From the Desk of Carolyn Dean MD ND
I’ll explain what I mean by “friable blood vessels, low grade scurvy, and the bleeding pattern doctors rarely trace back to a nutrient.”
Heavy periods get chalked up to “just how your body is” more often than almost any other women’s health complaint. As women approach perimenopause, cycles can become heavier, longer, shorter, or simply less predictable. As a result, it can be tempting to assume that this is just another part of getting older.
I don’t think we should automatically dismiss it that way.
There are many reasons menstrual bleeding can change, particularly during the years leading up to menopause. Hormonal fluctuations are one piece of the picture. However, fibroids, thyroid problems, PCOS, and other conditions can also contribute.
And there is another nutritional piece that doesn’t get any attention: Vitamin C and heavy periods, specifically the relationship between Vitamin C and the integrity of our blood vessels.
I’ve described this connection using a phrase borrowed from the history of Vitamin C deficiency: “low grade scurvy.”
That doesn’t mean every woman with a heavy period has scurvy. Instead, it means that Vitamin C plays an important role in collagen formation and blood vessel structure. Therefore, nutritional sufficiency is worth considering as part of a broader conversation about abnormal bleeding.
The Symptom Women Are Told Is Just “Part of Getting Older”
One of the most frustrating things about women’s health is how often a real symptom gets normalized simply because it is common.
Heavy or irregular periods are certainly common during the transition toward menopause. Hormones are changing, ovulation may become less predictable, and the menstrual cycle can behave very differently from one month to the next.
But “common” doesn’t mean “nothing to see here.”
If your periods have become substantially heavier, longer, or more disruptive than they used to be, I want you to pay attention to that change rather than simply accepting it as your new normal.
Your body is giving you information.
And the first step is simply becoming specific about what “heavy” actually means.
What Counts as a Heavy Period?
Medically, heavy menstrual bleeding, historically called menorrhagia, has recognizable patterns.
For example, it can include bleeding that soaks through a pad or tampon every hour for several hours. It can also mean needing to use two forms of menstrual protection at the same time, waking during the night to change protection, or experiencing moderate to heavy bleeding for more than a week.
Heavy bleeding can also have consequences beyond the inconvenience of changing protection frequently.
When blood loss continues over time, iron stores can become depleted and anemia can develop. Consequently, that may show up as tiredness, fatigue, weakness, or shortness of breath.
So, if you’re experiencing unusually heavy bleeding and you’re also feeling exhausted or short of breath, that’s something to discuss with your healthcare provider. Don’t simply assume you’re tired because you’re in perimenopause.
New, worsening, or very heavy menstrual bleeding deserves medical evaluation. There are several possible causes, some of which require diagnosis and treatment. Therefore, nutrition should complement that evaluation, not replace it.
Vitamin C and Heavy Periods: What About “Friable Blood Vessels” and “Low Grade Scurvy”?
This is where my Vitamin C perspective comes in.
In Total Body ReSet for Women, when discussing complementary approaches to menorrhagia, I wrote:
“Ensuring you have enough vitamin C complex from whole food to deal with friable blood vessels that may be related to low grade scurvy causing abnormal bleeding.”
I wrote Vitamin C: Listening to the Experts after Total Body ReSet for Women. Now I would say that Vitamin C supplements should be considered, not just Vitamin C from food sources.
The phrase “friable blood vessels” is important.
Vitamin C is required for collagen formation. Meanwhile, collagen is an essential structural component of connective tissue, including the tissues that help give blood vessels their strength and integrity.
When Vitamin C status is inadequate, the structural support around small blood vessels can become compromised, making them more fragile.
Historically, this is one of the reasons bleeding and bruising became such recognizable features of severe Vitamin C deficiency.
Again, when I use the phrase “low grade scurvy,” I’m not suggesting that every woman with heavy menstrual bleeding has a classic deficiency disease.
Instead, I’m drawing attention to the possibility that inadequate Vitamin C can affect connective tissue and blood vessel integrity before anyone would necessarily recognize a textbook case of scurvy.
That’s an important distinction.
Nutrition is one piece of the picture. It isn’t the whole explanation.
The Iron Piece Nobody Connects to Heavy Periods
There’s another nutritional connection that I think is especially important for women with heavy periods.
Iron.
If you’re losing more blood month after month, you’re also losing iron. Over time, that can contribute to iron deficiency and anemia.
But here’s where Vitamin C enters the conversation again.
Vitamin C helps convert dietary nonheme iron, the form found primarily in plant foods, from ferric iron (Fe³⁺) to ferrous iron (Fe²⁺). The body can more readily absorb this form. Therefore, Vitamin C becomes an important nutritional partner when we’re thinking about iron absorption.
This doesn’t mean that Vitamin C can compensate for significant blood loss. Likewise, taking Vitamin C is not a treatment for anemia.
It means that the nutrients involved in the story are connected.
If heavy menstrual bleeding is continually taking iron away, it makes sense to pay attention to both iron rich foods and the nutritional factors that support normal iron absorption.
This is one reason I prefer looking at nutrition as a system rather than a collection of isolated supplements.
The Copper Connection
Another fascinating twist to the anemia story is that copper is required to make the transport protein ceruloplasmin.
What does this protein transport?
Iron and copper.
And guess what? Whole food Vitamin C from food or whole food dietary supplements contains copper in tyrosinase found in food based Vitamin C.
How cool is that!
Why Perimenopause Can Make Everything More Complicated
The years leading up to menopause can make menstrual patterns particularly unpredictable.
One reason is that ovulation may become less regular. When anovulatory cycles occur, the normal hormonal sequence that coordinates the menstrual cycle is no longer sequential.
As a result, the uterine lining may continue to build without shedding in the usual predictable pattern.
When the lining eventually sheds, the bleeding can be heavier and may include clots.
That hormonal explanation is important. However, it doesn’t mean every episode of heavy bleeding during perimenopause should automatically be attributed to hormones.
In Total Body ReSet for Women, I also discuss conditions such as hypothyroidism, PCOS, and fibroids as recognized causes of heavy periods.
That list is a reminder of something I always want women to remember: a symptom can have more than one possible cause.
If your menstrual pattern changes significantly, particularly if the change is new or worsening, get it evaluated.
At the same time, you can ask whether your nutritional foundation is supporting the body’s normal structures and functions.
Both conversations can happen.
What Vitamin C Has to Do With the Whole Picture
Its role is pretty fundamental.
Vitamin C participates in collagen formation. In fact, collagen makes up 30% of total body protein.
That’s fundamental and structural because collagen is vital to making connective tissues and blood vessels. In addition, Vitamin C supports normal iron absorption from plant foods.
Those are straightforward nutritional mechanisms.
They help explain why I became interested in the relationship between Vitamin C and heavy periods in the first place.
Sometimes doctors look at a symptom and immediately ask, “What medication will stop this?”
That’s an important question when a woman is experiencing significant bleeding.
But I also want us to ask, “What does the body need to keep the tissues involved in this process healthy?”
Those are not competing questions.
A Whole Food Approach Worth Discussing With Your Provider
When I talk about nutrition, I always want food to remain part of the conversation.
Vitamin C rich foods include citrus, strawberries, kiwi, bell peppers, and many other fruits and vegetables. Including these foods regularly gives you Vitamin C along with the many other nutrients and plant compounds that come with whole foods.
In addition, if you’re concerned about iron, think about iron rich foods as part of the same nutritional foundation.
For women who want an additional whole food Vitamin C option, Whole C ReSet is my organic Vitamin C complex.
I see it as a complementary nutritional approach for supporting Vitamin C sufficiency, not as a treatment for heavy menstrual bleeding.
This is exactly the kind of approach I encourage women to research and discuss with their healthcare practitioner.
Because if your periods are unusually heavy, the first priority is understanding why.
Please don’t use a nutrition article as a reason to delay an evaluation. New or worsening heavy bleeding should be discussed with a healthcare professional. The same applies to exceptionally heavy or prolonged bleeding.
Likewise, significant fatigue, weakness, dizziness, or shortness of breath deserve attention.
Fibroids, thyroid disease, hormonal changes, and other conditions may require proper medical diagnosis and care.
Nutrition can be part of the conversation without pretending to be the whole conversation.
Don’t Let “Normal for Your Age” End the Conversation
October is World Menopause Month, and I think it’s a perfect time to change the way we talk about menstrual changes.
Yes, periods can change dramatically during perimenopause.
Heavy bleeding is also common.
But you don’t have to shrug your shoulders and accept every change without asking questions.
I want women to understand the difference between something being common and something that shouldn’t be evaluated.
And I want you to know that Vitamin C and heavy periods have a biological connection that rarely gets discussed. Vitamin C’s relationship with collagen and blood vessel integrity gives us one possible nutritional piece of the story, one I’ve described as “friable blood vessels” and “low grade scurvy.”
That doesn’t replace a medical evaluation.
Instead, it gives you another question to bring to the table.
Explore Whole C ReSet and bring this article to your next conversation with your healthcare provider.
This content is for educational purposes only and discusses nutritional and lifestyle support for normal structure and function of the body. It is not intended to diagnose, treat, or cure disease. Consult a qualified healthcare professional for personal medical guidance.
👉 Learn more and become a member here:
https://drcarolyndean.com/wellness-courses/
