Heavy period flow is when a woman loses more than 80ml of blood in one menstrual cycle. About 27% to 54% of women suffer from this condition, also known as menorrhagia. Untreated menorrhagia can lead to harmful conditions such as anaemia. We speak to five women who experience menorrhagia and share with you some ways to address this condition.
Recognise the Symptoms
It’s considered normal if you lose about 35ml to 40ml of blood over an entire period. But some women can lose as much as 80 mL of blood. “My period is usually the heaviest on the second and third day, that I have to change my pad every three hours and wear overnight pads. The flow is so much that I feel uncomfortable to go for outings as I would be afraid of leakage,” Emily (not her real name), a 45-year-old housewife shares.
Another symptom that accompanies heavy bleeding are cramps. Nabila, a 19-year-old university student, had period cramps and heavy flow when she began getting her period. “Sometimes the cramps are so bad that I would miss a day of school”. Meanwhile, her mother, Dian, 44-year-old sales and marketing expert, recalls having horrible cramps that she sometimes felt like holding a hot iron against her stomach to ease her menstrual pain.
Menorrhagia can lead to anaemia, a deficiency of healthy red blood cells that bring sufficient oxygen to your tissues. Suchitra, 34, a sales and marketing executive, shares that she would get tired easily in the first couple of days of her period when it’s the heaviest.
A woman’s period is one of those intricate processes that are regulated by hormones, primarily oestrogen and progesterone. Even heavy stress can affect your period. “I notice that I usually experience heavy flow when I’m having a hectic week,” Suchitra shares further.
Imbalances can also be associated with transitional periods. Sue, a 56-year-old housewife, didn’t have period pain and always had a regular cycle. That is until she reached the age of 55 and began having painful period cramps during the first three days.
Other possible causes related to or in addition to hormone imbalance include:
- Anovulation (absence of ovulation)
- Polycystic ovary syndrome (PCOS)
- Thyroid disorders
- Benign growths like polyps and fibroids
- Malignant growths, such as those that cause uterine cancer or cervical cancer
- Uterine infection
- Hormone replacement therapy or birth control
- Blood thinners and aspirin
- Breast cancer drug Tamoxifen
- Novel oral anticoagulants or NOACs
How You Can Address Heavy Period Flow
A recent study in the Klang Valley indicated that the prevalence of menstrual disorders is close to 64%. Painful periods and menorrhagia link to poor academic performance for teenage girls and work loss for adult women. So, what can you do about it?
Fortunately, many women are aware that they don’t have to suffer through the pain. Many of the women we spoke to shared that one thing they can do when the pain becomes unbearable is to take painkillers such as paracetamol (known as Panadol in Malaysia), or ibuprofen, which also acts as an anti-inflammatory medication.
Replace the lost iron
To address or prevent anaemia, there are many iron supplement options out there that you can buy at the pharmacy. If you don’t like to take supplements, then consume foods rich in iron like dark green leafy vegetables, meat, seafood, beans, nuts, and seeds.
Hormone replacement therapy
Certain artificial hormonal interventions such as birth control and hormone therapy may help with menorrhagia – for some women. Suchitra, mentioned earlier, tried birth control pills to address her heavy flow but had to stop as they didn’t work well with her body.
Some women consider a myomectomy (fibroid removal) or a uterine artery embolization (UAE) to deal with growths. Other more invasive procedures are like endometrial ablation. That’s when part of your lining is purposely destroyed, usually followed by sterilisation, or a hysterectomy, where your uterus is removed permanently. These would be the last resort, and we caution that you consult with your OBGYN at length before making such a decision.
The TCM Perspective
Traditional Chinese Medicine (TCM) also has a lot to offer in this realm, as some of the conventional treatments in Western medicine may not work well for some menorrhagia sufferers. We spoke to Physician Ho Li Ying, a TCM practitioner and expert who specialises in gynaecology.
“In TCM, qi (vital life force) controls blood flow. Heavy menstrual bleeding can occur when there is a qi deficiency in a woman’s body. That could be caused by burnout, frequent sexual intercourse, or excessive consumption of cold foods,” shares Physician Ho. “You would always be feeling exhausted, dizzy, and cold, with a period that is thin in consistency and appears pinkish or light red. This condition is also specific to a Kidney qi and Spleen qi Deficiency,” she elaborates.
To help nourish the blood and improve circulation, try some Ba Zhen soup, along with qi and blood nourishing teas that contain Dang Shen, (党参, Codonopsis pilosula) and red jujube, and overall nourishing foods like chicken essence and Huang Qi, (黄芪, Astragalus propinquus). You can also strengthen Kidney qi and expel cold with the Waist Tonic, which contains herbs like Du Zhong (杜仲) and Cordyceps Sinensis.
Excessive coldness in the body as well as feeling down emotionally due to depression or anxiety can cause poor qi and blood circulation. That will cause Blood status to arise.
Symptoms include insomnia, lower back pain, cold extremities, period cramps, and period blood that has a lot of clots and is dark red in colour.
“Bak Foong, a well-known and effective TCM formulation is a comprehensive formulation that I recommend to my patients,” Physician Ho suggests. “I also recommend Ba Zhen soup as a daily meal. Avoid cold foods and environments, and soak your legs in warm water before bedtime. Also, practice general self-care to help put yourself in a good mood,” she further recommends.
Blood-heat is another possible syndrome that is causing your heavy period flow. It is normally caused by excessive consumption of spicy and hot foods, living in hot weather, or staying up late. “You may also exhibit other symptoms such as always feeling thirsty, dry mouth, avoiding heat, fidgety, insomnia, with period blood that appears sticky and dark or bright red in colour,” elaborates Physician Ho.
Your TCM physician may suggest some proprietary combination of Sheng Di Huang (生地黃, Rehmannia glutinosa), Xuan Shen (玄參, Scrophularia ningpoensis) and other herbs that nourish yin and blood while expelling heat in the body and strengthening the kidney and the liver.
These TCM treatments that replenish the blood will not worsen the heavy period flow – the idea here is not just decreasing or increasing flow, but about restoring a harmonious balance in the qi and blood so that the flow goes back to a normal healthy level.
Many women go about their lives thinking that heavy period flow and other menstrual disorders are something they must endure. It is important to investigate what may be causing your menorrhagia and address the condition and underlying causes together with your healthcare provider. A normal period that doesn’t leave you exhausted and in pain is possible.
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