Menorrhagia

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)

Rating Nutritional Supplements Herbs
3Stars

Iron (for deficiency)

  
2Stars

Vitamin A

  
1Star

Flavonoids

Vitamin C

Vitamin E

Agnus castus

Black horehound

Cinnamon

Cranesbill

Oak

Periwinkle

Shepherd’s purse

Witch hazel
See also:  Homoeopathic Remedies for Heavy Menstruation
3Stars Reliable and relatively consistent scientific data showing a substantial health benefit.
2Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.

What are the symptoms of menorrhagia?

Menorrhagia does not produce symptoms unless blood loss is significant, at which time symptoms of anaemia, 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 treatments

Prescription drug therapy includes birth control pills (Ortho-Novum®, Loestrin®, Mircette®, Triphasil®) and gonadotropin-releasing hormones, such asleuprolide (Lupron®) and nafarelin (Synarel®).

Therapy is also directed at treating any underlying medical conditions, such as pregnancy, iron deficiency anaemia, thyroid dysfunction, and tumour. Severe cases might require surgical treatments.

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 agnus castus, 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, agnus castus is not a fast-acting herb. For frequent or heavy periods, agnus castus can be used continuously for six to nine months. Forty drops of the concentrated liquid herbal extract of agnus castus can be added to a glass of water and drunk in the morning. Agnus castus 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.