Also indexed as: Heavy Menstruation
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.
Checklist for Heavy
Menstruation (Menorrhagia)
What are the symptoms of menorrhagia? 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.
How is it treated? Conventional treatment includes medications
such as birth control pills and
gonadotropin-releasing hormone (Leuprolide®, Nafarelin®). Treatments are also
directed at any underlying medical conditions (e.g.,
pregnancy, iron deficiency, thyroid
dysfunction, and tumor). In severe cases, surgical treatments may be recommended.
Nutritional supplements 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
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.6 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.7 This is also the case
with shepherd’s purse (Capsella bursa-pastoris). 8 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 Res 1960;2:539–42.
6. Bone K. Vitex agnus-castus: Scientific studies and clinical
applications. Eur J Herbal Med 1994;1:12–5.
7. 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.
8. Ellingwood F. American Materia Medica, Therapeutics and
Pharmacognosy. Sandy, OR: Eclectic Medical Publications, 1919, 1998, 354.
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The information presented in Healthnotes is for informational
purposes only. It is based on scientific studies (human, animal, or in vitro),
clinical experience, or traditional usage as cited in each article. The results reported may
not necessarily occur in all individuals. For many of the conditions discussed, treatment with
prescription or over-the-counter medication is also available. Consult your doctor,
practitioner, and/or pharmacist for any health problem and before using any supplements or
before making any changes in prescribed medications. Information expires December 2003.
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