Also indexed as: Heavy Menstruation
A heavier than normal period can be difficult to deal with and
may signal other health issues. According to research or other evidence, the following
self-care steps may be helpful if your menstrual flow is out of the ordinary:
- Add some A
- To help normalize menstrual blood loss, take 50,000 IU of vitamin
A each day, for no more than 15 days
- Keep an eye on iron
- Take a blood test to find out if you need iron supplements to
replace lost iron and help prevent further bleeding
- Make time for a checkup
- Visit your healthcare provider to find out if your menorrhagia is
caused by a treatable medical condition
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full menorrhagia article for
more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and
lifestyle changes that may be helpful.
About menorrhagia
Menorrhagia is the medical term for excessive bleeding at the time of the menstrual period,
either in number of days or amount of blood or both.
Excessive menstrual bleeding must be evaluated by a doctor in order to rule out potentially
serious underlying conditions that can cause this problem.
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menorrhagia
What are the symptoms?
Menorrhagia does not produce symptoms unless blood loss is significant, at which time
symptoms of anemia, such as fatigue, may
occur. Women with menorrhagia may have heavy menstrual bleeding (consistently changing pads or
tampons more frequently than every hour) or a period that lasts more than eight days.
Medical options
Prescription drug therapy includes birth
control pills (Ortho-Novum®, Loestrin®, Mircette®, Triphasil®) and
gonadotropin-releasing hormones, such as
leuprolide (Lupron®) and nafarelin (Synarel®).
Therapy is also directed at treating any underlying medical conditions, such as pregnancy, iron deficiency anemia, thyroid dysfunction, and
tumor. Severe cases might require surgical treatments.
Vitamins that may be helpful
Since blood is rich in iron, excessive
blood loss can lead to iron depletion. Iron
deficiency can be identified with simple blood tests. If an iron deficiency is diagnosed,
many doctors recommend 100–200 mg of iron per day, although recommendations vary
widely.
The relationship between iron deficiency and menorrhagia is complicated. Not only can the
condition lead to iron deficiency, but iron deficiency can lead to or aggravate menorrhagia by
reducing the capacity of the uterus to stop the bleeding. Supplementing with iron decreases
excess menstrual blood loss in iron-deficient women who have no other underlying cause for
their condition.1 2 However, iron supplements should be taken only by
people who have, or are at risk of developing, iron deficiency.
In a study of women with menorrhagia who took 25,000 IU of vitamin A twice per day for 15 days, 93% showed
significant improvement and 58% had a complete normalization of menstrual blood
loss.3 However, women who are or could become pregnant should not supplement with more than 10,000
IU (3,000 mcg) per day of vitamin A.
In a study of women with menorrhagia associated with the use of an intrauterine device
(IUD) for birth control, supplementing with 100 IU of vitamin E every other day corrected the problem in all
cases within ten weeks (63% responded within four weeks).4 The cause of IUD-induced
menstrual blood loss is different from that of other types of menorrhagia; therefore,
it’s possible that vitamin E supplements might not help with menorrhagia not associated
with IUD use.
Both vitamin C and flavonoids protect capillaries (small blood vessels)
from damage. In so doing, they might protect against the blood loss of menorrhagia. In one
small study, 88% of women with menorrhagia improved when given 200 mg vitamin C and 200 mg
flavonoids three times per day.5 In another study, 70% of women with excessive
menstrual bleeding experienced at least a 50% reduction in bleeding after taking a flavonoid
product.6 The preparation used in this study contained 90% diosmin and 10%
hesperidin and was given in the amount of 1,000 mg per day, beginning five days prior to the
expected start of menstruation and continuing until the end of bleeding for three cycles.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful
Among women taking vitex, menorrhagia has
reportedly improved after taking the herb for several months.7 With its emphasis on
long-term balancing of a woman’s hormonal system, vitex is not a fast-acting herb. For
frequent or heavy periods, vitex can be used continuously for six to nine months. Forty drops
of the concentrated liquid herbal extract of vitex can be added to a glass of water and drunk
in the morning. Vitex is also available in powdered form in tablets and capsules. Thirty-five
to forty milligrams may be taken in the morning.
Cinnamon has been used historically for the
treatment of various menstrual disorders, including heavy menstruation.8 This is
also the case with shepherd’s purse (Capsella bursa-pastoris).9
Other herbs known as astringents (tannin-containing plants that tend to decrease discharges),
such as cranesbill, periwinkle, witch hazel, and oak, were traditionally used for heavy menstruation.
Human trials are lacking, so the usefulness of these herbs is unknown. Black horehound was sometimes used traditionally for
heavy periods, though this approach has not been investigated by modern research.
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
References:1. Samuels, AJ. Studies in patients with functional menorrhagia: the
antimenorrhagic effect of the adequate replication of iron stores. Isr J Med Sci
1965;1:851–3.
2. Taymor ML, Sturgis SH, Yahia C. The etiological role of chronic iron
deficiency in production of menorrhagia. JAMA 1964;187:323–7.
3. Lithgow DM, Politzer WM. Vitamin A in the treatment of menorrhagia.
S Afr Med J 1977;51:191–3.
4. Dasgupta PR, Dutta S, Banerjee P, Majumdar S. Vitamin E (alpha
tocopherol) in the management of menorrhagia associated with the use of intrauterine
contraceptive devices (ICUD). Int J Fertil 1983;28:55–6.
5. Cohen JD, Rubin HW. Functional menorrhagia: treatment with
bioflavonoids and vitamin C. Curr Ther ResClin Exp 1960;2:539–42.
6. Mukherjee GG, Gajaraj AJ, Mathias J, Marya D. Treatment of abnormal
uterine bleeding with micronized flavonoids. Int J Gynaecol Obstet
2005;89:156–7.
7. Bone K. Vitex agnus-castus: Scientific studies and clinical
applications. Eur J Herbal Med 1994;1:12–5.
8. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients
Used in Foods,Drugs, and Cosmetics, 2d ed. New York: John Wiley & Sons, 1996,
168–70.
9. Ellingwood F. American Materia Medica, Therapeutics and
Pharmacognosy. Sandy, OR: Eclectic Medical Publications, 1919, 1998, 354.