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Most women who suffer from heavy periods do not experience higher than usual levels of pain as a direct consequence, but many of the exact same issues that can give rise to dysmenorrhoea (painful periods) can equally cause heavy bleeding. Therefore, note that some of the material presented here, especially in discussing the potential causes for heavy bleeding, is also found in the article on dysmenorrhoea, found on this site here In practice, the simplest way to gauge how heavy the periods are is to ask, 'on your heaviest day or days, how often do you need to change a pad or tampon?' If she is bleeding through a pad or tampon in less than 2 hours and this is going on for a day or more, then that's certainly heavy but it must be noted that this is all relative and the general consensus is to accept whatever is normal for the woman who is generally in good health. If she starts bleeding a lot more heavily or frequently than she used to, then that is enough to assume that something untoward must be happening. The length of time for significant bleeding is at least as important as how heavy it is on any one day. A woman who is still needing to frequently change pads or tampons on day 3, 4 or 5 of their period is clearly getting a heavier than usual period. Likewise, bleeding that goes on for a week or more, or keeps happening throughout the month can be said to fit the definition of menorrhagia. Most of all, the way the bleeding is making the woman feel is the key factor in defining whether this is a problem or not. If she feels ok and is able to maintain her normal activities then it may be that she is just a heavy bleeder and probably on the damper side of the constitutional spectrum (more on that at the end of this article) but if she feels tired, depleted, drained and anaemic then, of course, this is a problem that needs attention to whatever is causing it
By no means do all women with menorrhagia have a thyroid imbalance but, in my experience and others, it is so often involved that it at least needs to be carefully ruled out. With menorrhagia in women, especially when they get into their late 20s or 30s, the thyroid should be thought of as a little bit guilty until proven innocent. A simple blood test may be all that is required to prove that innocence but note that a level of TSH that is above 3.0 may still show that there is an issue here (the normal range is set as going as high as 4.0 or even 5). Ample doses of the herb Withania root, along with as much of the key thyroid nutrient minerals; iodine, zinc and selenium as required, has been seen to restore the great majority of women who have an underactive thyroid back to health, with consequent improvements in excess menstrual bleeding. An overactive thyroid is a trickier matter, but one that can still respond to treatment. This subject, including notes on how to assess thyroid health, is discussed in more detail here
Hormonal imbalance as the root cause of menorrhagia can go much further than the thyroid. If there is a history of the premenstrual syndrome (PMS) causing significant disruption, and certainly if PMS is happening at the same time as the menorrhagia then this can be assumed to at least be having some impact on the excess bleeding or spotting. The herb Vitex (Chaste tree) can be extremely helpful here, so long as it is taken long enough and in a high enough dosage, and there are other well proven methods to help PMS as discussed in detail here Many women start experiencing menorrhagia when they begin the hormonal changes of the peri-menopause. If the heavy bleeding has only really begun since the age of 40, then the best way to get deeper into treating the cause may be to use some of the hormonal balancing herbs that can help with the perimenopause, more here A further and also common cause of hormonal imbalance in the reproductive system happens in women who have the metabolic syndrome. In essence, this is a genetically inherited disposition to create higher than ideal levels of insulin in response to a high carbohydrate diet. The metabolic syndrome gives many downstream effects on our health, none of them good. Common signs of the syndrome include a tendency to getting round in the middle (the apple shape) a higher than ideal blood pressure and a higher than ideal cholesterol and triglyceride level. It takes a lot of commitment to change the diet, but it is an entirely treatable condition, a comprehensive article on it is here
Many women with particularly severe menorrhagia will eventually go through a surgical technique known as laparoscopy, to investigate the lining of their womb, and may then be diagnosed with endometriosis. Even though the name 'endometriosis' is relatively new, the same condition has been described in early medical texts with different terminology. It has clearly been with us for a long time and we long ago needed to find ways that could help. For further discussion on this complex condition, read here
For treating menorrhagia associated to fibroids, it is again especially recommended to look into using the berries of the herb Vitex and the leaves of Lady's mantle as mentioned below. Likewise, the suggestions in the article on PMS linked above about reducing oestrogen are likely to help fibroids, sometimes referred to as 'oestrogen-bubbles' Small fibroids that are associated to excess bleeding have been seen to respond well to herbal medicine but if the fibroids are too large to have a realistic hope of shrinking then surgical options may also need to be considered, more here
For some women, a lack of one or more essential nutrients can either worsen or even cause their menorrhagia. Getting too low in iron can be a particularly vicious cycle if the periods become too heavy and this must be assessed (and then treated if need be) with a simple blood test. Iron is easy to assess, it is much harder than most people realise to determine whether a person is low in other nutrients through blood or other forms of testing. Until we have some more advanced technology to remedy this, one of the ways to get an overall impression is to have an honest look at the health of the skin, nails and hair. Making allowances for wear and tear from life or work, if they are not as robust as they ought to be then it is likely that the outside is reflecting the inside, and something will be lacking from the diet. Eating a healthy, whole-foods diets is good for anyone with any kind of health problem, the nuts and bolts of this are written up in some detail in an article called 'excellent nutrition', found here but I also want to make a special mention of Magnesium, as at least for some women, this particular nutrient has been a life-changer for their menorrhagia. That said, it appears that a person either rapidly responds to magnesium or they don't and the only way to know is to try and see. The fastest way to begin with this is by getting one of the many readily available magnesium supplements and taking it for at least once cycle to assess it. 200mg of elemental magnesium per day is the level you would need to take to do a fair trial of this. If you do feel that you respond well to magnesium then you should consider adding more magnesium-rich foods to your diet because minerals, like vitamins, work best in their most natural form.
A structural problem, for example a misalignment of the pelvis, or a postural stress into the low back can significantly impact on the circulation of blood to and from the uterus and are clearly a pivotal cause of menorrhagia in at least some women. It may need an experienced practitioner to assess for such a cause, such as a physiotherapist, an osteopath, or a chiropractor, or a person who works with posture and movement such as a yoga or Pilates teacher, or a practitioner of the Alexander or Feldenkrais technique. Or the woman may know herself that when she is more active, more flexible, that her periods are much lighter and that when she becomes sedentary, or she loses movement and flexibility, that her periods become too heavy. If a structural problem is the cause, or part of the cause, for the menorrhagia then, as well as using what remedies most appeal or are most available, the cure, or the necessary improvement, will be in treatment, or movement, or both. In this area in particular, when we suspect but can't be sure that a structural problem is an underlying issue, you simply have to go through a series of treatments or a process of practicing yoga, Pilates etc. and see how much difference it makes with or without the intervention to know how much of a cause it is. If relevant, a more detailed discussion on back problems is found here
You may need to be aware of the potential for drugs or devices to cause menorrhagia, because it seems that not all GPs think these matters through when they or another doctor prescribe them and then get feedback that things are not going well. There are a number of ways that we can increase hormonal imbalance with further chemicals, drugs such as the contraceptive pill itself (possibly given for period problems in the first place), using too many anti-inflammatories for too long, taking caffeine in quantity. If there is something being used on a regular basis, it may be wise to have a hard look at whether it is doing more harm than good. Likewise, the devices, IUDs that are commonly given to women for hormonal imbalances difficult periods have been frequently seen to be a major cause for an increase in bleeding. There always seems to be a great deal of reluctance to remove these devices, even when the woman is certain that she is much worse off since she has had it and says that things are getting worse from one month to the next! If it is clearly making things worse then get it out and don't let anyone talk you into taking more drugs as a better alternative. IUDs help some women, and they make others worse, it really is as clear as that.
Any woman, reading the above list, could feel some degree of overwhelm. Where do you start? Can I not just take a pill to make all this go away! At least in our society, most women come to see a herbalist when the pharmaceutical pills have stopped working, or they are getting too many side effects from them. It's understandable that treating causes is much harder, but if it leads to a lasting cure then surely any amount of time and trouble is worth it... The biggest challenge is knowing where to start, and what can help a great deal in this area is getting an understanding of our innate cycle of healing. This has been developed especially with students of holistic medicine in mind, but anyone can grasp and put to use its intuitive and common-sense practicality. There are four stages in the cycle; cleansing, activation, nourishment and rest. Seeing where you need the most help in any one area can help you to see where the most likely cause of the menorrhagia lies; this subject is opened up further here
Finding and treating causes, as discussed above, takes time. For the rapid relief of menorrhagia there are two herbs in particular that are likely to help. One or both of them is always worth trying and, so long as they are used in adequate doses and frequently enough, they are likely to help. At least for my own practice. top of the list is the herb Shepherd's purse, and I have here included some more detailed notes from its article on this site to give some practical information on how it can be used. The full article on Shepherd's purse can be found here
Most of my clinical experience using Shepherd’s purse has been in the treatment of excess menstrual bleeding and in this regard I have found it to be such a potent remedy that I would start by saying it is unwise to use Shepherd’s purse at the very beginning of the period, even if very heavy, because it may be anticipated that it will considerably 'bind the bleeding' and of course there is a necessity for the body to fulfil its natural process. Rather, wait for at least 1-2 days before starting Shepherd’s Purse for excessively heavy periods. With the tincture The method to get Shepherd’s purse to work for this is to take it in small and frequent doses, until the bleeding has slowed down or stopped. Mainly depending on the strength of the tincture 20 drops or 1 ml of Shepherd’s purse each time is often enough but this can be easily doubled to 40 drops or 2 mls if necessary. I nearly always use the Shepherd's purse alongside Lady's mantle and may also combine some Raspberry leaf at the same time. For a combination of Shepherd's purse with Lady's Mantle and/or Raspberry leaf I will probably use up to 3 or 4 mls of the combined herbs with each dose, depending on the size and sensitivity of the patient. With the tea Make a strong tea by adding 2 large cups of freshly boiled water (approximately 1 litre) to 3-4 heaped tsps of Shepherd's Purse dried herb. Cover and allow the tea to steep for a good 15 minutes. Strain and allow to cool before drinking. The equivalent dose to 1 ml of the tincture will be between 50-100mls of the tea depending on the strength and freshness of the dried herb. It is very strong tasting but once it is seen to work the unpleasantness tends to fade into insignificance. Dosage notes It is not correct that 'more is better' with herbal medicine and in fact often it is the reverse that 'less is more!' You have to spend time with herbs to understand them; they are much more a living medicine than are drugs. The first step is to feel them working, the second step is to get a sense of how often you need to use them and in what dose. As soon as the treatment is obviously working you can stop it but, if necessary, you can take a dose every 1-2 hours -- up to 6 doses in a day. If you don't feel anything happening by the 2nd or 3rd dose, then try taking the herbs at the higher end of the suggested dose range. They may be hard to take but they will not cause toxicity. Many women feel this treatment working almost straight away but, because it is not exactly a pleasant process, it is tempting to stop the treatment too soon. Listen to your body to know what to do and how long to keep it up for. Each extra time you take a dose you increase the strength of the effect. As mentioned, I almost always use Shepherd's purse alongside Lady's mantle. This is a herb that has a deep, long-acting tonic action on tissues that have lost tone and need a healing, binding influence. Lady's mantle works very well as a tea or a tincture and, for any woman suffering from menorrhagia, is almost certainly worth getting to know better, more about it here
There are many other combinations of herbs that may quickly help with a heavy (or a painful) period but what I can share from frequent personal observation is that a formula we make in our clinic called 'women's tea has been received with excellent responses from most women who have taken it when needed. All the herbs in it should be reasonably readily available so, if you would like to try it, the precise recipe and instructions for the tea are found here
So long as we are working towards treating one or more of the perceived causes of the menorrhagia, there is much to be said for taking herbs to help the general hormonal balance and health of the reproductive system. No one herb or combination of herbs are going to be right for all women, but I still want to give a short list of the herbs that have most often been seen to be of help. If you are able to obtain these herbs or, better yet, if you can work with a herbalist who is experienced in their use, you are likely to find some considerable support from one or more of these old and trusted allies. Black Cohosh has been rather 'pigeon-holed' as herbs for the menopause, but it is so much more than that, and one of its diverse uses can be to help with heavy periods, spotting etc. It is a dynamic, potent herb that does not require large amounts to have strong effects. Note that neither it, or Chaste tree described next, will suit everyone but sometimes you just have to try and see. More about Black Cohosh here Chaste tree (Vitex) was mentioned earlier in the section on hormonal imbalance. I wouldn't be without it in the treatment of menorrhagia and it is more often a part of my initial treatment plan than it isn't. I won't try to summarise how to use this herb here, it is too important to understand it in more depth and to get that it must be given time to work and that the dose may need to be considerably adjusted to get the desired result, more here The humble Raspberry leaf, just as good as a tea or a tincture, is one of the best all-round herbs to nourish and support a healthier womb. It is so often a part of my general treatment plan for all kinds of women's health troubles that most of my formulas would feel like they were missing something without it! Raspberry leaf can be taken by anyone, its gentle action never seems to cause any trouble or outstay its welcome. It is a balancing herb that I think helps the more dynamic hormonal herbs such as Black Cohosh or Vitex be better tolerated and get to where they need to go, more on it here Last, but by no means least, as it is a herb that I and others have learned to rely on in even the most severe cases of menorrhagia, is the great women's tonic herb, Dong Quai. This herb is revered in Traditional Chinese Medicine to build energy and blood and to help relieve the kind of energetic stagnation and congestion that is seen as the underlying condition behind menorrhagia. So well proven and highly regarded is Dong Quai for blood loss that it is routinely used in Chinese hospitals when a person has suffered a trauma with significant loss of blood. Dong Quai needs to be taken in strong doses to work its magic, but this is readily achieved and the herb is widely available. Any woman with chronic menorrhagia may benefit by getting to know it personally, more here
Finally, you might benefit from learning about your constitution to know what kind of foods, herbs, exercises etc. will work especially well for your health in general.
Please understand that I cannot personally advise you without seeing you in my clinic. |
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© 2011 R.J.Whelan Ltd