't fully understood, many women with adenomyosis experience extended bleeding episodes.

• Endometriosis (endometrial-like tissue outside the uterus)

When tissue similar to your uterine lining grows outside the uterus, it can cause irregular bleeding patterns, especially when it affects your ovaries or other pelvic structures.

• Polycystic ovary syndrome (PCOS)

PCOS disrupts normal ovulation, leading to irregular periods that can be very light and sporadic or extremely heavy and prolonged.

The Mira PCOS Supplements feature a scientifically backed 40:1 ratio of myo- and D-chiro-inositol, which can help restore hormonal balance and regularity of your menstrual cycle.

Pregnancy-Related Causes

Some people can be pregnant without knowing it, and pregnancy-related issues can indeed cause prolonged bleeding, too.

• Early pregnancy bleeding or spotting

Implantation bleeding or other early pregnancy complications can sometimes be mistaken for an extended period.

• Miscarriage

A miscarriage, especially in a very early pregnancy, might present as unusually heavy or prolonged bleeding that you assume is just a late, heavy period.

• Ectopic pregnancy (requires urgent medical attention)

When a pregnancy develops outside the uterus, it can cause irregular bleeding patterns. This is a medical emergency requiring immediate treatment.

Blood and Clotting Disorders

Underlying bleeding disorders affect your body's ability to form clots properly, leading to prolonged bleeding episodes. While bleeding disorders affect only 0.6-1.3% of women in the general population, they're found in approximately 20% of women with heavy menstrual bleeding.

• Von Willebrand disease and other clotting factor deficiencies

Von Willebrand disease is the most common inherited bleeding disorder, affecting up to 24% of women with heavy menstrual bleeding. When your blood doesn't clot effectively, periods can last significantly longer than the normal timeframe.

• Prolonged bleeding after injury or surgery

If you've recently had surgery, dental work, or an injury, ongoing bleeding issues might indicate an underlying clotting disorder that's also affecting your menstrual cycle.

Cancer and Precancerous Changes

While less common, malignancies can cause persistent abnormal bleeding patterns. 

It’s normal to worry when reading about symptoms online, but in most cases, especially without a known genetic risk, cancer is very rare. Still, it’s important to be aware of it.

• Cervical cancer

Cervical cancer often presents with irregular bleeding, including postcoital spotting and abnormal discharge.

• Uterine (endometrial) cancer

Uterine (endometrial) cancer typically causes irregular bleeding patterns, particularly in postmenopausal women, but can affect younger women as well.

• Ovarian cancer

Ovarian cancer rarely presents with vaginal bleeding, and when it does, it's usually accompanied by other concerning symptoms.

Light Bleeding and Post-Period Spotting

Light bleeding scenarios can range from barely noticeable spotting that requires only a panty liner to light flow that's noticeably less than your typical period but continues for an extended period. 

Several factors can cause this persistent light bleeding.

• Spotting after ovulation occurs in around 9% of reproductive-age women. It usually appears around mid-cycle and is caused by the natural decrease in estrogen levels after ovulation. This type of bleeding tends to be predictable and short-lived.
  

• Changes in bleeding patterns are common with intrauterine devices, especially those made of copper. Copper IUDs cause a "foreign body" type of reaction in your uterus, which can result in light bleeding or spotting.
  

• Hormonal IUDs can also cause mild irregular bleeding, especially during the first months of use.
  

• Endometrial infections, along with pelvic inflammatory diseases, can cause persistent bleeding. One example is the bacterial infection chlamydia, which can cause chronic endometritis, resulting in ongoing bleeding. People tend to ignore chronic endometritis because it does not produce a fever or severe pain, although it leads to continuous bleeding.

Medical evaluation becomes necessary for any abnormal period bleeding pattern because untreated conditions can progress to more severe forms.

Diagnosis: Finding the Cause

Getting answers about prolonged bleeding starts with understanding what's happening in your body. Your healthcare provider will work with you through a careful evaluation process, combining conversations about your health history with physical exams and specific tests. This systematic approach helps pinpoint the cause of your symptoms and ensures that nothing serious is overlooked.

Medical History

Understanding your unique bleeding pattern is essential to finding the right treatment. Your doctor will have a detailed conversation with you about your symptoms, asking questions like:

• when it started, 

• how heavy it is, 

• whether it occurs between periods, and

• any associated symptoms like pain or cramping.

They'll also usually review your contraceptive use, recent pregnancies, surgeries, medications, and family history of bleeding disorders. Tracking your symptoms before your appointment helps provide accurate information about your bleeding patterns.

Physical Examination

The physical exam focuses on finding visible causes of prolonged bleeding. Your doctor will perform a complete pelvic exam, checking your abdomen, vulva, vagina, cervix, and uterus for structural problems like an enlarged uterus, polyps protruding through the cervix, masses, or signs of infection. 

They'll also assess for anemia, thyroid problems, or hormonal imbalances that could contribute to abnormal bleeding.

The Mira Panorama Lab Test provides an at-home hormone evaluation through five key hormone tests, which include TSH, free T4, AMH, prolactin, and free testosterone, to detect menstrual cycle and fertility issues. The blood test provides easy access to identify thyroid problems and ovarian reserve issues, and hormonal imbalances that lead to irregular menstrual bleeding.

Finally, even though cervical cancer usually produces irregular spotting instead of extended bleeding for prolonged periods, Pap testing is usually another key part of the standard evaluation process.

Treatment Options for Prolonged Bleeding

Treatment for prolonged bleeding depends on the cause, how much it affects your daily life, and your personal health goals. Most women find relief with non-surgical approaches, though procedures may be recommended when other treatments haven't worked or for long-term resolution.

Non-Surgical Approaches

Hormonal therapy represents the first-line treatment for most cases. 

• Birth control pills reduce menstrual blood loss by 35-69%, while the levonorgestrel intrauterine device (LNG IUD) is even more effective at 71-95% reduction.
  

• Progestin-only treatments can also stabilize the uterine lining.
  

• Iron supplements become essential when prolonged bleeding causes anemia, addressing the fatigue and weakness that accompany iron deficiency.
  

• Antibiotics may help resolve bleeding caused by infections, such as pelvic inflammatory disease.
  

• Medications that directly reduce bleeding include tranexamic acid, which decreases blood loss by 26-54% when taken during menstruation, and NSAIDs like ibuprofen, which reduce flow by 10-52% by decreasing the production of some substances called “prostaglandins”.

The Mira Fertility Tea offers natural reproductive wellness support, while the Mira Prenatal Supplements provide essential nutrients for women trying to conceive after treating prolonged bleeding.

Minimally Invasive Procedures

When medication isn't enough, several outpatient procedures can effectively treat prolonged bleeding with minimal recovery time.

• Hysteroscopy uses a thin scope to directly remove polyps or small fibroids causing your bleeding.
  

• Uterine artery embolization blocks blood flow to fibroids, causing them to gradually shrink.
  

• Endometrial ablation removes or destroys the uterine lining: an option for women who don't plan to have more children.

Surgical Treatments

When other treatments haven't worked or aren't appropriate for your situation, surgical options can provide lasting relief.

• Myomectomy surgically removes fibroids while keeping your uterus intact - an option if you want to preserve your fertility or prefer to keep your uterus.
  

• Hysterectomy permanently stops bleeding by removing the uterus. While it's the most definitive solution and eliminates certain cancer risks, it's a major surgery that requires thoughtful discussion with your doctor about what's right for your situation.

Your healthcare provider will help develop a personalized treatment plan tailored to your specific situation, preferences, and health goals.

When to Seek Immediate Medical Attention

While most cases of prolonged bleeding aren't emergencies, certain symptoms need prompt evaluation because they may signal complications that require immediate care.

• Bleeding lasting longer than 7 days without improvement
  
  If your period stretches beyond a week with no sign of letting up, especially if it's heavier than normal, it's time to call your doctor. Bleeding that persists for two weeks or more typically indicates hormonal imbalances, structural problems, or other conditions that require treatment.
  

• Signs of severe anemia
  
  Prolonged heavy bleeding can lead to significant blood loss, causing symptoms like:
  

• extreme fatigue

• weakness

• dizziness

• rapid heartbeat

• shortness of breath

• feeling faint when standing

These symptoms indicate your body isn't getting enough oxygen-rich blood and can become dangerous if left untreated.

• Pregnancy complications

If pregnancy is a possibility, any unusual bleeding deserves immediate evaluation. Bleeding in early pregnancy can be a sign of miscarriage or ectopic pregnancy, and getting checked quickly is important for your health and safety. Your healthcare provider would rather see you and reassure you than have you wait and worry.

Additional warning signs include:

• Bleeding so heavy you're changing protection every hour

• Severe pelvic pain or cramping

• Fever or chills (signs of infection)

• Passing large blood clots

• Bleeding that keeps you from work, school, or daily activities

You know your body best. If something feels off or the bleeding is affecting your quality of life, don't wait – call your doctor or seek urgent care.

Living With and Preventing Abnormal Uterine Bleeding

Managing abnormal uterine bleeding involves treating symptoms and also undertaking measures to prevent future episodes. These measures can include lifestyle changes and regular check-ups.

Track Your Menstrual Cycle

Tracking menstrual cycles is crucial, as it provides important information for both you and your healthcare provider. Try to keep detailed records of 

• when bleeding starts and stops, 

• the intensity of the flow, 

• associated symptoms such as cramping or mood changes, and 

• any potential triggers. 

This information helps identify patterns and determine whether treatments are working effectively.

The Mira Hormone Monitor with the Wands offers precise hormone tracking, surpassing the capabilities of basic period apps. Measuring actual hormone concentrations in your urine can identify hormonal imbalances that contribute to abnormal bleeding patterns. 

The Mira App integrates this data with the Mira Basal Body Thermometer readings, creating comprehensive charts that reveal ovulation patterns and cycle irregularities your healthcare provider can use for diagnosis and treatment monitoring.

Try to Manage Stress

Stress does more than make you feel overwhelmed – it can actually interfere with your menstrual cycle. Chronic stress disrupts the hormonal communication between your brain and ovaries, which can lead to irregular ovulation and unpredictable bleeding.

Start with the basics: 

• move your body regularly, 

• prioritize 7-9 hours of sleep, and 

• build in time for relaxation, whether that's meditation, yoga, or simply taking breaks during your day.

Try to Keep a Healthy Weight

Your weight affects menstrual regularity by influencing hormone production. Significant weight changes in either direction – whether rapid weight loss or obesity – can disrupt ovulation and lead to abnormal bleeding.

Very low body weight or eating disorders can cause periods to stop completely, while higher body weight increases estrogen levels through fat tissue, which may result in irregular, heavy bleeding and increased risk for endometrial cancer.

The most effective approach focuses on gradual, sustainable changes: nourishing your body with balanced meals and staying active in ways you enjoy.

Regular Check-ups

Staying on top of routine gynecological care makes a real difference in catching problems early. During your annual exam, be sure to discuss any changes in your menstrual patterns, even if they don't seem like a big deal. Your doctor will perform a pelvic exam and recommend screening tests based on your age and individual risk factors.

Early detection matters. Conditions causing abnormal bleeding are typically more straightforward to treat when identified sooner rather than later.

Be Aware of Smoking, Medications, and Supplements

Additional preventive measures include avoiding smoking, which can worsen menstrual irregularities, and being aware of how medications or supplements might affect your cycle. Some herbal supplements and over-the-counter medications can interact with hormonal pathways and influence bleeding patterns.

Remember that what's normal varies significantly from person to person. While these general guidelines help promote menstrual health, working with your healthcare provider to understand your personal patterns and risk factors provides the best foundation for preventing and managing abnormal uterine bleeding.

Frequently Asked Questions

Why is my period off and on for over a month?

Bleeding for a month straight typically indicates hormonal imbalances, structural problems like fibroids or polyps, or underlying conditions such as PCOS or thyroid disorders. This abnormal vaginal bleeding pattern requires medical evaluation to identify the cause and appropriate treatment.

Is it normal to bleed 20 days continuously in the menstrual cycle?

No, bleeding for 20 days continuously is not normal and represents abnormal uterine bleeding that needs medical attention. Dysfunctional uterine bleeding lasting this long can lead to anemia and may indicate serious underlying conditions requiring prompt evaluation.

Why have I been bleeding for 2 weeks?

Bleeding for 2 weeks can result from hormonal fluctuations, contraceptive changes, structural abnormalities, or early pregnancy complications. While occasional extended periods can happen, persistent bleeding beyond 14 days warrants medical evaluation to rule out serious causes.

Why is my period not stopping after 2 weeks?

A period that won't stop usually indicates abnormal uterine bleeding caused by hormonal imbalances, structural problems like fibroids or cervical polyps, or medication effects. If it’s not stopping after 2 weeks, and especially if you’re bleeding for a month or longer, this requires immediate medical attention to prevent complications and identify treatable causes.