In the new patient intake form that my patients complete, there are a lot of questions regarding menstrual period details. How often does it come? Are there clots? Is it painful? And importantly- how heavy is it? You might have wondered what is considered a heavy period, after all, you only have yourself to compare with. In this article, I will give you some specifics to answer that question as well as information about what it could mean. Keep reading for more details.
According to The American College of Obstetrics and Gynecology (ACOG), a menstrual period is considered heavy when:
- It lasts for more than 7 days (some sources say if the flow is heavy for 3 or more days, this is considered heavy even if total number of days is not more than 7)
- You are bleeding through a pad or tampon in an hour or less, for several hours in a row
- You need to double up on pads or tampon + pad
- You need to change your pad or tampon during the night
- You have menstrual clots (pieces of tissue in the blood) that are the size of a quarter or larger
Why would it matter if you have heavy periods? The main reason to let your healthcare practitioner know is that heavy periods are closely associated with iron deficiency anemia. This can cause symptoms like fatigue, migraines, hair loss, restless leg syndrome, depression, shortness of breath and heart problems. So, heavy bleeding is clearly not an insignificant concern, and not something that should be normalized!
There are a wide variety of reasons why this could happen as well as treatments, and I encourage all my patients to speak to their doctor, get appropriate testing, and make treatment decisions from there.
How Might Acupuncture and East Asian Medicine Help?
In East Asian Medicine, there is a fundamental concept called “Blood Deficiency”- this might include symptoms such as:
- Pale tongue and overall complexion
- Thin, weak pulse
- Dry skin, hair and nails
- Palpitations
- Insomnia
- Fatigue
You can see how there is quite a bit of overlap between this condition and iron deficiency anemia. Also, I can’t tell you the number of times I have told someone that they are showing signs of blood deficiency and they mention that they were either anemic in the past or tend to be “borderline” anemic.
We treat blood deficiency using a variety of approaches including dietary recommendations, acupuncture, moxibustion and herbal medicine.
Dietary Recommendations:
Foods that are “blood nourishing” in East Asian Medicine (EAM) include most forms of protein, black sesame seeds, beets, dark leafy greens, goji berries and seaweed. It is important to have these foods regularly throughout the month but to emphasize them a bit more during the time between your period (cycle day 1) and ovulation. Cooking your food in a cast iron pan actually adds a little extra iron to your diet, and from a scientific lens we know that eating foods rich in Vitamin C (strawberries, citrus, spinach) alongside iron-rich foods can enhance iron absorption.
Acupuncture and Moxibustion:
There are certain acupoints which we use to improve both the quantity and quality of blood in the body. Liver 8, Spleen 6 and applying moxibustion at Stomach 36 and Urinary Bladder 18 are techniques we use here. Moxibustion is a technique where an herb called mugwort is heated and used to warm and stimulate points and areas of the body.
Additionally, acupuncture treatments tend to have a restorative effect as they stimulate the parasympathetic nervous system (the “rest and digest” one), enabling your stress response to get out of the way and give your body some space to repair itself.
Those who have very heavy periods often tend to have more intense cramps, and this is something that acupuncture can be very helpful in addressing.
Herbal Formulas:
While none of the above are a one size fits all, herbal formulas are truly very individualized. Herb formulas for heavy periods might include blood nourishing herbs but may also include herbs to address blood stasis (if there are clots or painful periods), improve digestion, reduce stress and potentially clear heat (often a part of the picture with heavy bleeding). After a very thorough intake, your acupuncturist can create a customized formula for you to try for 1-3 months, likely making adjustments along the way in response to the changes that are observed.
Why Am I So Tired? Is This Normal?
Whether you are experiencing heavier periods due to perimenopause or things have always been this way, don’t accept the narrative that “it’s normal”- insist that you are tested to rule out iron deficiency anemia, and ask your care provider to try and get to the bottom of why your periods are so heavy. Ask what you can do to feel better, especially if you are experiencing fatigue and other symptoms. Finally, reach out to us if you have questions or are interested in exploring additional, complementary methods of improving your health.