Lately, I've noticed many of my friends and clients grappling with troublesome menstrual cycles, and it’s definitely a topic that needs more attention. The world of women’s health, especially during perimenopause and menopause, is often shrouded in mystery—largely because we haven’t been given the right education by our gynecologists. To give them some credit, many gynecologists simply haven’t had the training to address dietary and lifestyle interventions that could really make a difference.

So, what happens when your period dances to an erratic tune, when you spot abnormal bleeding and looks like a murder scene, or when your cycle suddenly changes length? Often, doctors respond with a shrug, labeling it as “normal” and offering the bandaid of birth control and other medications.

Enter Ayurveda, which has long recognized asrigdara, or menorrhagia—heavy menstrual bleeding—as a condition rooted in the dysfunction of rakta, or blood. It’s fascinating how this ancient system of healing identifies the pitta dosha, which governs heat and transformation in our bodies, as a key player when it becomes imbalanced, leading to excess flow. Vata dosha increases with age, so perimenopause is marked by instability due to the air and space qualities of this dosha—cycles may be irregular, sometimes heavy and sometimes scanty. Interestingly, the kapha dosha, which is all about stability and lubrication, also plays a role, particularly when there’s a buildup of fluids. As an As an Ayurvedic Health & Wellness Coach, I draw on Ayurvedic principles, stambhana therapy, to help ease heavy menstrual flow. This approach emphasizes astringent, cooling, and nourishing foods, herbs, and beverages, along with gentle lifestyle practices designed to reduce congestion in the reproductive system and restore balance.

Perimenopause can feel like a hormonal rollercoaster. As your ovaries start winding down egg production, your brain sends out extra follicle-stimulating hormone (FSH) to try and keep ovulation going. Sometimes the ovaries respond with big bursts of estrogen, other times they stay quiet. The catch is that when ovulation doesn’t happen, you miss out on progesterone—the hormone that usually balances estrogen. Without that balance, estrogen can make the uterine lining grow too thick, which is why periods during this stage can turn heavier, longer, or more unpredictable.

Compounding this confusion, many women who seek hormone testing often find themselves in a whirlwind of mixed messages. During perimenopause, hormones can fluctuate wildly, rendering testing less helpful than desired. Instead of chasing after test results, finding ways to bring stability to this hormonal chaos can often be the most effective path forward.

For me, menorrhagia is an all-too-familiar foe—one I've battled in the past due to Polycystic Ovarian Syndrome (PCOS). PCOS causes heavy periods mainly because of skipped or irregular ovulation, leading to excess estrogen stimulation of the uterine lining without the balancing effect of progesterone.

Regardless of the cause, It’s no minor inconvenience. Many women are left making heart-wrenching choices about undergoing hysterectomies or other procedures, relying on synthetic hormones, or even confronting anemia due to severe blood loss. It’s a journey that deserves more discussion, more understanding, and the shared wisdom of those who walk similar paths. Let's shine a light on these experiences and empower one another through this complex phase of life.

Signs and symptoms of menorrhagia:

• Soaking through sanitary pads or tampons every hour

• Passing blood clots, especially those larger than a quarter

• Prolonged bleeding, lasting more than 7 days

• Tiredness and fatigue due to anemia

There can be many causes of heavy periods, as listed below, so you must get checked out by your gynecologist, first and foremost. 

• Hormonal imbalance (PCOS, perimenopause, post-pill imbalances, etc.)

• Uterine polyps or fibroids (need an ultrasound to determine this but these can come and go. Not always, but usually are accompanied by pain or discomfort in lower abdomen and during sex.

• Cancer of uterus, cervix, or ovaries

• Thyroid issues

• Vitamin deficiencies (Vit. D/K2, B12, etc.).

• Excessive exercise or malnutrition (extreme fasting)

• Chronic gut issues can contribute

Ayurvedic diet & lifestyle to reduce heavy bleeding:

• Avoid hot, spicy, acidic, sour, fermented, and overly salted foods: Tomatoes, lemon, chili pepper, caffeine, alcohol, etc.

• Avoid sedentary lifestyle: If inactive, start with stretching first thing in morning and before bed. If you have higher body fat, you often have higher circulating estrogen levels, causing heavier periods.

• Avoid processed foods and unhealthy fats

• Work through anger, grief, and chronic stress with a licensed therapist

• Eat cooling foods like rice, ghee, black raisins, pomegranate, dates, zucchini, cucumber, and basil (see cooling vs. heating foods linked below)

• Drink slightly cool water to slow the flow

• Drink throughout the day during menstruation: 3 cups coconut water + 1 ½ teaspoons organic rock or cane sugar, or coconut water with 1 teaspoon white sandalwood powder

• Lie down with feet elevated

Rice Wash Flow Stopper (Credit to The True Ayurveda Book of Home Remedies by Julie Bernier)

• 1 tablespoon white basmati rice

• 1 cup water

• Pinch of salt

• Pinch of cumin

Cooling, astringent, and nourishing: Rice water is naturally cooling (Shita Virya) and astringent, helping reduce heavy menstrual bleeding. Its starch and nutrients strengthen tissues (Dhatus), and it’s often combined with Ayurvedic herbs to support uterine health while replenishing lost fluids.

Instructions: Rinse the rice in a strainer once to remove any dirt. Rinse once more, catching 1 cup of the fluid and add a pinch of salt and cumin. Drink this on the days of excess flow. Up to two cups daily.

Disclaimer:
I am not a medical doctor, and the information shared through Conscious Biome Ayurveda LLC is for educational and informational purposes only. It is not intended to diagnose, treat, cure, or prevent any disease and should not be considered a substitute for professional medical advice, diagnosis, or treatment. Always consult with your physician or qualified health provider regarding any medical concerns or before making changes to your diet, supplements, or health practices.