NATUROPATHIC DOCTOR IN ONTARIO
Heavy Periods in Perimenopause
Causes, Concerns, and Natural Support Strategies
Heavy Periods in Perimenopause
Many women are surprised when their periods become heavier—not lighter—as they approach menopause. In fact, heavy menstrual bleeding is one of the most common symptoms in early perimenopause, and it can significantly affect daily life.
We want women to understand why these changes are happening, what they might signal, and how to address them using naturopathic tools that support the whole body—not just the symptom. If you’re in your 30s or 40s and experiencing heavier-than-usual periods, here’s what you need to know.
What Is Considered a “Heavy Period”?
Clinically, heavy menstrual bleeding (also called menorrhagia) is defined as losing more than 80 mL of blood per cycle or having a period that lasts longer than 7 days. But for many women, it’s less about the exact measurement and more about how disruptive the bleeding becomes. You may:
- Need to change pads or tampons every 1–2 hours
- Soak through clothing or bedding
- Wake up at night to manage bleeding
- Pass large clots
- Feel drained, dizzy, or short of breath during your period
If this sounds familiar, your body may be trying to get your attention.
Why Does Heavy Bleeding Happen in Perimenopause?
The most common root cause is hormonal imbalance, particularly a pattern known as relative estrogen dominance.
During early perimenopause:
- Estrogen levels often spike unpredictably
- Progesterone begins to decline due to less consistent ovulation and weaker corpus luteum activity
Estrogen’s job is to build up the uterine lining, while progesterone helps regulate and stabilize that growth. When estrogen is unopposed by enough progesterone, the uterine lining can become excessively thick—leading to heavier, prolonged, and sometimes more painful bleeding.
In addition to hormones, other contributors may include:
- Inflammation, which can make bleeding more intense and painful
- Stress, which suppresses progesterone further
- Thyroid dysfunction, which is common in women over 35 and can affect cycle regularity and flow
- Fibroids or polyps, which can develop more easily with estrogen dominance
- Nutrient deficiencies, particularly iron, B vitamins, and magnesium
When to Seek Medical Attention
While heavy periods are common during perimenopause, it’s important not to dismiss them as “just part of getting older.”
We recommend seeing a practitioner if:
- Your period lasts longer than 8 days consistently
- You’re soaking through products hourly
- You feel weak, lightheaded, or short of breath
- Your cycles are accompanied by severe pelvic pain
- Your periods stopped and then returned suddenly
In some cases, heavy bleeding may be a sign of a structural issue (like fibroids or polyps) or even an underlying condition such as endometrial hyperplasia. That’s why thorough assessment and appropriate lab work or imaging are essential.
Naturopathic Strategies for Managing Heavy Periods
At Sequence Wellness, our goal is to reduce symptoms while supporting your overall hormone health. Here are some of the tools we use to help regulate heavy bleeding naturally:
1. Support Estrogen Metabolism
- DIM (Diindolylmethane): A compound found in cruciferous vegetables, DIM helps shift estrogen metabolism toward more favorable pathways. It can be especially useful during estrogen-dominant phases of perimenopause.
- Calcium D-Glucarate: Supports estrogen clearance through the liver and prevents reabsorption of excess estrogen in the gut.
- Fiber: Eating 25–35g of fiber per day helps bind and remove excess estrogen through bowel movements.
- Cruciferous vegetables: Broccoli, kale, cauliflower, and Brussels sprouts are excellent for estrogen detox.
2. Balance Progesterone Naturally
- Vitex (Chaste Tree Berry): May support progesterone production by encouraging ovulation.
- Magnesium and B6: These nutrients help regulate the HPO (hypothalamic-pituitary-ovarian) axis and may support progesterone balance.
- Stress reduction: Chronic stress raises cortisol, which competes with progesterone production. Addressing stress is essential for hormonal harmony.
3. Reduce Inflammation
- Omega-3 fatty acids: Found in fatty fish or high-quality supplements, omega-3s help reduce prostaglandins that trigger cramping and excess bleeding.
- Evening Primrose Oil (EPO): Can ease breast tenderness and support a more balanced inflammatory response.
- Herbs like turmeric and Boswellia: These have natural anti-inflammatory properties and may be included in supplement protocols.
4. Herbal Support for Bleeding
Some herbs are traditionally used to manage menstrual flow:
- Ginger: Reduces menstrual blood loss and soothes cramping
- Yarrow and shepherd’s purse: Known for their ability to reduce heavy bleeding, often used in tincture form
Always consult your provider before starting herbs—especially if you’re on medications or have other health concerns.
Don’t Forget Iron
Heavy bleeding can quickly deplete your iron stores, leading to fatigue, brain fog, and reduced immunity. We often recommend:
- Ferritin testing to assess iron storage levels
- Heme iron or iron bisglycinate supplements, if needed
- Pairing iron-rich foods with vitamin C for better absorption
Restoring iron is essential not just for energy, but also for mood and cognitive function.
Can Testing Help?
Yes—when timed and interpreted correctly, hormone testing can provide valuable insights.
At Sequence Wellness, we may use:
- Cycle Day 21 progesterone and estradiol tests, if cycles are regular
- DUTCH hormone testing or cycle mapping, which tracks hormone patterns over time
- Thyroid panel, ferritin, and nutrient labs to rule out other contributors
These tests help us tailor treatment to your unique needs, rather than offering a one-size-fits-all solution.
You’re Not Meant to Just Cope
Heavy periods can feel like a storm you’re forced to weather each month—but it doesn’t have to be that way. With the right support, you can reduce the intensity of your bleeding, reclaim your energy, and restore your sense of normalcy.
At Sequence Wellness, we specialize in helping women move through perimenopause with confidence and clarity. If heavy periods are disrupting your life, we’re here to help you uncover the root cause and design a treatment plan that truly works for your body.
Book a consultation today to learn more about how we support hormone balance—so you can feel more like yourself again.
Your Doctor: Meet Dr. Sarah
Dr. Sarah Goulding is a licensed naturopathic doctor in Ontario and has a BSc in neuroscience and biology from Dalhousie University (2004), and did her 4-year naturopathic training at the Canadian College of Naturopathic Medicine (2010). She’s since accumulated over a decade of clinical experience, and refined her practice to focus on women’s health and digestion. She is licensed and registered as a Naturopathic Doctor in Ontario by The College of Naturopaths of Ontario (CONO) and is a member of the Canadian Association of Naturopathic Doctors (CAND) and the Ontario Association of Naturopathic Doctors (OAND).
Dr. Sarah Goulding blends science and compassion, and acts as a personal health researcher to help you navigate your health. Tools that she uses include nutrition, supplements and botanicals, bioidentical hormones, and lifestyle modifications. The closer you get to the root cause, the gentler the therapies needed to resolve the issue.
