When Your Period Suddenly Becomes “Too Heavy”

As a naturopathic doctor who has a special focus in hormone health and perimenopause, one of the most common symptoms I see in women in their 40s is:

Previously manageable periods that suddenly turn into flooding, clotting, “gushing” bleeding, and significantly interfere with work, sleep, exercise, and social activities.

Heavy bleeding in perimenopause is extremely common. During perimenopause, hormone production becomes more erratic. Cycles start to be become anovulatory (without ovulation), which means progesterone production drops significantly. Low progesterone contributes to the instability the uterine lining and thus contributes to heavier flow.

Heavy bleeding can also occur in pre-menopause, in women in their teens, 20’s or 30’s. This is often related to a hormone imbalance called “Estrogen Dominance”, which may also be combined with “Progesterone Deficiency”. Read more about that here.

Besides hormone imbalance, there can be structural reasons for heavy bleeding, which we’ll get into below.

Women are often remarkably resilient and accustomed to pushing through significant health symptoms, but heavy menstrual bleeding should not be suffered through in silence! With a proper assessment and an understanding of the underlying cause, symptoms can often be significantly improved.

Heavy Bleeding Inevitably Leads to Iron Deficiency

Heavy menstrual bleeding is one of the leading causes of iron deficiency anemia in women of reproductive age. Iron is essential for oxygen delivery, cognitive performance, thyroid function, mitochondrial energy production and neurotransmitter synthesis.

When iron stores start to drop - even before anemia becomes severe - women may notice:

• Poor concentration and difficulty finding words

• Mental exhaustion and poor resilience to stress

• Dizziness

• Increased anxiety or low mood/motivation

When iron deficiency has been going on untreated for a longer period of time, women may notice:

• Hair thinning or increased hair loss

• Difficulty getting through the work day

• Reduced exercise tolerance

• Migraine headaches

Many women are told their labs are “normal” despite having ferritin levels that are far from optimal. This is why a comprehensive assessment matters.

One of the most important steps is identifying whether there is a structural root cause contributing to the bleeding. Common contributors include:

• Uterine Fibroids - can cause increased bleeding by increasing the surface area of the uterine lining and cause disruption of normal uterine contractions

• Adenomyosis - occurs when endometrial tissue grows into the muscular wall of the uterus. It can cause heavy clotting, cramping, pelvic pressure and prolonged bleeding

How much blood is too much?

We want to start paying attention to a heavy flow when there is more than 2 ounces (2 shot glasses) worth of blood in any given day.

The Good News: Heavy Bleeding Can Improve Quickly

There are many evidence-informed naturopathic approaches that can help reduce the amount and duration of bleeding that work as quick as within a single cycle, or over a period of a few months.

• Homeopathic remedies – individualized based on your exact presenting symptoms. I have found homeopathic remedies to help the very same day they are taken, if the correct remedy is chosen. The most popular remedies I use are: Sabina, Ferrum phos, Phosphorus and China in low potencies. They are only taken during menstruation, which is very convenient.

• Botanicals – hemostatic herbs traditionally used for excessive bleeding, usually in tincture form. These can be taken about a week prior to start of menses and dosage depends on how heavy the bleeding it. Dose can range between ¼-1/2 tsp 3-7x per day.

• Targeted progesterone support using the herb vitex.

• Improve estrogen detox gently and only if necessary, to avoid further dropping of estrogen in perimenopause, and/or improve liver detoxification to indirectly improve estrogen detox

• Integrative treatment alongside naturopathic care – I believe in informed decision making. If pharmaceutical and surgical therapies are indicated, I believe in discussing the pros and cons, risks and benefits, and potential side effects of any recommended therapy so that you feel informed, assured, and confident in your treatment plan.

Every case is different, which is why individualized treatment matters.

Increasing Iron Levels in your Body Successfully

Iron supplements are incredibly difficult to absorb. Liposomal and Heme forms of iron are very well absorbed, and cause absolutely no stomach pain. Read more about different forms of iron here. Dosage is also important as well as taking supplements diligently and consistently or at least 3-4 months before re-testing Ferritin levels. Treating reasons for poor nutrient absorption is also a key aspect to raising your ferritin.

In certain cases, iron infusions may be an appropriate option, especially if you don’t respond well to oral iron supplements. If you fit specific criteria, some MD’s can refer you for iron infusions that are covered by provincial health care. There also are private clinics that offer different types of IV iron, so that you can get a tailored experience.

If you’re ready to get to the root cause of your heavy bleeding, book a complimentary 15-minute Discovery Call to get started.

Book Your Call

Disclaimer: All content in this blog is created and published online for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice.