Menarche is the testimony of womenhood. The transition of a girl into a woman and a woman into a mother. Brings a sense of fulfilment and ecstacy in her life. But on the contrary if menstrual cycle gets idiosyncrasy or irregularity due to any reason, it becomes a curse.
This is elaborated in Ayurvedic texts as Asrigdar. Sushruta assumes the term for this as Lohitkshara (Su.Ut.38) and Charak postulates this as Asraja the Raktapitta type of disorder. Medically the Dysfunctional uterine bleeding (DUB) is defined as an abnormal uterine bleeding caused by hormonal imbalance. Any alteration of the normal menstrual cycle mechanisms can lead to steady-state estrogen production and DUB. Ayurveda considers the DUB is a cluster of diseases that can be associated with many other diseases like infertility, anemia and many more.
Causes: The annoyance of the dosha especially amalgam of Pitta with Rakta is responsible. According to modern view, following are the causes for dysfunctional uterine bleeding:
Endocrine : Cushing’s disease, immature hypothalamic-pituitary axis, hyperprolactinemia, hypothyroidism, menopause, obesity, polycystic ovary disease, premature ovarian failure
Structural lesions: adenomyosis, coagulopathies, condyloma acuminata, dysplastic or malignant lesion of the cervix or vagina, endometriosis, endometrial cancer, uterine or cervical polyps, uterine tumour, trauma.
Infections : Chlamydia, gonorrhoea, PID
Medications: hormonal agents, low-dose oral contraceptive pills (OCPs), nonprogestin-containing IUDs, nonsteroidal anti-inflammatory drugs, (NSAIDS), progestin-only contraceptive (the ”mini pill”)
Pregnancy: Ectopic pregnancy, incomplete abortion, pregnancy complications,
1. Vaginal bleeding between periods
2. Abnormal menstrual periods
3. Variable menstrual cycles (usually less than 28 days between menstrual periods)
4. Variable menstrual flow ranging from scanty to profuse
6. Mood swings
7. Hot flashes
8. Vaginal tenderness
9. Hirsutism (excessive growth of body hair in a male pattern)
Signs and tests: A pelvic examination should be performed.
Tests usually include:
2. Serum HCG (to rule out pregnancy)
3. Thyroid function tests
4. Blood clotting profile
1. Androgen levels
2. FSH (follicle-stimulating hormone)
3. LH (luteinizing hormone)
The following procedures may be performed:
1. Endometrial biopsy
2. D and C (dilatation and curettage)
3. Pelvic ultrasound
Ayurvedic Management: There are many brilliant treatments available in ayurveda.
Medicinal treatment: Bolbaddh Ras, Bolparpatee, Pushpdhanva Ras, Purn chandrodaya Ras, Pushyanug churna, Aswagandha churn, Shubhra Bhasm, Kanya lauhadi vati, Maha phal ghrit, Ashokarishtha, balarishtha, Chandanasava, Usheerasava, Baboolarishtha, and other generic medicines are available in the market.
Panchkarma: Sweden and Uttar Vasti.
Diet and Lifestyle : The Madhur and Kashay Ras rich foodstuff is appreciable.
Yoga: At the time of onset of the bleeding, patient must do rest in bed. But in normal days some Yogasanas are found effective. Badha konasana, Yoga Mudra, Vakrasana, Uddiyana, Sarvangasana, Matasyasana and Shavasana are most recommended. Yoga should be done under the proper guidance of well trained yoga teacher; otherwise it can be injurious or fruitless exertion.
Pranayama (Rhythmic breathing):Poorak, Kumbhak and Rechak must be done for equal tenure, then do Nadi-Shodhan Pranayama or Anulom-Vilom Pranayama.
Attitudes to be adopted: Relaxation, faith, serenity, self-fulfilment, affirmation.