Tips For Heavy Periods
Heavy periods are a common reason I see patients in practice and they’re more than just a case of needing to buy an extra box of tampons a month. I’ve seen women feeling incredibly drained by their monthly cycle and sometimes at the stage where they are anaemic and low in iron.
So what makes a heavy period? The NICE guidelines (standard guidelines used in healthcare in the UK) defines heavy menstrual bleeding as more than 80 ml of blood lost in one cycle (1). The best way to check this is to count the number of tampons and pads you are using per cycle. One fully soaked tampon or pad contains 5 ml of blood with super absorbency tampons soaking up 10 ml. If you want to get more specific then you can use a menstrual cup as these contain volume measurement lines. If you have heavy periods a menstrual cup is a great option as it can hold up to 30 ml which is 3 super absorbency tampons!
For half of women with heavy periods no identifiable cause will be found which is very frustrating for those who want to take better control of their blood loss. Other causes include uterine fibroids, uterine cancer, bleeding disorders and thyroid disorders (2). If these have been ruled out by pelvic ultrasound and blood tests then the following tips should be helpful for you.
Track your cycle! If there’s anything I could recommend for any period problem it is to track your cycle using symptothermal monitoring (3). This will check to see if you’re ovulating. Ovulation triggers a spike in the hormone progesterone which lightens your periods, so if you’re not ovulating you’re not getting that natural progesterone boost. This is common reason for heavy bleeds seen in PCOS and the peri-menopause. If you can identify either of these conditions this opens up your options for treating an underlying cause (see previous blog posts on PCOS).
Eat more vegetables! Most vegetables contain something called phytoestrogens which can help with regulating and lightening periods. They work by interacting and blocking your oestrogen receptors. Higher levels of oestrogen when not balanced out by enough progesterone can cause heavy bleeding so by lowering your natural oestrogen there’s potential to lighten your flow (4). There are herbal remedies containing high doses of phytoestrogens but I couldn’t find enough evidence to recommend these and there’s not an agreed safe dosage. However not surprisingly there is no evidence of harm in eating more vegetables and only benefits to your health and well-being!
Take ibuprofen! Not my usual lifestyle advice but ibuprofen taken on the heaviest days of your flow can reduce bleeding by up to 50% (5). It’s simple and cheap to use and can be a great alternative to hormonal contraceptives.
Trial a dairy free diet? If you’ve tried the above and you’re not having any luck it could be worth trying a dairy free diet. Dairy can be inflammatory for many people and has been noted to influence ovulation (6). The evidence isn’t very strong but again this is low risk hormone free way to try and reduce bleeding.
References:
https://cks.nice.org.uk/topics/menorrhagia-heavy-menstrual-bleeding/background-information/definition/
https://cks.nice.org.uk/topics/menorrhagia-heavy-menstrual-bleeding/background-information/causes/
https://www.naturalcycles.com/cyclematters/the-symptothermal-method
Lethaby, A., Duckitt, K. and Farquhar, C. (2013). Non-steroidal anti-inflammatory drugs for heavy menstrual bleeding. Cochrane Database of Systematic Reviews. doi:https://doi.org/10.1002/14651858.cd000400.pub3.
Kim, K., Wactawski-Wende, J., Michels, K.A., Plowden, T.C., Chaljub, E.N., Sjaarda, L.A. and Mumford, S.L. (2016). Dairy Food Intake Is Associated with Reproductive Hormones and Sporadic Anovulation among Healthy Premenopausal Women. The Journal of Nutrition, 147(2), pp.218–226. doi:https://doi.org/10.3945/jn.116.241521.
