Heavy menstrual bleeding is known as menorrhagia and a very common blood disorder amongst women. Heavy bleeding affects about 25 percent of women. A blood loss of greater than 80 mL (a normal flow being between 25-80ml) or a menstrual cycle lasting longer than 7 days constitutes menorrhagia. To visualize this, 80 mL equates to sixteen fully soaked regular tampons, or eight fully soaked super tampons over all the days of your period.
Let's be clear about something: needing to change a tampon or pad every hour, seeing giant clots in your menstrual blood, or feeling like your period goes on indefinitely is not a normal state of being, and it's not a normal part of having a period.
Conventional Treatment of Heavy Periods
Ibuprofen: The conventional anti-inflammatory medication ibuprofen [Advil] reduces menstrual flow by half. It works by lowering the prostaglandins thta contribute to heavy flow. Take 200 mg every six hours during your first one or two days of bleeding.
Hormonal birth control: Hormonal birth control is the standard prescription for heavy periods, but for many reasons, it's not a great solution. Birth control simply masks the root causes of this hormonally driven problem vs. correcting the hormone imbalance. It can also cause greater imbalances.
Mirena IUD: Mirena is a better option than other types of hormonal birth control. It delivers a smaller dose of progestin than the pill and so does not completely suppress ovulation. Mirena reduces flow by 90 percent, thereby offering great relief for heavy periods. Unfortunately, once you remove Mirena, your heavy bleeding will return.
Lab Testing for Heavy Periods
Hormone testing is a must with this amount of bleeding. Having a complete thyroid panel, along with estrogen and progesterone testing, can help determine if there is an imbalance contributing to our symptoms. You also want to evaluate if you have iron deficiency anemia. I recommend the following tests:
Day 3: Estradiol
Days 19-22: Serum progesterone and estradiol or DUTCH test
thyroid panel (TSH, total T4 and T3, free T4 and T3, reverse T3, auto-TPO, anti-thyroglobulin antibodies)
CBC
Ferritin
Diet and Lifestyle to Prevent Heavy Periods
Natural treatments work to prevent heavy periods. They cannot stop a heavy period once it's underway.
Avoid cow's dairy: My clinical observation is that dairy makes periods heavier. That's consistent with a recent research finding that dairy may alter hormones and impair ovulation.
Keep insulin low: Insulin is a growth hormone and thickens your uterine lining. And too much insulin can impair ovulation and cause progesterone deficiency. You're more at risk for heavy periods if you have insulin resistance and insulin-resistant PCOS.
Exercise: Exercise improves insulin sensitivity, reduces inflammation, and promotes the healthy removal of estrogen through perspiration.
Maintain healthy gut bacteria: Healthy gut bacteria escort estrogen safely out of your body. Unhealthy gut bacteria do the opposite. They impair estrogen metabolism and cause estrogen to be reabsorbed into your body. One of the best ways to maintain a healthy microbiome is to avoid as much as possible drugs such as antibiotics that damage gut bacteria.
Eat phytoestrogens: Phytoestrogens are found in plant foods such as nuts, legumes, and flax seeds. They reduce your exposure to estrogen by blocking estrogen receptors and promoting the healthy metabollism of estrogen.
Supplements and Herbal Medicines to Prevent Heavy Periods
Iron-rich foods: Iron is a critical nutrient for heavy periods. Iron corrects the deficiency caused by your heavy periods, but it can also lighten your period. That's because iron deficiency is both a cause and effect of heavy periods. Think red meat, leafy green vegetables, blackstrap molasses, and liver.
Tumeric: Reduces inflammation and prostaglandins, thereby reducing menstrual flow in a way similar to ibuprofen. Tumeric also lowers estrogen by blocking an enzyme called aromatase. Unlike ibuprofen, you take tumeric every day of your cycle and then increase the dose during your period. Take tumeric with a meal for better absorption.
Other supplements for heavy periods include calcium-d-glucarate and micronized progesterone.
Foods rich in B vitamins. Eating foods rich in B12, B6, and folate can help with red blood cell production and boost your energy.
Cruciferous vegetables. Think brussel sprouts, broccoli, cauliflower. These vegetables are rich in DIM which helps the liver detoxify excess estrogen that could be causing your heavy periods.
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