Managing Heavy Periods in Perimenopause: Natural Support for Hormonal and Metabolic Health

Heavy periods can feel like they arrive out of nowhere — heavier flow, longer duration, more discomfort, and a big impact on your day-to-day life. If you're in your late 30s or 40s and noticing changes in your cycle, you're not alone. For many women, perimenopause is when periods begin to shift — and heavier bleeding is one of the most common concerns.

The good news? Once we understand what’s driving these changes, there are effective, natural ways to support your body and reduce the impact of heavy periods.

Why Are My Periods Getting Heavier?

In perimenopause, your hormone levels don’t just gradually decline — they fluctuate. You might still be producing plenty of oestrogen, but progesterone often drops first due to less consistent ovulation. This creates a state called "oestrogen dominance", where there’s more oestrogen relative to progesterone, leading to a thicker uterine lining and heavier bleeding.

But hormonal changes aren’t the only factor. Other common contributors include:

• Fibroids or polyps: These benign growths increase the surface area of the uterine lining or interfere with normal uterine contractions, making bleeding heavier or more prolonged.

• Adenomyosis: This condition causes the uterine lining to grow into the muscle wall, leading to heavy, painful periods and pelvic pressure.

• Endometriosis: Although often associated with pain, endometriosis can also contribute to heavy bleeding through inflammation and hormone disruption.

• Thyroid issues or nutrient deficiencies: An underactive thyroid or low iron and vitamin K levels can affect clotting and hormone regulation.

Heavy bleeding isn’t something to ignore. If you’re soaking through pads or tampons every 1–2 hours, waking at night to change protection, or feeling lightheaded and exhausted — it’s time to take action.

How to Manage Heavy Periods Naturally

Supporting hormone balance and metabolic health with food, lifestyle, and targeted nutrients can make a real difference. Here are some of the most effective strategies I use with clients:

1. Increase Fibre Intake

Fibre is one of the simplest yet most powerful ways to support hormone clearance and metabolic function.

• It binds to excess oestrogen in the digestive tract, helping your body excrete it efficiently

• It supports a healthy gut microbiome, which influences how hormones are broken down

• It helps regulate blood sugar, which reduces insulin resistance and supports progesterone production

Aim to include a variety of fibre-rich foods daily — think vegetables, legumes, whole grains, flaxseeds, chia, nuts, seeds, and fruit. Even small changes like adding lentils to soup or a sprinkle of ground flax on breakfast can add up.

2. Support Progesterone Naturally

We can’t always control ovulation, especially in perimenopause, but we can create the right conditions to support it.

• Eat enough protein, fats, and complex carbs to keep blood sugar steady

• Prioritise rest and recovery — chronic stress suppresses ovulation

• Avoid overly restrictive diets that deplete key nutrients

Certain herbs and nutrients may also help, but personalised guidance is best here.

3. Replenish Iron and Key Nutrients

If you’ve been bleeding heavily for a while, it’s likely your iron stores (ferritin) are depleted. This can lead to fatigue, poor concentration, and shortness of breath. Rebuild your stores through iron-rich foods like red meat, leafy greens, and legumes, paired with vitamin C to enhance absorption.

Magnesium is another key nutrient — it supports muscle relaxation, reduces inflammation, and can ease cramping and hormone-related mood swings.

4. Reduce Inflammation

Inflammation can make hormone receptors less responsive and worsen both bleeding and pain. Support your body with:

• Omega-3-rich foods (like flaxseeds, walnuts, and oily fish)

• Colourful fruits and vegetables

• Anti-inflammatory herbs and spices like turmeric and ginger

Limit alcohol, ultra-processed foods, and excess sugar where possible — these all contribute to systemic inflammation.

5. Manage Stress

Stress isn’t just a mental health issue — it has a real impact on your cycle. When stress is chronic, the body may prioritise stress hormone production over sex hormones, which can reduce ovulation and lead to lower progesterone levels.

Gentle daily practices like walking, yoga, time in nature, journaling, or simply saying no to what doesn’t serve you can make a big difference. Supporting your nervous system is just as important as supporting your hormones.

When to Seek Help

If your bleeding is severe or accompanied by pain, fatigue, or iron deficiency symptoms, it’s worth speaking to your healthcare practitioner. Imaging or hormone testing may be appropriate, and a combination of naturopathic and medical approaches is often the most effective path forward.

You Don’t Have to Put Up With Heavy Periods

Heavy bleeding may be common, but it’s not something you need to just live with. By supporting your body with the right food, nutrients, and stress management tools, you can reduce bleeding, feel more energised, and restore hormonal balance — naturally.

If you’re looking for personalised guidance, I offer 1:1 naturopathic consultations tailored to your unique cycle and symptoms. You can also explore helpful resources in the Southernwood Apothecary store.