Some women have had a problem with heavy menstrual bleeding since they started menstruating. Other women will just have one or two periods over the years that are abnormally heavy. For others heavy bleeding becomes a problem during the perimenopause. The medical term that we use for prolonged (>7 days) or excessive bleeding is menorrhagia. If the bleeding is prolonged and occurs at irregular or more frequent than normal intervals then we call it menomenorrhagia. Isn't that perfect? A nice long hard to say word for an embarrassing difficult to talk about problem. There are a number of medical problems that can cause heavy bleeding such as hormonal disturbances (annovulatory cycles), fibroids (benign growths), pregnancy, endometrial hyperplasia (abnormal uterine lining), infection, etc.
Important: You should see your health care provider if you have heavy bleeding to be evaluated for these conditions. They may recommend that you have a pelvic ultrasound and/or a biopsy of the lining of your uterus. If you are over the age of 40 (some people say 35) and you have intermenstrual (between periods) bleeding you should have an endometrial biopsy (EMB). You should also have your blood checked for anemia. If you are anemic iron supplementation can make you feel a lot better.
In most instances heavy menstrual bleeding can be controlled with minimally invasive therapies. Here are some ideas:
First, drink lots of water and eat well. Concentrate on foods high in iron such as dark leafy greens and dried fruits. Some women find they crave meat. Meat is high in iron but it is also high in saturated fat and it is pro-inflammatory so it can aggravate cramps.
Try nonsteroidal anti-inflammatories (NSAIDS) such as ibuprofen or naproxen sodium. They can decrease your bleeding up to 40% (and help with cramps). You can get them over the counter. Start taking them the minute bleeding starts and take them regularly for the first 2-3 days of your period.
Hormonal contraceptive methods can be very helpful:
· Oral contraceptive pills have been found to decrease bleeding for some women. You can take them continuously or stop your periods altogether if you wish. Just skip the placebo pills or take the new types of pills that don't have placebos.
· The Mirena IUS (IUD) releases progestogen, this thins the lining of the uterus and makes the period light or no period at all. It needs to be inserted by your provider and can be left in for 5 years.
· Depo-provera is an injectable contraceptive that causes decreased bleeding or no bleeding at all. You get shots every 3 months. It's important to take calcium while using this method.
Consider being evaluated by a Traditional Chinese Medicine practitioner who specializes in women's health. From a TCM perspective heavy bleeding can be viewed as "pelvic congestion" and symptoms can be relieved with acupuncture and herbs.
Herbs such as yarrow and Shepard's purse can be very helpful with heavy bleeding. Avoid dong quai and angelica because they can increase bleeding. Look very carefully at your women's supplements- they are frequently added.
Practice yoga. There are some poses that can help with menstrual bleeding and cramping. For example supta baddhakonasana or supported cobbler's pose relieves congestion in the pelvis. Ask your Iyengar instructor about others.
If you have tried many of the suggestions above and they do not help, then talk to your provider about other options. For instance, a new procedure called endometrial ablation is available. During this procedure the lining of the uterus is destroyed so that bleeding is reduced or eliminated. In women with severe bleeding or other issues such as large fibroids that don't respond to medical intervention, hysterectomy (surgical removal of the uterus) is recommended. As you can see, there are lots of options to consider. Let me know if I can help you understand which alternatives are best for you.
