Why are your periods so heavy?

Hormone specialist and London Nutritionist Kay Ali talks about heavy periods

Photograph by Shahab Yazdi.

Tampon, pad and double knickers. Sound familiar? Heavy periods are disruptive. I’ve had clients report that they can’t leave their home on the first day of their flow lest they want to risk being seen with a bleed through. The reality can be grim. Menstrual cups aren’t an option and double wear of pads and tampons often don’t cut it too. Some clients report that their bleeds are so heavy and clotty that staying on the contraceptive pill is their only viable option. While it’s true that each of us may have a different standard of what’s considered normal for our flow, very heavy bleeding A.K.A menorrhagia and large clots is not something to ignore.

How to know if your period is 'heavy'

But first things, first; what exactly is a heavy period? Afterall, it’s not like we’ve seen others to compare. Generally speaking I ask my clients the following questions to gage whether their bleeds are truly heavy. Answering yes to three or more is a good indication that they are.

  1. Are your bleeds longer than seven days?

  2. Do you need to double up on menstrual products?

  3. Do you experience clots larger than a 10p coin?

  4. Are you changing your menstrual products more than every two hours, on day 2 and onwards?

  5. Does the flow disrupt your sleep and are you needing to change your pad at night?

What causes heavy periods? By hormone specialist and London Nutritionist Kay Ali

Photography by Richard Jaimies.

There are many different conditions (and symptoms) that are characterized by heavy bleeding. There’s:

Menorrhagia: this is heavy and long uterine bleeding. Large clots are often part of the picture.

Metrorrhagia: this is when you bleed between your periods

Menometrorrhagia: a combination of heavy and long periods with clots and bleeding between

Polymenorrhea: when you experience periods too frequently (a cycle shorter than 21 days)

If you’re concerned about your periods and suspect that you have anyone of these conditions it’s important that you report back to your consultating medic for thorough investigation. It’s common that they’ll prescribe a contraceptive to help alleviate your symptoms. However, it’s important to note that this is a band aid to the issue. Without targeting the reasons why you’re bleeding too much, the problem remains unresolved and suppressed. I encourage my clients that we get to the root cause to help balance things out.

Hormone specialist and London Nutritionist Kay Ali's hormone balance checklist

Common causes of heavy or prolonged bleeding

Common causes for heavy and/or frequent bleeding that I consider in my clinic, often collaborating with GPs are:

  • Iron deficiency

  • Oestrogen dominance

  • Fibroids

  • Hypothyroidism

  • Bleeding disorders

  • Blood thinning medications

  • Liver or kidney disease

  • Miscarriage

  • Perimenopause

  • Adenomyosis

  • Polyps

  • Ovulatory dysfunction

  • Pelvic inflammatory disease

  • Endometriosis

  • Cancer

Understanding oestrogen dominance and its role in heavy periods

Blood orange_You Need A Nutritional Therapist

Photograph by Charles Yuz.

The most common underlying cause that I see is oestrogen dominance. This is a state of hormone imbalance where either oestrogen is too high due to excessive production or poor detoxification or oestrogen is elevated in relation to low progesterone.

"Our body needs oestrogen. It’s just that we have to get it in the right amounts at the right time in our cycle." - Kay Ali

So why exactly does oestrogen dominance cause such heavy bleeding? Well, oestrogen is a hormone that stimulates cell growth. This means that if there’s too much of it, it’ll overstimulate endometrial growth causing a very thick and rich lining in your uterus. Hence the heavy bleeding and in some cases clots.