What is Heavy Menstrual Bleeding?

Heavy menstrual bleeding is called Menorrhagia. It is defined as a woman who loses 5 ½ tablespoons (80 milliliters) or more of blood during their menstrual cycle.

Symptoms include:

• A menstrual cycle that lasts beyond 7 days, though up to 10 is still considered within the normal range if there is not excessive bleeding
• The need to change a sanitary pad or tampon every hour, for consecutive hours and days
• The need to double up protection, even thick pads are soaked through
• Bleeding through heavy pads while sleeping
• Large blood clots
• Feeling tired, fatigue or shortness of breath

Causes of Menorrhagia

Some women experience heavy bleeding during their menstrual cycle, but they are still ovulating and the heavy bleeding may be contributed to slight hormonal imbalances. Please know that one-two days of heavier bleeding can be normal, particularly days 2 and 3 of menstruation. Most women who are experiencing excessive bleeding during menstruation find it’s prolonged due to ovulatory dysfunction, in other words, they are not ovulating correctly. This is most often due to hormonal imbalance.

Women with a normal menstrual cycle usually have a balance of estrogen and progesterone. Follicle Stimulating Hormone (FSH) is released by the pituitary gland which signals the follicles to release estrogen. This signals the endometrium (lining of uterus) to begin to grow in preparation for ovulation and hopefully conception and implantation of the fertilized egg. The continued release of adequate amounts of estrogen by the mature egg, once released at peak amount signals the release of Luteinizing Hormone (LH). This signals the release of progesterone and the endometrium begins to build up in preparation for implantation. The release of LH also signals the egg to be released; this is ovulation. If conception never occurs, the progesterone levels drop and the uterine lining sheds as menstruation.

In women who have menorrhagia there is a disruption in the release of the hormones. This hormonal imbalance may show up as excessive menstrual bleeding because one of the functions in the ovulatory cycle was not triggered and the endometrium may have grown excessively. If not enough estrogen is released to trigger LH, ovulation does not occur which also does not trigger enough progesterone. Adequate amounts of estrogen and progesterone are needed to regulate the amount of blood to be built up in the uterine lining. Insufficient progesterone levels are linked to heavy menstrual bleeding.

Other Risk Factors To Rule Out

According to the Mayo Clinic menorrhagia may also be contributed to other risk factors. It is important to rule out other causes of excessive menstrual bleeding so that you can get a proper diagnosis, which will help you to know what healing methods will be most effective or appropriate. It is important if you have excessive menstrual bleeding to see a doctor that can help you to find the causes for your particular case.

• Uterine Fibroids and Polyps
• Endometriosis
• Blood disorders caused by coagulation issues, this may be genetic
• Medications or herbs that thin the blood, anti-inflammatory medications, and anti-coagulants. Systemic Enzymes and Dong Quai (Angelica sinensis) used in excessive amounts may contribute to excessive bleeding and should not be used without guidance by women with heavy menstrual bleeding.
• Adenomyosis is a condition in which the cells from the endometrium become embedded in the uterine muscle. This most often happens to women who are middle-aged and have had children.
• Thyroid problems
• Pelvic Inflammatory Disease (PID)
• Rarely liver or kidney disease
• Rarely cancer of the uterus, cervix or ovaries
• Miscarriage, if this is your first time experiencing heavy menstrual bleeding there is a chance you are having a miscarriage.

Once you and your doctor have ruled out more severe risk factors, such as those above, you can work toward determining if your estrogen and progesterone levels are within normal range. It is also important to know if you ovulating. Remember that some women with heavy menstrual cycles are still ovulating, but those with extreme excessive bleeding not related to above risk factors usually are not.

Note: If you have been diagnosed with one of the above risk factors, please seek treatment for those particular needs or refer to our guides for natural remedies that may help with those conditions.

Heavy Menstrual Bleeding and Anemia

Women with heavy menstrual bleeding are at high risk for developing iron deficiency, which is a type of Anemia. It is important if you have heavy menstrual bleeding to supplement with a good wholefood iron supplement as well as eat a wholefood diet rich in iron. A wholefood iron supplement is easily absorbed by the body and does not cause constipation like most prescription and over the counter iron supplements.

Foods rich in iron

Heme Iron

Non-heme Iron