Heavy Periods in Perimenopause

Heavier periods that last longer are common in perimenopause.

They may even be one of the first signs and symptoms that give you a clue about your changing hormone status.

You may also experience some pain or cramping but this shouldn’t be something that affects your daily life, or that lasts for more than a couple of days and cannot be relieved by taking ibuprofen.

However, if this is not the case and heavy bleeding lasts for longer than 7 days there may be another issue.

The scientific name for this type of heavy period is menorrhagia.

The NICE guidelines define menorrhagia as ‘excessive menstrual blood loss’ of 80-ml during one cycle.

This may mean changing pads or tampons (or using both at the same time)every couple of hours

To put this into context a super tampon can absorb roughly 10 ml of blood. This is the equivalent of 16 fully soaked regular tampons or 8 super tampons.

This can affect your quality of life and lead to iron deficiency anaemia which can cause hair loss, fatigue and shortness of breath.

The average blood loss is between 30-40 ml per cycle.

Menorrhagia is often be accompanied by pain that cannot be relieved by over the counter pain killers. Flooding (changing menstrual products every 30-60 minutes) and blood clots of over 2.5 cm may also be experienced.

If you can relate to these symptoms, this could be a sign that something is not quite right and you should consult your GP for medical advice.

Causes of Menorrhagia

The exact causes are not understood in around 50% of women, however in the remaining 50% potential causes can include; uterine fibroids, adenomyosis and endometriosis, endometrial polyps, pelvic infection or pelvic inflammatory disease, polycystic ovary syndrome (PCOS), suboptimal thyroid function and coagulation disorders.

How to manage heavy menstrual bleeding due to perimenopause 

If ovulation isn’t taking place every cycle (this is common in perimenopause), the lining of your womb can thicken and take longer to shed.

If you are experiencing chronic stress, or you are over or underweight, you may produce more inflammatory prostaglandins. This can lead cause inflammation and pain

7 Tips for managing heavy periods 

✅ Balance your blood sugar – Elevations in blood glucose lead to an increase in the production of insulin.

High levels of insulin can impair ovulation and the production of progesterone, leading to heavier periods

It can also increase the thickness of the lining of your womb which results in heavier bleeding

✅ Look after your gut health – Eating enough fibre and foods which help the beneficial bacteria in your gut to thrive

A healthy gut environment can help to excrete old oestrogen out of the body

Gut health testing can help to identify any potential issues

✅ Eliminate cow’s milk dairy produce – This may help to reduce inflammation and reduce heavy periods

✅ Lower your caffeine and alcohol intake – SORRY 😞 but caffeine and alcohol can lower progesterone levels when it is already decreasing due to perimenopause

Drinking alcohol may also impair your liver’s ability to process oestrogens

✅ Exercise – Exercise can help to balance blood sugar and insulin control

✅ Ibuprofen – may help to reduce bleeding by blocking compounds produced in the body called prostaglandins which can cause inflammation and pain

Ibuprofen may reduce blood loss by 20-40%. But just a reminder not to take ibuprofen on an empty stomach as it can cause damage to the stomach lining. And always follow the dosage on the packaging

Some research has shown turmeric (curcumin) supplements may be an effective alternative to ibuprofen. However, you will need to check that these do not interfere with any other medications that you may be taking

✅ Get your iron levels checked – ironically iron deficiency can lead to heavier periods. It may be necessary to take a good quality iron supplement

Other supplements may be recommended by a nutritionist or healthcare professional.