Menorrhagia is the medical term for menstrual periods in which bleeding is abnormally heavy or prolonged. Officially, the flow of more than 80 ml per menstrual period is considered menorrhagia, however a flow of 45-60 ml per period can actually be considered menorrhagia as well. Menorrhagia can also include a very long period of a week or longer, and passing large blood clots. Anemia is also common in women with menorrhagia and there may be symptoms such as tiredness, fatigue or shortness of breath.
The cause for menorrhagia is not clear. Most women with menorrhagia report regular periods and have been shown to have normal estrogen and progesterone levels. However, menorrhagia is most common in teens and in perimenopause, times in the lifecycle when estrogen levels tend to be higher and progesterone levels to be lower. Also, even with regular periods, there may be menstrual cycles without ovulation. In a normal cycle, the release of an egg from the ovaries stimulates the body's production of progesterone, the female hormone most responsible for keeping periods regular. When no egg is released, insufficient progesterone can cause heavy menstrual bleeding. This suggests that menorrhagia may be related to increased estrogen action before flow. Very rarely is menorrhagia caused by a primary bleeding disorder. Fibroids are commonly associated with menorrhagia but rarely a reason for it.
Treatment that is effective for very heavy flow includes ibuprofen, drinking extra salty fluids during heavy flow, increasing dietary or supplemental iron and cyclic progesterone therapy. Additional therapies include tranexamic acid (which encourages blood clotting) and the use of a progestin-releasing IUD.
In Chinese medicine, any irregularities in a woman’s reproductive cycle whether they be PMS, painful periods, irregular periods, or heavy periods, are a sign of a health imbalance that requires addressing. Menorrhagia is considered a type of abnormal bleeding and may be caused by heat (which interferes with the body’s function of storing blood and controlling blood flow), empty qi-energy (which may be caused by damage to the spleen so that it is unable to perform its function of restraining the blood), or blood stasis. The most common causes for these imbalances are emotional stress, especially depression and excessive emotions, excessive worry and anxiety, poor diet, particularly too much hot, spicy, or greasing foods or consuming alcohol, or lack of exercise. Imbalances can also arise due to excessive fatigue or due to a deficiency of kidney yin energy.
The good news is that acupuncture and Chinese medicine treat menorrhagia quite effectively and regardless of the causes, it responds positively to treatment. An acupuncturist will first work on treating the immediate symptoms, we call this treating the branch. Once the heavy bleeding is under control, we focus treatment on the root cause, whether it is heat, empty qi-energy, or blood stasis, and address this imbalance in order to prevent menorrhagia in the future and to break the pattern of a chronic condition. As the body becomes healthier, we can expect other symptoms to lessen or resolve as well, such as problems sleeping, period cramps or lower back pain, fatigue, and physical and emotional symptoms that relate to the cycle.
Chinese medicine also has valuable lifestyle principles to prevent menstrual disorders. These include eating and drinking a moderate and balanced diet, maintaining a regular sleep-wake routine, managing stress and emotions, and not dwelling on negative thoughts and frustrations. Also, it is wise to overdo it prior and during menstruation, which may mean cutting back on long work hours, avoiding stress, and doing lighter exercise during this time. While these may seem like common sense habits, they can have real and measurable effects on our health and wellbeing.
This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.