Successful treatment of heavy periods relies on identifying an underlying cause such as hormone imbalance (low progesterone), adenomyosis, or thyroid disease.
Treatment for heavy menstruation is to treat the cause as well as use general period-lightening strategies such as natural progesterone and a dairy-free diet.
Heavy periods caused by hormone imbalance
If your doctor says your heavy periods are the result of hormone imbalance, she means you’re having anovulatory cycles (not ovulating) and therefore not making the progesterone you need to thin the uterine lining and prevent heavy periods. For more information about anovulatory cycles and progesterone deficiency, read Ovulation is the main event of the menstrual cycle.
👉 Tip: Anovulatory cycles can also cause endometrial hyperplasia or uterine polyps.
Common causes of anovulatory cycles
- Polycystic ovary syndrome or PCOS. Identify your type of PCOS and treat that.
- Being a teenager so have not yet matured the communication between the brain and the ovaries. It should improve with time but in the meantime, use the period-lightening treatments discussed below.
- Perimenopause or second puberty because ovulation starts to wind down and you lose progesterone. This type of heavy bleeding is also called dysfunctional uterine bleeding or endometrial hyperplasia and is tough to treat. You may need almost every period-lightening treatment listed below.
- A medical problem such as thyroid disease or high prolactin.
👉 Tip: To know if you’re ovulating and making progesterone, track your basal body temperatures. Read The right way to test progesterone.
Heavy periods caused by endometriosis or adenomyosis
Endometriosis or adenomyosis are gynecological conditions that can cause pain and heavy bleeding. Your doctor might be able to pick them up with an ultrasound, or she might refer you to a gynecologist for further assessment.
Natural treatments for endometriosis and/or adenomyosis:
- Anti-inflammatory and anti-microbial treatments such as turmeric and a dairy-free diet. See Endometriosis is a disease of immune dysfunction.
- Calcium-d-glucarate (see below).
- Natural or micronized progesterone (see below).
👉 Tip: Fibroids are rarely the cause of heavy bleeding because most fibroids are located inside the muscle or on the outside of the uterus where they do not affect flow. Only ten percent of fibroids cause heavy bleeding.
Heavy periods caused by thyroid disease
Thyroid disease is a common and treatable cause of heavy menstrual bleeding. Experts say that screening for thyroid disease in every case of heavy menstrual bleeding “would avoid unnecessary surgeries and exposure to hormones.”
Ask your doctor to test your thyroid and then ask to see the results. If your TSH is higher than 3 mIU/L, it could be a sign of subclinical hypothyroidism (underactive thyroid). If you have thyroid disease in your family, ask your doctor to test “thyroid antibodies” or “TPO antibodies.” TPO antibodies are the marker of autoimmune thyroid disease or Hashimoto’s disease and can cause symptoms of underactive thyroid (including heavy periods) even when TSH is normal.
Natural treatments for thyroid disease:
- Thyroid hormone (T4, T3, or thyroid extract).
- Natural treatment to correct thyroid autoimmunity. See Chapter 11 of Period Repair Manual.
👉 Tip: If you’ve suffered heavy periods all your life, ask your doctor to screen for coagulation disorders such as von Willebrand disease. The condition accounts for up to 20 percent of all cases of heavy menstrual bleeding which is sometimes the only symptom.
Natural treatments for heavy periods
The following general treatments are in addition to the core treatment of fixing the underlying cause of your heavy periods. For example, if you have thyroid disease, then the solution is to take thyroid hormone plus look at one or more of the following.
Avoid cow’s dairy
Avoiding cow’s dairy (A1 casein) makes periods lighter because it reduces mast cell activation which has been identified as a cause of heavy periods. To have an effect, the dairy-free diet needs to be daily all cycle—not just during the flow.
A dairy-free diet can work particularly well for the heavy periods of teenagers.
👉 Tip: You can still have butter, goat and sheep milk products because they don’t have A1 casein.
Turmeric or curcumin is one of my favorite treatments for heavy periods. It works by reducing prostaglandins and lowering estrogen (by downregulating the enzyme aromatase). You can take turmeric every day of the cycle and then increase the dose during your period. Turmeric can also relieve period pain and endometriosis.
Iron corrects the iron deficiency caused by heavy periods, AND it lightens periods by increasing blood viscosity. If you’re deficient in iron, take 15 to 50 mg of a gentle supplement such as iron bisglycinate. The best food sources are red meat and eggs. Be sure to take it at a different meal from turmeric because turmeric can prevent the absorption of iron.
👉 Tip: Can’t get your iron up? It could be because you’re consuming too much dairy. Dairy inhibits the absorption of iron.
The active part of this supplement is the glucarate part (not calcium). Glucarate makes periods lighter by promoting estrogen metabolism by inhibiting beta-glucuronidase, a bacterial enzyme that causes conjugated estrogen to be reabsorbed from the gut.
Progesterone for heavy periods
Progesterone (PrometriumⓇ of UtrogestanⓇ) lightens periods by thinning the uterine lining. In that way, it’s similar to synthetic progestins such as norethisterone (PrimolutⓇ) and medroxyprogesterone (ProveraⓇ), but progesterone is better for mood and does not carry the breast cancer risk of progestins.
The standard way to take Prometrium is at bedtime during the final two weeks of the cycle.
👉Tip: If your doctor is reluctant to prescribe Prometrium or Utrogestan, refer her to Professor Jerilynn Prior’s document “For Healthcare Providers: Managing Menorrhagia Without Surgery.”
Advil or ibuprofen
Natural treatments work to prevent heavy periods, but they cannot stop a heavy period once it’s underway. If you want an easy fix during your period, try an NSAID medication like ibuprofen or naproxen, which can significantly reduce menstrual flow and buy you time while you work with the other treatments. Take Advil as directed on your heavy days, and take it with food to decrease the risk of stomach irritation.