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Menorrhagia: The Body Out of Balance
by Tera Schreiber

Almost every woman at some time in her reproductive life experiences heavy menstrual bleeding. Excessive or prolonged menstrual bleeding is medically termed menorrhagia.
When Meg Olsen suffered from menorrhagia, she found taking a full yoga class during her period to be a challenge. She would invariably need to use a tampon and a super pad to make sure that she contained the flow for just 90 minutes. Menorrhagia wrecked havoc on a fabulous vacation in South Africa and Swaziland where Olsen traveled on group safari day trips. Despite doubling pads and other creative measures, she had to change her pad every hour – when there were often no facilities. “There wasn’t even a tree or a bush to hide behind,” Olsen recalls. She was forced to hide under blankets in the car and even walked into the wilds of Africa in the dark just to find some privacy.

While not every woman who suffers from menorrhagia endures the same troubles in an exotic land, menorrhagia has a huge impact on a woman’s life. Causes of menorrhagia can be divided into three categories, says Karen Jones, a gynecologist with Swedish HealthCare for Women. “The most common causes are physical issues, hormonal issues, or just that heavy bleeding is normal for that woman’s uterus.”

Physical causes of menorrhagia include endometrial polyps and uterine fibroids. A physical examination, which may include diagnostic testing with ultrasound, can help determine if a physical problem exists. Occasionally menorrhagia can be a sign of severe physical conditions such as uterine cancer or a blood-clotting disorder. A biopsy or blood test may be indicated to rule out or diagnose these life-threatening problems. Because the risks of heavy menstrual bleeding are greater than just the inconvenience, it’s important to discuss it with your doctor. “If it is gradually getting heavier, talk to your doctor at your next annual exam. If it happens rapidly, it’s worth a visit right away,” urges Jones.

In the absence of a physical cause, Jones looks to hormonal issues. Periods become heavier and more irregular during perimenopause, when hormones may become unbalanced. While hormone imbalances can affect women at any age, Jones estimates that menorrhagia affects about 10 percent of the women in their late 30s and early 40s in her practice, which is consistent with hormonal imbalances caused by perimenopause.

The most common treatment options for menorrhagia include birth control pills, progesterone IUD, and endometrial ablation. Hormonal treatments are appropriate for a woman who is interested in preserving her fertility. However, endometrial ablation, a surgical process that cauterizes the uterus to inhibit the growth of the endometrial issue, is only appropriate when childbearing is not an issue.

Alternative health care providers offer additional treatment perspectives. Tracy McDaniel, ND, LM, says that naturopaths “work to balance the estrogen/progesterone ratio” with natural therapies that range from herbs and nutrition and lifestyle changes to bio-identical hormones and nutrients. “Naturopathically, we focus more on how to balance estrogen naturally rather than stopping its production,” says McDaniel. Because very heavy periods can be indicators of other issues that affect a woman’s fertility, such as lack of ovulation, McDaniel routinely asks her clients about length and quality of menstruation.

Likewise, acupuncture provides another alternative for relief. “One Chinese study used a Chinese herbal formula on 72 women with menorrhagia, and 87.5 percent of them showed a significant decrease in menstrual blood loss,” according to Kristi Stoddard, L.Ac. and Certified Chinese Herbalist. “We know acupuncture and Chinese herbal medicine has a profound effect on the endocrine system, regulating the production of hormones throughout the menstrual cycle. The effectiveness of acupuncture with menorrhagia appears to stem from its ability to regulate endometrial prostaglandins.”

Sometimes very heavy menstrual bleeding can cause new problems, such as anemia or, in extreme cases, hemorrhage. If the uterus is not contracting efficiently, the exposed uterine capillaries may bleed excessively and dangerously. While most cases of menorrhagia are not life-threatening, a hemorrhage certainly is. McDaniel tells her clients, “If you soak a super pad or tampon in a half hour, go to the emergency room. It could be a sign of hemorrhage and that needs to be addressed right away.”

In Olsen’s case, upon her return from Africa, she found that she was anemic. Anemia can increase menstrual bleeding, which worsens menorrhagia. Olsen found that by resolving her anemia, her menstrual bleeding has decreased dramatically.

When looking at benign menorrhagia, Jones considers the effect of the heavy periods on a woman’s quality of life before making recommendations on treatment. “If it’s no big deal for the woman, it’s okay not to treat it so long as there are no physical problems or other problems like anemia.” Yet, for those women who have benign menorrhagia and consider it to be a burden on their lives, there is help. Regardless of how they affect your life, heavy periods are certainly something to address with your health care provider.

Tera Schreiber is a freelance writer in Seattle and former Executive Director of Great Starts Birth & Family Education. She frequently writes about health issues and has a special enthusiasm for health education.

©2007 Caliope Publishing Company