Prolonged bleeding and staining can be a significant nuisance for women, especially for those who observe family purity laws according to Halacha (Jewish law). But before seeking remedies to “fix” it, the first thing to be done is to rule out that something serious is going on, like a hormonal balance, uterine fibroids, or anovulation. Before treating what feels like an “inconvenience,” get more information, beginning with understanding the basic principles about the menstrual cycle, so the most probable causes can be ruled out. Here’s a list of first questions:
- Is this a recent development or a long-term trend?
- Is your cycle regular or irregular (shorter than 24 days/longer than 35 days)?
- Have you ever been diagnosed with anemia?
- Is the bleeding related to having an intrauterine device (IUD) or to taking any form of hormonal or other medications?
- Might the bleeding be related to a nutritional imbalance, emotional stress, relationship issue, painful intercourse, lifestyle/diet change/weight gain or loss?
Paying attention to the body and to common sense can help verify the root cause/s of the problem.
This article addresses three main issues:
- Understanding the nature of normal, regular menstrual bleeding and staining versus non-menstrual, irregular bleeding and staining
- Recognizing the possible causes of unexplained/unfamiliar bleeding
- Remedies for shortening and reducing bleeding and/or days of staining (before or after menstruation)
About the Menstrual Cycle
A typical menstrual / fertility cycle is about a month long. A normal cycle is typically between 24-35 days. Menstrual blood should be bright red and not contain large clots. Your period is not supposed to cause debilitating pain. If you experience menstrual cramps and pain for more than 30 minutes, see this as an invitation to delve deeper into the possible causes.
A new cycle begins on the first day of real menstrual bleeding (not spotting or brown-ish stains). Having a few days of spotting before and/or after your menstrual bleed is normal.
A cycle ends the day before the next bleed. For example, if the period began on January 1 and again on Jan 30- the cycle length is 29 days (because we do not count the last day and the first day twice).
During the cycle, the body prepares for ovulation and pregnancy. Estrogen prepares the body for ovulation (taking anywhere between 10-20 days, from day one of the cycle). Progesterone prepares the body for pregnancy (taking 10-14 days on average, from ovulation to the next period). This means that the first part of the cycle is varied, where the second part is more set.
Current bleeding can only be verified as menstrual bleeding when you know for sure that ovulation occurred in the past two weeks. Menstruation always occurs 10-14 days after ovulation. A luteal phase shorter than 10 days can indicate a hormone imbalance like progesterone deficiency, which can cause premenstrual spotting.
Learning to monitor and chart your fertility signs, i.e. basal temperature, natural secretions, and cervical position, enables a person to know in advance when her next menstrual bleed will appear.
Possible Causes of Unexplained Bleeding and Irregular Cycles
Not all bleeding is actual menstrual bleeding. True menstrual bleeding is bleeding which occurs within two weeks of a prior ovulation. Contrary to what many people believe, it is not possible to have more than one period in a given month. If you bleed for more than seven days and you are not in hormonal transition (e.g. post-partum, post- hormonal birth control, post-miscarriage or pre-menopausal), this could be a sign that you are not ovulating and may have a hormone imbalance.
There are many causes of vaginal bleeding (link). During an exam (by a bodeket tahara/purity test or a gynecologist), the source of bleeding can often be clarified.
Known causes of non-menstrual bleeding/prolonged bleeding/spotting include:
- Anovulation (absence of ovulation), progesterone deficiency, and a short luteal phase. Dark stains can be a sign of blood flow stagnation.
- A hormonal imbalance caused by ovarian cysts (corpus luteum).
- Non-malignant tumors in the uterus (fibroids), or polyps (usually in the uterus or cervix).
- Thyroid imbalance (hypo-thyroid)
- Eating disorders such as obesity, anorexia, or malnutrition/poor nutrition
- Liver disease
- Prolonged stress
- Miscarriage, early pregnancy, or an ectopic pregnancy
- A recent pap test, gynecological exam, intercourse
- Injury and pelvic inflammation can cause heavy or irregular bleeding and staining, e.g. ectropion and endometriosis.
- Synthetic hormones used during breastfeeding (progesterone-only pills, e.g.Femulen or Cerazette), hormonal birth control, IUD’s, hormone replacement therapy, and fertility hormones
- Drugs that affect the blood clotting system (such as anti-inflammatory drugs, aspirin / Advil / ibuprofen)
- Being over 40 is related to hormonal fluctuations leading up to menopause. During this 3-10 year transition, the length of the menstrual cycle can change and cause irregular bleeding.
Holistic approaches to shortening menstrual bleeding and staining
One-to-two days of spotting before or after menstrual bleeding is considered normal. If spotting is longer than three days or if inter-menstrual bleeding occurs, religious women may want to consult with a Bodeket Tahara, to rule out a pathological cause of bleeding. Unexplained bleeding is not just a Halachic issue; it may be related to your overall health.
A woman who learns to monitor her fertility signs will always know in advance when her next period will occur.
Many holistic approaches can help shorten bleeding and staining. The material here represents but a few of these modalities. Depending on individual symptoms, a recommended first step would be scheduling an exam with your gynecologist. Blood, hormone, and ultrasound tests can also help facilitate a diagnosis about the source of your bleeding/staining problems.
If your interest in shortening your period or days of staining is for getting pregnant, and you have relatively short cycles and suspect you are ovulating early, then learning to track your fertility signs (fertility awareness/method-FAM) can be a valuable tool for understanding your cycle and identifying your fertility days in terms of the mikveh. FAM can also help confirm if you ovulate early on a regular basis. And remember this: Just because you were told, based on one ultrasound, that you ovulated early (before the mikveh) – does not mean that you are ovulating early every month. Just because your cycle is “regular,” does not mean that you ovulate on the same day every month. For discussing further questions about this issue, please consult a FAM teacher or a Yoetzet halacha.
- It goes without saying that a healthy and balanced diet provides vitamins and nutrients that are essential for hormonal health and normal periods. If you experience long periods or irregular cycles, you might want to consider how diet, body weight, stress level and lifestyle are affecting your cycle. What you eat affects your hormones, fertility and periods. Many modern diets can lead to nutritional deficiencies. If you are over/under-weight, follow a restrictive diet or just want to balance and make changes to your diet, consulting with a nutritionist or naturopath is key.
- Spicy foods are thought to increase body heat and move blood flow. Ginger, cinnamon, turmeric, and cayenne can be added to your diet on the days leading up to and during your period. Fruits and foods high in Vitamin C are thought to promote healthy period flow.
- Fermented foods are a natural source of probiotics, which can help balance your gut/microbiome and hormones.
- Seaweeds are high in calcium, iodine and omega 3 amino acids. They can be mixed with soups, grains, and salads. They can also be taken in capsule form.
- Leafy green vegetables, collard greens and root vegetables are high in calcium, iron and trace minerals. Eat more spinach, kale, swiss chard, and collard greens.
- Make sure you eat enough high-quality protein foods and whole grains
- Avoid red meat and refined foods. Avoid or reduce carbs, sugar, alcohol, caffeine, and nicotine.
- Ayurveda Medicine. Pranaveda (Israel)
Supplements for balancing menstrual cycle and hormones
- A high-quality, daily multivitamin containing magnesium, calcium, folic acid, iron, zinc, vitamin C, B6, B12, D, E, and K vitamins
- Flaxseed oil can help regulate ovulation and balance estrogen levels.
- Magnesium is a mineral that can improve blood flow (and also help with period pain)
Herbal remedies for shortening days of menstrual bleeding (beyond 7 days)
Herbs may prove useful but they often require time and patience before seeing results. One should always consult with a licensed practitioner before starting treatment and expect up to 3-4 months for herbal remedies to take effect. The following herbs are known to help balance hormones and the menstrual cycle:
- Shepherd’s Purse and nettle leaf can help with heavy bleeding and shorten menstrual days.
- Vitex (Chaste Tree/Chaste Berry) promotes ovulation, strengthens progesterone, and is used for cycle irregularity. It can reduce premenstrual staining and bleeding caused by an IUD. See more information here.
- Calendula (Marigold) may help regulate the cycle, induce menstruation and reduce menstrual cramps.
- Motherwort, Raspberry leaf, and blue cohosh can help regulate cycles and heavy bleeding
- Ginger (Zingiber officinale) and pomegranate flower (Persian Golnar) have been shown in one clinical trial to balance hormones and reduce heavy bleeding
- Chinese Herbs and acupuncture
Physical exercises, bodywork and massage
- Many of the following techniques are based on the idea that poor energy flow through the pelvic area and the reproductive organs can weaken the menstrual cycle and fertility itself. Abdominal massage, self-abdominal massage, and body-mind exercise can increase blood flow to these organs and mitigate energy blockages. See Arvigo Method, Arvigo practitioners in Israel, and Aviva Method.
- Facilitating menstrual blood release is a natural way to work with the pelvic floor muscles. See Sherman Method (Hebrew). This technique can help shorten days of bleeding and staining and lessen menstruation pain and cramps.
- Regular aerobic exercise has many benefits: it can lighten your flow, reduce the number of period days, reduce cramps, water retention, stress, and bloating.
- Yoga Poses. See Yoga for Women (Israel), Yoga for Menstruation,
- Self-pleasuring to orgasm during menstruation and towards the end of the period can stimulate blood flow to the pelvis and help shorten the days of menstrual bleeding and staining.
More Tips For Shortening Menstrual Bleeding
- Homeopathy is an individual, holistic approach for balancing hormones.
- Stress reduction activities like meditation can restore balance
- Over-the-counter medications like Advil and Nurofen (200 mg every six hours during the first days of menstruation. The substances can reduce the amount of bleeding (in case of heavy bleeding) but are not recommended for prolonged use.
- Roadmap to Progesterone (if imbalance is diagnosed) and Guide to Using Progesterone (Dr. Lara Briden)
In any case of abnormal or prolonged bleeding, one should consult a medical professional. The information provided on this page is not a substitute for professional advice and treatment. External links provided here are for informational purposes only; they do not constitute an endorsement or approval of the sites mentioned.