Does the thought of your monthly cycle fill you with dread? If you are holding back from things you normally love due to pain or because your flow is unpredictable or heavy, then it’s probably worth trying a few nutrition tips.
Research suggests that on average women lose between 6-8 teaspoons (35ml) of blood per cycle and up to 80ml is seen as normal. Heavy menstruation known as menorrhagia is classified when the blood loss is over 80ml, which can be due to particularly heavy bleeding or bleeding for longer than 7 days. Although many women may experience heavy menstrual bleeding, doctors would only consider it to be menorrhagia when a woman cannot maintain her usual activities due to severe blood loss and it is called dysmenorrhoea if severe cramps and pain are present.
If you have concerns about your monthly cycle and blood loss you should always discuss this with your GP and ask for a referral to a gynaecologist.
Why do some women get painful heavy periods?
There can be a variety of reasons why periods can be both heavy and painful, but please be reassured there are also plenty of nutrition, lifestyle and food supplement interventions that may help ease these symptoms as well as possible medical interventions.
Heavy painful periods can occur at any stage, but they appear to be more common during the teenage years and then again when women hit their forties. They can therefore hit mother and daughter at once. One explanation for this could be that at these life stages, progesterone is low compared to oestrogen. This suggests that oestrogen may make periods heavier, whilst progesterone could make periods lighter.
However, there are still lots of women that experience heavy periods throughout their lives and there are probably other factors driving this condition such as fibroids, endometriosis, and polycystic ovary syndrome (PCOS) which can be diagnosed by a gynaecologist.
Two other factors to be considered are anaemia and mast cell activation.
- When you have heavy monthly bleeding, you are at increased risk of becoming anaemic (iron deficiency) or becoming low in your iron stores (measured as ferritin levels in blood tests). Some common symptoms of low iron include fatigue, weakness, constipation, shortness of breath, and feeling dizzy and light-headed. If you suspect that you are anaemic or low in your iron stores, then it’s important to visit your GP and get your haemoglobin and ferritin levels checked. Ideally ferritin should be over 27 for menstruating women and preferably over 70 to feel well and energised.
- Another underlying factor is mast cells, which are part of the immune system that release histamine and may cause far reaching symptoms including hives, urticaria, allergies, sneezing, hot flushes, irritable bladder, anxiety, dizziness, nausea, period cramps and potentially premenstrual symptoms (PMS). There are a lot of mast cells in the uterine lining, and if activated, they release not just histamine but also heparin, which may make periods heavier as it is considered a natural blood thinner.
How can nutrition and lifestyle help with painful heavy periods?
Here are my top five clinical nutrition tips to try for a few months if you or your daughter are experiencing heavy or painful periods and want gain back control of your hormone health.
1. Reduce refined sugar and ultra-processed snacks
There is a strong link between premenstrual symptoms and elevated inflammation, which suggests that refined sugar, which is pro-inflammatory, has the potential to make periods worse.
Sugar also impacts our mood and energy levels therefore balancing blood sugar is also essential for balanced hormones. When our blood sugar is unbalanced, it can feel like we are experiencing a roller coaster of emotions and symptoms such as fatigue, mood swings, anger, anxiety, irritability and even insomnia. Removing or reducing your refined sugar intake over time should help to lessen symptoms associated with blood sugar dysregulation, especially if polycystic ovarian syndrome is present.
One study carried out in 2018 found a pattern that many teen girls who snacked on lots of sugars, sweets, puddings, tea, coffee, salt, fruit juices and added fat experienced moderate to severe period cramps.
2. Increase Omega oils
Studies have found that omega 3 fatty acids help to reduce overall pain and inflammation. One study cites that teenage girls’ painful period cramps can be helped by consuming more dietary omega 3 from oily fish like salmon, sardines, mackerel and anchovies as well as walnuts, flax seeds and chia seeds.
Flaxseeds can also help provide important fibre, as constipation or hard stools can exacerbate menstrual pain and many women find things easier when their bowels are flowing well during their period. If you are suffering from a sluggish bowel or constipation, flaxseeds may help get things moving again. Just add one tablespoon to your breakfast of choice – stir them into porridge or add them to a smoothie. Flaxseeds are also packed with nutrients such as potassium, magnesium, protein and soluble fibre.
3. Eat more cruciferous vegetables
Think green vegetables such as Broccoli, Brussels Sprouts, Cauliflower, Cabbage, Rocket and Kale which contain vitamins C, E and K, as well as fibre, and are rich in folate.
From a simple perspective, women who eat less fruit, veg and salad tend to have more painful periods. Cruciferous vegetables are also a great source of phytonutrient (plant-based) compounds, which may help to lower inflammation and thus pain. These vegetables are powerful because of their glucosinolate content. When we chew, digest, chop or blend glucosinolates an enzyme called mironase is activated; this then converts glucosinolates to indole-3-carbinol which helps to regulate and support hormone clearance.
4. Reduce your histamine food consumption
If you suspect that your heavy periods are being caused by histamine or mast cell activation, a useful way to calm this activity is to cut back on high histamine foods such as tomatoes, avocado, spinach, oranges, aged cheeses and cow’s milk for a few cycles and see if this makes a difference.
Specifically for some women, the protein A1 casein (which is found in most cow’s milk) can metabolise into an inflammatory peptide called BCM7 and this has the potential to activate mast cells. A1 casein doesn’t affect everyone like this, but you’ll probably know if you are sensitive to dairy.
Most Guernsey and Jersey milk contains more A2 casein which is much better tolerated, and you can buy special A2 milk from online organic shops. Goat and sheep milk, yoghurt and cheese usually also contain less A1 casein, and butter and ghee (clarified butter) are perfectly fine to consume. Some people choose plant-based alternatives such as almond or coconut.
5. Introduce magnesium
Did you know that magnesium also has an impact on hormones? It’s a very busy mineral with over 300 essential functions in the body, many of which help support hormone health from anxiety and sleep to PMS and bone health.
Try to consume food sources that are rich in magnesium including dark chocolate, leafy green salad leaves and veggies, nuts, tofu and seeds. If you struggle to eat these foods daily, you could also consider a magnesium supplement and/or an Epsom salt bath to ensure this essential nutrient is topped up.
What we eat can certainly steer us in the right direction towards less painful and heavy periods whilst also helping to balance other PMS symptoms that often come hand-in-hand with a heavy cycle. If you have any concerns about your menstrual health, then please get this checked out first by your GP to rule out any underlying causes and to put your mind at ease.
NatureDoc has a dedicated team of Nutritional Therapists who specialise in women’s health and can organise full hormone testing and individualised support for menstrual irregularities.
- A preliminary study of factors influencing perception of menstrual blood loss volume
- Stool frequency and form and gastrointestinal symptoms differ by day of the menstrual cycle in healthy adult women taking oral contraceptives: a prospective observational study
- Diet and Inflammation
- Endometriosis, dysmenorrhea and diet—What is the evidence?
- Supplementation with omega-3 polyunsaturated fatty acids in the management of dysmenorrhea in adolescents
- Relationship between Diet, Menstrual Pain and other Menstrual Characteristics among Spanish Students
- Major dietary patterns in relation to menstrual pain: a nested case control study
- Cruciferous Vegetables
- Effects of Magnesium and Vitamin B6 on the Severity of Premenstrual Syndrome Symptoms
- Effects of anemia and iron deficiency on quality of life in women with heavy menstrual bleeding