Do you find yourself using super tampons or pads and you have to keep changing it on a regular basis? Is your menses very long? If your answer is yes to these questions, you probably have heavy menstrual bleeding. The good news is, you can actually do something about it.
What is Menorrhagia?
Menorrhagia is the medical term for menses (menstruation) with prolonged and abnormally heavy bleeding. It’s defined as a woman who loses 80 ml or more blood during one menses cycle. Heavy menstrual bleeding is more common than one would think and many women suffer from it without even knowing.
Note: It is normal to have the heaviest bleeding during day 1-3 of menstruation.
Causes of Menorrhagia
There are several causes for heavy menses including:
Hormone imbalance:
During a normal menstrual cycle, the balance between oestrogen and progesterone regulates the buildup of the endometrium (uterus lining) which is shed during menses. If a hormonal imbalance occurs, the endometrium might develop in excess resulting in heavy bleeding.
An-ovulation:
If the ovaries don’t ovulate (release an egg), the corpus luteum can’t release progesterone as it would with a normal menstruation cycle. The body is left with too much oestrogen and not enough progesterone. As a result, the endometrium becomes thicker and more likely to shed with more blood loss, big clots, and prolonged bleeding.
For most women who experience excessive and prolonged bleeding, it is due to ovulation dysfunction (not ovulating correctly) caused by imbalanced hormones, oestrogen dominance in particular.
Uterus is A-tonic:
The muscles in the uterus are not doing their job as they should. Small capillaries feed blood into the uterus supporting its function.
This blood helps to build and shed the endometrium as well as clean the uterus. Strong and toned uterine muscles clamp down and close off the capillaries into the uterus which prevents too much bleeding.
If the muscles are weak and don’t clamp down as they should, it means the uterus is a-tonic. Too much blood flows from the capillaries into the uterus. This is also known as flooding or haemorrhaging and contributes to heavy bleeding.
Uterine-related problems:
- Uterine fibroids or polyps: are non-cancerous growths or tumors which may cause heavier or prolonged periods.
- Cervix or uterine cancer.
- Pregnancy complications: such as a miscarriage or ectopic pregnancy (baby grows outside womb) may cause heavy bleeding.
Medication:
Certain types of birth control, anti-inflammatory medication, hormonal medication and anticoagulants may contribute to heavier or prolonged menses.
Other medical conditions include
- Inherited bleeding disorders such as von Willebrand’s disease (blood is too thin) may cause abnormal bleeding.
- Adenomyosis, a condition that occurs when the endometrium glands become embedded in the uterine muscle.
- Liver and kidney disease
Symptoms of Menorrhagia
There are many symptoms the body might show, these include:
- Your menses exceeds 8 days
- You have to change your sanitary tampon, pad or period cup every hour to two, for several consecutive hours and days
- You bleed through heavy pads at night or have to wake up to change protection during the night
- You’re passing blood clots larger than 2 cm
- Thick pads get soaked through and you have to double up on protection.
- Your flow restricts your daily activities.
- During your menses you have symptoms of anemia, such as fatigue, tiredness and shortness of breath.
Diagnosis
Record your flow
You can calculate how much blood you lose during menses to determine if your flow is heavy or not. On average a soaked normal-size tampon or pad holds about 5 ml of blood. That means it is normal to have about 7-12 soaked normal-sized tampons or pads in a single menses. A super tampon or pad can hold up to 10 ml. A period cup can also be an effective method to gauge your flow.
You can use this diagram to keep a record of your flow and amount of days you have your menses. You may also take this to your healthcare practitioner if you need to consult one for severe menorrhagia.
Clinical diagnosis
When diagnosing menorrhagia your healthcare practitioner will ask about your medical history and menstrual cycle as well as look at your symptoms.
He/she might do the following tests to determine the cause:
- Pap test: Cells from your cervix are collected and tested for inflammation, infection and/or cancerous causing cells.
- Blood test: Anemia (iron deficiency), thyroid disorders or blood clotting abnormalities are evaluated through a blood sample.
- Ultrasound: Using sound waves your doctor will look at images of your uterus, ovaries and pelvis.
- Endometrial biopsy: A sample of tissues from the inside of your uterus may be examined by a pathologist for abnormal or cancerous cells. You may feel pains similar to period pains during this procedure.
- Hysteroscopy: A procedure where a tiny tool is inserted through the vagina and cervix into the uterus to see the inside of it. They will look for fibroids, polyps and other possible causes of bleeding.
- Sonohysterogram: Fluid is injected into the uterus. By using an ultrasound scan, your doctor can look for problems of the uterus lining. You may feel mild to moderate cramping or pressure during this procedure.
Risk factors
- Women who started with their menstruation at a young age may be at higher risk of menorrhagia.
- Taller women may have a higher risk of menorrhagia.
- After giving birth the risk for menorrhagia may increase.
- Perimenopausal women might have heavier blood flow.
- Women who have endometriosis may also struggle with menorrhagia.
Treatment
There are a number factors when determining treatment, these include:
- The cause and severity of the condition
- Your age, overall health and medical history
- The likelihood that your menses may become less with natural treatment
- Your future childbearing plans
- The effects the condition has on your lifestyle
- Your opinion and personal preferences
- Your tolerance to medications, procedures and therapies.
We will be focusing on the holistic approach of treatment. The goal of the treatment is to control the bleeding, prevent and treat anemia, and restore an acceptable menstrual pattern.
Nutrition
You become what you eat. Food plays an important role when it comes to body function. Your body uses the nutrients it gets from the food you eat to build new cells and hormones as well as make everything function correctly.
Diet changes you can make to prevent and treat Menorrhagia:
- Eat smaller portions frequently
- Eat plenty fresh fruit and vegetables
- Drink one glass of water for every 10 kg body weight
- Limit dairy products and animal fat
- Reduce or eliminate sugar
- Limit or avoid alcohol and caffeine intake
- Eat good quality and mainly plant based or whole foods
- Avoid processed food
- Avoid artificial sweeteners and preservatives
Important nutrients to prevent and treat Menorrhagia:
- Phytoestrogens: compete with stronger endogenous oestrogen, thereby reducing oestrogen stimulation in the endometrium (uterine lining).
- Iron: Heavy periods cause iron deficiency. Iron deficiency may worsen heavy periods.
- Iodine: lowers oestrogen receptors in the breasts and uterus and reduces the thickness of the uterine lining.
- Vitamin A: A vitamin A deficiency may be a contributing factor in the menorrhagia
- Vitamin. B complex: Vitamin B complex may help to normalise oestrogen metabolism.
- Vitamin C and Bioflavonoids: Vitamin C, along with bioflavonoids, help reduce heavy bleeding by making the capillaries stronger and preventing them from becoming fragile. Vitamin C also helps with the absorption of iron.
Important foods:
- Nuts, soy, and flaxseed contain phytoestrogens and essential fatty acids which may reduce blood flow.
- Brewer’s yeast, wheat germ, apricots, raisins, beans and cooked spinach are all excellent sources of iron.
Herbs to Balance hormones
If your menorrhagia is caused by hormonal imbalances (as in many cases), you might have to consider using something to balance your hormones. By doing so you may restore your menstrual cycle pattern.
Chaste Tree Berries
A full scope of menstrual disorders, including amenorrhea has successfully been treated with chaste tree.
How it works:
Chaste tree acts on the hypothalamus and pituitary gland by increasing Luteinizing Hormone (LH) production and mildly inhibiting the release of Follicle Stimulating Hormone (FSH). The result is a shift in the ratio between oestrogen and progesterone, in favour of progesterone. However, it may be used to balance hormones in both oestrogen or progesterone dominance.
Chaste tree stimulates ovulation, which in return produces progesterone. The rise in progesterone levels and increased ability to ovulate may be an effective treatment for some cases of amenorrhea. Lengthen a short luteal phase (second half of the cycle) which may increase fertility with this herb as well.
Chaste tree berries inhibit the pituitary gland from releasing prolactin by combining dopamine receptors, particularly when stress cause elevated prolactin. Elevated prolactin levels may cause some cases of amenorrhea. Prolactin release was significantly reduced with no side effects noted during testing.
Don’t expect immediate results when using Chaste Tree, because it doesn’t provide the body with actual hormones. It activates the menstrual cycle glands and organs to get the body to do its job correctly. This balancing function takes time. It usually begins to take effect after three months.
Herbs to control the bleeding
Raspberry Leaf
This herb is a wonderful uterine tonic. It helps to tone an Atonic uterus by strengthening the uterine muscles, preventing haemorrhage or flooding.
Raspberry leaf has astringent (contracting) properties on the uterus and can, therefore, be useful for frequent or excessive and heavy menses as well as dysmenorrhea (period pains) and other menstrual disorders. Additionally, it helps to detoxify excess hormones.
Ginger
Treat heavy menstrual bleeding with the proven ginger. A study showed a dramatic decrease in the level of menstrual blood loss. Signs of relieve was visible on the first use and progressively improved every month thereafter.
Stinging Nettle
Nettle is an ancient method used to reduce menstrual bleeding while also supplying a good amount of iron. As mentioned above anemia is common after heavy periods. Its astringent actions on the uterus also helps to prevent haemorrhaging.
Not only is it rich in iron, but it also contains vitamin A, B complex, and C as well as minerals such as calcium, potassium, and magnesium. Additionally, this nutritious herb is an excellent purifying remedy with digestive and diuretic qualities.
Yarrow
This herb is extremely astringent and is useful to control excessive blood flow. It has drying properties which strengthen and tightens uterine tissues as well as promotes detoxification. Stop heavy blood flow with this well documented herb.
Yarrow promotes circulation and may stimulate the uterus to bring on menstruation while being an aid to regulate your flow.
It is probably one of the best herbs one can use to stop heavy bleeding caused by endometriosis, ovarian cysts, and uterine fibroids. In addition to using yarrow to stop heavy bleeding, it is important to address the cause of the menorrhagia.
Stress Management
When you are stressed the hypothalamus and pituitary gland steals hormones, progesterone in particular, from the reproductive system for the synthesising of cortisol and adrenaline. This results in the body not having enough of the right hormones to function correctly.
Learn how to manage your stress here.
Change your attitude towards menstruation
Change the way you think and feel about your menstrual cycle. Being a woman, and having the menses is a beautiful thing. Your body works in such an intricate way. You can conceive, grow and carry a baby to bring it into this world. You wouldn’t have been able to do this if you didn’t have a menstrual cycle. The survival of our species is dependent on it.
