What to do if you have heavy periods?

Do you have a heavy period? Having a period where you lose more than 60-80ml; can have some serious negative effects on your health. If you are losing a lot of blood each month then you are losing a lot of iron. Here are some ways you can help ensure your body is getting and absorbing all the iron it requires.

What are heavy periods?

Periods are considered heavy if you lose more than 60 – 80ml of blood per period (approximately 3 – 5 tablespoons). This isn't so easy to measure, so ask yourself, does your period soak through to your clothes or bedsheets regularly? Do you find you have to change your menstrual cup, tampon or pad every hour for several hours? If you are using the correct menstrual product for your level of blood flow and these things still happen, you are likely experiencing heavier than normal periods. If you have normal blood flow but have periods that come more often than every 28 days or last longer than 1 week, you might be suffering with heavy periods too. Not only are they inconvenient and time consuming, but heavy periods could be harming your health.

Heavy periods are not always an indication of something more serious but it's good to ask yourself some questions to rule the possibility out. That way you can make sure you are managing the issue effectively. If your periods changed suddenly, are so painful that they interrupt your daily activities or you bleed between periods - you should see your doctor. They can rule out things like fibroids, endometriosis, thyroid issues, pelvic inflammatory disease and blood disorders. These issues may need a combination of conventional and alternative therapies to treat.

Even if there is no serious underlying issue at the root of your heavy periods, it is still important to address them in order to stay in good health.

Here are some ways you can do this:

Replace lost iron

If you are losing a lot of blood each month, you are losing a lot of iron each month too. Iron is needed to make haemoglobin, a protein in red blood cells that enables them to carry oxygen around your body. If your body doesn't have enough haemoglobin, your tissues and muscles won't get enough oxygen and won't work effectively. This can leave you feeling fatigued, breathless and light headed, it can also affect your circulation.

More than half of European women in their childbearing years have small or depleted iron stores. So, this may well be you, especially if you find yourself drooping when you should be dancing! One of the reasons why this is common and often undiagnosed, is that your haemoglobin (iron circulating in the blood) levels can be within the correct range, whilst your ferritin (stored iron) is low. As doctors mostly test for haemoglobin, the ferritin-related depletion may not be flagged.

If left untreated this can lead to a condition called anaemia which has a negative impact on breathing, heart rate, skin, hair and nails and anxiety levels. If you suspect you have anaemia, it's important to consult with your doctor to make a plan of action.

Taking an iron supplement each month is really important if you bleed heavily. In fact, it is important for any woman that bleeds each month, even if their flow is normal. In some ways, it is a new phenomenon that women bleed as regularly as we do nowadays. In the past, most women spent their child bearing years either pregnant or breastfeeding, which paused their monthly bleed for long spells. So, today more than ever women need to replenish their bodies after each period to make sure we are staying healthy and well.

Tips for replenishing iron:

Take an iron supplement every day. However, as always, moderation is key. Too much of a good thing can be extremely detrimental to your body, so try to make sure you're taking a gentle supplement that's going to be well-absorbed by your body. Floradix is my recommendation. It's easy on the tummy and contains high quality ingredients that are easy for the body to absorb. There is a vegan version too.
Fill your cupboards with lots of iron rich foods. Have a look at our blog about iron for some examples to get a shopping list started.
Cook iron rich meals. Here are a few of my favourite vegetarian iron-rich recipes: Spinach & Potato Curry, Spicy Tomato & Red Lentil Soup, Marinated Tofu Stir Fry, Vegetable Satay Stir-fry
In the week leading up to your period, take care to snack on iron rich foods rather than sugar-y ones. Sugar inhibits vitamin C absorption, which in turn will hamper iron absorption.

A.Vogel Self-Care: How to snack for a healthier period

In the week leading up to your period, take care to snack on iron and magnesium rich foods rather than sugar-y ones. Sugar inhibits vitamin C absorption, which in turn will hamper iron absorption.

Make sure you are absorbing your iron

If you are going to the effort of supplementing and modifying your diet to include more iron, you want to know that it is going to good use. There are some simple ways of ensuring that your iron is being absorbed:

Take a vitamin C supplement along with your iron supplement. Vitamin C enhances iron absorption. It captures non-haem iron and stores it in a form that's more easily absorbed by your body. Non-haem iron is the type of iron that comes from plant sources: beans, lentils, dried fruit and grains. Haem iron comes from animal sources such as meat, poultry and eggs. If you eat mostly non-haem sources of iron, take a teaspoon of apple cider vinegar in water before each meal to make sure you are getting some vitamin C alongside your plant-filled, iron-rich meal.
Take your iron supplement at a separate time to your cup of tea. Some teas and coffees are rich in tannins (the astringent agent that can make you pucker your mouth). Research shows that certain tannins may inhibit haem iron bioavailability. So, it's a good idea to drink your coffee, black or green tea separately to taking your iron supplement; and if your meals are primarily vegetarian or vegan, avoid having a cup of tea with your meal.
Make sure you are not having too much Calcium in your diet. Studies show that excess calcium hinders the uptake of iron. Even when we are not eating a healthy diet, we can still get calcium quite easily as it is contained in many foods. Therefore, there is rarely a need to use an additional calcium supplement, unless your health care professional has specified to.
Address low stomach acid if you suspect it is an issue for you. You can read more about how to determine whether you have low stomach acid, on our low stomach acid page. Low stomach acid is shown to impact our ability to absorb iron and is an important one to sort out for lots of other reasons too. Bitter herbs help to stimulate stomach acid so Digestisan works well for this.

There are certain groups of people who need to pay particular attention to whether they are absorbing iron well:

People taking ant-acids – this will affect the levels of stomach acid available to break down food or supplements and absorb iron from them.
If you suffer from Crohn's disease or other digestive issues such as IBS - conditions that effect your ability to break down food and absorb nutrients will impact your iron levels.
Vegans and vegetarians - If you are vegetarian or vegan, you will need to pay careful attention to your food sources of iron, as plant-based iron doesn't absorb as easily as iron from meat. That doesn't mean to say you can't have healthy iron levels as a vegetarian or vegan, but just that you need to give it thought, plan your diet to include plenty of iron sources, and maximise absorption by keeping your vitamin C intake equally buoyant.
Women who exercise a lot - Research has shown that iron-depleted women doing five 25-minute aerobic training sessions per week (at 75% to 85% of maximum heart rate) see less improvement from iron supplementation over 8 weeks than women who aren't exercising. These were women who weren't yet actually anaemic, but still low in iron. Iron depletion of this type is thought to be up to three times as common as iron-deficiency anaemia, which your doctor can identify with a blood test.

Look for the root cause of heavy bleeding

If you have ruled out the possibility of a more serious underlying issue, you might want to consider whether the reason behind your heavy bleeds are related to any of the following:

Age – at certain times in women's lives, hormones will become more erratic than before. Menopausal and teenage years, are two classic times when hormones become unruly and could result in heavy bleeding.
Medication - Some medicines affect your periods. Although oral contraceptives, often called 'the pill' often make your periods lighter or non-existent, in some cases (more likely to be oestrogen-based versions), they can make your period heavier. Other methods of contraception may also give rise to heavier periods, such as the intrauterine device (IUD), also called the coil. Other medications can make your periods heavier such as blood thinning medication for example. If your periods change suddenly after starting any medication, always refer back to the product information leaflet (PIL) for more information or contact your GP
PMS - Pre-menstrual syndrome (PMS) is a range of physical, mental and behavioural symptoms which women often suffer in the week or two in the lead up to their periods. Many of the symptoms of PMS, in particular feeling angry, irritable, having mood swings, sore breasts and experiencing painful, heavy periods are actually a result of a hormone imbalance such as high levels of oestrogen. This particular hormonal imbalance can be addressed by increasing your body's production of progesterone.