An Integrative Approach to Heavy Menstrual Cycles

Katherine Thurer, MD, FACOG

Excessive vaginal bleeding is one of the most common reasons women see their gynecologists each year, accounting for one third of all gynecology visits. In this article we will explore the normal menstrual cycle and what causes heavy periods. We will also uncover integrative medical treatment options for heavy periods, including a simple and safe in-office procedure that can reduce your heavy periods once and for all!

The normal menstrual cycle involves a complex harmony of communication between the hypothalamus and pituitary (glands in your brain), the ovaries, and the uterus. In a normal period, the lining of the uterus (the endometrium) grows in response to estrogen. It then changes to a more secretory form with exposure to progesterone (from ovulation); and then ultimately sheds when the progesterone level declines. How your period stops is equally intricate, involving a series of events that result in clot formation, uterine contractions, and constriction of the blood vessels that supply the endometrium.

The normal menstrual cycle starts every 24 to 35 days, lasts from 2 to 7 days, with less than 80mL (5 to 6 tablespoons) of blood loss per cycle. The average woman loses 2 to 3 tablespoons of blood each cycle.

What Causes Heavy Periods?

There are many causes of heavy periods, the most common are:


• Certain medicines and medical conditions: Some medicines (like warfarin, for example) can cause heavy periods. Some medical conditions, such as thyroid disease, von Willibrand's disease, or having a low platelet count, may also contribute to heavy bleeding.


• Abnormal growths in the uterus (such as fibroids or polyps): Structural defects of the uterus also cause heavy bleeding, such as fibroids and polyps (small growths) inside the uterus. Endometrial hyperplasia (an overgrowth of the lining of the uterus) can cause heavy bleeding as well. It is important to evaluate women over 35 years old with heavy periods for this precancerous condition.


• Anovulation (not releasing an egg once per month): Anovulation (not menstruating) is the most common cause of heavy bleeding in teenagers and women in or near menopause.

How Can an Integrative Approach Help?

The integrative medical approach for heavy periods includes a variety of medical, surgical, and other treatment modalities. Medicines including hormones are used to help decrease the amount of blood that is lost and regulate periods. Mirena, a hormone-containing IUD, can be useful for women who desire both contraception and a solution to heavy bleeding, as it causes a light period or even no period at all. Sometimes surgery is necessary to remove a polyp or a fibroid that impinges on the uterine lining.

Good news: Hormones and surgery are not the only options!

Some herbal formulations (such as Chaste Tree berry and Shepherd's purse) are useful to regulate the period and stop heavy bleeding. Acupuncture is a valuable tool to bring the woman's body back in balance as well.

At the Raby Institute for Integrative Medicine, we offer a minimally-invasive office procedure calledNovaSure®. This procedure, which can be performed in as little as 90 seconds, is a novel approach to the treatment of heavy periods. NovaSure gently removes the endometrium, so monthly bleeding is reduced or even eliminated. It does not interfere with the body's natural production of hormones (like some medicines) and it is significantly less invasive than a hysterectomy. Not all women are good candidates for this procedure, and it is only for women who do not wish to have children in the future.


To learn more about Dr. Katherine Thurer, MD, FACOG see her profile on our website. To schedule a consult with Dr. Thurer, call the Raby Institute at 312-276-1212 or email us at


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