Every month, a woman’s reproductive system undergoes certain natural changes to prepare the body for probable fertilization of the ovarian egg and subsequent pregnancy. This includes the buildup of the lining inside the uterus. However, in the event that the egg remains unfertilized, the lining of the womb breaks down and bleeds through the vagina. Thus, this vaginal flow of uterine blood and mucosal lining known as menstruation is the final step in the monthly menstrual cycle.
Despite the universality of the natural female reproductive phenomenon known as menstruation, one must bear in mind that there is no uniformity in the menstrual cycle of every woman. In fact, the period flow for a particular woman herself tends to vary from one cycle to another depending upon her diet, lifestyle, and hormonal changes. In a broader sense, however, an average menstrual cycle occurs every 28 days for a span of 5 days and results in the loss of approximately 30–40 ml of blood. The fluid flow is generally heavier during the initial few days and tends to taper off by the end of the monthly period. Disparities in the duration and amount of period flow are not considered to be a cause of concern so long as they don’t come in the way of your daily activities.
On the other hand, some women have to grapple with periods that are consistently marred with abnormally profuse bleeding, severely painful cramps, or unusual discharge such that it takes a toll on their general health and daily routine. This type of heavy menstrual bleeding, which is characterized by abnormally heavy or prolonged periods, is medically known as menorrhagia.
With almost one in every five women affected by this type of abnormal uterine bleeding, it is one of the most commonly reported gynecologic issues. Health factors such as blood component abnormality, hormonal imbalance, anatomical defects, and growth in the womb can contribute to the onset of this problem, but the definite underlying cause for menorrhagia remains largely unknown.
Symptoms of Heavy Menstruation
Given the variations in period flow from woman to woman as well as cycle to cycle, a heavy flow is defined as menstrual bleeding that lasts longer than 7 days. Moreover, if the blood flow is so excessive that it renders you homebound and incapable of carrying out daily chores and your professional commitments, it can be taken as a sign of menorrhagia.
Here are some other signs that indicate heavy periods:
- Your sanitary pad or tampon becomes saturated every 2 to 3 hours such that you have to change them repeatedly for several consecutive hours.
- You feel the need to double up on sanitary protection (use a tampon and a towel at the same time) to prevent leaks.
- There is passage of large blood clots that are the size of a quarter or larger.
- The flow is so abundant that you bleed through to your clothes or bedding.
- You experience severe and continuous cramping in the lower abdomen during your period.
- You may have to wake up in the middle of the night to change your sanitary protection.
- Mood swings.
- Extreme weakness.
- Shortness of breath.
Causes and Risk Factors
This problem can affect any woman of childbearing age. However, young adolescents who have recently started menstruating and older women approaching menopause tend to be more susceptible to this problem.
Being overweight, using certain medications such as blood thinners, and having a hereditary bleeding disorder can also put you at a higher risk.
There are many possible causes and risk factors that can make your menstrual flow heavier than normal and lead to the development of menorrhagia:
- Hormonal imbalance in the body.
- Fibroids or noncancerous tumors of the uterus.
- Uterine polyps.
- Miscarriage or ectopic pregnancy.
- Use of blood thinners.
- Underactive thyroid gland.
- Side effect of using an intrauterine device (IUD) for birth control.
- Ovarian dysfunction: If the ovary does not release an egg, no progesterone is produced, resulting in a hormonal imbalance and a thicker uterine lining.
- Genetic bleeding disorders such as Von Willebrand disease or a platelet function disorder.
- Medications including anticoagulant and anti-inflammatory drugs can result in heavy bleeding.
- It can also happen due to medical conditions such as adenomyosis, endometriosis, pelvic inflammatory disease (PID), and other conditions that can prevent normal blood clotting.
- Abnormally heavy bleeding, especially if it’s postmenopausal, can be taken as an indicator of uterine cancer.
- Herbal supplements such as ginseng, soya, or ginkgo can also disrupt your hormones and thereby affect the normalcy of your periods.
When to See a Doctor
If abnormally heavy bleeding becomes a regular occurrence, it can hamper your overall health in a far more serious and long-term manner. The most worrisome complication of this condition is the gradual onset of anemia with the continued loss of excessive blood on a monthly basis. It is, therefore, important not to undermine the possible repercussions of menorrhagia and seek the help of your healthcare provider if:
- You have to change your pad or tampon every 1 to 2 hours because it gets saturated that quickly due to profuse vaginal bleeding.
- Periods extend more than 7–8 days.
- You have spotting or bleeding between periods.
- You bleed after menopause.
- Your periods occur at increased frequency.
Treatment of Menorrhagia
Your doctor will determine the appropriate course of treatment after taking into account your age, medical history, and preferences. Some of the commonly prescribed treatment options for menorrhagia include the following:
- Because the heavy blood loss on a monthly basis can create a deficiency of red blood cells in the body resulting in anemia, iron supplementation may be recommended.
- Prostaglandin inhibitors, such as nonsteroidal anti-inflammatory medications (NSAIDs), can help mitigate the symptoms of menorrhagia, including cramping and excessive blood loss.
- Taking oral contraceptives (ovulation inhibitors) can cause hormonal alterations that are conducive for a lighter period flow.
- Oral hormone treatment using progesterone corrects the hormonal imbalance and reduces bleeding.
- A procedure called endometrial ablation may be suggested to permanently destroy the lining of the uterus with the use of heat, cold, or a laser.
- Endometrial resection is a surgical procedure that involves the removal of the uterine lining or endometrium using an electrosurgical wire loop.
- In severe cases, a hysterectomy may be prescribed, which entails the surgical removal of the uterus, cervix, and, sometimes, the ovaries.
- Women with bleeding disorders can benefit from using desmopressin nasal spray as it can enhance the level of blood-clotting properties.
What “Is Considered to Be “Heavy” Bleeding?
Because every woman has her own threshold for managing menstrual flow, there is no set standard to determine what qualifies as a heavy period. What might seem like heavy to one could be regular for another. Nevertheless, as a general rule of thumb, menorrhagia is associated with periods that last for more than a week and account for almost twice the standard amount of menstrual blood loss. When speaking in numbers, an average woman loses 30–40 ml of blood during a normal period. However, a woman suffering from menorrhagia is bound to experience far more copious menstrual flow that is usually greater than 80 ml per period.
Moreover, if you find yourself constantly hard-pressed to manage your period without changing your tampon or sanitary pad more often to avoid flooding or leakage, it’s as good a sign as any to visit your doctor for proper assessment. Because this kind of significant blood loss on a monthly basis can render you anemic, it is all the more important to get medical help as soon as possible.
Regulating Heavy Menstrual Bleeding Naturally
Heavy menstruation can affect your daily activities, as well as your emotional state and social life. Moreover, it can cause serious health problems such as iron-deficiency anemia.
As the treatment will depend on the underlying cause, it is suggested to consult your doctor for proper diagnosis and treatment. Plus, you can opt for some dietary changes and simple home remedies to manage the symptoms associated with menorrhagia.
Here are the top 9 home remedies for heavy menstrual bleeding.
1. Lady’s Mantle (Alchemilla vulgaris)
This plant has been a time-tested remedy to mitigate various forms of bleeding, whether it be due to a wound, bruise, or, in this case, menorrhagia. Lady’s mantle works as a natural astringent, which means it’s able to contract tissues in the body. It is on account of this effect that this herb has been used for centuries to treat excessive menstruation and other forms of bleeding.
- To make a tea using lady’s mantle, it’s recommended to steep 1 ounce (28 grams) of the dried herb in 1 pint (568 ml) of boiling water.
- Alternatively, you can make use of lady’s mantle tinctures which are readily available on the market.
2. Blackstrap Molasses
Blackstrap molasses is another effective remedy to control heavy bleeding. Being rich in iron, it aids in the production of red blood cells and may help regulate the amount of blood lost during menstruation. In addition, it helps reduce blood clots and soothes the muscles of the uterine walls to reduce pain.
- Add 1 to 2 teaspoons of blackstrap molasses to 1 cup of warm water or milk. Drink it once daily.
- Another option is to add ½ tablespoon of blackstrap molasses to 1 glass of lemongrass tea. Drink this tea once in the morning and once at night before going to bed.
Follow either of these remedies for a few months to notice improvement in your condition.
3. Vitamin C-Rich Foods
Upping your intake of vitamin C can help set off the damage induced by persistently heavy periods. One of the common repercussions of profuse menstrual flow is anemia, and vitamin C is just the thing you need to counter it. This nutrient facilitates better absorption of dietary iron by the body, which in turn helps tackle the deficiency of red blood cells associated with anemia. Moreover, both vitamin C and flavonoids can help stave off excessive blood loss due to menorrhagia by protecting the small blood vessels from damage.
- It is recommended that patients increase their dietary intake of fruits and vegetables, especially guava, sweet red pepper, kiwi, oranges and orange juice, and green pepper.
- Alternatively, taking iron with a 250 mg vitamin C tablet can improve its absorption.
4. Red Raspberry Leaves
Red raspberry leaves are beneficial for women suffering from heavy menstrual flow. They contain tannins that help strengthen the uterine muscles. Moreover, they help palliate other discomforting symptoms such as abdominal pain.
- Add 1 tablespoon of dried red raspberry leaves to 1 cup of hot water.
- Cover and steep for about 10 minutes.
- Strain and drink this tea up to three times daily.
- Start drinking this tea a week before your cycle is due and throughout your period.
Ginger helps tackle the twin problems of excessive period flow and dysmenorrhea or painful menstrual cramps, which are characteristic of menorrhagia. This healing ingredient works by inhibiting the production of prostaglandin hormone and enhancing its metabolism. Lower levels of PGE2 hormone have an anti-inflammatory effect that helps constrict blood vessels and curb menstrual flow.
- Make sure that your everyday meals are replete with a generous sprinkling of ginger.
- Add some ginger powder to a cup of water and simmer for 5 minutes. Drink this tea two times every day, especially post meals.
Acupressure and acupuncture provide a safe and noninvasive method of correcting menstrual cycle aberrations, including menorrhagia. Ancient Chinese medicine recognizes acupressure and acupuncture as effective ways of channelizing blood flow through a positive life force known as “chi,” which clears all the blocked meridian points in the body. The long-standing benefits of this alternative therapy can be optimized by learning it from an expert and then practicing it at home. Alternatively, you can also perform it under the guidance of a well-trained professional.
Cinnamon is effective in reducing heavy menstrual bleeding associated with endometriosis, uterine fibroids, and adenomyosis. This herb reduces the bleeding by stimulating blood flow away from the uterus. In addition, its anti-inflammatory and antispasmodic properties help relieve cramps.
A study published in the Iranian Red Crescent Medical Journal reported that cinnamon significantly reduced the pain, amount of menstrual bleeding, nausea, and vomiting in female college students and improved the severity of primary dysmenorrhea.
- Add 1 teaspoon of cinnamon powder to 1 cup of hot water. Simmer for a few minutes. Add honey, and drink this solution two times a day.
- Alternatively, take 3 drops of cinnamon bark tincture, two times a day.
- You can also take 15 to 30 drops of cinnamon essential oil diluted in ¼ cup of water, up to three times per day.
Follow any of these remedies during your period only.
8. Iron-Rich Foods
Iron is an important mineral for women dealing with heavy menstrual periods as it can help prevent iron-deficiency anemia.
- Eat iron-rich foods such as dark green vegetables, legumes, pumpkin seeds, egg yolks, liver, red meat, raisins, prunes, and cereals fortified with iron.
- You can also take an iron supplement after consulting your doctor.
Magnesium is a vital mineral to balance female hormones, such as progesterone and estrogen. Moreover, heavy menstruation can be caused by a magnesium deficiency in the body. Therefore, eating magnesium-rich foods will help control the profuse bleeding during menstruation.
- Eat magnesium-rich foods such as oats, nuts and seeds, avocado, dark chocolate, pumpkin, squash, and watermelon.
- If opting for a supplement, consult your doctor first.
Although these remedies are not backed by definitive scientific evidence, they have nonetheless gained considerable popularity among users and are therefore worth a try:
Cold Therapy: Gently massaging the abdomen with a cold compress or an ice pack works to curb the amount of period flow by constricting the blood vessels in that region.
Heat Therapy: Taking a warm bath or shower or using a heating pad goes a long way in alleviating menstrual cramps, which are particularly intense in cases of menorrhagia.
Cayenne: To get relief from excessive menstrual flow, you can also try cayenne pepper. It can help balance the blood flow in the body. Moreover, it helps maintain hormonal balance and relieve symptoms of heavy bleeding.
Coriander Seeds: According to Ayurveda, coriander seeds can help improve uterine functioning and balance female hormones in the body, thereby restoring normal menstrual cycle and flow.
- Keep a record of your menstrual flow.
- Have an extra supply of sanitary pads and tampons on hand.
- If having abdominal pain during menstruation, apply a hot water bottle to your lower abdomen or back.
- Drink a few cups of chamomile, sage, or green tea daily to relax.
- Do regular moderate exercise. Some good exercises include brisk walking, jogging, swimming, and bicycling.
- Enjoy a warm bath to relax your muscles and ease the pain and tension.
- Get plenty of rest and make yourself as comfortable as possible.
- Massage your lower back with warm coconut or olive oil to relieve the pain.
- Add supplements to your diet, such as zinc, calcium, and vitamins B6 and C. Before taking any supplement, consult your doctor.
- As lack of sleep can worsen the problem, get at least 7 to 8 hours of sound sleep.
- Do not lift heavy weight during menstruation.
- Duckitt K, Collins S. Menorrhagia. BMJ Clinical Evidence. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907973/. Published September 18, 2008.
- Gokyildiz S, Beji NK, Mecdi M. The Effects of Menorrhagia on Women’s Quality of Life: A Case-Control Study. International Scholarly Research Notices. https://www.hindawi.com/journals/isrn/2013/918179/. Published July 8, 2013.
- Bevan JA, Maloney KW, Hillery CA. Bleeding disorders: A common cause of menorrhagia in adolescents. Plum X Metrix. https://www.jpeds.com/article/S0022-3476(01)11226-6/abstract. Published June 2001.
- Devabhaktuni P, Thomas P, Kapadia A. Menstrual Abnormalities and Gynaecological Problems in Women on Anticoagulant and Antiplatelet Therapy: Management Options. Advances in Infectious Diseases. https://www.scirp.org/journal/PaperInformation.aspx?paperID=76474. Published May 16, 2017.
- What are the treatment options for heavy periods? Informed Health Online. https://www.ncbi.nlm.nih.gov/books/NBK279293/. Published May 4, 2017.
- Karatoprak GŞ, Koşar M, Ertürk S. Antioxidant Properties and Phenolic Composition of Alchemillamollis from Turkey. Plantamedica. https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0031-1282694. Published August 5, 2011.
- Elsevier. https://www.sciencedirect.com/topics/immunology-and-microbiology/alchemilla.
- Forret ABL-, Harvey PJ, Thier SML-. Menorrhagia: A synopsis of management focusing on herbal and nutritional supplements, and chiropractic. The Journal of the Canadian Chiropractic Association. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077876/. Published December 2007.
- Venkatasubramanian P, Jain R. Sugarcane Molasses – A Potential Dietary Supplement in the Management of Iron Deficiency Anemia. Journal of Dietary Supplements. https://www.tandfonline.com/doi/abs/10.1080/19390211.2016.1269145. Published January 26, 2017.
- ScienceDirect. https://www.sciencedirect.com/topics/medicine-and-dentistry/menorrhagia.
- Red Raspberry Leaf. ScienceDirect. https://www.sciencedirect.com/topics/medicine-and-dentistry/red-raspberry-leaf.
- Behbahani BM, Ansaripour L, Akbarzadeh M. Comparison of the effects of acupressure and self-care behaviors training on the intensity of primary dysmenorrhea based on McGill pain questionnaire among Shiraz University students. Journal of research in medical sciences. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5322691/. Published November 2, 2016.
- Penn YY. Acupuncture treatment for dysfunctional uterine bleeding in an adolescent. BMJ Case Reports. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6088286/. Published August 9, 2018.
- Jaafarpour M, Hatefi M, Najafi F. The Effect of Cinnamon on Menstrual Bleeding and Systemic Symptoms With Primary Dysmenorrhea. Iranian Red Crescent Medical Journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443385/. Published April 22, 2015.
- Iron supplements improve anemia, quality of life for women with heavy periods. Wiley. https://www.eurekalert.org/pub_releases/2014-06/w-isi060514.php. Published June 9, 2014.
- Surmonte C. Relieving Menstrual Symptoms Through Nurturing The Needs of Internal Organs. Georgian Court University. http://www.academia.edu/14689218./Relieving_Menstrual_Symptoms_Through_Nurturing_The_Needs_of_Internal_Organs. Published 2013.
- Proctor M, Farquhar C. Diagnosis and management of dysmenorrhoea. BMJ : British Medical Journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1459624/. Published May 13, 2006.