Abstract: – Many women experience variances in their menstrual cycles, including differences in the length, frequency, and quantity of flow, as well as spotting in between periods. This often crippling ailment in women is abnormal uterine bleeding. It can happen to ovulatory or anovulatory women between menarche and menopause. A variety of structural factors, including fibroids, polyps, and coagulopathies, can cause irregular bleeding in the uterus. Among the negative consequences of excessive menstrual bleeding include iron shortage, anaemia, and a lower standard of living. Women’s social and medical wellbeing are impacted. Menorhhagia is termed for menstrual bleeding exceeding more than 80 ml each cycle. This article is all about the study of menorhhagia in adolescent females and its homoeopathic management.
Introduction:- Menorrhagia is defined as heavy menstrual bleeding occurring every consecutive cycle which is more than 80ml each menstrual period. This is affecting the day to day life of a female. Mostly females don’t undergo the treatment and this leads to major complications. Early diagnosis and treatment are necessary to manage menorrhagia and to improve the quality of life of a female.
Aetiology:- Menorrhagia can have many causes, it can occur due to hormonal imbalance of hypothalamus-pituitary-ovarian axis . Even stress can be an issue.
Various medical conditions are there which causes menorhhagia.
- Uterine fibroids: The uterine wall can grow these noncancerous tumours outside or inside. They may result in uncomfortable periods or severe bleeding (Trusted Source).
uterine polyps: The tissue that lines the lining of the uterus is called endometrial tissue, and polyps are overgrowths of this tissue. - Irregular ovulation: The uterine lining may thicken and accumulate if hormonal imbalances lead to irregular ovulation. Heavy bleeding may happen during menstruation when this lining finally sheds. During perimenopause and puberty, this is typical. It can occasionally happen as a result of stress, weight loss, or medical disorders such hypothyroidism and polycystic ovarian syndrome (PCOS).
- Adenomyosis: In those who have this disorder, uterine lining tissue gets buried in the uterine muscle. Menstrual bleeding that is unpleasant and heavy may result from it. Nonhormonal intrauterine device (IUD): This kind of birth control implant is placed inside the uterus and has the potential to significantly increase bleeding.
- Pelvic inflammatory disease (PID): Untreated sexually transmitted infections frequently lead to this inflammation of the reproductive organs (Trusted Source).
Problems associated with pregnancy: Unusual bleeding might result from pregnancy-related issues including ectopic pregnancy or pregnancy loss.
- Cancer: Cancers of the uterus, cervix, and ovary impact the reproductive system and result in severe bleeding.
- Von Willebrand’s disease and problems with platelet function are two examples of inherited bleeding diseases.
- Medication: Heavy bleeding may occur from some anticoagulant and anti-inflammatory medications. (1)
Epidemiology: –
Worldwide, it is estimated that between 3% and 30% of women in their reproductive years have AUB, with a higher incidence around menarche and perimenopause. The frequency increases to 35% or higher when irregular and intermenstrual bleeding are taken into account, however many research are restricted to HMB. A survey of women in Europe revealed a 27% prevalence of HMB, whereas other research revealed a global prevalence of over 50%.It is challenging to pinpoint the precise prevalence because many women choose not to seek treatment for their symptoms, and some aspects of diagnosis are subjective while others are objective. (2)
Pathophysiology:- The classification of menorhhagia is broad, reflecting the diversity of its pathogenesis. Menorhhagia may result from pelvic pathology such as fibroids causing the endometrial cavity to deform, polyps causing endometrial protrusions into the cervix or vagina, or friable endometrial tissue. The endometrium becomes friable, vascular, and lacks adequate stromal support due to unopposed estrogen, which is likely the source of the friable endometrial tissue. This results in excessive, persistent uterine bleeding.
Additionally, systemic problems are to blame for menorhhagia. The prevalence of obesity has repercussions for all facets of life and all organ systems. Obesity in women has been linked to polycystic ovarian syndrome and unopposed estrogen. Menorhhagia can also result from coagulopathies; 13% of women.
Clinical features:-
- Stomach ache.
- Intervals extending over seven days.
- Passing blood clots that are at slightest 25 mm in estimate. The blood can appear rust-coloured, pink, brown, or ruddy.
- Dying through one or more cushions or tampons each hour for longer than two hours at a time.
- Losing over 80 millilitres of blood rather than the normal 35–40 millilitres amid your menstrual cycle.
- Indications of weakness incorporate weakness, fatigue, and shortness of breath.(3)
Assessment
The patient’s therapy and care are heavily reliant on the results of the laboratory evaluation. Every patient has a complete blood count, blood type and crossmatch, and a pregnancy test as part of their initial lab work. Thyroid-stimulating hormone, iron studies, liver function tests, and testing for sexually transmitted diseases are additional crucial tests that help direct the patient’s therapy. It is also advised to do initial coagulopathy lab work and von Willebrand disease tests if there is a clinical suspicion of coagulopathy.
Homoeopathic Management:-
Belladonna: Treats excessive bleeding with this homeopathic remedy. It is among the treatments for haemorrhage. The flow is primarily hot and dark crimson, with occasional spurts of decomposed blood. The associated side effect is a back ache. For the early stages of oedema, it works quite well. The blood spills over all the time. .
Crocus sativus: A lot of homeopathic physicians typically utilize this remedy. It is one of the best treatments for reducing heavy menstrual bleeding. There are moments when the bleeding is very heavy. The blood flow is typically quite black and is made up of threads or strings.
Crotalus Horridus: Prolonged menses with dysmenorrhoea ;Pain extends down thighs with aching in region of heart.
Cimicifuga Racemosa (Black Cohosh): Profuse menses.Menses are dark coagulated and offensive. (4)
Millefolium (Yarrow): Menses are too early, profuse and protracted.
Sabina: Menses too early and profuse which is partly fluid ,partly clotted. Colic and labour-like pain during menses.
Calcarea Carbonica (Calc carb.): Menses are too early and profuse.
Phosphorus: Catamenia too early ,too profuse and too long a duration . Metrorrhagia in cancer. (5)
References:
- Kumar S, Padubidri VG, Daftary SN, editors. Howkins & Bourne: Shaw’s textbook of gynaecology, 18th edition – E-book. 18th ed. New Delhi, India: Elsevier; 2022.
- Davis E, Sparzak PB. Abnormal uterine bleeding. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.
- Dutta DC. Textbook of Gynaecology. 6th ed. Delhi, India: New Central Book Agency; 2008.
- Boericke W, Boericke OE. Homoeopathic materia medica with repertory comprising the characteristic and guiding symptoms of the remedies. 2nd ed. Savage RB, editor. Sittingbourne, England: Homoeopathic Book Service; 1990.
- von Lippe A. Keynotes & redline symptoms of materia medica. New Delhi, India: B Jain; 2023..
