Menorrhagia / Excessive Menstrual Blood Flow
Dysfunctional uterine bleeding accounts for 30-40% of all gynecological visits, and 60% of all dilatation and curettage procedures. Fifty percent of patients undergoing hysterectomy for menorrhagia in Oxford, England, were scheduled for surgery because of regular heavy menstrual bleeding of unknown cause. The most commonly occurring causes of true excessive menstrual bleeding are: leiomyomas (fibroids) of the uterus, pelvic inflammatory disease, endometriosis and adenomyosis, lesions in the uterine cavity, such as submucous leiomyoma, intrauterine polyps, and intrauterine contraceptive devices. In the absence of any clinically apparent pelvic disease as described above, excessively heavy menstrual bleeding is called “dysfunctional uterine bleeding.” Benjamin and Seltzer describe dysfunctional uterine bleeding as “abnormal uterine bleeding in which there is absolutely no organic pathological condition to be detected on clinical pelvic examination.” In one study, 42 women who underwent hysterectomy for excessive menstrual blood losses were found to have no obvious pathology, nor an excessive number of arteries for abnormal glandular distribution. In other words, it is common for women to suffer from excessive menstrual bleeding for no known organic cause. Often the cause is due to biochemical imbalances produced by vitamin and mineral deficiencies and/or essential fatty acid imbalances, which may be systemic or tissue-specific.
A naturopathic approach to treating someone with menorrhagia would start with a complete hormone panel to discover any hormone imbalances. Most often the imbalance is estrogen dominance and this can be accompanied by low progesterone. Therefore treatment would start with an estrogen detoxification program. Estrogen is detoxified through the same p450 enzymatic pathway as caffeine and alcohol so one way to maximize the detoxification of estrogen is to eliminate caffeine and alcohol from the diet. Clinical nutrition may also be added to assist. Increased insulin due to insulin resistance also contributes to the estrogen dominance, therefore a low glycemic, high protein meal plan may be recommended to help address the underlying insulin resistance. Bio-identical progesterone may be prescribed or botanical natural progesterone if progesterone is low. Botanical medicine combination may also be prescribed to help slow down the flow of bleeding at the time of menses.