Controlling Heavy Periods

Some women notice that from the 40’s age group, they develop more premenstrual symptoms like irritability, anxiety, breast tenderness, inability to sleep, irritable bowel symptoms, and even depression. Some women may even get anxiety attacks, migraines and hot flushes at this time. Other women may develop painful, irregular or heavy periods.

Unfortunately, some end up with such heavy periods that they can become seriously anaemic (iron deficient) and unwell. Various medical treatments can be tried but some fail and the woman can end up having a hysterectomy.

These heavy and /or painful periods can occur because in the second half of the menstrual cycle, there is a reduction of both estrogen and progesterone hormones as the woman approaches menopause but the ratio of the two now tends to favour estrogen. It used to be that progesterone was more predominant in the past. This is why its called Estrogen Dominance by integrated medicine doctors.

Estrogen Dominance starts earlier or is worse when there is more stress. This may be familiar to many women who are generally overloaded and more stressed these days. They notice they are more irritable, have more premenstrual symptoms and the problem with periods that goes with this state of affairs significantly affects quality of life.

Conventional treatment of heavy periods

The treatment should be tailored to the individual, taking into consideration any health problems and if fertility needs to be preserved or enhanced.

1. Nonsteroidal anti-inflammatory drugs like ibuprofen, naproxen, diclofenac.
2. Oral contraceptive pill can be useful if the woman is at the young end and there is no risk of blood clots.
3. Progestin eg Provera, Norethisterone. This is synthetic progesterone and is the most commonly prescribed drug for this condition.
   Common side effects include weight gain, headaches, swelling, blood clot, and depression.
4. Levonorgestrel intrauterine system – Mirena® IUCD.
   Reduces menstrual blood loss by as much as 97% and can take up to several months to work well. In New Zealand, women need to fulfill certain funding criteria to obtain it for free, otherwise it can be paid for. The savings in pads and tampons would quickly make up for the cost, not to mention the misery saved. Side effects of Mirena include uterine bleeding or spotting, headache, ovarian cysts, vaginitis, painful periods, and breast tenderness.
5. Gonadotropin-releasing hormone agonists are used on a short-term basis due to high costs and severe adverse effects. They switch of the menstrual cycle from the pituitary gland.
   They cause menopausal symptoms and if used for prolonged periods, may cause reduced bone density and lowered HDL (good cholesterol).
6. Danazol® competes with androgen and progesterone at the receptor level, causing eradication of periods in 4-6 weeks.
   Side effects are acne, decreasing breast size, and, rarely, lower voice.
7. Tranexamic acid – Cyclokapron® is given during the first few days of the period to make it lighter.
   Side effects include menstrual discomfort, headache, and back pain.
8. If all of the above treatments fail, hysterectomy is prescribed.

Integrated medicine treatment would also look at the following:

• Correct significant iron deficiency because this causes heavy periods. Yes, this is a not very well known fact.
• Reduce any stress through counselling, and any other form of stress management.
• Correct deficiencies of Zinc, Vitamin D, Magnesium can be helpful. Dietary advice is given.
• Correct an underactive thyroid as this can cause heavy periods.
• Correct progesterone deficiency by using the bioidentical hormone which is the same as in the body.
• Correct any other hormone imbalances as needed.

Supplementing bioidentical Progesterone may also improve the following:

• Skin elasticity and wrinkles
• Sleep, mood, memory and concentration
• Bone density
• Heart disease and stroke risk
• Cancer risk – Breast, Uterus, ovaries
• Reduce the need for Hysterectomy.

Clearing up some misconceptions

Bioidentical Progesterone is made in a compounding pharmacy facility from soy bean or wild yam.

In contrast, synthetic progestins do not work at all in a natural way, and in fact have been found to increase breast cancer risk.

Wild Yam is not the same as using Bioidentical Progesterone. The human body cannot convert Diosgenin, the active molecule in wild yam, into progesterone. So wild yam creams don’t work.

For more information about bioidentical progesterone go to:
http://www.pharmaceutical.co.nz/

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