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. 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 Ayurvedic practitioner, I focus on stambhana therapy to curb this overwhelming flow and utilize sheetala annapana, which emphasizes cooling foods and beverages to bring balance.

From a scientific standpoint, the complexities of perimenopause can be overwhelming. As our ovaries slow their egg production, our bodies respond by ramping up the release of follicle-stimulating hormone (FSH) in a bid to maintain ovulation. This, in turn, boosts estrogen levels. When your estrogen outpaces progesterone, it can lead to an overly thickened uterine lining—which results in those frustratingly heavy periods.

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 for years due to Polycystic Ovarian Syndrome (PCOS). It’s no minor inconvenience. Many women are left making heart-wrenching choices about undergoing hysterectomies, 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.)

• Chronic gut issues can contribute

Ayurvedic diet & lifestyle suggestions 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

• Avoid processed foods and unhealthy fats

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

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