A balance of hormones must be maintained for the human body to function effectively. Hormonal imbalance refers to an excess or deficit of one or more hormones in the body.1 Even a small imbalance can have significant consequences, for example, heavy menstrual bleeding (HMB) or menorrhagia, which refers to menstrual periods that are abnormally heavy or last long.1,2 HMB results in significant blood loss and cramps, and this can negatively impact a woman’s ability to engage in daily activities.2

A balance between the hormones oestrogen and progesterone regulates the formation of the lining of the uterus in a normal menstrual cycle. This lining is shed during menstruation. An imbalance of these hormones may result in excess build-up of the lining, which consequently results in HMB.2

Hormonal imbalance can be caused by factors such as1:

• diabetes
• thyroid problems 
• eating disorders 
• polycystic ovary syndrome (PCOS)

It is advisable to consult a doctor if one is experiencing symptoms of hormonal imbalance or HMB.1 Simple tests such as a blood test to detect hormone levels, recommended by the doctor, will help in identifying the cause of the imbalance.1

Hormone therapy (using oral contraceptives, vaginal rings, etc.) is sometimes recommended by the doctor to regulate hormone levels, which will, in turn, regulate the menstrual cycle. Non-hormonal methods (e.g., the use of medications) may also be recommended depending on the cause of the imbalance and the HMB.1

Lifestyle modifications can also help in regulating the hormones causing HMB. These include3:

• eating a healthy diet rich in protein and fibre and low on processed sugar
• engaging in regular physical exercise
• managing stress, e.g., by listening to music or engaging in yoga practice
• getting enough sleep
• drinking green tea

Heavy periods are not usually life-threatening on their own, but they can be if an excessive amount of blood is lost. If two or more tampons or pads are required in an hour for two hours in a row, a doctor visit is recommended to understand the underlying cause of the HMB and get appropriate treatment as early as possible.4

References:

1. Herndon J. Can a hormone imbalance affect your menstrual cycle? Healthline. [Internet] 2018 August 11 [cited 2023 June 27]. Available from: https://www.healthline.com/health/hormonal-imbalance-menstrual-cycle.
2. Mayo Clinic. Menorrhagia (heavy menstrual bleeding). [Internet] 2022 June 25 [cited 2023 June 27]. Available from: https://www.mayoclinic.org/diseases-conditions/menorrhagia/symptoms-causes/syc-20352829#:~:text=If%20a%20hormone%20imbalance%20occurs,insulin%20resistance%20and%20thyroid%20problems.
3. Snyder C. 5 Impressive herbs that help balance your hormones. Healthline. [Internet] 2023 June 6 [cited 2023 June 27]. Available from: https://www.healthline.com/nutrition/herbs-that-balance-hormones
4. Cleveland Clinic. Heavy menstrual bleeding (menorrhagia). [Internet] [cited 2023 June 27]. Available from: https://my.clevelandclinic.org/health/diseases/17734-menorrhagia-heavy-menstrual-bleeding