How Long Is Too Long to Have a Cough?

Ask yourself these five questions to help determine when a lingering cough may actually be something to worry about.

A little coughing can be a good thing. It’s your body’s way of expelling microbes, allergens, and other unwanted invaders in your airways. Most coughs go away on their own in a few days or a couple of weeks. But some coughs can linger, lasting a month or longer, and might make you wonder if something more serious is going on.

Whenever a cough lasts that long–and especially if it’s accompanied by other worrisome symptoms–it needs to be checked out by a medical professional. Luckily, 90% of the time, it’s post-nasal drip from allergies, a stubborn cold, air pollution, acid reflux, or a medication side effect. In the minority of cases, a persistent cough can be something more serious–an infection like pneumonia, chronic asthma, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis (scarring of the lungs), and even lung cancer.

Even if it’s just due to a lingering cold, a chronic cough can have significant repercussions of its own, like making it hard to sleep or causing you to strain muscles, sweat, and feel dizzy. Your voice may become hoarse and, in some cases, your bladder may even leak.

If you have a chronic cough, ask yourself these questions to decide if you need to seek medical attention.

How long have I had the cough and is it getting better?

This may be your main clue that something is amiss. Most coughs–like the ones caused by colds and the flu–go away on their own in four to six weeks. These coughs also tend to get better gradually as time passes.

“In general, we don’t [worry] about a chronic cough until it has been present for about four weeks,” says Norman Edelman, MD, senior scientific advisor for the American Lung Association. “If you’ve had a really bad cold, sometimes it takes six to eight weeks for a cough to go away, and I wouldn’t worry about it if there’s a clear-cut, obvious cause.”

If a cough with no obvious cause lasts beyond the four-week mark, and definitely if any cough lasts longer than eight weeks, see your doctor. It’s probably nothing dire, but at the very least he or she may be able to relieve some of your discomfort.

“In general, when someone comes in with a chronic cough, we can identify the cause and treat it,” says Joshua Septimus, MD, associate professor of clinical medicine at Houston Methodist Hospital.

How bad is the cough?

Is it just a polite, little ahem that hardly anyone notices, or is it severe hacking that causes you to double over and others to move far, far away?

“If you’re coughing your head off, it’s a big deal,” says Dr. Edelman. “If you’re waking up at night, it’s a big deal.”

Extreme coughing may be a sign of something serious like an infection, but even if it’s not, a cough that interferes with your quality of life is reason enough to seek help.

Am I coughing up colored mucus?

Average colds usually produce white or clear sputum. That isn’t a big deal. Yellow or green mucus, on the other hand, suggests a more serious infection or other underlying cause.

“If you are raising colored sputum, you should see a doctor,” says Dr. Edelman.

The same goes if your chronic cough is making you tired or light-headed, results in chest or stomach pain, or causes your bladder to leak.

Am I coughing up blood?

“That’s one of those alarm-bell symptoms that you really need to see your doctor,” says Dr. Septimus. “The most common cause is bronchitis, but you don’t want to assume that.”

It could also be pneumonia, COPD, a blood clot, tuberculosis, lung cancer, or an autoimmune disease such as lupus.

“If you’re coughing up blood, you need a chest X-ray,” says Dr. Septimus.

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Do I have other symptoms?

If you have a runny nose and a sore throat, there’s a good chance the cough is just from a cold. Other symptoms, especially shortness of breath, could spell bigger trouble.

“In the context of a cough this is very important because it can indicate a number of different things,” says Dr. Septimus. Not being able to catch your breath could mean whooping cough (pertussis) or asthma. It could also mean tuberculosis, COPD, lung cancer, or heart failure.

Asthma can come not only with a cough but also wheezing and chest tightness. Tuberculosis typically also causes weight loss, while swelling in your legs, especially when you’re lying down, could indicate heart failure. A fever could signal pneumonia, bronchitis, or whooping cough.

See your doctor right away any time you have a high fever, if the cough or shortness of breath comes on suddenly, or if you have chest pain.

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