Menstrual Disorders Across the Age Spectrum: Recognizing Issues and Managing with Functional Medicine

BY HELENA AMOS, M.AC. L.AC., EURO. PHYSICIAN

One of the most complex, varied, mysterious and misunderstood components of women’s health is the reproductive cycle. And this is a source of great frustration and concern considering half of the planet’s population was born with a female reproductive cycle; and for the majority of women, it lasts three-quarters of their lifespan. Starting with puberty and sexual maturity, through childbearing years to postpartum sexual activity, and waning with menopause and aging, these components are regulated by environmental, genetic, physiologic, hormonal, behavioral, and psychosocial factors, which means that each woman’s experience is almost entirely unique.

Given how multifaceted the female reproductive cycle is, using a functional medicine approach to address related disorders makes good healthcare sense. Functional medicine (FM) takes a holistic view, aiming to identify and treat the root causes of health concerns in order to assess specific imbalances, determine appropriate treatments, and monitor progress over time. It’s an extremely flexible and individualized form of care, ideal for reproductive health disorders that can occur at any time across a huge age spectrum. Let’s consider the applications more closely.

Common Menstrual Concerns By Age Group

Menstrual period disorders can occur at any age, and their characteristics and causes may differ depending on the age group. Here is a description of common menstrual period disorders for young, middle-aged, and mature age.

Young Age (adolescence to early 20s)

• Dysmenorrhea: This refers to severe menstrual cramps often experienced during the teenage years. It can be primary (without any underlying condition) or secondary (caused by conditions like endometriosis or fibroids).

• Amenorrhea: This condition occurs when a young woman misses her period for several months. It can be due to factors like extreme weight loss, excessive exercise, or conditions affecting the reproductive system.

• Irregular periods: Teenagers often experience irregular menstrual cycles during the first few years after menarche. This can lead to unpredictable bleeding patterns.

Middle-aged (late 20s to early 50s)

• Polycystic Ovary Syndrome (PCOS): This hormonal disorder is common in this age group, leading to irregular periods, ovarian cysts, and hormonal imbalances.

• Heavy or prolonged periods (menorrhagia): Excessive bleeding or periods lasting longer than usual can occur due to hormonal imbalances, uterine fibroids, or other underlying conditions.

• Premenstrual Syndrome (PMS): Some women experience physical and emotional symptoms like bloating, fatigue, body & headaches, mood swings, and/or breast tenderness, a few days or weeks before their period.

Mature Age (late 40s and beyond)

• Perimenopause and Menopause: As women approach menopause, they may experience irregular periods, lighter or heavier flow, or longer gaps between periods. Eventually, menstruation ceases altogether during menopause.

• Menopause-related disorders: Menopause can bring about various symptoms like hot flashes, night sweats, vaginal dryness, and mood changes, just to name a few. These symptoms are caused primarily due to declining hormone levels.

PMS, Menorrhagia and PCOS: An In-Depth Look

It is fair to say that a large percentage of women who have had or are having a menstrual cycle will experience at least one or more associated disorders within the duration of her reproductive lifespan. Of the disorders listed here, Premenstrual Syndrome (PMS), Menorrhagia, and Polycystic Ovary Syndrome (PCOS) are three of the most prevalent, and are therefore worth discussing more in depth.

Premenstrual Syndrome (PMS)

From mild to acute, PMS is experienced in varying degrees by the majority of menstruating women. According to recent established studies available through the NIH National Library of Medicine on global and regional prevalence rates, an estimated 90% of females of reproductive age were impacted by mild to acute premenstrual symptoms. Among them, about 20% to 40% encounter PMS, while 2% to 8% experience PMDD, or premenstrual dysphoric disorder — a more severe type of PMS. Although the exact cause of PMS is not fully understood, various elements can contribute to its development. Here are some common causative factors and a functional medicine approach to its treatment:

1. Hormonal Imbalances: Fluctuations in estrogen and progesterone levels during the menstrual cycle can contribute to PMS symptoms. FM aims to rebalance hormone levels by addressing underlying factors such as impaired liver detoxification, adrenal imbalances, or disrupted feedback loops within the hormonal system. Treatment may involve hormone support, herbal remedies, or lifestyle modifications.

2. Nutritional Deficiencies: Certain nutrient deficiencies can contribute to PMS symptoms. FM emphasizes a nutrient-dense diet rich in vitamins, minerals, and essential fatty acids. Specific nutrients that may be targeted include magnesium, B-vitamins, vitamin D, and omega-3 fatty acids. Supplementation might be recommended if deficiencies are identified.

3. Inflammation: Chronic inflammation in the body can worsen PMS symptoms. FM focuses on identifying and addressing sources of inflammation, which might include a poor diet, gut health imbalances, or environmental toxins. Anti-inflammatory dietary modifications, gut healing protocols, and targeted supplements might be recommended.

4. Gut Health Imbalances: Disruptions in gut health, including imbalances in gut bacteria (dysbiosis) or leaky gut, can contribute to inflammation and hormonal imbalances that exacerbate PMS symptoms. FM aims to improve gut health through specialized diets (such as the Low FODMAP or Specific Carbohydrate Diet), probiotics, prebiotics, and gut-healing nutrients.

5. Stress and Adrenal Function: Chronic stress can affect hormone balance and worsen PMS symptoms. FM emphasizes stress management techniques such as mindfulness, meditation, Yoga, and adaptogen herbs to support adrenal health and improve stress response.

6. Detoxification Support: Supporting the body’s detoxification pathways, specifically the liver, is important for hormone metabolism and elimination. This may involve dietary modifications, liver-supportive supplements, and practices like saunas or dry brushing.

7. Individualized Treatment: It’s essential to consult with a qualified functional medicine practitioner who can assess your specific health profile and develop an individualized treatment plan for your PMS symptoms. They will combine diagnostic testing, lifestyle modifications, dietary changes, supplements, and other targeted interventions to address your unique imbalances and improve overall well-being.

Excessive Menstrual Bleeding (Menorrhagia)

Data compiled by the Centers for Disease Control and Prevention show heavy menstrual bleeding, or menorrhagia, is one of the most common problems women report to their doctors. It affects more than 10 million American women each year, meaning about one out of every five women has it. Menorrhagia can have several causative factors. Here are some of the most common and a functional medicine approach to treating each one:

1. Hormonal Imbalances: Hormones are a key player in so much that’s involved with the reproductive cycle. Imbalances in estrogen and progesterone levels can lead to abnormal uterine bleeding. FM focuses on rebalancing hormone levels by addressing underlying factors such as disrupted feedback loops, impaired liver detoxification, or adrenal imbalances. Treatment may involve hormone support, nutritional interventions, herbal remedies, or lifestyle modifications.

2. Uterine Fibroids: Noncancerous growths in the uterus called fibroids can cause heavy menstrual bleeding. Nutritional approaches, supplements, or hormonal support may be involved in any treatment designed to reduce the size of fibroids or alleviate symptoms.

3. Endometriosis: Endometriosis is a condition where the tissue similar to the lining of the uterus grows outside the uterus, leading to heavy bleeding. FM aims to address inflammation, hormonal imbalances, and gut health imbalances that can contribute to endometriosis symptoms. This may involve dietary modifications, anti-inflammatory approaches, gut healing protocols, and targeted supplements.

4. Thyroid Disorders: Thyroid imbalances, such as hypothyroidism or hyperthyroidism, can impact menstrual bleeding. FM involves assessing and treating thyroid function and optimizing thyroid hormone levels.

5. Nutritional Deficiencies: Nutrient deficiencies, particularly iron deficiency, can contribute to heavy menstrual bleeding. Once nutrient deficiencies are identified, corrections can be made through dietary changes and targeted supplementation.

6. Blood Clotting Disorders: Certain blood clotting disorders, such as von Willebrand disease or platelet function disorders, can lead to excessive bleeding. FM involves assessing clotting factors and working with a healthcare team to manage these disorders.

7. Medication Side Effects: Some medications, like anticoagulants or certain hormone therapies, can cause heavy menstrual bleeding. Treatment may involve exploring alternative medication options or addressing any underlying imbalances aggravated by the medication.

8. Lifestyle Factors: Stress, poor sleep, lack of exercise, and other lifestyle choices can contribute to hormonal imbalances and worsen excessive menstrual bleeding. Stress management techniques, quality sleep, regular physical activity, and other lifestyle modifications are emphasized to support overall hormonal health.

Polycystic Ovary Syndrome (PCOS)

According to the World Health Organization, PCOS affects an estimated 8–13% of women of reproductive age, and up to 70% of cases are undiagnosed. The prevalence is higher among some ethnicities and these groups often experience more complications, in particular related to metabolic problems. Clinically, PCOS is viewed as a complex condition that involves multiple underlying imbalances within the body. FM aims to identify and address the root causes to achieve long-term resolution. Some of the various contributing factors to PCOS may include:

• Hormonal imbalances: PCOS is characterized by elevated levels of androgens, a group of male hormones. Factors that disrupt hormone balance include impaired liver detoxification, excess cortisol (stress hormone), or imbalances in other reproductive hormones like estrogen and progesterone.
• Insulin resistance: Insulin resistance occurs when the body’s cells become less responsive to the hormone insulin, leading to elevated blood sugar levels. This can disrupt normal hormonal signaling, increase androgen production, and interfere with ovulation.
• Inflammation: Chronic inflammation can contribute to the development and progression of PCOS. Identifying and addressing sources of inflammation, such as a poor diet or gut health imbalances, is important.
• Gut health: There is emerging evidence suggesting a potential link between gut health and PCOS. Dysbiosis (an imbalance in the gut bacteria) and digestive issues may play a role in exacerbating PCOS symptoms.
• Environmental factors: Exposure to environmental toxins, such as endocrine-disrupting chemicals found in plastics or pesticides, can interfere with hormonal balance and contribute to PCOS.

A qualified functional medicine practitioner can help develop an individualized treatment plan tailored to tackle the list of possible contributing factors for PCOS. Alternative treatments in functional medicine for PCOS and similar disorders focus on addressing the root causes and rebalancing the body’s systems. Here are some alternative approaches commonly used:

1. Diet and Nutrition: A nutrient-dense, low-glycemic diet is often recommended to stabilize blood sugar levels and reduce insulin resistance. This may involve reducing processed foods, refined sugars, and carbohydrates while increasing whole foods, fiber, healthy fats, and lean proteins. Some practitioners may suggest specific dietary protocols like the Mediterranean diet or the low-carb, high-fat (keto) diet.

2. Supplements and Herbal Remedies: Specific supplements and herbs may be recommended to support hormonal balance, reduce inflammation, improve insulin sensitivity, and regulate menstrual cycles. These may include omega-3 fatty acids, inositol, N-acetylcysteine (NAC), magnesium, berberine, and herbal remedies like saw palmetto, chasteberry (vitex), or white peony.

3. Stress Management: Chronic stress can disrupt hormone balance and exacerbate PCOS symptoms. Stress reduction techniques like mindfulness meditation, Yoga, deep breathing exercises, and regular exercise are often suggested to support overall well-being and hormonal health.

4. Exercise: Regular physical activity can help improve insulin sensitivity, manage weight, reduce inflammation, and support hormonal balance. A combination of aerobic exercise, strength training, and mind-body activities like Yoga or Pilates may be recommended.

5. Detoxification Support: Supporting the body’s natural detoxification systems, such as the liver, can be beneficial for women with PCOS. This may involve incorporating foods and nutrients that promote liver function, such as cruciferous vegetables, as well as targeted supplements and practices like saunas or dry brushing.

6. Mind-Body Therapies: Techniques like acupuncture, acupressure, and Traditional Chinese Medicine are often used to rebalance energy flow, regulate menstrual cycles, and support hormonal health. These therapies aim to address imbalances in the body’s meridian system.

7. Sleep Optimization: Prioritizing quality sleep is crucial for hormonal balance. Practicing good sleep hygiene, creating a soothing sleep routine, and addressing any underlying sleep disorders may be recommended.

Acupuncture Treatment for Menstrual Disorders

Acupuncture is a Traditional Chinese Medicine technique that involves the insertion of thin needles into specific points on the body. It has been used for centuries to promote health and balance within the body. Acupuncture can play a role in the treatment of various menstrual disorders by helping to regulate hormonal imbalances, ease symptoms, and restore overall well-being. Here are some ways acupuncture can be beneficial:

• Regulating Hormones: Acupuncture has been shown to have a regulatory effect on hormones, including those involved in the menstrual cycle. It can help balance estrogen and progesterone levels, which may be beneficial for conditions like irregular periods, PCOS, or hormonal imbalances.
• Relieving Pain: Acupuncture is often used to alleviate menstrual pain and discomfort, including cramps (dysmenorrhea) by promoting blood flow and reducing inflammation.
• Balancing Energy Flow: According to Chinese medicine philosophy, disruptions in the flow of Qi (energy) within the body can lead to menstrual disorders. Acupuncture targets specific acupuncture points to restore the flow of Qi and promote balance within the body.
• Reducing Stress: Stress can contribute to menstrual disorders and exacerbate symptoms. Acupuncture has a calming effect on the nervous system and can help reduce stress levels, thereby improving emotional well-being, regulating the body’s stress response, and positively impact menstrual health.
• Improving Blood Flow: Acupuncture can stimulate blood circulation, which is essential for a healthy menstrual cycle. Enhancing blood flow to the reproductive organs can improve the delivery of oxygen and nutrients, while also supporting the removal of waste and toxins.
• Supporting Overall Well-being: Acupuncture is a holistic approach that considers the whole person, not just isolated symptoms. By addressing the underlying imbalances within the body, acupuncture aims to promote overall well-being, which can have a positive impact on menstrual health.

It’s important to note that acupuncture is typically used as a complementary therapy alongside conventional treatments for menstrual disorders. It can be most effective when integrated into a comprehensive treatment plan that may include lifestyle modifications, dietary changes, exercise, and other interventions. Seeking guidance from a licensed and experienced acupuncturist who specializes in menstrual disorders is recommended for personalized treatment.

Since half the world’s population is female, their reproductive health and overall wellbeing is imperative to understand and safeguard. Functional medicine approaches to assessment, treatment and monitoring of all aspects related to the reproductive cycle, and the disorders that can occur during its lifespan, are important to consider as effective healthcare, and should be made available for women in need anywhere, anytime.

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If you’re interested in exploring acupuncture & TCM and Functional Medicine approaches for your issues related to menstrual disorders, or other women’s reproductive health concerns, schedule a consultation with us to develop a treatment plan. Contact our office: 301-881-2898 or email doctorhelena@gmail.com.

Photo credit: Illustration 87710530 © Anna Odintsova | Dreamstime.com