Heavy Periods: Understanding Root Causes, Herbal Allies, and When to Get Tested

Heavy periods are mostly benign, but can be one of the most debilitating forces we have to deal with. Whether you had it your whole life, or this is a recent shift in your menstruation, I’ve prepared this in-depth overview and included some wholesome tips on how to improve your periods. I know it can be life changing to those who need it.

If any of that resonates, it’s time to look deeper. Heavy periods are common — But they don’t have to be. Let’s explore what may be driving them, how herbs can gently support your body, and when it’s wise to get some testing done.

What Is Considered a Heavy Period?

“Bloodbath”, “Murder scene”, “Waterfalls”….. I know it all too well, but let’s have a clear understanding of what’s heavy:

“Heavy” means different things to different people, but medically, it’s often defined as:

• Bleeding that lasts more than 7 days

• Soaking through a pad or tampon every 2 hours for several hours

• Passing large clots (larger than a quarter)

• Needing to double up on protection

• Feeling fatigued or dizzy due to blood loss

But numbers aside, you get to decide what feels heavy, disruptive, or out of balance.

What can the root causes of heavy periods?

1. Estrogen Dominance

Estrogen is responsible for building up the uterine lining each cycle. But when it isn't balanced by enough progesterone — due to stress, poor ovulation, sluggish estrogen detox, or hormonal shifts — that lining can become too thick. The result? Heavier, longer, or more clotty bleeding.

This imbalance, often called estrogen dominance, is especially common in times of stress or transition (like perimenopause).

Signs may include:

• PMS (bloating, breast tenderness, irritability)

• Mid-cycle spotting

• Short luteal phase (the time between ovulation and your next period)

What helps:

• Support healthy ovulation: vitamin B6, magnesium, vitex

• Encourage estrogen clearance: fiber, cruciferous vegetables, liver-supporting herbs like dandelion or burdock

Estrogen Dominance in Perimenopause:

In your late 30s and 40s, hormonal shifts naturally begin. Ovulation becomes less consistent, which means less progesterone — while estrogen can still surge. Without progesterone to balance it, estrogen becomes “unopposed,” leading to heavier, longer, or more unpredictable cycles.

Additional signs:

• Changing cycle length (shorter or irregular)

• Mood swings, night sweats, or mid-night waking

• Mid-cycle or post-period spotting

What helps:

• Nervous system regulation (daily stress relief practices)

• Adaptogenic herbs: ashwagandha, rhodiola

• Progesterone support: vitex, vitamin B6, vitamin C

• Uterine tonics: covered in the next section

2. Sluggish Liver

Your liver helps break down and eliminate excess estrogen. If it's overwhelmed — by stress, alcohol, processed foods, or lack of nutrients — estrogen may recirculate, worsening hormonal imbalance.

Signs:

• Heavy periods

• Acne or PMS

• Sensitivity to caffeine/alcohol

• Waking up between 2am-4am
  
  

  What helps:

• Bitter herbs (dandelion root, burdock, artichoke leaf) that increase production of bile, which helps with smoother digestion.

• Hydration

• Increasing plant based foods, like green leaves & broccoli.

• Avoiding alcohol, sugar, excess caffeine

• Prefer organic produce, limit environmental toxins, and ditch commercial cosmetic products.

3. Gut imbalances

The second phase of estrogen detoxification happens in the gut. Therefore, in my client consultations, one of the first questions I ask is: “How often do you eliminate?” Aka, how often do you poop? If the answer is ‘not every day’ or ‘every other day,’ a little lightbulb goes off for me, and I put the client on a protocol for improved digestion. The reason is, we need to “poop out estrogen” every. single. day. Otherwise, the molecules are circling back to the system, and causing hormones imbalances.

Signs:

• Digestion issues like: constipation, bloating, food sensitivities.

• Low mood, brain fog

• Food cravings

What helps:

• Flax seeds

• Increase fiber intake, which serves like prebiotics, as well as fermented foods.

• Taking a quality probiotic supplement

• Address gut inflammation: Add spices like turmeric, cumin, thyme, oregano. and cut inflammatory foods like gluten, sugar, processed foods, etc.

4. Perimenopause

Perimenopause typically begins in your late 30s to mid-40s, though for some it starts earlier or later. It's a transitional time when hormone production — particularly progesterone and estrogen — becomes less predictable. You may still be cycling, but ovulation can become irregular, which means your body produces less progesterone to balance the effects of estrogen.

This hormonal seesaw can lead to heavier, longer, or erratic periods, along with a mix of physical and emotional symptoms. It's not just a shift in fertility — it's a whole-body recalibration.

What’s Happening Biologically

• Lower progesterone: Without consistent ovulation, progesterone levels decline — leading to estrogen “dominance” (even if estrogen itself is also declining).

• Spiking or fluctuating estrogen: Estrogen may rise and fall unpredictably, causing emotional sensitivity, breast tenderness, and heavier bleeds.

• Nervous system dysregulation: Cortisol, sleep, and blood sugar become more sensitive — amplifying mood swings, anxiety, and fatigue.

• Changing brain chemistry: Hormones like serotonin and GABA are affected, influencing mood, sleep, and resilience.

Common Signs of Perimenopause

• Changing cycle length (shorter, longer, or skipped cycles)

• Heavier or more painful periods

• Mid-cycle or post-period spotting

• Mood swings, irritability, or anxiety

• Night sweats and disrupted sleep (especially 2–4am waking)

• Weight changes or bloating

• Increased sensitivity to stress, caffeine, or alcohol

• Feeling “wired but tired,” especially before bleeding

What Can Help

• Nervous System Regulation

Your nervous system is the conductor of your hormonal symphony. Calming daily rituals can profoundly ease symptoms.

• Daily walks, yoga, breathwork, nature time

• Magnesium glycinate, passionflower, blue vervain

• Sleep hygiene: dim lights, screen-free wind-down, consistent bedtim

• Adaptogens to Build Resilience

  Ashwagandha: grounding, supports sleep and anxiety

  Rhodiola: energizing, great for brain fog or low mood

  Tulsi (Holy Basil): uplifting, helps with cortisol and overwhelm

• Progesterone-Boosting Allies

  Vitex (Chaste Tree): supports ovulation and lengthens the luteal phase

  Vitamin B6 & C: essential for natural progesterone production

• Seeds (flax, pumpkin, sesame, sunflower)

• Herbal Uterine Tonics

(See next section) Raspberry leaf, yarrow, and other tonics can help regulate flow and restore tone to the uterus during this transition.

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My favorite herbs for Heavy Periods

Plants can gently help your body come back into balance. Here are some of the most effective herbs for heavy or prolonged menstrual bleeding:

Yarrow (Achillea millefolium)

• Actions: Astringent, hemostatic (slows bleeding), anti-inflammatory, tones the uterine.

• Use: Tincture or tea at onset of bleeding

• Great for: Sudden, heavy flow, cramping.

• Energetic note:
  Yarrow is a boundary-setter. It helps you hold your energetic line, especially when your cycle feels like it’s pouring out of you. A fierce protector and a healer of leaks — physical, emotional, spiritual.

Shepherd’s Purse (Capsella bursa-pastoris)

• Actions: Uterine tonic, contracts blood vessels

• Use: Often used acutely for heavy flow; can be taken as tincture during heavy days or in herbal infusion.

• Great for: Short-term control of excessive bleeding

• This herb grounds and centers quickly. It's like an herbal emergency brake — helping you reconnect to safety and stillness when bleeding feels out of control.

Raspberry Leaf (Rubus idaeus)

• Actions: An ancient tonic of the reproductive system: Uterine tonic, gently astringent, mineral-rich

• Use: Drink daily as a nourishing tea

• Great for: Long-term support and tone of the uterus.

• Energetic note:
  Raspberry leaf is the wise grandmother of the womb — steady, grounding, reliable. It reminds your body of its rhythm and rebuilds trust between you and your cycle.

Vitex (Vitex agnus-castus)

• Actions: Balances hormones by supporting ovulation and boosting progesterone

• Use: Daily tincture, long-term (3+ months)

• Great for: Estrogen dominance, irregular cycles

• Energetic note:
  Vitex helps restore inner authority. It’s ideal when your hormonal rhythm feels chaotic or disempowered. This herb brings you back into harmony with your body’s deeper wisdom.

Nettle (Urtica dioica)

• Actions: Rich in iron, astringent, rebuilds blood, lymphatic mover

• Use: As a tea, infusion, or tincture. Before, during or after the bleeding.

• Great for: Water retention, bloating, slow digestion, anemia, recovery after heavy bleeding.

• Energetic note: not only physically nourishing, but energetically rebuilding. For those who feel drained, depleted, or like they've “bled out” more than just blood.

Ginger Root (Zingiber officinale)

• Actions: Strong anti-inflammatory, antioxidant, analgesic (helps with pain)

• Use: Can be used fresh or dry in infusions, or in tincture.

• Great for: Painful & heavy periods, included bloating.

• Energetic note:
  Ginger awakens and enlivens. It brings heat to cold, stagnated systems — helping the blood move freely and pain to ease. It’s especially useful when your cycle feels emotionally heavy or you feel frozen in overwhelm.

Blue Vervain (Verbena hastata)

Actions: Nervine, antispasmodic, liver stimulant, mood stabilizer
Use: Tincture in small doses (5–10 drops), 1–3x daily
Great for: Tension held in the neck/shoulders, PMS irritability, “Type A” burnout energy
Energetic note:
Blue Vervain is medicine for the overachiever’s nervous system — the person who holds it all together until they bleed. It soothes frazzled nerves, helps you drop from your head into your body, and reminds you that softening is a form of strength.

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When to Get Tested

While herbs and nutrition are powerful allies, some symptoms need deeper exploration. If you’re experiencing any of the following, lab work is a wise next step:

You should get tested if:

• Your periods are getting progressively heavier

• Bleeding lasts more than 10 days regularly

• You’re passing large clots or soaking protection hourly

• You feel faint, dizzy, or weak during your period

• You’ve entered your late 30s or 40s and your cycle has changed

• You’re struggling to conceive or regulate your cycle

Useful tests to request:

• Complete Blood Count (CBC) — to check for anemia

• Ferritin — to assess iron storage

• Thyroid panel (TSH, Free T3, Free T4, antibodies)

• Hormones: Estradiol, Progesterone, LH, FSH

• Pelvic ultrasound — to rule out fibroids or polyps

A word on polyps, cysts, endometriosis and adenomyosis

While hormonal imbalance is a common cause of heavy periods, it’s important to rule out other underlying conditions — especially if symptoms are intense or new for you. Structural causes like uterine fibroids, polyps, or adenomyosis can lead to excessive or prolonged bleeding, clotting, pelvic pressure, or pain. In some cases, a bleeding or clotting disorder may also be involved, particularly if you’ve experienced heavy periods since your teens or have frequent bruising. These are all valid reasons to seek further evaluation. A pelvic ultrasound can help identify physical changes in the uterus, while coagulation panels and other blood work can uncover clotting issues that may otherwise go unnoticed. Getting clear on what’s going on allows you to choose the most effective — and safest — support plan.

The good news - Even if you have these, don’t panic just yet… there are natural ways to support your body, and help to shrink these, often without a need for operation.

Oftentimes, the common root cause of these benign structures is, in fact, estrogen dominance. (Check text above).

Heavy periods are a signal. They are a starting point. And they might be the door to a greater healing. With the right information, herbal wisdom, and occasionally testing, you can move toward more ease, vitality, and confidence in your cycle.

Not sure where to start? I offer 1:1 consultations where we review your cycle, your symptoms, and your labs — and build a personalized herbal plan that supports you on every level.