Menstrual Bleeding, Heavy

Symptoms

• Amount of Blood

  • Soaking through one or more sanitary pads or tampons every hour for several consecutive hours.
  • Needing to use double-sanitary protection to control your menstrual flow.

• Length of Menstruation

  • Bleeding for a week or longer.

• Problems with Blood

  • Passing large blood clots.

• Iron Deficiency

  • Symptoms of anemia, such as:
    • tiredness
    • fatigue
    • shortness of breath

Diagnosis

The following are signs you should see your gynecologist: 

• Vaginal bleeding so heavy it soaks at least one pad or tampon an hour for more than a few hours.
• Irregular vaginal bleeding.
• Any vaginal bleeding after menopause.

Causes

Many problems can cause heavy bleeding.

In my patients who have been recommended to have a hysterectomy because of fibroids and bleeding, treating these areas often eliminated the need for surgery.

• Uterine Fibroids

  Other problems may be causing the bleeding even if fibroids are present.

• Deficiencies

  Low thyroid (even with normal tests) or low iron.

  Just as heavy bleeding can cause low iron, low iron can cause heavy bleeding—creating a nasty spiral.

  I give iron until the ferritin blood test is over 60 ng /ml.

  The doctor will say it is normal if over 12, but this has been shown to miss over 80% of cases of severe iron deficiency. Get the ferritin up over 60, and ignore the test’s normal range.

• Dysfunctional Uterine Bleeding

  DUB is another common cause of heavy bleeding, especially around menopause.

• Medications

  IUDs or medications (e.g., Ibuprofen) which delay clotting.

Treatment

• Supplements

  • Iron

    Take 50 milligrams of iron a day (containing at least 50 mg of vitamin C to help absorption).

    Iron supplements will normally turn the stool black.

    Precautions

    Do not take iron within 6 hours of thyroid meds, or it will botch the thyroid's absorption.

  • Thyroid Hormone

    If symptoms of low thyroid are present, or a test called the "Anti-TPO Antibody" is positive, consider supplementing with a low dose of thyroid hormone, even if the thyroid tests are normal.

  • Vitamin A

    Clinical experience suggests that vitamin A 50,000 units a day for 3 months may help (along with the other 2 above — I use all 3 together) in cases of dysfunctional uterine bleeding that occurs around menopause.

    I mostly try this as an alternative to hysterectomy for chronic heavy bleeding.

    Precautions

    This is a high dose of vitamin A.

    • It will cause birth defects, so people need to be sure to not get pregnant while on it and for six months after they've stopped taking it.
    • People should not take the vitamin A if they have liver disease (it may worsen the hepatitis).