Menorrhagia

October 26, 2020FemalesHypothyroidismPregnancy complicationsUterine fibroids1

Menorrhagia is a common disorder in women. Menorrhagia is the medical term for menstrual bleeding lasting for longer than 7 days. About one in every 20 women has menorrhagia.

Sometimes bleeding can be very heavy , means you have to change your pad for less than 2 hours. In menorrhagia the patient can pass clots the size of a quarter or even larger. With menorrhagia you can’t maintain your usual activities due to excessive blood loss.

Causes –

In a normal Menstrual cycle ,there is a balance between oestrogen and progesterone. These are hormones in the body that help regulate the build up of the endometrium which sheds each month during menstruation. For menorrhagia ,there may be an imbalance in oestrogen and progesterone levels. As a result of the imbalance ,the endometrium develops in excess , when it is eventually shed ,there is heavy menstrual bleeding. As hormone imbalances are often seen in adolescents and women approaching menopause ,this type of menorrhagia is fairly common in these groups.

Another frequent cause of menorrhagia is Uterine fibroids.

There are some other causes of menorrhagia which are as follows-

a) Cancer like Uterine , cervical ,endometrial.

b) Inflammation or infection of the vagina , cervix or pelvic organs.

c) Polyps (Small growths on the cervical or Uterine wall)

d) Thyroid conditions.

e) Liver, kidney or blood disease and the use of blood thinning drugs.

f) Adenomyosis

g) Intrauterine device (IUD)

h) Pregnancy complications like of placenta praveia.

Sign and symptoms –

1) Symptoms of anaemia such as tiredness , fatigue or shortness of breath.

2) Menstrual periods that for more than 7 days.

3) Need to use double sanitary protection to control your menstrual flow.

4) Menstrual flow that soaks through one or more sanitary pads every hour.

5) Menstrual flow that includes large blood clots

6) Needing to wake up to change sanitary protection during the night.

7) Restricted daily activities due to heavy menstrual flow.

Risk factors –

Risk factors varies with age and whether you have other medical conditions that may explain your menorrhagia. In a normal cycle ,the release of an egg from the ovaries stimulates the body’s production of progesterone ,the female hormone must responsible for keeping periods regular. When no egg is released , insufficient progesterone can cause heavy menstrual bleeding.

Menorrhagia in adolescents girls is typically due to an ovulation.

Menorrhagia in older reproductive age is typically due to Uterine pathology , including fibroids ,polyps and adenomyosis.

Diagnosis –

1) Blood test to check for disorders such as anaemia , thyroid and clotting disorders.

2) Pap smear to evaluate for cervical infection , inflammation , dysplasia and cancer.

3) Endometrial Biopsy.

4) Ultrasound.

5) Hysteroscopy

6) Dilatation and curretage used as treatment but also to detect abnormalities.

Treatment –

Treatment depend upon the cause of menorrhagia :-

1) Polyps are generally removed , fibroids may require a myomectomy or hysterectomy.

2) Hysterectomy and radiation are usually considered for Endometrial cancer.

3) A hormonal imbalance may require hormone treatment.

Drug Treatment –

1) Iron supplements to treat anaemia.

2) Tranexmic acid to reduce blood loss.

3) Oral contraceptive to regulate the menstrual cycle.

4) Oral progesterone to treat hormonal imbalance.

Ayurvedic perspective towards Menorrhagia –

Ayurveda considers heavy bleeding as Asrigdara or Raktapradara. Asrik means blood and dara refers to excessive flow.

Due to unwholesome diet and habits vata with rakta and pitta gets vitiated which leads to heavy flow with fatigue ,backpain etc. It is of 4 types :-

Vataja ,pittaja ,kaphaja and sannipataja.

Based on these types following treatments can be adopted :-

1) Stambhana (Blocking Therapy ) –

It is the first line of treatment as where we treat the cause which is excessive blood flow. For that following Ayurvedic herbs are useful :-

Some more herbs are :-

Draksha ,Padmakesar ,Dhataki ,Kutaja ,Mochras ,Doorva ,Lajjalu etc.

2) Sheetal Upacharya ( cooling treatments and medicines ) –

Some more preparations are :-

Usirasav ,Lodhrasav ,Drakshadi kasaya ,Bol parpati etc.

3) Sheetal Annapaana ( cooling foods and drinks ) –

Sheetal annapana is also recommended for the purpose of treatment. To arrest the bleeding the medium that pacify Pitta and kasaya ras ( Astringent taste) are advised.

Treatment modalities include Virechana ,vasti , vaginal douche,yoni pichu ,avagahan etc.are also very much useful.

Diet –

1. Eat natural superfoods rather than hot and spicy foods.
2. Avoid coffee and alcohol.
3. Low fat diets should be preferred.
4. Rich in fibre diet with lots of fruits and raw vegetables.
5. Cakes,pastries and cookies should be avoided.

Activities –

1) Avoidance of stress.

2) Breathing exercises are advised to calm the body .

3) Avoid sternous activities.

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