Natural Period Repair: Tips from Dr. Lara Briden

Lara Briden is a board-certified naturopathic doctor with nearly 20 years of experience in female health. Her book is Period Repair Manual: Natural Treatment for Better Hormones and Better Periods. We asked her for some of her best tips for treating irregular cycles.

Tracking your period is the best way to understand the ins and outs of your cycle, but now you’re wondering: Is my period healthy? Is it normal? If not — what can I do about it?

First things first: What is considered average and healthy?

You don’t have to have a perfect 28-day cycle. As long your period starts every 21 to 35 days, you have a healthy cycle. It can even vary a little month to month (by more than eight days at a time).

Your actual bleeding should last between two and seven days, and you don’t want to lose more than 80 mL of menstrual fluid over all the days. A regular tampon holds 5 mL so you can fill 16 tampons and still be in the norm. More than that is considered a heavy period. (1)

Irregular Periods or No Period

It’s okay to miss the occasional month, but if your period doesn’t match these criteria, or does not come at all, then something might be up.

The first step is to see your doctor so they can rule out pregnancy, perimenopause or medical causes such as thyroid disease and celiac disease. Your doctor will then test your hormones and hopefully be able to offer you a diagnosis. Two of the most common explanations for irregular periods are: 1) polycystic ovarian syndrome (PCOS), and 2) hypothalamic amenorrhea (2).

PCOS

Polycystic ovarian syndrome is a condition in which the ovaries make too much testosterone compared to estrogen and progesterone. It can cause irregular periods, acne and facial hair (hirsutism). PCOS affects up to 1 in 10 women (3).

Naturopathic Treatment:

PCOS is made worse by high blood sugar and insulin (4), so one of the best treatments is to stop eating sugary foods such as dessert, fruit juice and sweetened yogurt. The nutritional supplements magnesium, berberine (5) and inositol can help to regulate blood sugar and may relieve symptoms of PCOS.

Functional Hypothalamic Amenorrhea (FHA)

Amenorrhea is the Latin word for lack of periods. Hypothalamic amenorrhea simply means lack of periods because of your hypothalamus (your brain’s hormone command center). It’s not that anything is wrong with your hypothalamus, exactly. It has simply stopped producing a hormone required for menstruation (GnRH). This can happen in response to things like emotional stress, or not eating enough (6).

Naturopathic Treatment:

Convince your hypothalamus that all is well and it’s okay to have periods again. To do that, you might need to reduce stress and/or gain some body fat. The herbal medicine ashwagandha (Withania somnifera) helps to regulate the body’s stress response (7), and so can be helpful for hypothalamic amenorrhea.

Tip: Are you eating too much soy? Soy inhibits the release of the pituitary hormone FSH (follicle-stimulating hormone) (8), and can therefore inhibit ovulation and stop periods.

Definition: Ovulation is the release of an egg from the ovary, and it’s how your body makes progesterone. Do you know if you ovulate? Or even what ovulation is? If you don’t know, you’re not alone. In a recent poll, 64% of people we asked had no idea.

Heavy Periods

If you bleed for more than seven days, or lose more than 80 mL of menstrual fluid (16 fully soaked regular tampons), then you have a heavy period. Please see your doctor so they can rule out possible causes such as as fibroids, clotting disorders and thyroid disease.

Definition: Fibroids are benign growths of the uterine muscle.

If your doctor can find no other cause, they may conclude your heavy bleeding is “hormonal”, which means too much estrogen and not enough progesterone.

Naturopathic Treatment:

You can promote the normal detoxification of estrogen by maintaining healthy intestinal bacteria (9). Bacteria benefit from vegetables, probiotics, and from avoiding the unnecessary use of antibiotics. Another way to reduce estrogen is to take a phytonutrient derived from broccoli called DIM (diindolylmethane) (10).

You can enhance progesterone with the herbal medicine Vitex agnus castus. (11)

Tip: If you suffer heavy periods, you may have become deficient in iron, which, in turn, can make your periods even heavier (12). Please talk to your doctor about a blood test and possibly an iron supplement.

Painful Periods

Period pain is common and is usually nothing to worry about, as long as it is not severe or affecting your quality of life.

Standard period pain occurs during the first day or two, and is mild enough that it does not interfere with school or work. This pain is caused by a type of mild inflammation from prostaglandins, which help the uterus contract. Standard period pain can easily be relieved by an over-the-counter anti-inflammatory such as ibuprofen.

Severe period pain occurs later in the period and between periods, and can be bad enough to prevent you from attending school or work. Severe period pain does not respond to standard painkillers or to natural treatments, and can be a sign of an underlying medical problem such as fibroids, infection or endometriosis. Please see your doctor.

Tip: Endometriosis is a serious inflammatory disease in which bits of uterine lining grow throughout the pelvis. It affects over 1 in 10 women (13).

Naturopathic Treatment:

Standard period pain responds well to natural supplements such as zinc (14), turmeric (15) and magnesium (16). Supplements work gently and gradually, so they must be taken every day throughout the month — not just during your period.

Premenstrual Syndrome (PMS)

Last but not least, we come to the irritability and cravings you may experience before your period.

“PMS is common, but it’s not inevitable. It’s one of my favorite things to treat because it responds so well to natural treatment.” — Dr. Briden

Naturopathic Treatment:

PMS responds very well to magnesium. In some people, magnesium deficiency may actually be the main cause of PMS (18). PMS also responds well to the herbal medicine Vitex agnus-castus (11).

Dr. Lara Briden

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References

1. Long NW. 1990. Abnormal Vaginal Bleeding in Hurst JW (Ed.), Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths.
2. Camacho P. 2011. Female and Male Reproductive Disorders in Clinical Endocrinology and Metabolism. CRC Press
3. Trivax, B et al.. Diagnosis of polycystic ovary syndrome. Clinical Obstetrics and Gynecology. 2007: 50: 168–177. PubMed:17304034
4. Pauli JM. Current perspectives of insulin resistance and polycystic ovary syndrome. Diabet Med. 2011 Dec;28(12):1445–54. PMID: 21950959
5. Li L et al. A Single Arm Pilot Study of Effects of Berberine on the Menstrual Pattern, Ovulation Rate, Hormonal and Metabolic Profiles in Anovulatory Chinese Women with Polycystic Ovary Syndrome. PLoS One. 2015 Dec 8;10(12):e0144072. Pubmed: 26645811
6. Chandrasekhar K et al. A prospective, randomized double-blind, placebo-controlled study and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults. Indian J Psychol Med. 2012;34(3):255–262. PubMed: 23439798
7. Allaway HC et al. The physiology of functional hypothalamic amenorrhea associated with energy deficiency in exercising women and in women with anorexia nervosa. Horm Mol Biol Clin Investig. 2016 Feb 1;25(2):91–119. PubMed: 26953710
8. Cassidy A et. Biological effects of a diet of soy protein rich in isoflavones on the menstrual cycle of premenopausal women. Am J Clin Nutr. 1994 Set;60(3):333–40. PMID 8074062
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10. Memorial Sloan-Kettering Cancer Center; Diindolylmethane; Aug. 12, 2010
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12. Taymor ML et al. The etiological role of chronic iron deficiency in production of menorrhagia. JAMA. 1964. 1;187:323–7. PubMed 14085026
13. Bulletti C et al. Endometriosis and infertility. J Assist Reprod Genet. 2010 Aug;27(8):441–7. PubMed: 20574791
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15. Lantz RC. The effect of turmeric extracts on inflammatory mediator production. Phytomedicine. 2005 Jun;12(6–7):445–52. PubMed: 16008121
16. Seifert B. Magnesium — a new therapeutic alternative in primary dysmenorrhea. Zentralbl Gynakol. 1989;111(11):755–60. PubMed: 2675496
17. Abraham GE et al. Serum and red cell magnesium levels in patients with premenstrual tension. Am J Clin Nutr. 1981 Nov;34(11):2364–6. Pubmed: 7197877