We typically think of menopause as the stage in life when periods are declining and eventually ending. Yet heavier periods are common among women in menopause. Why do some women experience heavier periods and how can they be managed?

What are heavier periods?

First of all, not every woman in menopause will experience heavier periods. Second, periods are definitely individual: what’s heavier menstrual flow for one woman will be either more or less than that for another woman. Heavier menstrual flow and irregular periods often occur together during this transitional time.

Generally, a heavy flow is defined as more than 80 milliliters per period. If you have twelve or more soaked sanitary products during a period, that is viewed as a heavy flow. A greater number of clots and larger ones are also common. A “normal” flow is about 2 to 3 tablespoons of blood over three to five days, although this is merely an average. Any amount of blood in the 25 to 80 ml range is viewed as “normal.”

Read about 7 shocking ways menstruation impacts people and mother earth

Why does menopause cause heavy periods?

During a normal menstrual cycle, follicle stimulating hormone (FSH) causes eggs to mature in the ovaries. The follicles make estrogen, which in turn causes the uterine lining to thicken. The ovaries release a mature egg and creates progesterone. When the egg isn’t fertilized, menstrual flow occurs.

During perimenopause, however, there are fewer follicles to stimulate so FSH production increases, which results in ore estrogen produced. This in turn causes the uterine lining to become thicker, resulting in heavier bleeding. In addition, ovulation doesn’t always occur during perimenopause, but the uterine lining still thickens. Once it sheds, the result is a very heavy flow.

According to researchers at the University of Michigan, the majority of women will experience an increase in flow and duration of bleeding. They note that “With the onset of the menopausal transition in their 40s, women’s menstrual periods can change dramatically.” The authors point out that these changes can last from 2 to 10 years.

More specifically, the authors found that it wasn’t unusual for women to bleed for 10 or more days, spot for six or more days, and/or experience heavy bleeding for three or more days during perimenopause into menopause.

The study looked at more than 1,300 women ages 42 to 52. Ninety-one percent had one to three occurrences of bleeding that lasted 10 or more days during a three-year period, 88 percent experienced six or more days of spotting, and nearly 78 percent had three or more days of heavy menstrual flow.

How to a manage heavier periods naturally

Several lifestyle tips may help ease heavier periods during perimenopause and menopause.

• • Eat well. Foods with added refined sugar and caffeine both can contribute to heavy periods. Focus on whole, natural fruits and vegetables, whole grains, seeds and nuts, and lean protein to provide you with the nutrients you need for optimal health.
  • Control stress. Hormone production is affected by stress, so it’s best to manage stress every day. Yoga, tai chi, meditation, progressive relaxation, fun exercise, visualization, listening to soothing music—take time to control stress as a way to help alleviate heavy flow.
  • Get enough iron. If you experience heavier periods than normal, you may be at risk for iron-deficiency anemia. Foods rich in iron include dark leafy vegetables, figs, beans, tofu, blackstrap molasses, and spinach. If necessary, your healthcare provider may recommend an iron supplement.
  • Try an herbal remedy. The herb Agnus castus is best known for helping women who have premenstrual syndrome. However, it also can help balance hormones during perimenopause and menopause.
  • Manage your weight. Fat tissue produces estrogen. Therefore, if you reduce your weight, estrogen levels should decline and you may not develop the thicker uterine lining and thus a heavier period.
  • Check your meds. Some medications, including birth control, can contribute to heavier bleeding. Your doctor may help you find alternatives if a medication is involved.
  • Get vitamin C. You will need more vitamin C because it helps the body absorb iron, which may help prevent anemia. Citrus fruits and bell peppers are great food sources.

when to see a health provider

According to Sioban Harlow, University of Michigan professor of epidemiology and an author of a study on prolonged and heavy bleeding during menopause, “These dramatic changes can be disconcerting and often provoke questions about whether something is wrong.” If you are experiencing bleeding that soaks a tampon or pad in an hour and lasts for more than two hours, clots larger than a quarter, fatigue and dizziness, bleeding after menopause, bleeding after sex, or bleeding that lasts more than two weeks, see your doctor.

Other causes of heavier blood flow that may occur include uterine fibroids, endometrial polyps, bleeding disorders, uterine cancer, or use of certain medications, such as anti-inflammatories and anticoagulants. A physician can help you discover whether there is another underlying cause for heavier bleeding and menstrual irregularity.

bottom line

Heavier periods and irregular menstruation are common among women who are in perimenopause and menopause. These are temporary although they may last years, and you can take some natural measures to alleviate them.