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Understanding Heavy Bleeding


Bottom Line/HEALTH: All right, I’m going to get icky for a second, and I’m sorry. But women, for years it was all very consistent every month, and then suddenly you reach a stage in your life and whoosh! You got a week’s worth in hours. And it’s not a pretty, bloody sight. Let’s find out what’s going on with the heavy bleeding as we get older, and how you can deal with it, handle it, and can you minimize it.

I’m Sarah Hiner, President of Bottom Line Publications, and this is our Conversation With the Experts, where we get the answers to your tough questions from our leading experts.

Today I’m talking to Dr. Holly Lucille, a leading naturopathic physician and expert in integrative medicine. Dr. Lucille was listed in Time Magazine’s ALT list as one of the top 100 most influential people and is the author of Creating and Maintaining Balance: A Woman’s Guide to Safe Natural Hormone Health. You can learn all about her at

Welcome, Holly. Thank you for talking to me today.

Holly Lucille, ND, RN: Yeah, thanks Sarah.

Bottom Line: All right, so what’s going on with this heavy bleeding? That had to be the worst part to me of the whole menopausal process.

Dr. Lucille: I love that you bring this up, because it is a little shocking and it’s uncomfortable as there’s a lot of cramping and pain involved. You’re like, “Hey, what is going on?”

If it’s normal menopause – and once again, we like to educate on the normal variants of menopause – people can understand that there is a little shifting and changing going on, and this is definitely one of them.

Due to the decrease in ovulation, estrogen, which is dominant in your first half of the cycle – and hormones deliver messages, and estrogen’s message is to tell cells to grow and proliferate. It’s working very hard to get the uterine lining all plumped up for the egg to come down. The second half of the period is dominant in progesterone, pro-gestation. So if we’re not ovulating, that progesterone is not there, so we’re having this buildup of estrogen. We’ve got estrogen working really hard, but sometimes it is too much.

So that one period that you will eke out, even though it’s become irregular or maybe there’s been a very, very long time since you had your other one, is going to be a little bit more profound, I should say.

Bottom Line: So the estrogen basically keeps building and building and building because the progesterone doesn’t tell it to shut off?

Dr. Lucille: Exactly. They’re not having that dynamic dance anymore. There are other shifts going on because they’re both starting to decline naturally. However, we have to take into consideration environmental influences, especially around this time. Because there are modern day environmental influences on our endocrine or hormone system, and it shows up as menopausal type symptoms, especially when we first start. And this is definitely one of them.

Bottom Line: It seems that there are multiple ways that it shows up. For me – hello, world; no secrets at Bottom Line – it was like a week compressed into a day. It just went whoosh. Versus some people, it just stays very heavy for a longer time. Is either of those more normal or less normal?

Dr. Lucille: Here’s the thing: everybody goes through it differently. Believe me, I’ve been practicing for 15 years now and I’ve seen so many different stories and heard different stories regarding this process for folks.

The most important thing is if you have any concern whatsoever, or if things aren’t feeling right at all, it’s important to make sure that you’re evaluated to rule out something called dysfunctional uterine bleeding. Because there are other causes; sometimes cancer can be a cause of heavy bleeding, and we want to make sure that we’re going to rule that out so we can know that this is just menopause and that we’re transitioning through this, and it’s just one of the signs and symptoms.

Bottom Line: I was just going to ask you when somebody should see a doctor. So let me ask you this: should pain be associated with heavy bleeding or no change in pain level?

Dr. Lucille: Sometimes people do experience pain, because what happens is the uterus has to contract in order to slough off that lining. Those contractions, for all of you lovely mothers who’ve had babies and such naturally, there is some pain involved in that. But sometimes pain isn’t involved. Everybody’s different in the way that their prostaglandin symptoms manifest, and whether they have great essential fatty acids on board – if so they’re decreasing that inflammation, and then, therefore, the pain receptors.

Bottom Line: If I’ve never had cramping before, will I suddenly get cramping? Or is it only pain if somebody’s been a cramper all along?

Dr. Lucille: It’s a possibility. Everybody does it differently, and yeah, certainly, if you’ve got a lot of blood to shed there, your uterus might do something that you’ve never felt it do before.

Bottom Line: It’s all a new process, right? Is there anything that people can do to ease the bleeding through this process?

Dr. Lucille: For the most part, that really is a natural process that needs to happen. It’s a good thing; better out than in, we say at this point in time. So getting through it and also being aware, decreasing your fear around it. Also, I would say for the pain that it would be more of a modifiable sign in making sure you do have good essential fatty acids on board, good anti-inflammatories, and that you’re avoiding food triggers and things that are going to make that process worse.

Bottom Line: How about post-cycle? Is there anything they should be doing to replenish their body?

Dr. Lucille: At this point in time, nourishment comes in full force. When you look at diet in the dictionary, it actually means habitual nourishment. So absolutely, if you’re losing a lot of blood, you want to be able to make sure that you’re eating a lot of – I call them floppy greens. Replenishing from a phyto perspective or a plant perspective those nutrients – iron, magnesium, etc. – that you could’ve lost in the process.

Bottom Line: Then how about drinking water? Need more fluids at all?

Dr. Lucille: I’m a big advocate of staying hydrated all the time, so certainly that’s a metric you want to be able to check off, for sure.

Bottom Line: All right, great. Thank you very much, Dr. Holly Lucille. The bottom line on heavy bleeding while you’re going through menopause? It’s a natural process. It’s going to happen. It’ll happen to different people in different ways. So don’t be scared of it, but be in touch with your doctor; if you have any kind of pain, if you have any kind of uniqueness that’s happening, make sure that your doctor checks you out. Also, nutrition is more important than ever. Healthy greens, omegas, lots of water. This is Sarah Hiner with Bottom Line.

Source: Holly Lucille, ND, RN, a naturopathic doctor based in West Hollywood, California. She is the author of Creating and Maintaining Balance: A Woman’s Guide to Safe, Natural Hormone Health and serves on the board of directors for the Institute for Natural Medicine.

Date: January 6, 2015
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