Perimenopause & Heavy Bleeding with Dr T; plus Dharma Summit; Navaratri; DARSHAN tix IT’S TOMORROW! – your SV Ayurveda Newsletter Sept 26, 2019, #37, Vol 9

Perimenopause and Menopause –
Symptoms & SVA Remedies
Many women start to experience problems with their menstrual cycle in the few years leading up to menopause. There are several reasons for this and it is actually quite easy to treat using our SVA approach. As with everything else however, we need to first and foremost identify the underlying causative factors, which, if you have been reading my articles for the past several years, vary in each individual. Even though different people can be experiencing similar symptoms, the causes will be completely different in each case. 
If you present to your family doctor or endocrinologist with menstrual cycles that are coming every two weeks, or cycles that continue on for 3-4 weeks with heavy bleeding or just a normal regular cycle that is extremely heavy, your doctor may recommend a procedure called a D&C (dilation and curettage) which dilates the cervix and then scrapes or suctions tissue from the lining of the uterus to reduce the heavy menstrual bleeding. Biopsies may be taken to examine the tissue under a microscope to establish the cause of the abnormal bleeding.  
What usually is found is either a fibroid growth or a uterine polyp, most of the time both noncancerous and benign. The doctor may then recommend oral contraceptives or oral progesterone. These may work, however the oral contraceptives, if taken for long periods of time, come with numerous side effects. For severe bleeding caused by a fibroid, they may recommend uterine artery embolization to shrink the fibroids in the uterus by blocking the uterine arteries and cutting off their blood supply. Depending on the size, number and location of the fibroids, your surgeon may choose to perform a myomectomy or surgical removal of the uterine fibroid. Or endometrial ablation may be recommended to destroy (ablating) the lining of the uterus (endometrium) using a laser applied to the endometrium to destroy the tissue, resulting in lighter periods. And when all else fails, a hysterectomy may be recommended to remove the uterus and cervix.
What I do is teach the patients to reflect upon why they may have developed a polyp or a fibroid in the first place, and work on addressing that core issue. Here’s our approach to this problem — first you must understand some basic principles of estrogen/progesterone production.
Estrogen creates growth in the body — at the time of puberty it develops the breast tissue, the hips become rounded out and it also builds up the endometrium lining, which is the lining women shed during their menstrual cycles – when they are not pregnant. While it is advantageous to have estrogen, it needs to be balanced with progesterone, which prevents too much growth or building up of the endometrium – or uterus lining. If you have read my book, Healing the Thyroid With Ayurveda, I have described a scenario which creates an imbalance in the ratio of estrogen to progesterone. It is almost like a domino effect where one imbalance leads to another and then another, resulting in heavy menstrual cycles or frequent or unending periods.
Usually, something is affecting the thyroid gland, weakening it: either too much stress; or late nights; other factors resulting in Vata aggravation; drinking fluoridated water (fluoride is a poison to the thyroid gland); too many immunizations – such as flu shots which contain mercury (the thyroid absorbs the mercury and becomes disabled as a result; insufficient protein in the diet (the thyroid hormone is made out of animal protein); and several other reasons I’ve discussed in my book. Once the thyroid is weak, the gall bladder gets impacted and it will not empty the bile well. The bile that the gall bladder secretes plays a very important role. The bile clears out the excess estrogen which the liver breaks down and redirects to the bile, for removal via the bowel movement. When the thyroid becomes sluggish, the gall bladder automatically becomes sluggish, the bile doesn’t squirt and as a result the estrogen reabsorbs back into the bloodstream, creating a situation called “high estrogen/low progesterone.” 
You now know that estrogen builds up these various tissues, and too much of it can create cysts on the breasts or ovaries, uterine polyps and/or fibroids. It also builds up the endometrium lining so you could even have very heavy and/or long cycles or numerous cycles (every two weeks for example) even without the presence of a uterine fibroid or polyp.
So what do you do? The answer is to identify all the reasons your thyroid might be weak and address those reasons, support the thyroid gland with the herbs I mention in my book, and promote the flow of bile out of the gall bladder, thus preventing a buildup of estrogen. We use triphala, haritaki, Prakrit tablets to promote the flow of bile out of the gall bladder. We then use Alodhra, Ashoka and coriander seed tea to recalibrate the ratio between estrogen and progesterone. Sometimes we may have to add White Oak Bark if the menstrual bleeding is too heavy, and if there is a fibroid, cyst or polyp, it is recommended to use Kanchenar, which is available as a crude herb, glyceride drops or transdermal cream. Kanchenar both prevents as well as shrinks glandular growths.
In addition, in cases of heavy bleeding, Vaidya recommended reducing the intake of estrogenic foods. For example, minimize and/or completel avoid: fennel seeds, or fennel seed tea, or the fennel vegetable; as well as asparagus; orange yams; these are highly estrogenic and will increase your menstrual flow. The same is true for the more estrogenic herbs such as: Maca and Shatavari. Stay away from cane sugar which is also estrogenic. As well as pineapple and papaya: these are highly estrogeic as well. And always keep things balanced by adding/consuming progesterone-producing herbs such as: Alodhra, Ashoka and Coriander. Vaidya has also made a wonderful progesterone supporting formulation called “Femi-Ojas” that comes in nectar form as well as a transdermal cream. You can add this to your protocol. Also the Devadaru is a wonderful nectar drop he made that addresses the overall “intelligence” of the feminine hormonal system and reinstates it. It does not supply estrogen or progesteron but works on the overall intelligence and flow of the system, correcting and supporting it. 
However, another possible scenario is that the liver is overheated, and since the liver makes the blood, the blood overheats, which can also contribute to heavy menstrual bleeding. In this case you have to examine what toxins are coming into your body through: pharmaceuticals, nutraceuticals (synthetic vitamins), bad food, or even onions and garlic in the diet, etc. The liver has to process all the toxins which you come into contact with via the air you breathe, the water you drink, the food you eat and the skin care products you use – whose chemicals absorb directly from the skin and into the blood. In SVA, we have numerous ways of pacifying and cooling down the liver, including DGL cream down the spine and on the liver, Bhumi Amla, Mankand, and SVA herbalized Liver clay directly on the liver. In addition, we recommend to never skip or delay meals and to go to bed latest by 10:00 p.m. Skipping meals – even for intermittent fasting – and having a late bedtime both create aggravate ranjaka pitta, or the liver, and can result in heavy menstrual flows.  
Also: favor sweet juicy fruits instead of sour fruits; avoid alcohol and coffee; follow the SVA diet, which we always recommend as it is not only alkalinizing but supports overall circulation which is necessary on so many levels. Yellow squash and green zucchini are the best vegetables for cooling down the liver — and especially good is Loki squash (aka “bottle gourd”), if you have an Indian or Asian market nearby. 
If you decide that you want a D&C, or an ablation or other approach to fix your heavy menstrual bleeding, you should still address the underlying reason(s) that caused the bleeding in the first place, otherwise that imbalance could create more fibroids or polyps, or wreak havoc elsewhere in the body.
I hope this article helped shed some light on why menstrual flow can become heavy during perimenopause — which is a common occurence for many women; but it is also known to occur in younger women — so it is best to understand, isolate, and address the root cause(s) of such imbalance early on before they are allowed to becomes too difficult to manage with the use of herbs and SVA protocols.
Dr. Marianne Teitelbaum

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