Bleeding is often referred to as excessive and heavy when more than 80ml is lost, including any spotting at other times in the menstrual cycle. It is more common in women over 40 who are on the verge of peri menopause or menopause but it can still affect younger women.
Heavy bleeding is one of the signs that menopause is approaching and the woman's cycles can lengthen or shorten in duration. Sometimes mid cycle bleeding will occur.
Heavy bleeding can also be an indication of other illness that may be present, such as endometriosis, uterine cancer or cancer of the cervix. Polyps or fibroids can also be instrumental in causing heavy bleeding depending on the location and size of the fibroids. Some small fibroids cause no problem but others may cause pain as they increase in size. They can also block the fallopian tubes and interfere with the function of other organs such as the bowel.
Stress can contribute to heavy bleeding by disrupting the endocrine system. If the pituitary gland is over stimulated due to excess stress, an imbalance of hormones results with changes to the menstrual cycle and function of the endocrine system.
Heavy bleeding can also be a sign of iron deficiency, so diet needs to be addressed. Serum iron levels should be measured to determine any deficiency in iron stores.
Intrauterine devices or IUDs have been known to contribute to heavy bleeding, along with ectopic pregnancy where the fertilised egg lodges in the fallopian tube instead of the uterine lining.
Some hormonal contraceptive pills and HRT have been known to instigate heavy bleeding; you really should consult with your prescribing doctor if this happens.
Other causes are: Hypothyroidism, polycystic ovarian disease (PCOD), Stein-Leventhal syndrome, ovarian tumour, obesity, coagulation disorders, thrombocytopenia, platelet disorders, von Willebrand's disease, leukaemia, ingestion of aspirin or anticoagulants, renal failure/dialysis.
In the majority of cases, most medical people will say the cause of menorrhagia is unknown. Recent research indicates that a particular chemical substance inside the uterus contributes to the process of menstruation. Endothelin is a substance that helps to stop the bleeding, but women with menorrhagia have very little endothelin. Suggestions from this research are that excessive bleeding could be curbed with medications that act on endothelin levels. However, any synthetic hormones you take may result in other side affects.
Treatment for menorrhagia depends on the cause and can include:Medication such as prostaglandin inhibitors, hormone therapy or antibiotics.Dilatation and curettage (D&C) where the cervix is dilated and the endometrium gently scraped away.Change of contraception - IUD or hormones may need to be explored.Surgery to remove tumours, polyps or fibroids, or to treat ectopic pregnancy.Treatment of underlying disorder - hypothyroidism or bleeding disorder.Hysterectomy - the removal of the entire uterus is a drastic last resort, and usually not considered as a treatment for menorrhagia unless serious disease, such as cancer, is also present.
Natural Therapy Treatments
Natural therapists would always take into consideration the thyroid and liver function, which as part of the endocrine system have a direct influence on the menstrual cycle each month.Herbs and/or homoeopathics and supplements after the cause has been established.Bowen Therapy can establish a balanced flow of qi energy and blood to the uterine area while alleviating any cramps or pain and releasing stress. Many people are still unaware of this therapy and the many benefits you can receive for a myriad of health disorders by working along meridian pathways with gentle movements that send neurological messages to the brain. It is non-manipulative (unlike Chiropractic which manipulates), gentle and non invasive and can be received while wearing loose clothing. Bowen therapy has been known to stop the bleeding in some cases sometimes with just one treatment, but the cause must always be investigated.Acupuncture is another therapy to receive in conjunction with any remedies a naturopath prescribes, balancing qi energy via meridian pathways, using tiny needles in the application. The expertise of the acupuncturist is important. They do not necessarily need to tap the needle and turn it, which can create pain. You need to ask their approach.Meditation to combat stress along with encouraging 7-8 hours of unbroken sleep a night. If there are sleep problems such as insomnia then this is treated with necessary remedies. Lifestyle factors contributing to stress need to be addressed. Over the years, I have had positive feedback from many people who have experienced the benefits of meditation for stress and various health disorders, some saying they have slept through the night for first time in years.Fish oils/Cod Liver Oil are important nutrients since research indicates that vitamin A is generally deficient in heavy bleeders. The quality of any supplement is very important - cheaper oils may not be optimum in nutrition and some can be rancid or contain traces of heavy metals such as mercury.Diet must be addressed - a wholesome healthy diet with good quality proteins, high complex unrefined carbohydrates if you do eat some grains, but I would recommend eliminating all grains if possible including anything that includes gluten/yeast. Gluten and yeast contribute to inflammation and bloating. Include plenty of dark green leafy vegetables and natural sugars from fruit, which play an integral role in your overall health and maintaining a healthy balanced hormonal cycle.Some herbal remedies that could be used to assist you would be Shepherds Purse, Vitex Agnus Castus, Greater Periwinkle, Cranesbill, Helonias, Beth Root, Hydrastis and Blue Cohosh. Some of the homeopathics that could be used to assist heavy bleeding are Sepia, Caulophyllum, Secale cor, Sabina, Melifolium, Hamamelis, Trillium pendulum and Cyclamen to name a few. However it is important that you do not self prescribe any of these remedies at all! Some are what herbalists refer to as "low dose" herbs and can make matters worse if you are not skilled in formulations or understand what the actives of each plant can do. Herbs are potent and not to be underestimated. They have to be handled by trained herbalists many of whom have studied for up to three years.
I recommend anyone experiencing heavy bleeding obtain an ultra sound, and have a full blood count to determine any deficiencies. Also have a full hormonal reading, including thyroid, and a pap smear then decide if you wish to see a medical doctor or a qualified naturopath or acupuncturist for treatment. Leaving this disorder for too long without treatment perhaps out of fear will result in other health issues manifesting, extreme fatigue and anemia. Hysterectomy is not always necessary if you begin to treat the disorder in the very early stages. Remember there are other options than conventional pharmaceutical drugs which can create many side effects.
Sydney-based Lyn Craven is a practitioner of naturopathy, nutrition, medical herbalism, Bowen therapy, Reiki energy healing and meditation, and is a corporate health presenter/consultant with 19 years' experience in natural therapies. www.lyncravencorporatehealth-naturopath.com
Disclaimer: Information presented in this column is not intended as medical advice but to advance the understanding of holistic nutrition and lifestyle and its place in a balanced approach to health. Readers are encouraged to be guided by their own healthcare professionals.
Lyn Craven is a practitioner of Naturopathy, Bowen Therapy, Reiki and Corporate Health Consultant. She runs a private practice in Bondi, Sydney and also consults via phone and Skype. Lyn has recently created a meditation CD for anxiety, stress and self healing. She can be contacted on 0403 231 804 or firstname.lastname@example.org