While many women associate declining estrogen and progesterone with menopause, female hormones actually begin to fluctuate years earlier during the transition period known as perimenopause. With an average span of four years, perimenopause comes with a number of physical and emotional symptoms like hot flashes, sleep disturbance, vaginal dryness, reduced libido, mood swings, and headache. Roughly 25 percent of women also experience heavy bleeding, or menorrhagia, which can cause weakness and extreme fatigue one to two days each month, and lead to anemia if severe. Understanding the connection between perimenopause and heavy bleeding helps women better deal with this bothersome symptom.
Women with concerns about perimenopause and heavy bleeding can start by answering a few questions:
- Does your period arrive more frequently than every 21 days?
- Does your period last longer than seven days?
- Do you spot in between periods?
- Is the amount of flow at least twice that of your normal period?
- Are you changing even high-absorbency pads or tampons frequently?
- Does menstrual flow contain large blood clots?
If you have answered "yes" to any of the questions above, you may be experiencing menorrhagia.
The Cause of Menorrhagia during Perimenopause
According to Dr. Christiane Northrup, a prominent doctor and women's health expert, estrogen dominance (an imbalance in the ratio of estrogen to progesterone) causes menorrhagia in menopause. Too much estrogen results in an overgrowth of uterine lining, which breaks down and sheds in a disorderly way. This leads to irregular heavy bleeding or spotting in between periods.
Remedies for Menorrhagia
Natural progesterone creams may reduce the thickness of uterine lining, and women can also visit a health care provider for a stronger product in capsule form.
An NSAID pain reliever like ibuprofen has the potential to cut menstrual flow in half by blocking prostaglandins. The recommended dosage is 200 mg every six hours for the first few days of a woman's period.
The herb turmeric also shows promise for reducing menstrual blood flow. It should be taken once per day throughout the month as an oral supplement.
Related: The Probiotic-Menopause Connection
Research shows that women with diets high in phytoestrogens experience lighter periods. Phytoestrogens compete with stronger endogenous estrogens that stimulate production of uterine lining. Foods high in phytoestrogens include nuts, soy products, and flaxseed.
Women should incorporate foods with iodine into the diet. Iodine has a down-regulating effect on estrogen receptors, which helps reduce the thickness of uterine lining. Good sources of iodine include sea vegetables, scallops, cod, and yogurt.
Menorrhagia results from an overgrowth of uterine lining caused by hormonal imbalance. Women dealing with perimenopause and heavy bleeding can try several natural and/or prescribed remedies for relief. Although 25 percent of women in perimenopause experience menorrhagia, it also results from certain medical conditions. To rule out endometriosis, fibroids, infection, underactive thyroid, or uterine polyps, women with heavy bleeding should consult with a health care provider.