Heavy periods are no fun, period.

Heavy periods are considered losing more than 5 tbsp of blood throughout all the days of the bleed. Some women lose even more than this! Heavy periods are common in your teen years and in your 40s. Why? Because both of these times are when progesterone is low in relation to estrogen. This is because when puberty first starts there are more anovulatory cycles - menstrual cycles without ovulation occurring. The body is getting use to ovulating for the first time and on a regular basis so progesterone production is still low. The only way to make progesterone in the body is when you ovulate. This is also the case in secondary puberty or perimenopause, which commonly starts in your 40s. There are more anovulatory cycles in your 40s as your menstrual cycling is getting ready to cease all together when menopause hits. Remember, the only way to make progesterone in the body is by ovulating. Progesterone keeps the uterine lining in check, not allowing it to grow too thick. The thicker the lining is, generally the heavier the period bleed is as all the uterine lining needs to be shed and does so with the drop off of estrogen and progesterone right before a menstrual bleed.

Other factors that may cause heavy periods include low iron, fibroids, adenomyosis, hypothyroidism, clotting disorders, miscarriage, and mast cell activation (made worse by a high estrogen environment).

If you have heavy periods here are a few questions you may ask yourself:

#1 Are you ovulating? Hint -your app cannot tell you that you are in fact ovulating. Blood work can tell you such as a cycle day 24 progesterone lab test or 7 days after ovulation (say day 21). Other signs of ovulation include cervical mucus changes, a basal body temperature spike and/or a positive LH ovulation predictor strip test. Some women also get ovulation pain.

#2 Are you iron deficient? Wait -I thought heavy periods led to low iron not cause them?…Actually, it may be true for both. Having low iron can make heavy periods worse as well as heavy periods leading to low iron. It can become a vicious cycle! It is best to test your iron status by ordering some blood work. It is not recommend to just assume you have low iron if you have heavy periods because your heavy periods might be caused by something else. Also, taking iron when you don’t need it can be pro-inflammatory, which can cause other issues. Blood work ordered by your naturopathic doctor or family doctor will indicate how much iron you need and how to dose it properly and for how long.

#3 Could it be something else? Uterine fibroids and adenomyosis are benign growths inside the uterus in different locations and can result in heavy periods. These are diagnosed or found by ultrasound. A low thyroid function and clotting disorders can also be the reason behind your heavy periods. Histamine intolerance can also result in heavy periods from mast cell activation. Mast cells are a type of cell that are part of the immune system and release histamine. A lot of receptors for these cells are found in the uterus and when activated by a high estrogen environment can cause heavy periods (and cramping).

The good thing is that you don’t have to suffer from heavy periods! Getting the proper diagnosis from your naturopathic doctor or imaging from your family doctor can help find the root cause of your heavy flow so as to correct it. Naturopathic doctors can order blood work and will use treatments like natural bio-identical progesterone, zinc, curcumin, ginger, a low histamine diet, iron, thyroid medication, and more to rid you of your heavy periods depending on what the cause is. I wish you easier, lighter periods from now on :)