| Caroline Donoghue |

 

From heavy flow to no period at all, painful cramps to bloating, dark brown to light pink period blood, your menstrual cycle can tell you a lot about what is going on in your body. In this article you will learn to interpret the signs your body is telling you and why the contraceptive pill is not the solution for hormonal imbalances.

If you are like the majority of women, your period is affecting you to some extent. In fact, premenstrual syndrome (PMS) affects 80% of women during the 7-14 days before their period begins (1). There are over 100 signs and symptoms associated with PMS and although it is normal to observe little changes which in most cases are relatively mild, it is not normal to experience severe bloating, fatigue, depression, breast tenderness, headaches or painful cramps before your period.

Knowing about your menstrual cycle is not just important for fertility. In fact, our period is an amazing tool to evaluate how healthy you are and gives a great insight into numerous health conditions. Experts are calling it our fifth vital sign. It is considered an important health indicator like our pulse, breathing rate, blood pressure and body temperature (2).

Every woman is different but there are common characteristics of a healthy period.

 

period

 

Here are 4 things you should monitor to know which hormones are in and out of balance:

 

  1. The amount

A healthy period has an average of 35-50 ml of total blood loss. It shouldn’t have any clots or clumps. A few days of spotting right before or after your flow is normal.

A heavy flow is when you need to change your pad or tampon every hour or if you see big blood clots. According to the NHS it is defined as losing 80 ml or more in each period and/or having periods that last longer than 7 days (3)

Losing too much blood is abnormal and could be a sign of fibroids or polyps. It could also lead to anemia therefore it is important to see your doctor to get checked.

On the other hand, losing too little blood could be a sign of low oestrogen and progesterone. These could be explained by a deficiency in some essential nutrients (4).

 

  1. The colour

Healthy period blood should have a bright red colour. It can be described as a cherry colour.

If you see dark red or black clots (large or small) it could be due to low progesterone, elevated oestrogen and congestion in the uterus.

If you see brown stains at the beginning of your period, it is an indication of some blood stagnation due to lower progesterone levels.

On the other hand, if the blood is too light – pink rather than red, it could indicate an oestrogen deficiency or iron deficiency (4).

 

  1. The length

A healthy period should last around three to seven days but the average is usually between four to six days (5).

A short bleed (less than 3 days) can be a sign of low oestrogen and progesterone. This could be because of key nutrient deficiencies or adrenal dysfunction (4).

 

  1. The frequency

A healthy period should arrive every 25-35 days.

Very frequent bleeds (having your period twice a month or all month without a break) could be due to a sluggish thyroid so it is important to check your thyroid levels.

If you have irregular periods or no period at all, this is not normal and conditions like polycystic ovary syndrome or hypothalamic amenorrhea should be ruled out by your doctor.

 

So, where do you stand – is your period looking healthy?

There can be many reasons that explain variations in your menstrual flow such as hormonal imbalance, unstable blood sugar, poor nutrition and poor liver function. Whatever the reason, it is recommended to pay attention to your fifth vital sign. Interpreting your period is important for your health. You can track your period with wonderful apps such as Clue, Life or Moody Month.

When you’re experiencing period troubles, sometimes it feels that the contraceptive pill is the best and only option.

A study in the US found that 58% of women use the pill for reasons other than contraception including reducing menstrual pain, acne and migraines (6). The problem is that if you have underlying hormonal issues, the pill will not fix the root cause and the longer you have a hormonal problem, the more complicated it is to treat.

The question you should ask yourself is: why did you have these symptoms in the first place? The contraceptive pill will mask your symptoms but it will not cure you. If you decide at some point to come off the pill to become pregnant, you will be at risk of post-birth control syndrome. All your symptoms that were never addressed may come back and often worse than before. These symptoms can happen 4 to 6 months following the discontinuation of the pill (7).

Although it is undeniable that the oral contraceptive pill is highly effective for birth control, it also affects the women’s body more than we may realise. Here are important facts that you may not already know:

 

It depletes essential nutrients in your body

The World Health Organization (WHO) reported that the pill influences a woman’s nutrient requirements – it affects vitamin and mineral levels (8).

Unfortunately, drug-nutrient interactions often get overlooked by conventional medicine but if you’re on the pill you will want to pay more attention to the following key nutrients (8,10,11):

  • The minerals magnesium, zinc and selenium
  • Folic acid, vitamins C, B2, B6, B12 and E

This is of particular concern for women in the 21st century as our soils are not as nutrient rich as before and our busy and modern lifestyle (aka chronic stress, high sugar intake, processed foods and lack of sleep) already depletes our body from important nutrients. For instance, did you know that stress depletes magnesium and that sugar depletes vitamin C?  (9)

All these factors combined is a recipe for nutrient deficiencies and the problem is that nutrient depletion can lead to serious health complications. Therefore, improving your dietary intake and taking appropriate dietary supplements may be necessary to help counter these possible negative side effects.

 

It impacts your mental health 

The side effects of the pill go beyond feeling a bit moody! In fact, studies showed that taking synthetic oestrogens and progestins could potentially interact with the neurotransmitter metabolism that impacts mood (serotonin, norepinephrine, dopamine, GABA and peptides) (12).

Back in 2016, the Journal of the American Medical Association released a study that associated the use of the pill with an increased risk of antidepressants (…). The risk was even greater among adolescents suggesting depression as a potential adverse effect of the contraceptive pill (13).

 

It alters your gut microbiota

The gut microbiota (also called gut flora), refers to all the microorganisms that live in our digestive system. This includes fungi, bacteria, viruses, and protozoa (single cell organisms) and they live mainly in our large intestine. We’re talking about both beneficial and harmful microorganisms and you have about 100 trillion of them living in your gut. These beneficial gut bugs are very much needed for good health and support many different functions in our body.

Our gut bacteria help us to digest and extract nutrients from the food we eat. They also create vitamins that are key for giving us energy. Gut bacteria play a role in developing our immune system, regulating our blood sugar and appetite, managing hormonal balance, preventing us from getting infections, communicating with our nervous system and brain (the gut-brain axis) and so much more.

It is fair to say that a healthy gut is required for good health!

Studies have shown that the contraceptive pill can negatively impact the gut microbiome making us more vulnerable to dysbiosis (a bad mix of the wrong type of bacteria) and leaky gut (where the walls of our intestines become damaged and unwanted substances such as bacteria, toxins and undigested food particles enter the bloodstream). (14)

This can engender various digestive issues and an increased risk of autoimmune disease – which brings us to the next point!

 

It triggers autoimmune disease

Oestrogens and progestins have profound effects on the immune system and there is good evidence that the pill triggers autoimmune disease especially Ulcerative Colitis, Crohn’s disease, multiple sclerosis, Lupus and interstitial cystitis.(15,16,17).

These are only 4 facts but what’s even more worrying is that it doesn’t stop here. The contraceptive pill also increases the risk of blood clots, breast cancer and diabetes (7).

The pill is not the solution for hormonal balance, it will without a doubt make things worse for your body. It is important not to mask your symptoms and instead try to get to the root cause. Don’t let your period dictate how you feel!

 

Caroline Donoghue
DipION, mBANT, CNHC reg
Registered Nutritional Therapist
www.thenutritherapist.com

September 2021

 

References:
  1. Gillings, M. (2014) Were there evolutionary advantages to premenstrual syndrome?. Evolutionary Applications, [online] 7(8), pp.897-904.
  2. The American College of Obstetricians and Gynecologists – Committee Opinion (2020) Menstruation in Girls and Adolescents: Using the Menstrual Cycle as a Vital Sign. [online] Acog.org. Available at: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2015/12/menstruation-in-girls-and-adolescents-using-the-menstrual-cycle-as-a-vital-sign?utm_source=redirect&utm_medium=web&utm_campaign=int  [Accessed 19 July 2021].
  3. Nhs.uk. 2018. Heavy periods. [online] Available at: https://www.nhs.uk/conditions/heavy-periods/  [Accessed 19 July 2021].
  4. Vitti, A. (2013) Woman Code, Hay House
  5. Reed BG and Carr BR. (2018) The Normal Menstrual Cycle and the Control of Ovulation. [Updated 2018 Aug 5]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279054/  [Accessed 19 July 2021].
  6. Jones, R., (2011) Beyond Birth Control: The Overlooked Benefits Of Oral Contraceptive Pills. [online] Guttmacher Institute. Available at: https://www.guttmacher.org/report/beyond-birth-control-overlooked-benefits-oral-contraceptive-pills [Accessed 18 July 2021].
  7. Dr Brighten, J. (2019) Beyond the pill, Harper One
  8. Palmery M, et al. (2013) Oral contraceptives and changes in nutritional requirements. Eur Rev Med Pharmacol Sci. 2013 Jul;17(13):1804-13. PMID: 23852908 [online] PubMed. Available at: https://pubmed.ncbi.nlm.nih.gov/23852908/ [Accessed 18 July 2021]
  9. Weatherby, D. (2004) Signs and Symptoms Analysis from a Functional   Perspective, 2nd edition, Bear Mountain Publishing
  10. Lussana, F., et al., (2003) Blood levels of homocysteine, folate, vitamin B6 and B12 in women using oral contraceptives compared to non-users. Thrombosis Research, [online] 112(1-2), pp.37-41.
  11. Wakeman, M., (2019). A Review of the Effects of Oral Contraceptives on Nutrient Status, with Especial Consideration to Folate in UK. Journal of Advances in Medicine and Medical Research, [online] pp.1-17.
  12. Hall, K., et al., (2015) Contraception and mental health: a commentary on the evidence and principles for practice. American Journal of Obstetrics and Gynecology, [online] 212(6), pp.740-746.
  13. Skovlund, C., et al. (2016) Association of Hormonal Contraception With Depression. JAMA Psychiatry, [online] 73(11), p.1154.
  14. Adlercreutz, H., et al., (1984). Studies on the role of intestinal bacteria in metabolism of synthetic and natural steroid hormones. Journal of Steroid Biochemistry, [online] 20(1), pp.217-229.
  15. Khalili, H., et al., (2012). Oral contraceptives, reproductive factors and risk of inflammatory bowel disease. Gut, [online] 62(8), pp.1153-1159.
  16. Khalili, H., et al. ( 2016) Association Between Long-term Oral Contraceptive Use and Risk of Crohn’s Disease Complications in a Nationwide Study. Gastroenterology, [online] 150(7), pp.1561-1567.e1.
  17. Williams, W., ( 2017) Hormonal Contraception and the Development of Autoimmunity: A Review of the Literature. The Linacre Quarterly, [online] 84(3), pp.275-295.