Hormones 101

First things first: Birth control is NOT the only solution for heavy cycles! In fact, when it comes right down to it, birth control is more of a band-aid than a solution. Are you someone who wants to understand what actually going on? Underneath there are several possible imbalances at play and we always want to know which it is.

Technically the medical term used to describe heavy cycles is menorrhagia. It’s not a disease but it sure sounds like one. The problem is that it can be very depleting and generally difficult to live with each month.   A cycle that lasts more than 7 days or a blood loss around 80 ml is considered heavy.   A tampon or pad can hold about 5 ml. If you use a Diva cup you can calculate this accordingly.   In comparison a normal cycle is 35 ml or less per month and lasts between 3-7 days.

Every woman is different so determining your own normal is key.   Track your cycle to see how many days and ml yours is. If you are soaking around 16 pads or tampons in one cycle it’s definitely heavy.

A Few More Guidelines

Take note if it comes in less than 25 days or more than 35 days

Changing your pad/tampon or emptying your diva cup every 2 hours

Your ability to work, exercise or engage in other activities due to fear of leakage

Having to get up in the night to change

A diagnosis of anemia

Feeling fatigued, short of breath or depressed

What’s Happening to Cause this?

Heavy cycles happen when estrogen is higher in relation to progesterone. This commonly occurs at the beginning or ending of reproductive age. Teens and peri-menopausal women are affected the most.   This is because the part of the endocrine system that communicates with the ovaries is either revving up or slowing down. It’s the hypothalamus that triggers ovulation and progesterone production follows ovulation.

Keep in mind that estrogen has many positive effects in the body.  It’s anti-inflammatory, and supports the immune system.  Its also anti-oxidant and regulates enzymes, gene expression and metabolic function.  Estrogen is critical to brain development and decreases the incidence of strokes.   Women may live longer than men due to estrogen. It is also protective.  For example estrogens support gut health.  It also reduces the incidence of prostate and breast cancer.

Related Patterns of Hormone Imbalance

  1. Heavy clots indicate more estrogen in relation to progesterone. Estrogen causes proliferation so more uterine lining, swollen breasts, weight gain, skin issues, PMS and headaches can involve a pattern called Estrogen Dominance.
  2. Poor thyroid function is another major factor. Subclinical hypothyroid is more common than we think and is poorly diagnosed. It causes poor clearance of estrogen from the body as well as limits the amount of progesterone produced.
  3. Fibroids are also caused by a e-dominant pattern. One type of fibroids can actually cause heavy bleeding but this is not common.
  4. Post pregnancy including miscarriage, abortion or full-term birth.   Blood loss of this variety is due to deficiency.
  5. Birth control like the copper IUD and depo provera shot can cause heavy cycles.
  6. A bleeding disorder known as coagulopathy affects 20% of teenagers with heavy cycles.
  7. Inflammatory disease of the pelvis, liver or kidney

Steps You Can Take

Rule out anything serious by getting your routine pelvic exam. Request an ultrasound to check for fibroids and to see the thickness of your endometrial lining.

Blood work needs to include a full thyroid panel and a complete blood count to check for anemia. Regular STI checks and pap smears are also important.

Birth control is commonly prescribed for heavy cycles especially the oral birth control pill and the Mirena IUD.   D & C ‘s are used to remove uterine lining temporarily or an endometrial ablation or hysterectomy are permanent interventions.

A Functional Medicine Approach

I focus on nutrient intake first. Vitamin A from cod liver oil has been shown to reduce heavy cycles significantly.   B vitamins can reduce excess estrogens by supporting liver function and therefore estrogen metabolism. With b vitamins quality and bioavailability is important. I use Seeking Health because of this. Buffered Vitamin C at doses around 3000mg per day has been shown to reduce heavy bleeding and improve the absorption of iron. There is a cycle of blood loss, anemia and fatigue that requires some lifestyle adaptations as well as diet changes.

Real rest and meditation help cortisol regulation. Cortisol is upstream of all sex hormones and usually plays a significant role in hormone imbalance. I do thorough testing to see what is actually going on prior to treatment that includes free and total cortisol, its daily rhythm and all of the sex hormones plus their metabolites.

Every Woman is Unique

No two bodies are the same so getting to know yours is the most powerful step in this journey. We are always changing so this is a process we do again and again. Send me your questions. This post came out of multiple patients asking what caused their cycles to change and what could be done other than birth control.