Menstruation - Health, Herbs and Hope!

Menstruation is a huge part of women's lives - on average a women will menstruate for 37.5 years of her life.

As a practitioner and even as a student, when I first began to take patients with menstrual complaints. I noticed that there was such a lack of knowledge of what was considered 'normal' and 'healthy' .Patients would be presenting with pain, excessive bleeding as well as other extreme symptoms, but because their menstrual cycle had been like this throughout their entire lives, they considered this 'normal' and nothing was an issue - This would be the case until they had done their research or talked to others, such as friends or family.

A good thing which I have noticed changing, is there is less stigma around menstruation. I certainly still notice with the older generation, that talking about periods has to be very discreet and it is also sometimes shameful (Dependant on the person). However, in the younger generation I am pleased to see that information is being created and shared about menstrual health. There is also more growing social acceptance of being on your period. It is natural bodily process!

However, what can I as a herbalist do to help with menstruation? For years, I suffered with excessive bleeding, extreme fatigue and terrible PMS! I thought that this was normal and what periods just are. This was until I became a herbalist and began researching, because I could not accept experiencing terrible moods swings for 37.5 years of my life!

Please continue to read to find out some of my tips to help tackle your "Normal" menstruation.

Overview of the Menstrual cycle:

I think it is important to have a basic understanding about how your cycle works, this will help you to track it and adjust your lifestyle to suit the time in your cycle.

The menstrual cycle is divided into four phases:

• menstrual phase

• follicular phase

• ovulation phase

• luteal phase

1) Menstrual phase

This phase is classed as the first phase of your menstrual cycle and it is when you get your period.

It begins when the egg is not fertilised and your levels of oestrogen and progesterone drop. Your thickened uterus lining is no longer needed to have a baby, so you excrete it! This is usually a combination of blood, mucous and tissue!

Common symptoms which can occur in the menstrual phase:

• Cramps

• Mastalgia (Tender breasts)

• Mood swings + Irritabilty

• Bloating

• Headaches + Migraines

• Fatigue + lethargy

• Lower back pain

2) The follicular phase

There is overlap between the Menstrual phase and the Follicular phase, as the Follicular phase begins on the first day of your period.

The Follicular phase begins when your Hypothalamus (A structure in your brain, which is involved with your Endocrine and Nervous system) signals to the Pituitary gland (A part of the endocrine system, which has involvement in hormone secretion) to release follicle stimulating hormone (FSH). FSH stimulates your ovaries to produce follicles and each follicle contains an immature egg.

Common symptoms experienced in the Follicular phase:

• Increased energy ( Often highest amount of energy throughout your cycle)- Due to rising Oestrogen and Progesterone levels

3) The Ovulation phase

In this phase your Oestrogen levels begin to rise and trigger your pituitary gland to release Luteinising hormone (LH), which begins the process of ovulation. Ovulation is the time where your egg travels down your fallopian tube towards the uterus to be fertilised.

Common symptoms in the Ovulation phase:

The ovulation phase is where you are at your most fertile - So if you are trying to conceive - Now is the perfect time to try! As you will be the most fertile in this phase!

Oestrogen and testosterone levels peak at ovulation - so you may feel an increase in libido, energy and extroversion!

4) Luteal phase

After the release of the egg it will change into the Corpus luteum (A temporary organ, which produces progesterone). If you do not get pregnant the Corpus luteum will shrink away and be reabsorbed. This leads to a large drop in Oestrogen and Progesterone, which causes the beginning of your period.

During the luteal phase, if pregnancy does not occur - you may experience symptoms of PMS:

• Mood changes and Mood swings

• Mastalgia (breast swelling, pain, or tenderness)

• Migraines and Headaches

• Weight gain and fluid retention

• Changes in sex drive

• Food cravings

• Insomnia (trouble sleeping)

There we go! All four stages of the menstrual cycle! Hopefully, having an understanding of what is happening in your body can help you to have more compassion for yourself and give you knowledge of how to look after yourself too.

Health tips and Herbal medicine to help you and your cycle:

Before I begin, I would like to say that what I have written here is just general advice and it may not fit everyone. I will also try to cover as many common symptoms as I can, but I may not be able to cover all of them!

Also, If you feel uncertain about taking Herbal medicine, then please always check with a practitioner, as they will more than happy to help you. Furthermore, always be mindful if you are taking medication, as some herbal medicine can interact, this includes contraceptives!

• Fatigue

I feel that this is a very common symptom experienced by many women during their menstrual phase. This is due to the fact that we are losing a lot of blood - On average women loose 2-3 tablespoons of blood per period, sometimes more or less depending upon yourself.

Heavy blood loss can contribute to conditions such as anaemia. Anaemia is due to a lack of Iron and this in turn causes a lack of red blood cells, being able to transport oxygen around the body. This causes fatigue and exhaustion!

Disrupted sleep is another contributor to fatigue, experienced throughout the menstrual cycle. Obviously, if sleep and rest is disrupted then we can not function as efficiently as we would like.

What can we do?

1) Take an Iron and vitamin C supplement

It would help to take an Iron and Vitamin C supplement coming up to and throughout your period. This will help to combat the loss of Iron, through blood loss on your period. It is always best to take an Iron supplement alongside a Vitamin C supplement, as it vastly increases bioavailability.

2) Eat iron rich foods

It is always good to have eat a high in Iron diet, when you are menstruating.

Foods to include are:

• Molasses

• Liver and other organ meats

• Red meat

• Spinach + Other dark green vegetables

• Dark chocolate

• Kidney beans

3) Practice good Sleep hygiene

Maintaining good sleep hygiene is important to helping to get a restful nights sleep and increasing energy levels.

We often neglect good sleep hygiene in the modern world - Going to sleep at different times, looking at our phones before bed and as soon as we wake up etc.

How can we practice good sleep hygiene?

• Set a time to go to sleep - Keeping to a set time for sleep will help to set your circadian rhythm

• Set a time to stop looking at your phone

• Meditation, breathing exercises or yoga before bed - To help promote relaxation

• Having a shower or bath before bed - Again to help promote relaxation

• Create the right environment for you to sleep in! - whether you set the right temperature in your bedroom or have podcasts playing or not. Cater your bedroom to yourself.

Herbs to help with Fatigue:

There are lots of different herbs to help with fatigue, as fatigue can be caused by a variety of things. However, I have written about different herbs, which are not too difficult to find and are particularly nourishing to the body.

Withania somnifera - Ashwagandha

This herb has been used in Ayurvedic medicine for thousands of years, it is has been said to give you the strength of a horse.

It is classed as an adaptogen, which is a class of herbs, that has been shown to increase resilience to internal and external stressors.

This herb is particularly nourishing and can help to increase red blood cell count and increase iron levels, which can help to reduce the risk of anaemia.

This herb also has a sedative effect on the nervous system and can help to reduce anxiety, which can contribute to fatigue due to the fact that being anxious takes a lot of energy from us. It will also help to create and bring forth relaxation for helping to sleep.

Urtica dioica - Nettle leaf

Nettle is a very nutritional rich herb, it is high in iron and other vitamins and minerals. Therefore, increasing nutrient intake into the body increases cellular health and functionality, which in turn increases health and where there is health there is energy!

Ocimum sanctum - Holy Basil or Tulsi

Tulsi is a sacred herb in India and has been used in Ayurvedic medicine for thousands of years. The word Tulsi is derived from the sanskrit word for 'Matchless one'.

This herb has adaptogenic properties, as this herb was shown to prevent increased corticosterone levels (steroid hormone which is secreted in response to stressors), by preventing a rise in the secretion of this steroid hormone, this can help the body to become more resilient to stress, due to the fact that there is no rise in hormone levels to indicate that a threat is being perceived. Therefore, by becoming more resilient to stress less energy is exerted and less fatigue arises.

Tulsi also has been shown in research to reduce blood sugar and regulate blood sugar levels in the body, which helps with energy regulation.

• PMS - Premenstrual syndrome

  PMS is often experienced more in your luteal phase, as progesterone increases due to it being secreted by the Corpus Luteum. Once your Corpus luteum is reabsorbed after failed conception, your oestrogen and progesterone drop, which can also trigger PMS. PMS can affect many people differently, you might feel increased irritability, anger, depression, anxiety and be very sensitive overall.

What can we do to help this?

Look after your liver

When progesterone and your other hormones increase in your body, this can lead to excess, and these excessive amounts of hormones in your body contribute to your variation in moods. But what organ is responsible for excreting these hormones, so that they do not back up into your system? The Liver!

Therefore, take herbs to support your liver, such as Milk Thistle (Silybum marianum), Dandelion root (Taraxacum officinale radix) or Turmeric (Curcuma longa). All of these herbs increase liver health through various mechanisms, which will help your liver to flush out excessive hormones.

Nervous system herbs

There are herbs available, which can help to calm your nervous system. These class of herbs are beneficial when you are experiencing anxiety or irritability from your PMS, as they are calming and uplifting.

Good herbs to take are:

• Chamomile (Matricaria chamomilla) - Calming and uplifting, specific if your anxiety gives you stomach issues, such as cramping, butterflies, IBS.

• Oats (Avena sativa) - Calming and nourishing (High in B vitamins), repairing to your nervous system.

• Motherwort (Leonurus cardiaca) - This herb is uplifting, calming and specific if you get heart palpitations with your anxiety.

• Skullcap (Scutellaria lateriflora) - Nourishing and repairing to your nervous system (High in minerals and vitamins), specific for fast and cyclical thoughts.

• Vervain (Verbena officinalis) - Nourishing and repairing to the nervous system, uplifting and relaxing for nervous tension. This herb is also a bitter and is beneficial for stimulating the liver, which can help to get rid of hormonal excess.

Lifestyle changes and self care

A valuable thought, when experiencing PMS is to remember to care for yourself.

This might mean a variety of different things, for different people, as everyone's self care practices are individual.

Whether it means eating more food, sleeping more, having more baths, seeing friends or going for long walks.

In this period of your cycle, do what feels good and right for you and your body, as I feel like we are pressured to slog on with our life and schedules, without acknowledging that we are not as energised and more emotional than in other periods of our cycles. Take it easy on yourself!

• Irregular menstruation

  Irregularly menstruating is annoying for everyone, never knowing when your period is about to arrive carries an underlying uneasiness and the need to carry sanitary products around with you at all times.

  However, irregular menstruation does not only include irregular timings of your period it can include:

  • Missing three or more periods in a row.

  • Menstrual flow (bleeding) that’s much heavier or lighter than usual

  • Periods that last longer than seven days.

  • Periods that are accompanied by severe pain, cramping, nausea or vomiting.

  • Bleeding or spotting that happens between periods, after sexual intercourse or after menopause.

Get an Investigation

If you are experiencing menstrual issues which feel are not right and are irregular. Then my first suggestion would be to call your GP and ask for your issues to be investigated. This can help to spot underlying issues, such as PCOS, Endometriosis or hormonal imbalances. The GP can offer you to get scans and bloods tests, which can be very useful, as you will understand what is going on with your body.

Contraception

I would also consider your contraception (If you are on any), especially if you are on hormonal medication. Hormonal medication interrupts your hormones and can lead to heavy bleeding, light bleeding or no bleeding at all or spotting between periods. Furthermore, contraception such as the copper coil IUD can cause excessive bleeding. Therefore, consider your contraception and you can always call your GP or sexual health clinic to have it revised.

Herbal medicine for Heavy bleeding

For heavy bleeding, herbs known as uterine astringents are beneficial at helping to stem excessive bleeding. These astringe excess fluids and tone the uterus, which reduces heavy bleeding and can also help with uterine prolapse.

Herbs which are helpful are listed below:

• Raspberry leaf ( Rubus idaeus)

• Lady's mantle (Alchemilla vulgaris)

• Sheperds purse (Capsella bursa-pastoris)

• Yarrow (Achillea millefolium)

Irregular bleeding and scanty bleeding:

Irregular bleeding and scanty bleeding can be due to a wide variety of issues, both internal and external. Let's look at some of the issues....

Lifestyle factors

Irregular bleeding times and light bleeding can be due to lifestyle factors, such as stress, obesity, anaemia and excessive exercise.

Therefore, I would recommend that you review your lifestyle and see if there is anything which could be changed?

Plastic use - the hormonal disruptor

Furthermore, excessive plastic use can be a contributing factor to hormone disruption. Plastic is known to secrete Xenoestrogens, which is a synthetic oestrogen. These Xenoestrogens are ingested and absorbed by us, as everything we use is wrapped in plastic. These Xenoestrogens trick our body into thinking we have lots of oestrogen in our bodies and this can cause hormonal disruption and menstrual disruption.

Herbal hormonal balancers

However, there are herbs which can help to balance and regulate hormones, through a variety of different mechanisms, usually through working on the Endocrine system. The Endocrine system is responsible for hormone secretion and therefore regulation numerous bodily functions. There is one particular herb I like for hormonal regulation, which is easy to grow and to buy!

Sage (Salvia officinalis)

Sage has been used throughout centuries, in the middle ages there was a proverb that went ' Why should a man die whilst sage grows in his garden?' this refers to its wide variety of medicinal uses and its value as a medicine. In regards to helping with the menstrual cycle, Sage has shown to have hormone balancing effects and also to be slightly oestrogenic, due to it containing phyto-oestrogens (Plant-derived oestrogens, which mimic oestrogen in the body). Why not try having a cup of Sage tea?

• Cramping

Period cramps severity can vary depending upon your health. The cramps may vary in feeling, such as dull, heavy, sharp or throbbing. It may contribute to other sensations, such as headaches, nausea or lower back pain. Period cramps are usually caused by prostaglandins, which are chemicals which cause the uterine muscles to tighten and relax.

How to help:

Yoga

Yoga has been shown to help relieve menstrual pain and discomfort. Where are the common areas that you feel menstrual related pain? Lower back, pelvis, upper thighs and stomach....That's where I feel it the most. Yoga is great for stretching out tight muscles that are cramping up and causing pain. Yoga also helps to promote relaxation and can be beneficial if you are experiencing stress and anxiety on your period too. Why not try a few poses?

Magnesium

Magnesium is a mineral, which has many roles in the body, including muscle function! Magnesium has been shown to help to relax cramping muscles, which may help to relieve muscle tension experienced on your period. Magnesium can be found in foods, such as:

Fruits - Bananas, Avocados and Apricots

Nuts and seeds - Almonds, Cashews, Pumpkin and Chia seeds

Legumes - Lima and Black beans

Greens - Spinach, Cabbage and Broccoli.

Magnesium can also be supplemented internally, there are many types of magnesium and each type can be absorbed differently. Magnesium citrate and Magnesium glycinate seem to be easily absorbed and tolerated in the stomach.

Magnesium can also be applied topically and absorbed through the skin - Try using magnesium bath salts or a magnesium gel! Topical gels can be great, as they can be directly applied to the muscles which are cramping up!

Herbal medicine to help with cramping:

Topical oils

Essential oils diluted into a carrier oil and rubbed onto the lower abdomen can help relieve cramping and relax tension.

Essential oils such as:

Peppermint

Cinnamon

Lavender

Clary sage

Herbal antispasmodics

Herbs with an anti-spasmodic action can be used to relax the uterine muscles and relieve cramping:

Crampbark (Viburnum opulus)

Motherwort (Leonurus cardiaca)

Black haw (Viburnum prunifolium)

These herbs can all be taken as tinctures (Water+ alcohol extractions of the plant constituents). Motherwort can also be taken as a tea, however it can be quite bitter, so if you do not like bitter tastes, then a tincture would be better.

Conclusion

Thank you for reading and I hope that you have found something to take away from my blog! I want to reduce the social stigma of periods and help people realise that the majority of periods are not normal! This is due to the lifestyle and environment we are living in today - high stress, high chemical exposure, poor diet etc.....

However, this does not mean that you are suck and your periods are always going to be like this. There are things you can do to elicit change, just remember to go easy on yourself and take it one step at a time!

Best wishes

Dylan x

Reference list

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Hutz, R. J., III, C., Larson, J. K., Liu, Q., Stelzer, R. V., King-Heiden, T. C., Baldridge, M. G., N Shahnoor and Julien, K. (2014) ‘Familiar and novel reproductive endocrine disruptors: xenoestrogens, dioxins and nanoparticles’, Current trends in endocrinology, vol. 7, p. 111 [Online]. Available at https://pmc.ncbi.nlm.nih.gov/articles/PMC4364387/ (Accessed 24 December 2024).

Munro, M. G., Mast, A. E., Powers, J. M., Kouides, P. A., O’Brien, S. H., Richards, T., Lavin, M. and Levy, B. S. (2023) ‘The relationship between heavy menstrual bleeding, iron deficiency, and iron deficiency anemia’, American Journal of Obstetrics and Gynecology, Elsevier BV, vol. 229, no. 1, pp. 1–9 [Online]. DOI: https://doi.org/10.1016/j.ajog.2023.01.017 (Accessed 24 December 2024).

NHS website (2024) Side effects and risks of hormonal contraception [Online]. Available at https://www.nhs.uk/contraception/choosing-contraception/side-effects-and-risks-of-hormonal-contraception/ (Accessed 24 December 2024).

Pinkerton, J. V. (2023a) Abnormal Uterine Bleeding [Online]. Available at https://www.msdmanuals.com/professional/gynecology-and-obstetrics/menstrual-abnormalities/abnormal-uterine-bleeding?query=the%20menstrual%20cycle (Accessed 24 December 2024).

Pinkerton, J. V. (2023b) Premenstrual Syndrome (PMS) [Online]. Available at https://www.msdmanuals.com/professional/gynecology-and-obstetrics/menstrual-abnormalities/premenstrual-syndrome-pms?query=the%20menstrual%20cycle (Accessed 24 December 2024).

W. Jahnen-Dechent and Ketteler, M. (2012) ‘Magnesium basics’, Clinical Kidney Journal, Oxford University Press, vol. 5, no. Suppl 1, pp. i3–i14 [Online]. DOI: https://doi.org/10.1093/ndtplus/sfr163 (Accessed 24 December 2024).