Being a woman means you will bleed. Not all blood is from wounds, nor does it always have to be be dangerous, scary, or gross. Bleeding is a natural, normal, and healthy part of a woman’s life. Beginning with menstruation, then during and after childbirth, and finally during menopause. As a woman slowly changes hormonally during the process of menopause many women experience erratic menstrual cycles and sometimes heavy unexpected flows commonly referred to as “flooding.” On today’s Apothecary Wisdom we’re continuing our conversation about menopause and menstrual flooding. I’m so glad you’re here with me today. Together we’re growing and learning more about women’s wisdom, botanical wisdom, and feminine power.
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This is a really important conversation for us to have, and for women to understand and know how to address some of the causes of irregular and heavy periods. Did you know that hysterectomy is one of the most commonly recommended treatments for abnormal vaginal bleeding? In the US, there are as many as 650,000 hysterectomies performed per year (that’s 12 per second!). It’s important to note that more than half of those surgeries are considered unnecessary! By age 65, approximately 37% of women will have undergone a hysterectomy, even for relatively benign conditions such as fibroids. Approximately 650 women die from complications from the procedure each year.
Just as cesarean sections can be life saving and yet are over performed in the birth world, the same is true for hysterectomies. They can be life saving and yet overly performed in the women’s health world.
Common causes of perimenopause and dysfunctional uterine bleeding.
- Anovulatory bleeding
- Dysfunctional uterine bleeding (DUB)
- Menorrhagia “flooding”
- Atrophic vaginitis
- Endometrial hyperplasia
- “Flooding” also known as Menorrhagia and is a form of DUB (excessive bleeding, either in number of days, amount of blood, or both)
Today we’re learning about and managing perimenopause and menstrual “flooding”.
Before we get any deeper let’s clear one thing up right away. How much bleeding is too much? How long is too long? A menstrual period that lasts longer than 7 days is considered a long period. Often times though doctors consider a period lasting more than 10-12 days is abnormal and should be evaluated.
If you soak 2 full-sized pads in 30 minutes or less, or any continuous vaginal bleeding.
Signs of excessive blood loss requiring immediate medical attention include: dizziness, light-headedness, weakness, fainting, hypotension, rapid heart rate, shortness of breath, and pallor all constitute a potential emergency. Call 911.
Most women have or will experience at least one episode of heavy vaginal bleeding or “flooding” during normal healthy peri menopausal phase. Nonetheless, incidences of abnormal vaginal bleeding should be evaluated to rule out any abnormal or serious gynecologic disorders, such as cancer.
Menstrual flooding is also called Menorrhagia a type of Dysfunctional Uterine Bleeding (DUB). It is defined as excessive, prolonged, unpatterned endometrial bleeding in the absence of disease. (Romm, 139)
Flooding, or DUB, is a common concern for many women because they don’t know what to expect from their cycles. It’s estimated that 5%-10% of women experience some form of DUB in their life time. Irregular uterine bleeding accounts for 20% of all gynecologic visits. DUB may be painless or painful, it can severely limit activity as well as lead to fatigue and increased risk of illness, depletion, and anemia.
DUB occurs most commonly at the beginning and end of the reproductive years; 20% of cases occur in adolescent girls and more than 50% occur in peri menopausal women. The vast majority of DUB cases occur with anovulatory or infrequent ovulatory cycles. Most anovulatory DUB is due to low estrogen or estrogen withdrawal. For perimenopausal women, the ovaries become less productive and less responsive. Low estrogen levels do not support sufficient ovulation which leads to irregular periods.
Botanical Strategies for Dysfunctional Uterine Bleeding and Menstrual Flooding
Any time you have excessive, unpatterned, or prolonged periods consider getting a consultation with your trusted health care provider. It’s important to rule out potential pathology. After a gynecologic exam and the irregular menstrual bleeding has been ruled out to be benign, then it’s reasonable to implement botanical strategies in combination with other complementary therapies such as nutrition, mindfulness practices, stress reduction, and weight management. If these therapies do not bring the desired results then consider more aggressive medical management.
Herbs can be a woman’s best friend. Learning about herbs for menstrual health is empowering. Recognizing the difference between normal and abnormal bleeding in menopause and knowing which herbs can help is a step toward personal independence. It is a proactive step in the process of connecting with your body and woman’s wisdom. Herbal approaches for menstrual flooding can address acute bleeding episodes and/or for chronic irregular and heavy periods.
The primary goals of the herbs are too:
- Normalize the excessive or prolonged bleeding
- Correct anemia or other underlying nutritional deficiencies
- Reduce Stress
- Balance Hormones
Let’s break this down a little bit:
Herbs that help normalize or reduce the excessive or prolonged bleeding are often called antihemorrahagic, astringent, or hemostatic herbs. Generally speaking, astringent or antihemorrhagic herbs help dry up wet tissue i.e. they help stop bleeding.
Helpful astringent herbs for menstrual flooding include:
All of these herbs are time honored as a woman’s herbs for their ability to reduce postpartum hemorrhage, menstrual flooding, and increase uterine tone. These herbs help control acute excessive uterine bleeding.
They can be enjoyed as a tea or as tinctures. However, I recommend tinctures for these herbs because they are so astringent, they leave your mouth dry and bitter. They are not the best tasting herbs to drink. You can blend these herbs together and make your own tincture or have an herbalist make a custom blend for you.
Helpful herbs to correct anemia or other underlying nutritional deficiencies
These herbs and natural remedies are considered nutrient dense and supply the body with absorbable forms of essential vitamins A, C, D, & K and minerals such as iron, calcium, magnesium, potassium, phosphorus, and zinc. When women experience prolonged episodes of heavy menstruation they are depleted, fatigued, and become anemic. All of which perpetuate the other associated symptoms of menopause such as depression, anxiety, hot flashes, insomnia and physical pain.
Herbs to help reduce stress
Chamomile, passion flower and valerian are all classified as relaxing nervines. Relaxing nervines are herbs that have a comforting, and soothing effect on your central nervous system, muscle-skeletal system, digestive system, improve sleep and help calm nervousness, fear and anxiety. Watch these videos I made about Relaxing Nervines and learn how to incorporate them into your life.
Ashwagandha is an adaptogenic herb that helps regulate hormones and create a calm pleasant effect in your body, helping you sleep better, and feel more centered and stable. Watch these videos about adaptogens to understand how they can help you right now.
Herbs to help balance hormones in perimenopause:
These herbs are all referred to as hormonal modulators or hormonal regulators. Chaste Berry is recognized for its wide reach, in terms of gynecologic applications, especially for menstrual disturbances such as PMS, endometriosis, PCOS, and menstrual flooding. It’s important to note that Chaste Berry may exacerbate depression in some women.
While Dong Quai is helpful for irregular cycles and unpatterned periods, it is not recommended for heavy menstruation or flooding because it may enhance or promote uterine bleeding.
It is my sincere hope that you have gained some insight into what is happening in your body, how to find relief from the confusion, and how to manage the irregularity of menstrual flooding. Remember that menopause is a natural and normal part of a woman’s fertility cycle. It’s supposed to be intense, challenging, messy, and empowering. You’re changing fundamentally and your irregular bleeding is a part of the process, it’s a part of embracing the unknown. I encourage you to find something positive about the spontaneity of your body and the power of your transformation.
Today we went a little deeper into our conversation about perimenopause and menopause and just started learning about menstrual irregularities, dysfunctional uterine bleeding, and heavy periods. There is so much more to learn!
In our next post, we’ll continue our journey through menstrual health and dive deeper into understanding our amazing bodies; how they’re changing and how we can work with herbs and life affirming practices to help us adapt and evolve into our healthiest, wisest selves.
Next week we’ll cover how to enjoy your period and what you can do to bring more menstrual harmony into your life.
Until next time my beautiful friend, drink deep, and always walk in beauty.
Disclaimer: This post is for educational purposes only. It is not intended to treat, diagnose or cure any disease or pathology. What you do with this information is your personal responsibility.
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