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Menorrhagia
 
Often Overlooked Dietary, Drug and Genetic Causes of Heavy Menstrual Bleeding

Contents:

See my Frequently Asked Questions section on Menorrhagia for specific diet and lifestyle tips to prevent menorrhagia, more possible causes of menorrhagia, and a great article on menorrhagia to share with your doctor.

Read my disclaimer and terms of use.

Overview

Menorrhagia is defined as a condition of excessive blood loss during menstruation. There are many causes of menorrhagia. The condition should always be diagnosed by a doctor to rule out a variety of potentially serious underlying conditions such as cancer and uterine fibroids. However, in my experience, doctors may not always be aware of all of the possible causes of menorrhagia, especially a vitamin K deficiency. So if you have a case of menorrhagia due to an unknown cause, you may find the information below on vitamin K deficiency and other causes of heavy menstrual bleeding of interest.

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My Experience with Heavy Menstrual Bleeding and Vitamin K

I've had problems with menorrhagia my entire life. I've been to lots of doctors for my condition and had many tests, yet for most of my life no root cause could ever be found. A few years back I was diagnosed with a genetic disorder called Ehlers-Danlos syndrome (EDS), which can have menorrhagia as one of its symptoms. The EDS diagnosis provided a logical reason for my bleeding problems, and perhaps those of some of my female relatives, too, but it still did not provide any solutions, since EDS is considered an incurable genetic disorder.

Through reading nutrition books and doing my own research, I discovered that my menorrhagia was most likely caused by a vitamin K deficiency. When I added more vitamin K to my diet, and avoided foods and drugs that blocked vitamin K, I no longer had any problems. I've been reading lately that vitamin K deficiencies are actually very common in the U.S. these days (as are hysterectomies for excessive menstrual bleeding), so it does make me wonder how many other women with menorrhagia also may have a vitamin K deficiency problem. (For more on this topic, see my section on Diet Treatment for Heavy Periods - what I've personally found helpful.)

 

 

Salads to the Rescue

In my experience the best way to get more vitamin K is to eat romaine or leafy green lettuce occassionally. While a deficiency of this important vitamin is not good, too high an intake has adverse health consequences as well, such as blood clots. Since it is a lot harder to over dose on vitamin K from a lettuce salad once in a while than it is from over the counter tablets, personally I think the salad greens (preferably organic) are the safer and more natural choice.

 

 

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Vitamin K and Menorrhagia

The following links contain information about vitamin K deficiency and heavy menstrual bleeding:

The Merck Manual on Vitamin K - "Bleeding is the usual manifestation. Easy bruisability and mucosal bleeding (especially epistaxis, GI hemorrhage, menorrhagia, and hematuria) can occur. Blood may ooze from puncture sites or incisions. "

Medline Study: Systemic causes of excessive uterine bleeding - lists vitamin K deficiency as one of the known causes.

Healthworld Online: Vitamin K - "Additional K is given at times to women with heavy menstrual flow."

Related sections of my site are:

Nosebleeds and Vitamin K Deficiency

Ovarian Pain from Vitamin K Deficiency

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Vitamin K Deficiencies

The following links contain interesting information on vitamin K, including food sources of vitamin K and recent evidence that vitamin K deficiencies may be more common than was once thought:

Vitamin K: Another Reason To Eat Your Greens - New studies find that vitamin K isn't as abundant in the diet as once thought.

The Gale Encyclopedia of Medicine: Vitamin K - "Where a bleeding disorder can be corrected by vitamin K treatment, the diagnosis of vitamin K deficiency is proven to be correct."

NEW YORK, Oct 01 (Reuters) -- Nutrition experts say American physicians are undertrained when it comes to issues of nutrition and health. ``The authority whom patients most wish to consult for information on health -- their physician -- remains insufficiently informed about the role of diet in the prevention and treatment of disease,'' concludes a recently convened panel of US nutrition experts known as the Intersociety Professional Nutrition Education Consortium. Its prime directive is to raise the level of nutrition education at US medical schools.

from Yahoo! News

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Anticoagulants and Heavy Menstrual Bleeding

Anticoagulants are medications that thin the blood by blocking the action of vitamin K. Not surprisingly, one of the side effects of anticoagulant therapy is heavy menstrual bleeding. One of my grandmothers was put on anticoagulants for an aneurysm, and she also had to have a hysterectomy for menorrhagia. I wonder, knowing what I know now, if her bleeding problems and need for a hysterectomy were caused, in part, by her anticoagulant medication. Plus I suspect she also had a variation of Ehlers-Danlos syndrome, and she may have had a tendency to bleed easily anyway, so it's no wonder she would have had problems on blood thinning drugs.

Here are some Web sites regarding anticoagulant therapy and heavy menstrual bleeding.

Complementary and Alternative Healing University - Warfarin Sodium: "Long term usage can cause nose bleeding, gum bleeding, purpura, blood in urine, uterine bleeding, blood in stool, bleeding of ulcers and wounds."

Toxicity, Warfarin from Emergency Medicine/Toxicology: "More common findings of excessive anticoagulation are ecchymoses, subconjunctival hemorrhage, epistaxis, vaginal bleeding, bleeding gums, or hematuria."


Salicylates and Vitamin K

Salicylates are substances that also block the action of vitamin K. Aspirins contain high amounts of salicylates, which is why people who take lot of aspirin often develop bleeding problems. I'm what is known as "salicylate sensitive" -- I develop bleeding problems when I ingest too many salicylates, whether it is from aspirin or even just my diet. Certain foods such as fruits, nuts, mints, vinegar and spices contain high amounts of salicylates.

I've often seen aspirin recommended as a treatment to help women deal with the pain of heavy periods. I wonder if that is good advice for everyone, especially other women who may also have menorrhagia from an undiagnosed vitamin K deficiency. I know someone who was put on aspirin for heart problems, but then developed menorrhagia as a side effect from the aspirin. As soon as she cut back on the aspirin, her menorrhagia cleared up.

 

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Other Factors That Can Impact Vitamin K

Besides the obvious cause of not getting enough vitamin K in the diet, there are many other factors that are linked to vitamin K deficiencies. These include:

One of my friends improved her menorrhagia problem by taking acidophilus supplements. Acidophilus are a type of good bacteria that live in your intestine and manufacture vitamin K.

Factors linked to increased levels of vitamin K include:

The common link between soybeans and the pill is that they both are known for raising estrogen levels, giving us a clue then, that like many other nutrients, vitamin K may be estrogen dependent. Another clue to this is that women are more likely to be low in vitamin K after menopause than before menopause.

It is well established that women often experience heavy periods right before menopause. Perhaps this is because their vitamin K levels are decreasing along with their estrogen levels as they approach menopause, and their heavy periods are simply a sign of this increasing vitamin K deficiency. It would be a highly logical possibility to consider.

Also see my sections on health conditions linked to vitamin K deficiency and Ehlers-Danlos: Diet Treatments for more on this subject.

 

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Menorrhagia and Hysterectomies

One of the reasons women get hysterectomies is to control heavy menstrual bleeding. I understand that this stops the bleeding, but does it address the root cause of what was causing the bleeding in the first place? I don't see that it always does. If the bleeding was due to a systemic problem like a vitamin K deficiency, then the person who had the hysterectomy may stop having excessive menstrual flow, but she would still be at risk for other problems associated with a vitamin K deficiency, such as internal bleeding and osteoporosis.

In the old days, dentists didn't fill cavities-- they just yanked out the whole tooth to get rid of a tooth ache. Now we have a bit more sophisticated methods of dentistry, but I'm not so sure we can say the same for women with uterine problems. All too often the solution seems to be to just remove the woman's uterus, without exploring less invasive treatment options.

Here are some interesting links on hysterectomies:

Hysterectomy among Women of Reproductive Age, United States, Update for 1981-1982 - "Nearly 5 million American women underwent hysterectomy in the last decade, making this procedure one of the most frequently performed operations for women of reproductive age (1) and an important public health concern."

Healthfacts: Hysterectomy Still Overdone: How to Avoid One - listed below are some interesting quotes from this article.

"Benign uterine growths (fibroids), pelvic pain, and excessive menstrual bleeding (menorrhagia) are the most common reasons for hysterectomy."

"A new study suggests that in about 70% of cases, this operation continues to be inappropriate (Obstetrics & Gynecology, 2/00)."

"When Ms. Coffey asks the reason for a hysterectomy, she said that women usually answer by saying that they are bleeding. "But bleeding is just a symptom, not a disease, and you need to know the cause," she cautioned, "We tell women how to get the most basic evaluation..."

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Other Possible Causes of Menorrhagia That are Not Well Known

Bleeding Disorders
Most people have heard of hemophilia, but there are other more common bleeding disorders, and many have menorrhagia as a symptom. Up to 1% of the population may be affected by von Willebrand disease, an inherited bleeding disorder. Symptoms of von Willebrand disease include heavy and prolonged menstrual period bleeding, prolonged and frequent nosebleeds, easy bruising, and bleeding with toothbrushing or after dental or other surgery.

Some bleeding disorders can either be present at birth or acquired later on, as in the case of a blood clotting Factor II Deficiency. Acquired Factor II deficiency may result from liver disease, deficiencies of vitamin K, and use of anticoagulants. Symptoms include umbilical cord bleeding at birth, nose bleeds, abnormal menstrual bleeding, abnormal bleeding after delivery, bleeding after trauma, bleeding after surgery and bruising.

Idiopathic Thrombocytopenic Purpura (ITP) is another bleeding disorder that has excessive menstrual bleeding as a feature. ITP symptoms include bruising, nose bleeds (epistaxis), petechiae and bleeding gums. Other symptoms include mucosal bleeding, hematuria (blood in the urine), or excessive menstrual bleeding.

Information on bleeding disorders may be found at the Online Inheritance in Man database at the U.S. National Institute of Health's Web site. If you enter "menstrual bleeding" or "menorrhagia" in their search criteria, quite a few genetic disorders crop up including:

  • Integrin Beta-3
  • PTA Deficiency
  • Factor X Deficiency
  • Purpura Simplex
  • Thrombocytopenia
  • Gray Platelet syndrome
  • Klippel-Trenaunay-Weber Syndrome
  • Estrogen Receptor 1
  • East Texas Type Bleeding Disorder

There is also a good summary list of the major types inherited bleeding disorders at the National Hemophilia Foundation site. Connective tissue disorders such as Ehlers-Danlos syndrome (I've been diagnosed with this) and osteogenesis imperfecta have also been linked, in some cases, to heavy periods. Women with EDS have a very high rate of hysterectomies for abnormal uterine bleeding.

High Estrogen Levels
Years ago, the late nutritionist Carlton Fredericks wrote in his books that an excess of estrogen was one of the causes of menorrhagia. In his books, he recommends a variety of dietary changes and supplements to reduce estrogen levels. One of his recommendations is to use vitamin B6. One of my friends tried vitamin B6 when she had her period for a month straight and the doctors could find nothing wrong with her. She said her period stopped within an hour after taking a single vitamin B6 pill.

Another friend of mine had menorrhagia from taking hormone replacement therapy to prevent osteoporosis. Her bleeding problems stopped when she stopped the HRT. Abnormal uterine bleeding is one of the known side effects of HRT. Because the aim of HRT is to increase estrogen levels, this provides a clue that the late Dr. Fredericks may have been right, and that in some cases menorrhagia may be caused by excess estrogen levels, perhaps whether it is caused by HRT or other factors, such as diet or genes.

Recent studies, published years after Dr. Frederick's books were popular, confirm that alcohol does increase estrogen levels, so avoiding alcohol is one factor to keep in mind if your estrogen levels areelevated. Recent studies also show that increased physical activity does tend to reduce estrogen levels.

Iron Deficiency Anemia
In the book, Encyclopedia of Natural Medicine, written by Michael Murray and Joseph Pizzorno, the authors state that one of the main factors to be considered in menorrhagia is iron deficiency. The book mentions two studies supporting this theory, including one from the the Journal of American Medicine. (Unfortunately I could not locate either study in PubMed in order to provide a link for more information.) According to Murray and Pizzorno, one study found an improvement in menorrhagia symptoms in 75% of the women on iron supplements, compared to 32.5% from the placebo group.

Because too much iron has also been associated with significant health problems such as cancer and heart attacks, many doctors recommend that women only take iron supplements if they have actually been tested and found to be deficient in iron. Iron deficiency can be determined from a blood test. For people who have menorrhagia where the cause is unknown, iron deficiency would certainly be a factor worth considering, as iron deficiency is a very common problem worldwide. Women with who lose excessive amounts of blood from menorrhagia are at especially high risk for iron deficiency, meaning iron deficiency could become both a cause and effect factor in menorrhagia.

Hypothyroidism
Menorrhagia is also common in women with hypothyroidism. Hypothyroidism happens when bodily functions get slowed down as a result of impaired or absent production of thyroid hormone. Hypothyroidism has been linked to iron deficiency anemia, which, as noted above, is another established cause of menorrhagia. Interestingly, hypothyroidism has also been linked to breast cancer, which is known to be linked to high estrogen levels, another condition which has been linked to menorrhagia. Which means menorrhagia has been linked to:

  • iron deficiency anemia
  • high estrogen levels
  • hypothyroidism

And, interestingly, regardless of the presence of menorrhagia, these conditions all seem to have some sort of association with each other. I'm not sure why, but perhaps they commonly occur together because they have some shared biochemical causative factors.

Other Vitamin Deficiencies
Vitamin A has also been used to treat menorrhagia. Vitamin E is mentioned as a treatment for menorrhagia in a lot of nutrition web sites, but I couldn't find any studies to support this. It is interesting to note that vitamin A and E are antagonists of vitamin K, so if too little vitamin K can cause menorrhagia, perhaps too much is also problematic. Vitamin E has been linked to reduced estrogen levels--it's why it is sometimes recommended as treatment for women with breast cancer and fibrocystic breasts
. So perhaps vitamin E may be beneficial for heavy periods when the root cause of the bleeding is from excess estrogen levels. Hypothetically, vitamin E would not be a good treatment if the cause of the heavy periods was a vitamin K deficiency, as vitamin E blocks vitamin K and raises the risk of bleeding.

Poor Liver Function
The liver manufactures important proteins that are needed to prevent excessive bleeding. Poor liver function can impair the ability of the blood to clot properly.

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Summary

An established cause of menorrhagia is a lack of vitamin K, which is needed to coagulate blood. Recent studies show that vitamin K deficiencies are actually more common in the U.S. than once thought. Logically, then it would makes sense to consider a vitamin K deficiency as a possible cause of menorrhagia, especially in cases where women had other signs commonly linked to a vitamin K deficiency such as osteoporosis, fractures, nosebleeds, easy bruising, bleeding gums, etc. Based on my personal experience, and from looking at web sites on menorrhagia, the link between vitamin K and menorrhagia does not seen to be widely known among either medical practitioners or the general population. Other causes of menorrhagia that are either not well known, or not well established, but may be worth considering in the diagnosis and treatment of heavy menstrual bleeding include inherited or acquired bleeding disorders, connective tissue disorders, iron deficiency anemia, hypothyroidism, excess estrogen conditions, and/or deficiencies of vitamins A or E.

Many women in the U.S. have hysterectomies due to heavy menstrual bleeding. The U.S. has one of the highest rates of hysterectomies of any country in the world. A recent U.S. study found that as much as 70% of hysterectomy operations were unnecessary, in part because surgery was rushed into before other, less risky and invasive treatment options were considered. Checking for a vitamin K deficiency and other known causes of menorrhagia would be a logical first step consideration in the treatment of the disorder, and perhaps would help to decrease the amount of unnecessary hysterectomies done in the U.S. each year.

See my Frequently Asked Questions section on Menorrhagia specific diet and lifestyle tips, more possible causes of menorrhagia, and a great article on menorrhagia causes to share with your doctor.

 

 

 

 

 



For a list of books that helped my connective tissue disorder symptoms, including my fibromyalgia, TMJ, MVP and scoliosis, please see my recommended book list.

Visit my home page or my site map to use my search feature, and see information on connective tissue disorders and related features.

These sections may be also of special interest:

Food Cures for Heavy Periods - the diet treatment I've perosnally found helpful.

Migraines, Hormones and Magnesium - low magnesium and estrogen levels may be to blame for headaches prior to menstruation.

Holistic Doctor and Dentist Directory

Vitamin K Deficiency - symptoms and causes

Ovarian Pain from Vitamin K Deficiency

Nose Bleeds: Overlooked Causes of Chronic Epistaxis

Foods that Thin the Blood

Related Links:

Museum of Menstruation and Women's Health - Discover the history of menstruation and women's health on this web site (MUM for short). A very unique site devoted to menstruation and selected topics of women's health.

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