Menorrhagia or Heavy menstrual bleeding
Menorrhagia is a medical term for periods with heavy bleeding. Periods are considered heavy if there is enough blood to soak a tampon or a pad every hour for several consecutive hours. Menorrhagia is the most common type of abnormal bleeding from uterus.
Causes of heavy menstrual bleeding or Menorrhagia
Following are the causes of heavy menstrual bleeding.
- Functional menorrhagia
Functional menorrhagia is a condition in which menstrual cycle is normal but bleeding is heavy.The likely cause is disruption in the hypothalamic-pituitary-ovarian unit,caused by stress,body weight,exercise patterns or certain drugs.
2.Pelvic inflammatory disease (PID)
PID is caused by infection, which may or may not be sexually transmitted. The symptoms include :
• heavy periods
• abnormal bleeding
• pelvic pain
A bloody or purulent discharge is common if the PID is caused by gonorrhoea.
Overgrowth of cells in the lining of the uterus (endometrium) cause the formation of uterine polyps.They are also called endometrial polyps.Uterine polyps are usually benign but some can be cancerous or may eventually turn into cancer.
Uterine polyps range in size from a few millimeters to several centimeters . They are attached to the uterine wall by a base or stalk.
A woman may have one or many uterine polyps.They usually stay within uterus but some may slip into vagina.Uterine polyps usually occur in women undergoing menopause or those who have completed their menopause.Some younger women can get uterine polyps too.
Signs and symptoms of uterine polyps include:
- Bleeding between menstrual periods.
- Vaginal bleeding after menopause.
- Irregular menstrual bleeding.
- Excessively heavy menstrual periods.
Some women are symptom-free.But others may experience any of the above mentioned symptoms.Uterine polyps can become cancerous.
Uterine fibroids are benign lumps or noncancerous tumors that grow on the uterus. Symptoms may include:
• heavy periods
• painful sex
• an urge to urinate.
• Pain in the lower belly or pelvis
• Prolonged menstrual periods (7 days or longer)
Treatment options include hysterectomy, embolization, and hormone therapy.
Fibroids are common in women over 30 and affect about one in every five women. They may vary in size and number and can be diagnosed with an ultrasound. Rarely, fibroids can undergo malignant change and develop into a uterine sarcoma.
Types of Uterine Fibroids:
All uterine fibroids are similar in their makeup: They all are made of abnormal uterine muscle cells growing in a tight mass or bundle.
Uterine fibroids are sometimes classified by where they grow in the uterus:
• Subserosal fibroids are on the outside wall of the uterus.
• Myometrial (intramural) fibroids grow in the muscular wall of the uterus.
• Pedunculated fibroids usually grow outside of the uterus, attached to the uterus by stalk.
• Submucosal fibroids grow just under the interior surface of the uterus, and may protrude into the uterus.
Symptoms of Uterine Fibroids
In many women uterine fibroids cause no symptoms but some women do experience symptoms from uterine fibroids, they can include:
• Heavy bleeding during periods
• Pain in the lower belly or pelvis
• Bloating or fullness in the belly or pelvis
• Pain with sex
Endometrosis is a condition in which cells lining the uterine cavity grow in incorrect places like ovaries,pelvic ligaments,tubes,bowel or bladder.These cells are sensitive to hormonal action and bleed during menstruation,but this blood has no way of leaving the body.This results in internal bleeding and can cause pain and infertility.
Some women with endometriosis experience no symptoms but other women with this condition may experience the following:
- Pain that gets worse during periods
- heavy periods with clots
- abnormal bleeding patterns
- Bloating, cramping, and changes in bowel movements.
- Pain during sex.
In women who are able to conceive, symptoms may get better during pregnancy, but they may return after having the baby.
When normal endometrial cells (cells lining the uterine cavity) become displaced and grow in the uterine wall,the condition is called adenomyosis. These cells are responsive to hormonal stimulation and bleed causing pain and often heavy menstruation. Adenomyosis is a common cause of menstrual pain and heavy periods in women over 40.
7. Contraceptive causes
These are rare for women who use either natural family planning (based on the detection of ovulation); or barrier methods (condoms, diaphragm or cervical cap).
i) Tubal ligation
Tubal ligation is a medical procedure in which a woman’s Fallopian tubes are tied or cut.it’s a permanent method of birth control.Tubal ligation has been shown to be associated with heavy periods.
ii) IUD(intrauterine device)
The IUD or ‘loop’ can cause heavy and painful periods. Some women may experience bleeding between periods, especially in the first three months after insertion of IUD. Severe pain or bleeding may be an indication that the IUD has dislocated or an infection has developed, and requires immediate assessment.
Disturbance in hormone levels, deficiencies of certain nutrients or blood clotting may result in heavier periods. The more common causes are related to the following systems.
i) The endocrine system
Imbalances of the adrenal hormones,or abnormalities in the thyroid function may cause heavy periods.
ii) The liver
Poor liver function can also cause heavy periods.
iii) The blood
Disorders of blood production or blood clotting can be related to bleeding abnormalities. Anemia and low serum ferritin can cause heavy menstrual bleeding.
9.Pregnancy and bleeding
Pregnancy-related conditions are common causes of abnormal bleeding among women of childbearing age.
A heavy period may be an early miscarriage or a ‘blighted ovum’ where the fetus fails to develop normally. Bleeding later in an established pregnancy, and before the fourteenth week,might also be a miscarriage.
Natural treatment Options for Heavy Periods
Treat iron deficiency anemia
Women having heavy periods are at the great risk of developing iron deficiency anaemia. Treatment for iron deficiency anaemia should involve iron supplements and a change in diet to increase iron levels, as well as treatment of the underlying cause.
If you are suffering from iron deficiency anemia then you should take ferrous sulfate tablets twice a day.Some people experience side effects when taking iron(ferrous sulfate) supplements, including:
- abdominal (tummy) pain
- feeling sick
- constipation or diarrhea
- black stools (feces)
Over time these side effects should go away.If they persist, reduce the dose or take ferrous gluconate.Ferrous gluconate has less concentrated dose of iron and thus fewer side effects.
Eat Iron rich foods.Iron-rich foods include:
- dark-green leafy vegetables, such as curly kale and watercress
- brown rice
- nuts and seeds
- iron-fortified cereals or bread
- pulses and beans
- white and red meat
- dried fruit, such as dried apricots,raisins and prunes
some types of foods , drinks, and medicines, may make it harder for your body to absorb iron. These include:
- calcium – found in dairy products, such as milk.
- antacids and proton pump inhibitors (PPIs) – medications used to relieve indigestion
- tea and coffee.
- wholegrain cereals – although wholegrains are a good source of iron themselves, they contain phytic acid, which can interfere with iron absorption.
Improving iron absorption:
- Apart from increasing the amount of available iron in the diet, there are a number of other ways to increase iron levels.
- Eat vitamin C-rich foods, particularly when consuming foods high in iron.
- Add acidic dressings, such as vinegar and lemon juice, to iron-rich foods.
- Eat bitter vegetables or fruit before or during the meal to increase the flow of gastric acid which will improve the absorption of minerals. Bitter green vegetables not only contain iron but also stimulate its absorption.
- Avoid tea (especially black tea) or coffee until the iron deficiency improves. If you must drink coffee take it an hour before eating. Don’t take iron tablets with a cup of tea or coffee.
- Eat meat with salad instead of wholegrains if you are suffering from severe iron deficiency.
Eat foods rich in bioflavonoids
bioflavonoid are a diverse group of compounds which naturally occur in food and medicinal plants.These compounds have many effects on the body, some of them are related to heavy menstruation.
BioFlavonoids are commonly found in astringents― plants traditionally used for heavy periods or menorrhagia. In one study Citrus bioflavonoids reduced bleeding of almost all of the women who were given 600 mg of bioflavonoid compound.
A bioflavonoid deficiency may cause heavy periods.If your excessive bleeding is because of bioflavonoid deficiency then increasing fruits,especially citrus fruit and vegetables will bring relief. Buckwheat leaf tea is rich in bioflavonoids and can help with heavy menstruation.
Foods rich in bioflavonoids:
- Red Bell Peppers or Sweet Peppers
- Citrus Fruits
- Brussels Sprouts
- Tropical Fruits - Exotic fruits, like mangoes and papayas, have a lot of bioflavonoids and other nutritional elements packed under their skins.
- Green tea and buckwheat tea.
Take a low fat high fiber diet
In many cases,Heavy menstruation is caused by estrogen excess, A low fat, high fiber diet will reduce menstrual flow by increasing estrogen clearance and regulating prostaglandin balance.Intake of Saturated fats should be reduced.Products containing saturated fats include:
- full-cream dairy products,
low fat high fiber diet helps to regulate hormone balance and keeps extra pounds off.
Reduce severe pain
Along with heavy menstrual bleeding, you might have painful menstrual cramps . You can choose to have prescription medication , or try home remedies for menstrual cramps.
Exercise and reduce stress levels
Exercise helps to improve all the functions of body.It helps in weight loss,stress reduction and maintaining hormonal balance.women should exercise lightly,as heavy exercise increases physical stress and thus may cause hormonal imbalances. For women best exercise is walking, jogging, cycling,swimming etc, done at a moderate pace for an hour.When the pace of exercise is slow but duration is long it has calming effect on body and improves stamina.Infertility is common in female athletes who do excessive exercise so avoid that.
You can also try herbal teas to reduce stress,Chamomile tea is the best.Stress can interfere with menstrual cycle. Actually, stress is one of the major causes of menstrual cycle disturbances.
Reducing stress will do a lot of good to not just to your reproductive system but to your whole body.
Reducing caffeine and alcohol intake.
Coffee may increase the likelihood of developing uterine fibroids and also worsens the premenstrual syndrome symptoms.Alcohol increases the risk of developing endometrosis and also interferes with prolactin production which may lead to heavy periods or absence of menstruation.For maintaining a regular cycle,reduce caffeine and alcohol intake.
Take Vitamin K and A
Vitamin K is essential for normal clotting of blood. It has been shown to reduce heavy periods.
Green leafy vegetables are major source of vitamin K and they are often lacking in average diet. A balanced diet containing dark green leafy vegetables and yogurt will also improve any deficiency quickly.You can also take a vitamin K supplement.Taking a vitamin A supplement or eating foods rich in vitamin A may also help with heavy periods.
Herbal Remedies for Heavy Menstrual Bleeding
Yarrow (Achillea millefolium)
Historically, Yarrow was used to stop the bleeding of wounds but soon it started to be used to stop the bleeding any where in the body.Yarrow contains small amounts of the tannin compounds that are usually found in astringent herbs, but its ability to stop menstrual bleeding is considered to be caused by other constituents,notably the flavonoids and the alkaloids.
Yarrow is safe for long-term use.
How to make Yarrow Tea:
- Add 3-4 teaspoons of dried herb to 4 cups of boiling water.
- Steep for 10 minutes or you can remove the pot from water and leave the herb soaked in water for overnight
- Next day after straining you can drink the tea in divided doses during times of heavy menstruation.
The dose of fluid extract is 2–4 ml three times daily.
You can also use alchemilla vulgaris ladies mantle for reducing heavy blood flow.
Hydrastis canadensis (Golden seal)
Golden seal is a useful herb rich in nutrients,minerals and alkaloids especially hydrastinine .It has immune stimulating and astringent properties which help in reducing bleeding.
0.25–1 ml of the tincture three times daily. Hydrastis is contraindicated in pregnancy.
- Do not use goldenseal without consulting a physician if you have had heart disease, diabetes, glaucoma, a stroke, or high blood pressure.
- high doses may interfere with B vitamin metabolism.
Capsella bursa-pastoris (Shepherd’s purse)
No matter what the reason for your heavy periods you can use shepherd’s purse and it will provide relief. It has Drying and Cooling properties and thus very effective for uterine bleeding accompanying pelvic infection.
Shepherds purse should not be boiled in water because in temperatures above 45C,it produces toxic nitriles .Its best to take this herb in extract form.
Women with hypotheroidism should not use this herb.
The usual dose is 1–4 ml of the extract.