Abnormal uterine bleeding is a common gynecologic disorder that can affect in women during reproductive age group. In most of the cases it is associated with anovulation. During puberty and peri-menopausal periods, anovulatory bleeding is a common occurrence. During transition state abnormal uterine bleeding has a physiological basis and is secondary to estrogen withdrawal. Homoeopathic treatment can do according to their physical, mental and pathological planes.
KEYWORDS: AUB, endometrium, menses, estrogen, homoeopathy.
Menstruation is a visible manifestation of cyclic physiologic uterine bleeding due to shedding of the endometrium. Any uterine bleeding outside the normal volume, duration, regularity, or frequency is considered as abnormal uterine bleeding (AUB). (1)
Cyclic bleeding at normal interval, the bleeding is either excessive in amount > 80 ml2, or duration more than 7 days, or both.
IUCD in utero
Hypo or hyperthyroidism
Idiopathic thrombocytopenic purpura
Cyclic bleeding where the cycle is reduced to an arbitrary limit of less than 21 days. And remains constant at that frequently. If it is associated with excessive and/ or prolonged bleeding, it is called epimenorrhea.
Predominantly adolescence, during delivery, and abortion.
Irregular cyclic bleeding from the uterus, amount of bleeding is variable. Irregular bleeding in any form of contact bleeding, intermenstrual bleeding in an, otherwise normal cycle is also included in menorrhagia.
Contact bleeding- carcinoma cervix
Mucus polyp of cervix
Chlamydial or tubercular cervicitis
Menstrual bleeding occurring more than 35days apart and which remains constant at that frequency is called.
Common in adolescence and preceding menopause.
When menstrual bleeding is usually scanty and last for less than 2 days, it can be due to oral contraceptives, thyroid dysfunction, malnutrition.
Absence of menstruation.
Physiologically during pregnancy and lactation.
1. Cryptomenorrhea: periodic shedding of endometrium and bleeding, but menstrual blood fails to come out. It can be congenital or acquired.
Congenital: imperforated hymen, transvers vaginal septum, atresia of external vagina.
Acquired can be stenosis of cervix, following amputation, deep cauterization.
Secondary vaginal atresia following neglected and difficult vaginal delivery. Patient can be presented with periodic apin in lower abdomen. (4)
Primary amenorrhea (1)
A young girl has not yet menstruated by her 16 years of age, is having primary amenorrhea.
The normal upper age limit is 15yrs, and lower mean age is 14 yrs.
Abnormal chromosomal pattern
Developmental defect of genital tract
Dysfunctional thyroid and adrenal cortex
Malnutrition, anaemia, tuberculosis, congenital uterine synechiae.
Absence of menses for 6 months or more in a woman in whom normal menstrualtion has been established.
Premature ovarian failure
Malnutrition, anemia, diabetes
Contraceptive pills, psychological factors
ALETRIS FARINOSA: (3)
Premature and profuse menses with clots, retarded and scanty flow
Habitual tendency for miscarriage
Uterus seems hevy, prolapse with pain in the right inguinal region
Menses copious followed by watery copious oozing between period
Discharge of blood between periods, at every little accident < after hard stool, walking little longer
Menses too early and profuse, uterine symptoms < lying down
ARANEA DIADEMA: (3)
Menstrual blood has a smell of ammonia
Menses too early and copious, accompanied by pain in lumbar region < at end pf period
Lumbar and abdominal neuralgia with vomiting and yawning during menstrual cycle
Ovaries feels too large, pain in left ovary, ovarian cyst, tumour,
Bearing down pain
Prolapse of uterus with pain in left ovary and small of back, extending oin front and downward
Eroded spongy cervix
Palliative in schirrus of uterus
Sore feeling through out abdomen, leucorrhea, foul , excoriating,bloody water,
ARISTOLOCHIA CLEMATIS: (3)
Brown discharge, watery flow, eczema of the vulva, sesual itching during menses,
Menses absent , late or short, blood black with clotting,
Amenorhea, dysmenorhea, infrequent menses.
Atrophy of ovaries and breast
Leucorrhea immediately before menses
Menses scanty, last only one day
Before menses, pain in stomach and lumbar region
Genital feel numb
Induration of ovaries
Tumor or atrophy of overies
Menses too early, pain as from a bruise, in the pekvis
Rigidity of the os
Menses increased, bright red too early, too profuse
Dragging around loins
Cutting pain from hip to hip
Menses and lochia are very offensive and hot
Badly smelling hemorrhages, hot gushes of blood
Violent bearing down towards genitals, as if everything would fall out
Better standing and sitting erect, worse when lying down.
Useful in confinement of women those who have their children late in life,
Leucorrhea with colic
Before menses, headache colic chilliness and leucohhea
Cutting pain in uterus during menstruation
Menses, too early, too profuse, too long with vertigo, toothache and colic, dampfeet
The least excitement causes the return of the complaint
Menses late in fat , flabby girls with palpitation , dyspnea and headache
Absence of menses in plethoric women, from fright
Much sweat about genitals
Infertility with copious menses
Mental excitement causes dysmenorrhea, or causes menses to return
Uterine polyps, uterus easily displaced
Thick , milky, gushing or yellow leucorrhea, by menstrual flow, by walking
Menses copious, blood thick
Menses every three weeks with bearing down sensation and pain on the top of the head
Vagina dry and hot, dyspareunia, vaginismus
Bearing down pains comes and goes.
Intermittent pains in the ovaries
Gossipium will relieve tardy menses, especially with the sensation that the flow is about to start , but does not do so.
Menses too watery , backache, weight and dragging in pelvis
Uterine subinvolution and fibroids, with gastric Pain and debility.
Menorrhagia and metrorrhagia with fibroids.
Removes the tendency to habitual adherent placenta
Hot watery discharge from uterus, fibroid tumours at menopause
Leucorrhea worse after menses, acrid and corroding, shreddy, tenacious
Menses too late or suppressed, checked or too early
Excessive discharge dark clotted or tough , black blood like tar
Leucorhea , discharge of milky white mucus, thick non irritating, bland
LILIUM TIG: (4)
Menses, early scanty, dark clotted offensive
Flow only when moving about
Congestion of uterus, prolapse, anteverted
Bearing down sensation with urgent desire for stool, as though all organs would escape, ceases when resting
Bloated feeling in uterine region, neuralgic pain in uterus
Menses scanty, intermits, with nausea and bearing down pain
Menses watery thin , offensive
Sticking pain in external parts
Dysmenorrhea , ovarian neuralgia, recurring sharp darting pain in vagina and vulva at close of menses
Severe stitches or cutting pain through uterus
SENECIO AUREUS: (5)
Feels like menses would come,
Menorrhagia, a copious flow, which continuous untill they become anaemic
Dysmenorrhea, after abortion
Menses retarded, suppressed
Functional amenorrhea in young girls with backache
Before menses, inflammatory condition of throat, chest and bladder
After menstruation commnces, these improves
Anaemic dysmenorrhea with urinary disturbances
Premature and very profuse menses
THLASPI BURSA PASTORIS: (5)
Metrorrhagia, too frequent and copious menses
Haemorrhage with violent uterine colic
Every alternative period is very profuse
Leucorrhea before and after menses
Bloody , dark , offensive, stains indelibly
Sore pain in the womb when rising
Scarcely recovers from one period ,before another begins
1. Konar ,hiralal. DC Dutta’s text book of gynaecology
2. Kinirons mark, Ellis Harold, French’s index of differential diagnosis An A-Z. 15th edition.
3. Murphy, robin. Lotus Materia Medica, 2nd edition
4. Clarke, JH .A dictionary of practical Materia Medica, B jain publishers
5. Boericke,W. New manual of homoeopathic materia medica with repertory.
ABOUT THE AUTHOR
Dr JYOTHI S CHANDRAN
DEPT OF MATERIA MEDICA
FATHER MULLER HOMOEOPATHIC MEDICAL COLLEGE, DERELAKATTE, MANGALORE