Natural Treatment for Very Heavy Periods

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It’s 7pm on a Friday night, and I get a panicked call from my patient Karen. She’s bleeding so heavily that she cannot leave the bathroom. She’d been at work earlier when she soaked through three super tampons in an hour, and then ruined her favorite pair of jeans. Her work colleague had to help her into a taxi. Karen is understandably frightened. I send her to a local medical center for the clotting drug tranexamic acid, which will slow her bleeding.

I know what will happen next. Karen will meet with her gynecologist who will tell her that her only options are the Pill, Mirena IUD or surgery. At 45 years old, Karen has always tried to use natural treatments. She never imagined that she would end up in a situation like this.

There is hope. Natural treatment can work to prevent heavy periods, and it eventually did work for Karen. The key to using natural treatment is to start it early: as soon as you notice your periods getting heavier.  This is especially true if you are 40 or older, and if you have direct relatives (like your mother or older sisters) who also suffered very heavy periods. You know what’s coming.

How Heavy is Very Heavy?

A normal bleed is anywhere up to 80ml (milliliters) of blood lost over the entire period. To put that in perspective, one soaked regular pad or tampon holds 5ml. A super-tampon holds 10ml. So, 80ml equates to 16 fully soaked regular tampons, or 8 fully soaked super-tampons, spread over all the days of the period.

Very heavy bleeding is much, much more than 80ml. Some women report that they lose up to 500ml (2 cups) of blood. Frightening. As we saw in Karen’s case, very heavy bleeding means blood-soaked clothing. It means serious iron deficiency, and sometimes a trip to the hospital.

Heavy periods can occur at any age, but they are more common in young teenagers and perimenopausal women. For both age groups, heavy bleeding is usually the result of hormone imbalance, namely too much estrogen (which thickens the uterine lining), and not enough progesterone (which reduces the uterine lining).

Teenagers 13 – 16 years old

Heavy periods are a temporary thing for teenagers. They happen because estrogen receptors are quite sensitive for the first year or two of periods. As estrogen receptors become less sensitive over time, the periods will become lighter. Periods also lighten when girls start to ovulate more regularly, and make more progesterone.

Here are some simple ways to reduce heavy menstrual flow in teenagers:

  1. A conventional anti-inflammatory like ibuprofen (Advil or Nurofen) blocks prostaglandins and reduces menstrual flow by half. I learned this simple treatment from Canadian endocrinologist Jerilynn Prior, and it works great. The recommended dose is 200mg every 6 hours during the first day or two of the period. Ibuprofen is not a natural treatment as such, but in my view it is a very sensible and practical solution. Two days of ibuprofen per month is far, far preferable to the Pill (which is the standard medical solution for these girls).
  2. The herbal anti-inflammatory Turmeric also works to reduce bleeding. It should be taken every day throughout the month.
  3. Avoid cow’s milk products to reduce inflammation and lighten periods. Dairy-free really works for some girls, but it might take 2-3 months to see the full benefit. A2 milk (like Jersey, goat and sheep) is usually ok.
  4. Supplement iron. Heavy periods cause iron deficiency and iron deficiency worsens heavy periods. It’s essential to supplement. Use a good quality, gentle chelated iron (like iron bisglycinate). Dose is 15-50mg and is best taken after the evening meal.

Perimenopausal women 40-50 years old

Perimenopausal heavy periods – like my patient Karen – are more serious than the temporary heavy periods of the teenage years. Without treatment, perimenopausal periods can get heavier and heavier as menopause approaches.

Natural treatments for perimenopausal heavy periods include those treatments discussed above (ibuprofen, turmeric, dairy-free diet and iron), plus the following:

  1. Get a medical diagnosis. Heavy bleeding is usually caused by hormone imbalance, but your doctor needs to rule out more serious issues such as endometriosis, uterine polyps, infection or fibroids. Fibroids are benign growths in the muscle wall of the uterus. They are extremely common during perimenopause, and often occur in women who also report very heavy bleeding. Only rarely (10% of the time), are fibroids the actual cause of the bleeding. I will write a future post on natural treatment for fibroids.
  2. Identify and address underlying thyroid disease. Under-active thyroid like Hashimoto’s autoimmune thyroid disease can cause heavy periods.
  3. Enhance Estrogen Detoxification. Estrogen is normally cleared through your liver and  bowel. To keep those organs healthy, you should reduce alcohol and avoid antibiotics that damage your intestinal bacteria. Intestinal bacteria play a major role in metabolizing and clearing estrogen, and you may notice heavier periods shortly after disruption of intestinal bacteria by antibiotics. You can further enhance estrogen detoxification with vitamin B6, and  200mg of the nutritional supplement DIM (Diindolylmethane), which is an extract from cruciferous vegetables.
  4. Eat phytoestrogens. Studies show that a diet high in phytoestrogens like nuts, soy and flaxseeds make periods lighter. Phytoestrogens compete with stronger endogenous estrogens and therefore reduce estrogen stimulation of the uterine lining.
  5. Get enough iodine. As discussed in my breast-health post, iodine down-regulates estrogen receptors. It does so in all tissue including the breasts and uterus, so it reduces thickening of the uterine lining..
  6. Keep insulin low. Like estrogen, insulin is a growth hormone and thickens the uterine lining. Women who are overweight or who have insulin-resistance are more likely to suffer very heavy periods and fibroids. Obesity also causes high levels of an estrogen called estrone, made by body fat. The best way to improve insulin sensitivity and to lose weight is to quit sugar, and to supplement magnesium and berberine.
  7. Natural Progesterone. The standard medical treatment for heavy periods is a synthetic progestin such as medroxyprogesterone tablet, or levonorgestrel (Mirena) IUD (see below). Natural progesterone is a viable alternative to synthetic progestins for some women. Natural progesterone does reduce the thickness of the uterine lining (although less strongly than a synthetic progestin), and has far fewer side effects. Natural progesterone can be used as a topical cream, but that is not always strong enough. Some women need to use a higher dose progesterone capsule, which must be prescribed by a doctor. Please see Dr Jerilynn Prior’s Doctor’s Guide for Managing Menorrhagia

A word about Medical treatments:

Hysterectomy (surgical removal of the uterus) has been the standard medical treatment for heavy bleeding for many decades. It is still necessary for some women, but I encourage my patients to keep their uterus, if at all possible. Hysterectomy doubles the long term risk for vaginal prolapse and urinary incontinence. It can also reduce sexual response and the ability to orgasm. Conversely, some women report improved sexual function after hysterectomy because their gynecological symptoms are relieved.

The progestin-secreting intra-uterine device (Mirena) decreases menstrual flow by 90%. Mirena delivers a very small dose of the synthetic progestin levonorgestrel directly to the uterine lining. Some of that synthetic hormone does enter the blood stream, but at levels of one tenth of most contraceptive Pills.  Mirena can cause acne or depression.

Endometrial ablation is the surgical scraping or destruction of the uterine lining. It is effective, but 22% of women require a repeat procedure, and 20% report long term pelvic pain.

I mention these medical treatments only because I know that they are sometimes required, despite all of your best efforts. To resort to a medical treatment is not a failure on your part. No one can be expected to endure very heavy periods for long. It is still worth trying natural treatment first, because it can work. Natural treatment has another advantage: it corrects the underlying hormone imbalance, which will bring broader health benefits, including breast cancer prevention.

Yours in Health, Lara Briden

About the author

LaraBriden210

Lara Briden, ND, before qualifying as a Naturopathic Doctor, studied evolutionary biology at University of Calgary.  She then went on to graduate from the Canadian College of Naturopathic Medicine (CCNM)  in 1997. Her love of science and the natural world has informed the way she practices medicine. Seeing the body as a pragmatic, regenerative system. The body wants to be healthy. So often, the best thing that we can do for health is to remove the obstacles that get in its way. In her 18 years as a Naturopathic Doctor, thousands of patients have entrusted her with their hormone stories. Every story was unique.  Here is what she has learned: Some things really work for hormone balance. The rest are just theories. With this blog, she strives to assemble some health truths, and to dispel some health myths. Some Truths: Coffee has merits; the Pill is chemical castration; and antibiotics are bad for hormones.  Another Truth:  Wheat, sugar and vegetable oil are not suitable food for humans (or for any creature). That is not new information, but it is a truth that has recently been made sexy by the Paleo hipsters. Follow her on her blog and on Facebook.

Brenda Rogers

With over 25 years experience as a corporate trainer, naturopath, yoga teacher and wise woman educator, Brenda is the head clinician and coach at Quintessence Health.

"A healthy mind and body simply ensures you have the time and energy to fully express and manifest your life’s purpose – it facilitates the unfolding of joy."

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