Menstrual Abnormalities - amenorrhea menorrhagia and dysmenorrhea

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An A-Z Woman's Guide to Vibrant Health

Menstrual Abnormalities

A normal menstrual cycle involves complex hormonal interactions that stimulate the ovaries to produce and release estrogen, progesterone and ova (eggs). Menstruation normally occurs in the first five days of the cycle as a result of a decline in estrogen and progesterone levels when pregnancy does not occur. Without these hormones to support the uterine lining, it pulls away, tearing capillaries and causing bleeding.

In the follicular phase (Days 6-14), a shift in follicle-stimulating hormone and luteinizing hormone (LH) triggers production of estrogen from the ovaries, which encourages the growth of a new uterine lining, known as the endometrium. At the midpoint of the cycle, rising estrogen levels cause LH levels to surge, and in response, the ovaries release an egg, typically between Days 12 and 14.

In the next phase, Days 14 to 28, the site of egg release (corpus luteum) secretes copious amounts of progesterone, necessary to prepare the endometrial lining to receive a fertilized egg. At this stage in the luteal phase of the cycle, progesterone levels exceed estrogen levels. If pregnancy does not occur, progesterone and estrogen levels drop, leading to menstruation, and the cycle begins again.

Cycles continue until an average age of 52 years and would normally only be interrupted by pregnancy and breastfeeding. Hormonal problems, including imbalances in the estrogen/progesterone ratio, can interfere with normal cycles. Problems with menstruation include amenorrhea (absent periods), menorrhagia (excessive bleeding), dysmenorrhea (extremely painful menstruation) and irregular periods. There is often a variety of underlying conditions that prompt these symptoms.

Amenorrhea
Amenorrhea means the absence of periods. Periods typically begin in the early teens, and should continue, unless pregnancy occurs, until menopause. A physician should examine girls who haven’t started puberty by age thirteen, or who start puberty but do not menstruate within five years, and girls who have reached the age of sixteen without menstruating.

Amenorrhea may be caused by an abnormality in the pituitary gland, brain, adrenal glands, ovaries or other components of the reproductive system. Thyroid imbalances are often a factor in infrequent or lack of periods (See Thyroid). Hormonal irregularities such as polycystic ovary syndrome may prevent the release of an egg, disrupting the hormonal cycle. (See Polycystic Ovary Syndrome) High levels of stress or Cushing’s syndrome can cause the production of excess cortisol, suppressing production of the necessary reproductive hormone DHEA, and resulting in the disruption of periods. Anorexia, excess exercise and being overly thin may interfere with the menstrual cycle, as can scarring of the uterus or placental tumors called hydatidiform moles.

Menorrhagia
Menorrhagia means heavy bleeding. Approximately 75 percent of abnormally heavy bleeding is the result of hormonal imbalances that interfere with the proper functioning of the reproductive system. Sustained high levels of estrogen are typically involved. Hydatidiform moles, uterine fibroids and polycystic ovary syndrome may also be present. (See Uterine Fibroids, Polycystic Ovary Syndrome). Low levels of thyroid hormone are also a cause of heavy bleeding (See Thyroid).

Physical causes of heavy bleeding include adenomyosis (abnormal growth of uterine cells), which is often found in girls whose mothers took diethylstilbestrol (DES). These girls are at increased risk of vaginal and cervical cancer when they are older. Injury from sexual abuse, infection or prolapse of the uterus can also cause bleeding. The National Hemophelia Association predicts that up to three percent of women suffer from undiagnosed bleeding disorders such as von Willebrand disease, a genetic disease caused by a deficiency or a defect of a crucial blood clotting protein. Deficiency in Vitamin K, vital for blood clotting, may also be a factor in heavy bleeding. Excessive blood loss can lead to anemia (See Anemia).

Dysmenorrhea
Dysmenorrhea is marked by painful cramps, headache, nausea, vomiting and frequent urination, with menstruation severe enough to interfere with the normal activities of 5 to 15 percent of women. Primary menstrual pain may result from uterine contractions that occur when blood supply to the endometrial lining diminishes. The expulsion of clots is also a source of pain. Secondary dysmenorrhea can be the result of such conditions as endometriosis, adenomyosis (abnormal cell growth), fibroids and abdominal adhesions. (See Uterine Fibroids, Endometriosis)

Whether you are experiencing heavy periods, painful periods or no periods, these abnormalities must be reported to your doctor. Be sure that you receive a referral to a gynecologist, who should perform an ultrasound (either vaginal or abdominal) to help discover the cause of your symptoms. Abnormal bleeding, pelvic pain or abdominal fullness should not be ignored.

PRESCRIPTION FOR WOMEN'S HEALTH

Nutrients

Dosage

Action

Multivitamins with minerals; (contains no iron)
FemmEssentials or MultiEssentials for women

As directed. See Appendix A for the complete listing of recommended nutrients and their actions.

Provides all the nutrients a woman needs every day to support all functions

EstroSense

2 capsules at breakfast

containing:

Milk Thistle 100 mg

Supports liver health, which is important for metabolism of hormones

D-glucarate 300 mg

Important for healthy metabolism of estrogen; detoxifies breast cancer-promoting agents

Turmeric 100 mg
(95% curcumin
100 mg inositol daily )

Prevents breast cancer, detoxifies cancercausing form of estrogen, excellent to reduce chemotherapy side effects

Indole-3-carbinol 300 mg
(found in cruciferous vegetables)

Reduces risk of breast cancer, can be used in conjunction with tamoxifen; prevents healthy estrogen from converting into the cancer-causing form

Green tea extract 200 mg daily

Protects against breast cancer

Rosemary extract 50 mg daily

Reduces tumor formation and breast lumps; antioxidant

Lycopene 10 mg daily

Antioxidant, reduces risk of breast cancer

Sulforaphane 400 mcg daily

Reduces risk of breast cancer

Vitamin K

80 mcg per day

Stops heavy bleeding

Potassium Iodine or kelp

Follow directions on the label

Important for thyroid activity. Deficiency of iodine promotes heavy periods and infertility.

Natural Progesterone cream

In Canada, progesterone cream is a prescription drug. Use 6% natural progesterone 1/4 to 1/2 tsp morning and night between day 5-28 (or whenever your normal cycle ends). In the U.S., ProgestaCare by Life Flo is my choice as it delivers 20 mg in a pre-measured pump dose.

Restores progesterone level and alleviates estrogen dominant symptoms. Contols heavy bleeding. Also used to promote menstruation

Cramp bark tincture

1/2 teaspoon every 2-4 hours for acute pain

Relaxes the uterus and reduces cramps

Evening Primrose or Borage Oil

3000 mg per day of Evening Primrose oil or 2000 mg of Borage oil daily

Anti-inflammatory; controls inflammatory prostaglandins involved in pain and inflammation Stops diarrhea and flooding periods

Chaste Tree
(Vitex) berry

100 to 175 mg daily

Balances estrogen-to-progesterone ratio Normalizes menstrual cycle and stops PMS

HEALTH TIPS TO ENHANCE HEALING

See Endometriosis for health tips.


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