Heavy periods are particularly common in women at midlife. However, there are some really simple solutions that work well to rebalance your flow, so it’s worth getting it checked out by your doctor and a naturopath so you can have your life back!
Definition of heavy periods
Basically, there are 2 types of irregular heavy bleeding that can occur:
- Menorrhagia, defined as an abnormally long (>7 days) or abnormally heavy menstrual period (>80 mL). This is persistent and not just the occasional period. Heavy periods affect tens of millions of women worldwide most of whom are in their 40’s and 50’s.
- Metrorrhagia, which is bleeding that occurs between the menstrual period. It can present as a light bleed to flooding.
Irregular bleeding should be investigated to rule out any major causes of concern such as cancer of cervix, ovary or uterus, so don’t just keep putting up with it or thinking it’s normal. It’s not.
Once we know it’s simply related to hormone irregularities, naturopathic medicine can help to restore function and bring you back into balance.
A bit more detail…
The term dysfunctional uterine bleeding is used when all pathology (including pregnancy) and anatomical examination to the contrary has been ruled out.
Dysfunctional uterine bleeding is caused by hormonal disturbances of a regular cycle and there is often absent or irregular ovulation leading to erratic endometrium shedding.
It’s common with:
- Teenage girls
- Menopausal women
- PCOS & androgen excess
- Obesity
- Thyroid disease
- Stress
- Extreme weight loss
- IUDs
What puts you at risk of heavy periods?
Lifestyle factors are huge! When we’re out of balance, our hormones are out of balance. Risk factors include:
- Obesity puts all kinds of stress on the body and this can disrupt normal hormone balance
- High intake of the wrong types of fat and sugar will starve the body of the proper nutrients it needs to create hormonal balance
- Stress of course, disrupts the endocrine system and the body will favour the production of stress hormones over reproductive and thyroid hormones
- Liver stress leads to the poor elimination of hormones which can then accumulate in the body, causing disruption
- Being sedentary, is a different kind of stress on the body which impacts functioning of pretty much every system you can imagine
- Iron deficiency can cause the body to skip menstrual periods, or it can cause abnormally heavy menstrual flow. Heavy periods, in turn, cause iron deficiency, which can become a vicious cycle.
What else could heavy periods be?
It could be more serious. This is why you need a proper investigation first via your doctor:
- Uterine fibroids
- Uterine polyps
- Endometriosis
- Pelvic Inflammatory Disease (PID)
- Cancers
- Choice of contraceptive
- IUDs, diaphragms, cervical caps & tubal ligation
- Non-gynaecological
- Blood clotting disorders, endocrine disorder, chronic liver disease etc
What tests can you do?
If it’s even necessary, salivary hormone tests can be conducted. While these are not covered by Medicare, they can give you peace of mind.
- They can be done in the privacy of your home and sent directly to the laboratory
- They give assays of various hormones
- It’s non-invasive
- It’s accurate
What can salivary hormone tests measure?
The Female Hormone Profile measures:
- E2, DHEAs, Progesterone,
Testosterone Adrenal Stress Profile measures:
- Cortisol 8am, 12noon, 4pm, 8pm; DHEAs 8am
Male Hormone Profile measures:
- DHEAs, Testosterone, E2
Sleep Profile measures:
- Cortisol midnight, Melatonin midnight
28 Day Female Cycle Hormone Profile measures:
- 11 x samples of E2, Progesterone; 1 x Testosterone
What is the medical treatment for heavy periods?
It usually starts with the least invasive therapy and progresses until it’s resolved.
- Combined oral contraceptive pill (COCP)
- Progestogen + levonorgestrol IUD (Mirena®)
- Reduces recurrent and persistent bleeding but can cause PMS-like symptoms
- Hysteroscopic D & C
- Uterine ablation
- Hysterectomy
Medication and it’s possible side effects
- Nonsteroidal anti-inflammatory medication
- Limited side effects, due to short term use
- Oral contraceptives
- Break through bleeding
- Nausea
- Weight gain
- Headache (contraindicated for women with migraines)
- Breast tenderness
- Thrombosis or embolism
- Prolonged use of Gonadotrophin-releasing hormone agonist medication
- Bone demineralization
- Reduction of high-density lipoproteins
- Medicated intrauterine devices
- Low rate of side effects
- Hysteroscopy
- Allows visualisation of the uterine cavity
- Endometrial resection and ablation therapy
- Relief of symptoms
- Less invasive, less costly and decreased morbidity as compared to hysterectomy
- Hysterectomy
Naturopathic approach to heavy periods
Take a case history
Of course, we always start with a thorough case history focusing on the menstrual cycle. We need to know what you’ve tried before. What you’ve been able to stick with. What’s worked and what hasn’t worked.
We need you to complete a menstrual cycle diary for 2-3 months – have printed up & on hand and we need to educate you on what might be going on.
Evaluate the diet
- Fat balance
- Phytoestrogen content
- Quantity of dark green leafy veg – high in Vit K
- ↑ methylating foods – Brassicaceae family
Evaluate lifestyle
- For weight management
- For stress management
What is the naturopathic treatment for heavy periods?
Naturopaths will most likely use herbs as they are extremely effective at balancing the hormonal system. The types of herbs we might use include:
- Antihaemorrhagics/Astringents to decrease blood flow eg Yarrow or Shepherd’s Purse
- Anti-Inflammories help reduce the inflammation causing the heavy blood flow eg ginger
- Uterine tonics help tone and nourish the uterus and include herbs such as Dong Quai, Blue Cohosh or Raspberry Leaf
- Emmenagogues that stimulate blood flow to the pelvic area and uterus; some stimulate menstruation. Examples include Mugwort and Sage
- Female tonics which balance the reproductive system and include Chaste Tree and Shatavari.
- Liver herbs which help the body eliminate excess hormones include Dandelion or St Mary’s Thistle
- Adrenal tonics or Adaptogens, which help the body become more resilient and adapt to stress and includes Withania, Siberian Ginseng or Rhodiola.
Traditional Female Tonics
Chaste Tree (Vitex agnus castus) is probably the best-known herb in Europe for treatment of hormonal imbalances and abnormal bleeding in women. It has been used for the full scope of menstrual disorders. It acts on the hypothalamus and pituitary gland and has a progesterone-like effect. Chaste tree is a very important herb for normalising and regulating the menstrual cycle, but it is not a fast-acting herb and it may take several months to achieve result.
Traditional Anti-Inflammatories
Ginger (zingiber officinale) has been shown to inhibit prostaglandin synthesis, the enzyme believed to be related to excessive menstrual loss. Ginger’s traditional use as an anti-inflammatory agent, and anti-inflammatories are effective in reducing the flow from heavy menses.
Traditional astringent herbs
Astringent herbs form a large category of tannin-containing plants that are used to reduce blood loss from the re- productive tract. Astringent herbs are used to correct uterine or cervical bleeding. Of these, shepherd’s purse has a long history of use in the management of preventing or arresting heavy bleeding. In most cases these herbs are used in combination formulations for weeks and possibly months to be effective. Yarrow has been used since medieval times to treat bleeding wounds. It is a herb traditionally known as a uterine stimulant. It increases muscular tone and stimulates reproductive activity, and is also known to be effective for the treatment of menstrual problems.
Traditional uterine tonics
Improving uterine tone may normalise and regulate menstrual bleeding. Tonic herbs can be used in combination formulations for weeks and months to bring results. The root of Blue Cohosh, a perennial herb that grows all over the United States, when used with other astringent herbs acts as a uterine tonic and helps regulate the menses and the amount of flow.
Dong Quai is used in Chinese medicine for the treatment of multiple gynecological conditions. It’s exact method of action is unclear but it has been proven to be helpful with heavy bleeding.
Summary
Remember to stop putting up with heavy periods and get it checked out. If you’re doctor can’t help you or you’d like concurrent natural treatment seek out naturopathic care. Herbs have been used for millennia for women’s reproductive troubles and are extremely effective at rebalancing the body.
REFERENCES
Hechtman, L. (2011). Clinical Naturopathic Medicine. Elsevier, Australia.
Trickey, R. (2011). Women, Hormones & the Menstrual Cycle 3rd Ed. Trickey Enterprises, Victoria.
Brenda Rogers
Brenda Rogers is The Natural Menopause Expert. Her Passage to Power programs and events are designed to transform women from overwhelm, struggle and fatigue into the new generation of women seeking adventure and empowerment at midlife and beyond.
- Facebook: https://www.facebook.com/groups/themenopauselounge
- Website: www.qwomen.com.au
- Email: brenda@qwomen.com.au
