Author: Lindsay Adams, CH, CN
Do you ever wonder what your period might be telling you? Do you skip periods or get them more than once a month? Do you rely on pain medication or a heating pad to make it through a day with menstrual cramps? Do you soak through pads or tampons regularly? Do you feel faint, dizzy or heavily fatigued during your monthly bleed?
If you said yes to any of the above, I’m here to tell you that all of these common period symptoms are not normal. A hormonal imbalance or reproductive disorder may be to blame and you have options. The more you know about the root causes of your health concerns, the more you can do to begin healing.
The Healthy Menstrual Cycle
The menstrual cycle is measured from the 1st day of your period to the last day before your next period. A normal cycle lasts between 26-34 days. Teenagers & those in perimenopause can experience a much wider range and still be considered normal. Though all bodies are different, a healthy bleed lasts from 3 – 7 days. Flow is typically heaviest on day 1 or 2, but you shouldn’t be soaking through more than 6 pads/tampons on any day. Pain should not exceed occasional mild cramps or pelvic tension. Breasts should also be pain-free and without cyclic lumps or cysts. Headaches and migraines should not precede or accompany your period regularly. The sudden drop in estrogen & progesterone that initiates our monthly bleed can prompt mild shifts in mood, energy, sleep and our desire for social interaction. Slowing down around this time is perfectly normal, but these shifts should not feel extreme or disruptive to you.
Premenstrual Syndrome (PMS)
PMS has many variations of normal. An increase in prostaglandins during the week before your period can cause loose stools, mild bloating, mild cramping or various signs of inflammation. Mild pelvic heaviness or tension can occur due to increased blood flow to the uterus. A drop in estrogen levels can cause mild constipation. Hormone-induced water retention can lead to breast fullness/sensitivity or abdominal bloating. Cravings for sugar or carbs are common and likely due to a drop in serotonin levels. Chocolate cravings could also be attributed to this, but some theorize that we crave the magnesium found in chocolate, which can ease muscle cramping. Our body’s innate wisdom could also be responsible for red meat cravings as an antidote to iron loss during bleeding.
The Stress Effect
You may notice that when you have a particularly stressful life event occur (e.g. moving, relationship struggles, illness or loss), that your next period changes. Some folks skip their period all together when under excessive levels of stress. Others experience a change in blood flow, pain, timing or their PMS symptoms. These temporary shifts in your cycle are not typically cause for concern, especially if the variance in time is 6 days or less. When this happens and you can identify a likely trigger in your life, focus on slowing down, eating nourishing foods & listening to your body’s needs.
The color of your menstrual blood can also offer some key information. Bright red blood is fresh blood and often denotes a healthy flow. Very pale or light pink/watery blood could indicate low iron or anemia. If your blood is always light in color, ask your healthcare provider for anemia screening bloodwork. A grey or yellow hue in your menstrual blood could indicate a vaginal infection. See your healthcare provider as soon as possible. Very dark blood (brown or black) typically indicates old blood. This blood has been sitting in your uterus for a while and could indicate the beginning or end of your period. If you see this kind of blood throughout your period, you may have pelvic congestion or sluggish blood flow. Herbs like Red Raspberry leaf, Ginger, Motherwort, Chamomile and Mugwort can ease pelvic congestion.
Abnormal Period Symptoms
Now, let’s talk about common abnormal period symptoms and what you can do about them! Let me start by emphasizing that if any of the following symptoms occur (especially if your symptoms are new or progressively worsening) you should always start with a visit to a medical doctor, naturopathic doctor or midwife. These practitioners can evaluate your symptoms, possibly offer you a diagnosis and rule out any life-threatening conditions. If you’ve done this and still don’t have answers, don’t lose hope!
If you have to change your pad/tampon every 1-2 hours, your blood clots are the size of a quarter or larger or your period lasts 8 days or longer, you may have a heavy period. While this is exceedingly common, it is not normal and can lead to fatigue, dizziness, low energy, shortness of breath and/or anemia. Heavy periods can point to a hormonal imbalance, endometriosis, polycystic ovarian syndrome (PCOS), uterine fibroids or ovarian dysfunction.
Two key types of hormone imbalance can cause an excessive buildup of our endometrial lining, which results in heavy menstrual bleeding. These types of hormone imbalances are estrogen dominance (high estrogen levels) or low progesterone. In either case, cramping is common due to the uterus contracting more intensely to expel the extra blood.
Symptoms associated with estrogen dominance are cyclic breast tenderness, menstrual migraines, mood swings, short menstrual cycles, bloating and water retention. Diagnoses associated with estrogen dominance are endometriosis and fibroids. Natural therapeutic options for estrogen dominance include:
- Eating plenty of cruciferous veggies (like broccoli), dark leafy greens, fermented foods and high-fiber foods. All of these play an important role in increasing estrogen clearance from the body.
- Utilizing supportive herbs such as Peony root and St. John’s Wort. Use the latter with caution if you take any crucial medications, as it can interfere with them.
- Focusing on your gut health. Disruptions in your intestinal microbiome can cause a huge variety of hormonal problems, including estrogen dominance. Eat fermented foods daily.
Low Progesterone & PCOS
Low progesterone is associated with fertility problems, irregular & long menstrual cycles, low libido, spotting between periods, insomnia, endometriosis, cyclic breast pain, miscarriage, water retention, anxiety and depression. This hormonal imbalance has two main causes: PCOS and/or not ovulating (anovulation). You may suspect PCOS if your periods are more than 35 days apart, you struggle with acne, hair loss or hair in unwanted places, difficulty losing weight or difficulty conceiving. See a doctor for diagnosis. Management of PCOS is a complex process, but key therapeutics include:
- A consistent exercise routine. If you don’t typically exercise, start with a 30-minute walk 2-4 times/week.
- Balancing your blood sugar by increasing protein and healthy fats in the diet and reducing carbohydrates and sugars.
- Eating omega-3 rich fish regularly or take a high-quality Omega 3 fish oil supplement (I recommend Nordic Naturals).
- Sleeping at least 7-8 hours a night. I cannot emphasize enough how crucial this is for your hormone health!
- Utilizing herbal allies for PCOS. Some of my favorites are White Peony root (especially when paired with Cinnamon – try this combo in a tincture!), maitake mushrooms, Spearmint tea, Ashwagandha, Holy Basil (Tulsi) and Reishi. Work with a clinical herbalist to formulate a custom protocol for best results.
Anovulation (the absence of ovulation) is a bit more complicated to manage. There are a myriad of causes and I cannot cover them all within the scope of this article. The most common cause of anovulation is a condition called hypothalamic amenorrhea, which is primarily characterized by skipped periods (amenorrhea) in combination with low body weight, sudden weight loss or severe personal stress. Hypothalamic amenorrhea is found most commonly in high-intensity athletes and those who eat a very low-calorie or restrictive diet. Therapeutics include:
- Reducing exercise frequency and/or intensity by 5-15%.
- Increasing your calorie intake. Make sure your diet includes ample healthy fats and healthy carbs. Depending on how long you’ve been experiencing amenorrhea/anovulation, these changes can take up to 6 months to return your periods to normal.
- Using supplements that like Vitamin B6, Vitamin C and Omega-3 fish oil. Flaxseeds can also be supportive.
Menstrual pain is a bit harder to pin down than the previous menstrual concerns, but relief is nearly always found with improvement of our overall health, even if pain is due to endometriosis or fibroids. Strategies for reducing menstrual cramps include:
- Focusing on a healthy diet with ample protein, healthy fats and vegetables, with a focus on plant-based meals. Reducing or eliminating refined carbohydrates, sugars and processed foods reduces inflammation in the body and can reduce menstrual pain in turn.
- Using supplements like omega-3 fish oil, calcium, magnesium, Vitamin D3 and Vitamin B1 (thiamine). High doses of Omega-3 can help reduce acute pain within a few hours, but preventative doses the week before your period are most effective.
- Utilizing herbs to reduce pain, like Ginger root, Motherwort, Crampbark, Turmeric, Jamaican Dogwood and Wild Yam. I have found powdered Crampbark capsules to be especially effective.
- Considering a switch to pads or period underwear from tampons or menstrual cups. Many women (including myself) find immediate relief.
- Exercising regularly. It can prevent or reverse period pain.
- Orgasms! Whether with a partner or solo, these wonderful little stress-relievers can relieve pelvic discomfort and period pain.
There are countless other ways that our periods communicate with us about our health and each person will require a personalized approach to find relief and balance. If you dread your period every month, I hope you’ve acquired a bit of insight in to what your period is trying to tell you and where to go from here. If you want to dive deeper on your menstrual health and get personalized nutritional and herbal recommendations, consider seeing a Clinical Herbalist and Nutritionist for support!
Visit Lindsay’s Class Pages:
Menstrual and Reproductive Health
- Colorado School of Clinical Herbalism Curriculum. Uterine & Ovarian Reproduction, A&P and Materia Medica.
- Romm, Aviva. Hormone Intelligence: the complete guide to calming hormone chaos and restoring your body’s natural blueprint for well-being. 2021
- Holmes, Peter. The Energetics of Western Herbs: Treatment Strategies Integrating Western and Oriental Herbal Medicine, Vol. 1&2. 2006.