Common period problems

Period problems are very common, but they are not normal. And fortunately this is where naturopathy shines! Nutrition and lifestyle can be game changers when it comes to addressing period problems.

Painful menstrual cramps (dysmenorrhea)

“Normal” period pain is slight cramping in your pelvis or lower back on the day before and/or the first couple of days of your menstrual bleed, that can be relieved by ibuprofen. 

  • Please Note: There is a big difference between what is “normal” and what is common.  The problem with “normalizing” common symptoms like period pain, is that we start to see living with this issue as normal or acceptable, and not as a problem that needs to be remedied. We might think that the only option is to medicate the symptom or just deal with it, until it has impacted our ability to live our lives, rather than addressing the underlying issue. Period pain has been normalised to such an extent that it takes the average endometriosis suffer 10 years to achieve a diagnosis! 

  • A small level of discomfort or pain during your period is ok - after all, your uterine muscles are contracting to shed your menstrual lining, so obviously you will feel something! Slight cramping in your pelvis or lower back on the day before and/or the first couple of days of your menstrual bleed is to be expected, and you should be relieved by ibuprofen (if you choose to take it). 

  • Period pain is caused by the release of prostaglandins in the uterus, which cause the uterus to contract and shed its lining (hence our menstrual bleed). 

  • Hormonal imbalances (i.e. elevated oestrogen:progesterone) can also increase the amount of prostaglandins released and subsequently increase pain. 

  • Severe or intense period pain that lasts for days, that can’t be relieved with ibuprofen and causes nausea or vomiting  can indicate more serious conditions such as endometriosis, uterine fibroids or polyps, pelvic inflammatory disease or adhesions. These underlying causes need to be investigated. 


Short menstrual cycles (polymenorrhea) 

  • Bleeding which occurs more than every 21 days. 

  • This type of increased bleeding is usually caused by a dysfunction in the hypothalamic-pituitary-axis (HPO axis) due to stress, abnormal height to weight ratio and restricted eating or perimenopause.  

  • Short cycles can indicate anovulatory cycles (cycles without ovulating), a short follicular phase or a short luteal phase associated with low progesterone. 


Abnormal bleeding (metrorrhagia)

  • Abnormal or intermenstrual bleeding occurs at times other than at the onset of menstruation.

  • Light spotting on the day of ovulation is common and normal. This can occur due to a dip in oestrogen. Oestrogen dips before LH surge, and egg release, this can impact endometrium stability. It does not necessarily require treatment. 

  • Mid cycle bleeding can be a sign of polyps, fibroids, endometriosis or infection - investigations are required. 

  • A light bleed mid cycle could also indicate an anovulatory cycle.

  • If premenstrual spotting occurs for longer than two days prior to a period, this can be suggestive of an inadequate luteal phase (low progesterone), or thyroid disease, polyps, endometriosis or fibroids - investigations are required. 

Heavy bleeding (menorrhagia)

  • Heavy bleeding is losing more than 80mL of blood during your period. 

  • Heavy or prolonged bleeding can occur due to cervical lesions or polyps, fibroids, infection or other abnormalities - investigations are required. 

  • Heavy periods can also occur due to oestrogen excess and low progesterone, thyroid disorders, impaired oestrogen metabolism or anovulatory cycles. 

  • Bleeding after sex can indicate inadequate lubrication, but also infection or inflammation - see your GP. 



Long or infrequent cycles (more than 35 days - oligomenorrhea) 

  • Menstruation should occur at least every 35 days. 

  • It is possible to have a longer follicular phase, however the luteal phase can never be longer than sixteen days (this is the lifespan of the corpus luteum which secretes progesterone). 

  • Cycles longer than 35 days can occur due to PCOS, anovulatory cycles, long follicular phase, hyperprolactinemia, transition to menopause or disorders of thyroid gland. 




Very light periods (hypomenorrhea) 

  • 25mL or less of blood loss during a period can also be indicative of an anovulatory cycle (no ovulation) causing a light or scanty bleed.  

  • Hypomenorrhea can also occur due to low levels of oestrogen, deficiency especially with low body weight, undereating, stress, smoking, anemia, thyroid disorders and excessive soy/phytoestrogens in the diet. 

Amenorrhoea (absent periods)

  • Primary amenorrhoea is when menses have not commenced by age 17.

  • Secondary amenorrhoea is when periods are absent for more than 6 months when pregnancy or menopause is not the cause.

  • Causes of secondary amenorrhoea include poor diet or undereating, low body weight, excessive exercise, PCOS, hyperprolactinemia, elevated stress levels, depression,  illness, or thyroid disorders. 

  • May occur following cessation of the oral contraceptive pill (OCP). Stopping the OCP can reveal pre-existing conditions like PCOS which may not have been apparent while OCP was being taken, due to causing regular “pill bleeds”. 



How is your period report card looking? If you need help with regulating your hormones and menstrual cycle, get in touch to see how naturopathy can help you.

Hayley Brass