6 Natural Remedies for Heavy Periods in Perimenopause

Heavy periods, or menorrhagia, are common during the perimenopausal years.

Actually, one in four women will have a hysterectomy due to this heavy bleeding. (The Lancet).

Your OBGYN may offer an endometrial ablation, fibroid surgery, IUD insertion, or birth control pills to reduce your flow, but they all have potential secondary effects.

My experience? I was told this heavy bleeding was due to my fibroids. So, I removed them.

• Little did I know that this wouldn’t “fix” the excessive blood clots.

• Months after surgery, I was left with more blood clots and low iron due to excessive bleeding. And, no one ever checked my Ferritin.

So, you must learn how to metabolize your estrogen and get to the root cause of this heavy bleeding.

Because you don’t want to struggle for years with exhaustion, low ferritin, and brain fog due to the excessive bleeding you’ll experience.

And, if you have a daughter, most likely she’ll follow your pattern.

In this post, I’ll cover how I finally fixed blood clots and heavy bleeding during my perimenopausal years.

So, why does this happen?

8 Common Root Causes of Heavy Bleeding in Perimenopause

1. Mold Toxicity (Mycotoxins)

   • – Mold exposure can raise estrogen levels and lead to heavy or early periods even in young girls (Kościelecka et al., 2023).

     –This was our experience! We moved into a house with mycotoxins, and both my daughter and I struggled with blood clots. No one suspected mold, even the mold inspector who was struggling with his own health problems.

2. Elevated Cortisol

   • – Chronic stress impacts ovulation and progesterone, which can make bleeding heavier (Woods et al., 2009).

   • – Waking up and having coffee for breakfast is one of the biggest mistakes we can make when it comes to regulating our cortisol.

3. Alcohol Consumption

   • – This increases estrogen and histamine load, contributing to heavier and more painful cycles, not to mention insomnia.

4. Estrogen Dominance

   • – A relative excess of estrogen compared to progesterone, often due to poor metabolization or detoxification of excessive estrogen.

5. Poor Liver & Gallbladder Function

   • – This impairs the clearance of excess hormones and inflammatory compounds.

6. Low iron or Ferritin

   • – With great blood loss, we have to replace your iron, but in a mindful way. Often, taking iron supplements does not work.

7. Vitamin K deficiency

   • – Those of us with the gene GGCX (gamma-glutamyl carboxylase) and VKORC1 (vitamin K epoxide reductase complex subunit 1) need to supplement with Vitamin K most days to prevent blood clots. [source]

   • – Plus, you always want to take Vitamin K with your Vitamin D supplements.

6 Remedies for Perimenopausal Heavy Bleeding

The best place to start is by adding bioidentical progesterone, especially if you’re over 35. But it’s just the first step.

1. Topical Bioidentical Progesterone

• How it helps: Supports the luteal phase, reduces estrogen dominance, improves sleep, and decreases clot size.

• Dosing: Typically applied from cycle days 14–28 at 20–40 mg nightly (always test hormone levels and work with a practitioner).

  • Cons: This works at first, but you may then experience secondary effects of progesterone, such as hunger and yeast infections.

    • This works best when you start perimenopause. As you progress through the years, your dosing and hormones should change. Getting tested every 3-6 months is helpful.

2. Shepherd’s Purse (Capsella bursa-pastoris)

• How it helps: An astringent herb that tones the uterus and reduces acute bleeding.

• Dosing: 1–2 dropperfuls of tincture every 2–3 hours during heavy flow (short-term use only).

• Form: Alcohol-based tincture for fastest action.

  • Note: This can help during the days of your heavy cycle, usually day 2 or 3.

  • Keep in mind, we still have to address your low iron and blood clots.

3. Vitex (Chaste Tree Berry)

• How it helps: Balances pituitary signals, increases progesterone, regulates cycles.

• Dosing: 1-5 drops, Days 7-14 of your cycle

• Timing: This works best for women who have a cycle less than 28 days long.

• Pro tip: Vitex is very nuanced and can cause depression in some women who are sensitive to progesterone. Read this post and this one to learn more.

4. Iron + Vitamin C

• How it helps: Replenishes lost iron from heavy bleeding, prevents anemia, and improves energy.

• Dosing: This is tricky; dosing varies depending on your Ferritin status.

• Tip: Choose iron bisglycinate, WITH cofactors for gentler digestion and greater absorption.

  • Use Seeking Health Iron with cofactors every other day for 12 weeks if you have low ferritin <30 or <20 ng/ml.

    • Grassfed Blood Supplement HERE can help if your Ferritin is below 20 ng/ml.

  • Skip Liposomal Vitamin C and ascorbic acid, as this will interfere with your iron absorption.

    • Use whole food Vitamin C, like Camu Powder, to increase your Vitamin C. I like this ONE.

5. Liver Detox Support

• How it helps: Your Ferritin is stored in your liver.

  • Supporting your liver is key to reducing blood clots, improving estrogen metabolism, and reducing your inflammatory load.

• Herbs:

  • Milk Thistle (200–400 mg daily) + Dandelion Root tea (1–2 cups/day).

• Lifestyle: Remove alcohol, plastics, and synthetic fragrances from your home.

• Tip: Try the Queen of Thrones, Castor oil pack 3x week.

6.Adding Vitamin K

• The Linus Pawling Institute states, “Vitamin K helps manage heavy periods by enabling the liver to synthesize essential blood-clotting proteins (Factors II, VII, IX, and X) through a process called gamma-carboxylation.” [source]

• Consume green leafy vegetables (K1), and fermented foods and meats (K2) to increase your K1 absorption.

Conclusion

Blood clots are a sign to pay attention, rather than cover up. When we don’t address blood clots, we struggle with exhaustion for years to come and pass it on to our children. Lifting your iron to Functional Medicine numbers is key to healing your body. Consuming iron from liver and organ meats can help us heal more naturally.

xo

Tara

References

1. National Institute for Health and Care Excellence. (2021). Heavy menstrual bleeding: assessment and management. NICE Clinical Guideline [NG88].

2. Kościelecka, K., Kuć, A., et al. (2023). Endocrine Effect of Some Mycotoxins on Humans: A Clinical Review. Toxins, 15(9), 515. https://doi.org/10.3390/toxins15090515 ↩

3. Woods, N. F., Mitchell, E. S., & Smith-DiJulio, K. (2009). Cortisol Levels during the Menopausal Transition and Early Postmenopause. Menopause, 16(4), 708. https://doi.org/10.1097/gme.0b013e318198d6b2 ↩

4. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31790-8/fulltext ↩

5. Kościelecka, K., Kuć, A., Kubik-Machura, D., Męcik-Kronenberg, T., Włodarek, J., & Radko, L. (2023). Endocrine Effect of Some Mycotoxins on Humans: A Clinical Review of the Ways to Mitigate the Action of Mycotoxins. Toxins, 15(9), 515. https://doi.org/10.3390/toxins15090515 ↩

6. Woods, N. F., Mitchell, E. S., & Smith-DiJulio, K. (2009). Cortisol Levels during the Menopausal Transition and Early Postmenopause: Observations from the Seattle Midlife Women’s Health Study. Menopause (New York, N.Y.), 16(4), 708. https://doi.org/10.1097/gme.0b013e318198d6b2 ↩

7. Weston BW, Monahan PE. Familial deficiency of vitamin K-dependent clotting factors. Haemophilia. 2008 Nov;14(6):1209-13. doi: 10.1111/j.1365-2516.2008.01853.x. PMID: 19141161; PMCID: PMC2643352. https://pubmed.ncbi.nlm.nih.gov/19141161/ ↩

8. https://lpi.oregonstate.edu/mic/vitamins/vitamin-K ↩