Why am I bleeding so much? Understanding Heavy Periods

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January 29, 2018
heavy periods, heavy menstrual bleeding, toronto naturopath, toronto naturopathic doctor

Does it feel like you’re changing your tampon every hour?

It’s not ideal, am I right?

Time to start thinking about heavy periods, yes it’s a thing. Today I’m focusing on the signs of heavy periods, why they happen, and what some natural treatment options to consider. 

Symptoms of Heavy Periods

Menorrhagia is the official name for heavy periods – of course no one ever (aside from docs) use this term, but it’s important to know it. You might have heavy periods if you experience:

  • Losing more than 80mL of blood during the cycle

  • Bleeding that lasts more than 7 days

  • Bleeding that soaks through one or more tampons/pads less than two hours or for several hours in a row (see chart below)

  • Needing to wear more than one pad at a time to control menstrual flow

  • Waking up at night to change pads or tampons

  • Blood clots that are as big as a quarter or larger

  • Periods that interfere with daily activities (aka. standing up from a chair might be terrifying)

  • Iron deficiency (ie. cold hands and feet, hair loss, overall feeling fatigued, dizziness and lightheadedness). 

Ideally, we should be losing only 20mL to 60mL of blood per cycle. If you’re losing more than 80mL then this could severely affect your iron status. 

Use this chart to keep track of how many pads and tampons you are using throughout your cycle:
heavy periods, heavy menstrual bleeding

Risk factors of heavy bleeding

Risk factors include:

  • Relative with bleeding disorders/has been treated for excessive bleeding

  • History of anemia (aka. low iron)

  • Period longer than 7 days

  • Frequent brusing/nosebleeds/gum bleeding

  • Recurrent miscarriages

  • Bleeding during pregnancy

Causes of Heavy Bleeding

Hormonal Causes

These include: HPO axis immaturity, stress, PCOS, and hypothyroidism.

Teens and women entering perimenopause are most likely to experience heavy menstrual bleeding, as estrogen tends to be higher than its counterpart progesterone. Similarly, if you are not ovulating (even though you have regular periods), progesterone will not be produced, leading to a relative excess of estrogen. 

Estrogen is the hormone that is in charge of building the endometrial lining, and if progesterone is not there to balance it out then that could be why you’re experiencing heavy periods. 

Bleeding Disorders

These include: Von Willebrand disease, platelet function disorders, hemophilia and thrombocytopenia

Structural Changes

These include: adenomyosis, Ehlers-Danlos syndrome, endometrial cancer, endometrial hyperplasia, endometriosis, fibroids, uterine infections, and uterine polyps


These include:  Anticoagulants/blood thinners, antidepressants, antipsychotics, corticosteroids, herbs, hormonal contraceptives, tamoxifen

Heavy Periods from a TCM perspective

Liver Qi Stagnation

Liver qi stagnation is incredibly common in women, as it usually stems from stress. Basically, qi (life force/energy) is no longer able to flow unobstructed throughout the body. The liver, whose main job it is to store blood is also no longer able to do so. The tongue may be dark in colour (ie. blue or purple), abdominal distention may be present along with breast distention, frustration, irritability and pain. Other period-related symptoms might occur such as irregular periods, no periods, and PMS. 

Blood Stagnation

If liver qi stagnation has been occurring for a while, this may lead to blood stagnation. Because the qi is not able to move smoothly throughout the body, the blood is also unable to do so. This may also be due to cold and heat in the body. Symptoms may include nose bleeds, heavy bleeding during periods, pain with periods (ie. a sharp stabbing pain), a darker flow and clots. 


When the body is cold, it creates stasis. Think about it this way – when you are freezing, you are likely to snuggle in a blanket and curl up in a ball, rather than start exercising or being active. 


Heat can often be drying and create difficulty in movement. This may result in early, bright red periods, constipation, nosebleeds, dry mouth, etc.  

Treating Heavy Periods

Treating the Cause

Obviously there are many reasons why someone may be experiencing heavy periods. As a naturopathic doctor, one of my primary jobs is to discover the root cause of the problem and treat based on that. 


As anemia is very common in women with heavy periods, you need to get your ferritin and CBC tested before you supplement. I like supplementing with iron, rather than increasing iron rich foods because blood changes will happen more quickly this way. Nevertheless, eating your fair share of leafy greens will have it’s own healthy benefits. 

Vitamin C

This vitamin helps to increase iron absorption, especially when you’re eating iron-rich food sources. A really easy way to incorporate greens and vitamin C together is by eating a salad! Add some red pepper, lemon juice, cabbage and even parsley to a salad can help increase iron and help with absorption!

Supporting TCM Theories

The reason why I love integrating traditional Chinese medicine into period-related conditions is because it really focuses on the mind-body connection. As you saw above, stress can greatly affect how our energy moves throughout the body. And if it’s not moving as well as it should, it can result in a variety of other symptoms. 

That’s not to negate the importance of making sure you have enough ferritin in your body, but we are more than just our blood work and the foods we aren’t eating. 

To support your body from a more holistic perspective, I would recommend visiting with a Naturopath to see how your symptoms fit into the bigger picture. 

Final Thoughts

Heavy bleeding can happen for a variety of reasons and while everyone would prefer to use Dr. Google to figure out the right supplement to take to stop it, it’s incredibly important to get some blood work done to find out why it’s happening. Once you have that piece of the puzzle figured out, then you can choose the right treatment to get you back to feeling 100%. 

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