Heavy Periods
Do you have heavy periods? It can be a sign of a deeper imbalance.
Whatever a woman is seeing me for as a naturopath, whether it’s anxiety and stress, tummy issues, weight loss or skin health, I always ask her about what her periods are/were like. That’s because just like the digestive system, the subtle variations of your period and cycle can reveal a lot about your hormonal status and this can have a big effect on overall health.
For instance: Did you know that your balance of progesterone and oestrogen can affect your immune system? And your sleep, your mood, and your digestion? It makes sense when you realise how much your hormones do in your body, that having imbalances in your hormone levels or not ovulating properly (such as in PCOS, amenorrhoea or when using hormonal contraception like the Pill) can have a big flow on effect to the rest of your health.
So if your period is not regular, goes for too long, or is too heavy, clotted or painful, this can be a sign that something is out of balance. Many women don’t realise that their heavy periods are not something they need to ‘put up with’, and that help is available to them. I have seen herbal medicine and nutrition work well with heavy periods, usually causing a big effect within the space of a few months. In some cases, there may be something more complicated going on (such as a clotting disorder, severe endometriosis or fibroids) which can benefit from conventional medicine alongside natural medicine.
What is a normal flow
Anything greater than 80mL of blood lost in a period (which equates to roughly 16 or more soaked pads or tampons) or a period longer than 7-8 days is considered to be a heavy flow. If you are using a menstrual cup, you can use the markings within this to count how much blood you are losing during your period, however if you are using pads and tampons you can count how many you are filling up. Many women with a heavy flow are put off from the idea of using a menstrual cup because they will have to change it during the day, or are worried about leaking, however this can be backed up with liners or absorbent underwear such as those from Modibodi. I have written about this before here.
If you experience any of these signs, you may have a heavy flow:
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Having to change a pad or tampon every hour or less.
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Filling 16 or more pads or tampons each period.
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Leaking while wearing pads/tampons, despite using a high absorbency.
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Bleeding for more than 7-8 days
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Regularly passing clots that are larger than a 50c coin.
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Needing to change your overnight pad once or more during the night, or leaking through onto the bedsheets.
If you need to back up your menstrual cup or tampon with a pad, consider using period absorbing underwear. They are designed with technology that helps to wick moisture and smell, and can be a much more comfortable option for women who dislike wearing pads. They’re also environmentally friendly!
Got Clots?
Why so heavy?
Iron deficiency
Oestrogen dominance
While oestrogen is usually a beneficial hormone that helps to support mood, reproductive function, bone and tissue health (to name but a few) for some women there can be too much of a ‘bad’ type of oestrogen. There are several variations that the oestrogen hormone can be formed as in the body and for some women the majority of their oestrogen is in a metabolite form that is not beneficial. This may be due to exposure to chemical oestrogens (xeno-oestrogen) from their environment or it may be due to poor detoxification systems. This imbalance can contribute towards heavy bleeding for some women. For other women, oestrogen level imbalances and their heavy periods may be caused by thyroid imbalances or stress.
Treatment typically involves addressing the detoxification pathways of oestrogen with herbs and nutrients such as DIM, calcium d-glucarate and broccoli sprouts.
Clotting disorders
Some clotting disorders can cause a women to experience very heavy periods. If your periods are heavy from menarche (when you first got your periods) it is a clue you may have a genetic clotting disorder, for example von Willebrand’s disease. If you have a family history of this condition or you have had heavy periods from a teenager, it’s a good idea to get yourself screened by your doctor for this condition, as specific medication may be required.
Fibroids
Schematic drawing of various types of uterine fibroids: a=subserosal fibroids, b=intramural fibroids, c=submucosal fibroid, d=pedunculated submucosal fibroid, e=fibroid in statu nascendi, f=fibroid of the broad ligament
Fibroids are a non cancerous growth within or attached to the outside of the uterus that can range in size anywhere from the size of a pea to the size of a melon.
They are not fully understood but often will respond to hormonal treatment that reduces oestrogen excess, along with herbs that target the excess tissue growth.
Depending on the size and location of the fibroids they may need to be surgically removed, for instance if they are in a position that blocks the cervix affecting fertility. A lot of the time fibroids will not cause any significant problems and may not need treatment.
Menopause
All women experience menopause differently, and for some they may find that their periods become very heavy in the early stages of menopause. This may respond to uterine astringent herbs in addition to herbs to support the menopausal transition (commonly this may be herbs to help with stress and oestrogen balance).
What to do about it
Address the cause
It’s always a good idea to rule out serious issues first, so see your doctor for a pap smear, and potentially further testing such as an ultrasound and a blood test that can look for clotting issues, iron deficiency or other causes of heavy bleeding. Having identified the cause, you can begin to fix the problem with natural, and/or conventional medicine.
For some people the bleeding is SO heavy that an endometrial ablation may be necessary. This is when the lining of the uterus is destroyed and removed, so that a the periods are much lighter or absent. This is not ideal if you are wishing to have children, have had a caesarean section, or cancer of the uterus, cervix or endometrium.
Herbal medicine
If you want to reduce your heavy periods without surgery or going on the pill, you can consider using herbal medicine. It’s best if you can see a herbalist or naturopath who can guide you through the process of addressing the cause of the heavy bleeding and can make a herbal formula specific to you. There are herbs that can help heavy periods such as Shepherd’s Purse, Beth Root, Tienchi Ginseng and Squaw Vine, can be helpful to reduce the heaviness of the bleed.
How long will treatment take
I find that heavy periods will typically respond to herbal medicine within the first cycle with a slight reduction of flow, however it may take a few months to achieve a more “normal” flow. This may be longer if the bleeding is caused by a condition such as endometriosis or fibroids.
