What one woman describes as a heavy bleed can differ greatly from what another woman experiences during her period. Heavy menstrual bleeding is also referred to as menorrhagia and it’s diagnosed when we lose more than 80 ml of blood during our cycle or when our bleed continues for more than 7 days.
The following is a helpful guide to help you determine exactly how much 80 ml is or what it looks like.
One regular soaked pad or tampon holds around 5 mL.
A super tampon holds 10 mL.
A menstrual cup typically holds around 25mL (but they do have markings on the side so check to be sure).
This means that you’d have to completely fill more than 3 menstrual cups over your bleed, or use 16 fully soaked tampons.
What causes heavy bleeding?
Women most commonly suffer with heavy bleeds because they’re not making enough progesterone through ovulation. This is why as menopause approaches, and we ovulate less, our periods can become longer and or heavier. It’s also (partly) the same reason that young girls experience heavy or long bleeds at menarche; because they too are not yet making enough progesterone nor as they ovulating regularly.
Heavy bleeding can also occur from overstimulation of the endometrium due to excessive or unbalanced oestrogen levels. Note that oestrogen thickens the uterine lining while progesterone thins it, reduces it or stops our bleeding completely. This is why progestin (the synthetic hormone designed to mimic progesterone) is prescribed for heavy bleeding.
So what can cause the imbalance in oestrogen and progesterone?
Chronic stress
Inflammation
Thyroid disease
Insulin resistance
Inadequate dietary carbohydrates
Excessive exercise
Low body fat
Iron deficiency
Clotting abnormalities
Hormone drugs
Contraception and intrauterine devices
Reproductive cancers
Nutritional deficiencies (such as vitamin K)
Poor metabolism/clearance of hormones through the bowel
If left unaddressed hormonal imbalance like this can lead to reproductive conditions known for heavy bleeding. They include: Endometriosis, polycystic ovarian syndrome, fibroids, ovarian cysts, adenomyosis, pelvic inflammatory disease, endometrial hyperplasia and polyps.
Something else to note is the role histamine plays in heavy bleeding. Most of us are familiar with histamine for its role in allergic response but it also plays a part in hormonal health. When oestrogen is in excess and or progesterone is low, we have higher levels of histamine from mast cells and mast cells are abundant in the uterine lining. When activated they lead to the production of a natural blood thinner that can make periods heavier. Thankfully there are many natural treatments to both reduce histamine and normalise oestrogen.
How can you reduce heavy bleeding?
From a naturopathic perspective, it’s imperative to identify your drivers. Why are your hormones out of whack? Exploring this before treading down the conventional medicine path can prevent the long-lasting impact that hormone drugs have on the endocrine system. Of course, some women (like those who hemorrhage monthly) need the immediate relief that's found with medication but the great thing is that it’s possible to concurrently balance hormones with natural medicine while taking the sometimes necessary bandaid approach. To get you started I've listed some tips below.
Start by improving your oestrogen clearance.
That means taking the load off your liver and encouraging daily bowel motions. Cutting out alcohol, reducing additives, sugar, and exposure to toxins will take you far. In online consultation, we can also prescribe DIM, I3C and Calcium-D-glucarate as part of specialised formulas that eradicate nasty oestrogens and reduce heavy bleeds.
Take a break from (non-fermented dairy).
It’s been found that 1 in 3 people who eat dairy form a peptide called BCM7 which can activate mast cells and in turn unwanted oestrogen.
Rebuild and replenish iron stores.
Heavy menstrual bleeding significantly depletes our body of iron. In turn, low iron can cause and exacerbate heavy periods. By rectifying iron levels, you can increase blood viscosity and lighten your menstrual flow.
Eat well and eat enough.
This is essential for monthly ovulation and progesterone production which as you now know - lessens bleeding. Remember refined sugar is pro-inflammatory and fibre helps us eliminate oestrogen.
Reduce your exposure to environmental oestrogens and anything that messes with your endocrine system.
Endocrine-disrupting chemicals (EDCs) mimic naturally occurring hormones in the body like oestrogen, androgens and thyroid hormones. Get rid of products in the house that contain chemicals and avoid drinking from plastic or heating it up in the microwave.
Reduce inflammation.
Prostaglandins are inflammatory chemicals that get produced around menstruation so the uterus contracts and expel blood. Turmeric, zinc and magnesium supplementation can inhibit excess prostaglandin release. Zinc also reduces histamine release.
Eat phytoestrogen rich foods.
Phytoestrogens like tempeh, edamame, miso, sprouts, ground flax and legumes help normalise our oestrogen levels.
Ensure your iodine levels are up to scratch.
The ovaries naturally contain some of the highest levels of iodine in the body. Iodine decreases oestrogen sensitivity by down-regulating oestrogen receptors and improving detoxification of oestrogen, thereby reducing causative factors of heavy periods (and sore breasts too)!
Support your body with herbal medicines.
Herbal medicines are a beautiful way to naturally normalise your bleeds. Herbs like Tienchi Ginseng, Achillea millefolium, Alchemilla vulgaris, Capsella bursa-pastoris, Lamium album, Mitchella repens, Rehmannia glutinosa and Trillium erectumis are all known for their anti-haemorrhagic effects. If that all sounds like jibberish to you, book in for a consultation and we can make you up a specialised mix. Healing your menstrual cycle takes at minimum three months, and of course longer if you suffer from any complex condition like Endometriosis that is multifaceted and may require surgery. The aim though is primarily healthy ovulation and healthy hormone clearance. To ovulate every month, we need healthy follicles and it takes 100 days for a follicle to fully mature from its dormant state to ovulation.
If you need 1:1 support with your menstrual cycle, book in for our 'Heal Your Hormones package' or find out if it's right for you with a free 10 minute naturopathic call.
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