Abnormal Uterine Bleeding: Natural and Non-Synthetic Ways to Regulate Your Cycle

Abnormal uterine bleeding (AUB) is a common problem throughout the lifespan and one of the most common reasons to see a gynecologist.

In our 30s and 40s, changes can occur that are chalked up to perimenopause.

As an obgyn, we’re taught to use “hormonal” therapy. By that I mean birth control in one form or another. I use quotes around the word hormonal in this case because birth controls are using synthetic analogs of hormones. Medicine calls them “hormones”, others call them endocrine disruptors.

Traditional therapies for AUB that will be discussed at your obgyn office:

• Birth Control Pills

  • This is a huge category with many variants

  • All are synthetic hormones, whether in combination (ethinyl estradiol + progestin) or isolation (progestin only)

  • How they work: birth control pills are overriding the hormonal system that orchestrates ovulation and therefore periods. The period you have on birth control pills is from the birth control pills, it's not your natural cycle

• IUD

  • These devices can be hormonal or not hormonal (again read “hormonal” with quotes, this is just the language used in the medical field)

  • Typically non-hormonal can cause heavier crampier bleeding, so aren't usually used for problematic bleeding

  • Progestin-containing IUDs have a synthetic progestin, often levonorgestrel in varying doses

  • One particular device is FDA approved for the treatment of heavy bleeding

  • How it works: the release of progestin throughout the uterus keeps the lining of the uterus from growing or getting thicker, thereby decreasing or stopping the amount of blood flow in a period

• Endometrial Ablation

  • This is an outpatient procedure that may be performed in office or hospital

  • How it works: using various technologies, these devices are essentially "burning" the lining of the uterus, which is the part that sheds every month as a period

• Hysterectomy

  • This is removal of the uterus.

  • Hysterectomy does not describe removal of the tubes (salpingectomy) or ovaries (oophorectomy), these may or may not be performed at the time of hysterectomy

  • This is a major but extremely common surgery and comes with the risks of a major surgery

  • Can be performed many ways: vaginal (least invasive), laparoscopic (small incisions, minimally invasive), abdominal (large belly incision)

  • Unfortunately many obgyns in training are not acquiring the skill to perform vaginal or abdominal hysterectomies because laparoscopic/robotics are so common

But what if these treatment options don't align with your plan or your faith?

If we consider that heavy bleeding (shedding of the uterine lining) is from an imbalance between estrogen (causes the lining to grow, the “gas pedal”) and progesterone (thins the lining, the "brake pedal”), then targeting these pathways may relieve the bleeding.

In perimenopause, it's common to have highly erratic estrogen levels. It may be high followed by very low.

Persistently high levels are called "estrogen dominance" online, while in the medical field we call it unopposed estrogen. We need estrogen to be opposed by progesterone.

Here's how we might target these two hormones without synthetic medications:

• Metabolize estrogen

  • To help the body break down circulating estrogen so it doesn't stay persistently high

  • This is done through the gut:

    • Take in adequate fiber through diet or supplement

    • Take in adequate B vitamins with Methylation support or a full complex

    • Eat your veggies which helps the liver break down estrogen

• Clean your environment

  • “Xenoestrogens” are chemicals in our products and environments that act like estrogen in our bodies, much like birth control pills do

  • You won’t see the term Xenoestrogen on a product label. It may be within substances like pthalates, parabens, dyes, preservatives, and pesticides

• Exercise

  • Exercise in itself helps metabolism, including estrogen

  • Decreasing fat (within a safe margin) also helps and here's why:

    • Fat cells release an enzyme called aromatase.

    • Aromatase converts hormones in the testosterone family to estrogen

    • Fat cells are then contributing to the “dominance” of estrogen

• Allow progesterone production

  • There’s a theory called The Pregnenolone Steal, suggesting that with increasing stress, the body has to use the hormone building blocks to make cortisol (our “stress hormone") rather than reproductive hormones

  • With chronic stress, progesterone is not prioritized and cannot counterbalance estrogen the way it should

  • By decreasing stress, production can shift to reproductive hormones rather than fight-or-flight hormones

• Supplement progesterone

  • Bio-identical progesterone (as opposed to synthetic chemical structure) can be used as support to help heavy bleeding

  • Typically comes as a capsule taken every night

  • Can be used cyclically (taking only part of the month) to mimic a natural cycle

I hope this offers some options to consider if you suffer from abnormal bleeding. Abnormal bleeding can cause anemia which can require intervention or be life-threatening. It's important to be evaluated properly and discuss options for you as an individual.

Resources:

Some of the information contained in this article is the result of my training, medical knowledge, and personal experience without a specific source to be cited.

The author can earn commissions through affiliate links.

Disclaimer: This is not medical advice. This is for educational purposes only. Discuss with your

doctor.

https://www.thorne.com/take-5-daily/article/estrogen-dominance-what-it-is-how-to-recognize-it-and-what-you-can-do-about-it?

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