heavy periods 101: signs, common causes & healing

If you’ve experienced heavy periods (menorrhagia), you know how debilitating, uncomfortable, and concerning they can be. Unfortunately, menstrual issues, like heavy bleeding, are commonly dismissed as ‘normal for women’ or masked with the birth control pill or nonsteroidal anti-inflammatory drugs, like ibuprofen, aleve, etc. While medication can be necessary and the best option for some (I’m not against using it where appropriate), it only addresses the symptom rather than the root of the issue. 

Menstruation is considered the 6th vital sign; it provides information on our overall health, and irregularities, like heavy bleeding, are an opportunity to learn more about our body and to address an underlying imbalance/issue that needs our attention.

WHAT DEFINES A HEAVY PERIOD?

Before I jump into causes, how do we know if our period is considered ‘heavy’? While menstrual flow is different for everyone, here are a few signs that your menstruation is heavier than it should be: 

• Soaking through one or more tampons or pads every hour for several consecutive hours

• Having to double up on sanitary protection 

• Needing to change your tampon/pad throughout the night 

• Bleeding for longer than a week

• Blood clots that are bigger than a quarter

• Symptoms of anaemia (more on this below!) 

Your period is 'heavy' if you experience one or many of these symptoms. 

5 COMMON CAUSES OF HEAVY PERIODS

1. Estrogen Dominance

Estrogen Dominance is a hormonal imbalance where estrogen isn't properly balanced with progesterone (both female sex hormones). Excess estrogen causes the uterine lining to build up, which results in heavy periods. 

Insulin resistance, poor gut or liver health, and exposure to xenoestrogens (chemicals that mimic estrogen in the body) can all lead to excess estrogen. Apart from heavy periods, other signs of estrogen dominance include: PMS, breast tenderness, cold hands and feet, hair loss, insomnia, and brain fog—not fun!

Despite the name, women with normal (or even low) estrogen levels can also have estrogen dominance if they have low progesterone. A common cause of low progesterone is stress because our adrenals use progesterone to produce cortisol (stress hormone). 

Estrogen dominance is a common cause of heavy periods, but it's not the only one (as you'll see below!). 

2. PCOS

Since becoming a Holistic Nutritionist, I’ve been shocked by how many women I speak to have been diagnosed with PCOS (polycystic ovary syndrome); about 20% of women of reproductive age have PCOS, and its prevalence is rising. While females are supposed to have a small amount of androgen (male) hormones, PCOS is a hormonal disorder triggered by elevated androgens. 

Missing, light, or even heavy periods are common in women with PCOS. In addition to menstrual irregularities, symptoms of PCOS include: excess body and facial hair, acne, pelvic pain, and fertility issues; if you experience these symptoms alongside your heavy periods, I would recommend working with a naturopathic doctor to get some tests done to rule out PCOS. 

3. Hypothyroidism

Research has actually shown that thyroid problems are more common in women than men, so it’s definitely something to be aware of if you’re experiencing symptoms of hypothyroidism (think dry skin, hair, and nails; unexplained weight gain; cold intolerance; fatigue; constipation; and sparse eyebrows).

Hypothyroidism can lead to heavy periods in a few ways. Firstly, hypothyroidism can impair the detoxification of estrogen and reduce the amount of sex hormone binding globulin (SHBG), leading to excess estrogen. As mentioned above, estrogen dominance is a common cause of heavy periods. Secondly, hypothyroidism can halt ovulation (aka ‘anovulation’), which results in a heavier flow. 

If you suspect your heavy period could be related to hypothyroidism, I highly recommend booking an appointment with your healthcare provider to get tested. Or if you have a diagnosis, working with a Registered Holistic Nutritionist will help you understand the nutrition, lifestyle and mindset strategies to support thyroid health and healthy periods. 

4. Iodine Deficiency

Iodine is an essential (meaning we need to get it from our food!) trace mineral crucial to thyroid function. Therefore a deficiency can lead to low thyroid function and, consequently, heavy periods (as mentioned above). 

Iodine is only in a few food sources, like dairy, iodized salt, seaweed, and seafood, but luckily we only need a small amount of iodine per day (~ 150 mcg for most adults). With so many people adopting plant-based diets that exclude many sources of iodine, it’s no surprise that iodine deficiency in women of reproductive age is on the rise. 

While you definitely don’t need to eat dairy or seafood to get enough iodine, we always need to be mindful of nutritional gaps when cutting out certain foods—can’t stress this message enough! 

Working with a RHN will help meet your daily iodine requirements to support thyroid function and healthy periods. 

5. Iron Deficiency

This one is super interesting! When we think of the connection between iron deficiency anemia and heavy periods, we usually think of heavy periods causing low iron (which they definitely can!). But iron deficiency can also lead to changes like a watery or heavy flow—who knew? 

It makes sense because we need minerals and vitamins from our food to support the different hormonal, metabolic, and chemical processes that result in menstruation. Nutrient deficiencies can throw everything off, causing an imbalance. 

This also lines up with a Traditional Chinese Medicine (TCM) perspective. According to Registered Acupuncturist Dee Dorrance (you can find her on Instagram @pokedbydee), heavy periods can be caused by issues of excess but also by depletion or deficiency. When our Qi is deficient—not strong or firm enough—it can’t hold blood in the vessels, and therefore it flows in excess, resulting in heavy periods and a vicious cycle of deficiency! 

HEALING HEAVY PERIODS REQUIRES A TWO PRONGED APPROACH 

When it comes to healing heavy periods, we need to focus on (1) identifying/healing the underlying imbalance and (2) rebuilding nutritional stores and addressing any deficiencies caused by chronic blood loss. 

If you’re experiencing any of the symptoms outlined above, I highly recommend booking an appointment with your healthcare provider for a blood test and a proper diagnosis. Once diagnosed, a Holistic Nutritionist (like me!) can explain the connection between your health concerns, lifestyle, and eating habits while providing strategies to bring the body back into balance. A Holistic Nutritionist will also put together a list of nutrients of focus, an example meal plan, and supplement recommendations to rebuild your nutritional stores.

BOTTOM LINE

Heavy periods are common, but that doesn't make them normal; they're often just one sign of an underlying imbalance, deficiency, or issue that needs our attention. Luckily, once you know the root cause of your heavy periods and make the necessary holistic adjustments, you can begin to heal and get back to a healthy, manageable flow. 

Struggling with heavy periods? Book an intake call here to work with me 1:1, or follow me on Instagram for more health and wellness tips! 

Disclaimer: Tips and suggestions mentioned in the article are for educational purposes only and should not be construed as professional medical advice. Always consult your main healthcare provider if you are experiencing any of the symptoms outlined in this article.