Heavy flow and endometriosis
Heavy bleeding is defined as producing over 80mL of blood per cycle and may also manifest as the following:
▫️Having a flow that soaks through 1 or more pads or tampons every hour for several hours
▫️Having to double up on pads to control bleeding
▫️Needing to change pads or tampons overnight
▫️Having menstrual periods lasting longer than 7 days
▫️Having large blood clots
▫️Having a flow that keeps you from doing things you would normally do
Many things can cause heavy bleeding. Endometriosis is one of them.
Iron deficiency is common in endometriosis. Since iron is carried by the red blood cells, bleeding during menstruation leads to loss of iron. As your body attempts to make up for this loss, iron is pulled from stores within the body leading to a heavier bleed and increased risk for iron-deficiency anaemia.
Some people with endometriosis (and adenomyosis) produce more prostaglandins, a pro-inflammatory chemical responsible for the period. Prostaglandins can cause abnormally aggressive contractions that contribute to heavy bleeding.
Endometriosis alters the balance between oestrogenic and progesterone in some people, which is related to heavy bleeding as oestrogen builds the uterine lining and can cause the growth of things like polyps or fibroids (which also contribute to heavier bleeds).
3 Tips for heavy flow and endo
1. Get enough iron daily – low iron can contribute to a heavier flow. Iron is also needed for the CYP enzymes that support oestrogen metabolism. Consume eggs, legumes, wholegrains and grass-fed meat.
2. Get enough omega-3s – Prostaglandins cause uterine contractions that may result in heavier flow. Omega-3s like those found in oily fish, flaxseeds, eggs and walnuts can offer an abundance of prostaglandin formation.
3. Support proper oestrogen metabolism – Elevated oestrogen, or poor oestrogen metabolism causes growth of the endometrial lining (i.e. heavy flow). I usually recommend a DUTCH test to get a clearer picture of oestrogen metabolism.