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.
Endometriosis is not like other period problems. It’s not a hormonal condition like PMS and PCOS. It’s affected by hormones, yes, but fundamentally endometriosis is an inflammatory disease and possibly a microbial disease.
Conventional treatment has not yet caught up with the new research into endometriosis and immune dysfunction. Hormonal suppression remains the primary treatment, which is unfortunate because it has many side effects and does not work all that well.
Here’s a story about very heavy periods. It’s 7pm on a Friday night when I get a panicked call from my patient Karen. She’s bleeding so heavily that she cannot leave the bathroom. She’d been at work earlier when she soaked through three super tampons in an hour and then ruined her favorite pair of jeans. Her work colleague had to help her into a taxi. Karen is understandably frightened. I send her to a local medical center for the clotting drug tranexamic acid, which will slow her bleeding.
I know what will happen next. Karen will meet with her gynecologist who will tell her that her only options are the pill, the hormonal IUD, or surgery. Karen had always tried to use natural treatments. She never imagined she would end up in a situation like this.
A change is coming for endometriosis treatment. Until now, the clinical approach has been surgery followed by hormonal suppression with the hormonal birth control or other drugs. Going forward, the approach will shift to anti-inflammatory and immune-modulating treatments. That’s because there is growing evidence that endometriosis is not primarily a hormonal condition. It is autoimmune.