Menorrhagia Written by Priya Singh

Menorrhagia

Definition : Menorrhagia is defined as cyclic bleeding at normal intervals, the bleeding is either excessive in amount (>80ml) or duration on born. The term menotaxis is often used to denote prolonged or both. The term menotaxis is often used to denote prolonged bleeding.

It is generally caused by condition affecting the uterus or its vascularity, rather than any disturbance of function of the hypothalamic pituitary ovarian axis. When ever uterine endometrial surface is enlarged, the bleeding surface is increased, thus prevail in women suffering from uterine fibroids, adenomyosis, uterine suffering from uterine fibroids, adenomyosis, uterine polyps, myohyperplasia or endometrial hyperplasia.

Menorrhagia is also seen in women with increased uterine vascularity such as in chronic pelvic inflammatory disease and pelvic endometriosis. The uterus is often extroverted in position with restricted mobility. Such a uterus tends to be bulky and congested. Presence of an IUCD often leads to heavy and prolonged bleeding. Lastly, Menorrhagia may be the result of bleeding disorder like Von Willebrand’s disease.

A normal menstrual blood loss is 50-80ml, and unaltered but the duration and quantity of the menstrual loss is increased. Menorrhagia is essentially and symptoms and not in itself a disease. The underlying cause may be difficult to detect.

Classification

1. Epimenorrhoea :- Epimenorrhoea is defined as cyclic bleeding where are cycle is reduced to a arbitary limit of 21 days or less and remain constant at that frequency.
2. Puberty Menorrhagia :- Puberty Menorrhagia is a threshold bleeding of adolescence caused by increased or unopposed oestrogen and absence of progesterone in the anovulatory cycles. Menorrhagia may be noticed few periods are normal. Puberty menorrhagia occurs in bleeding lasting many days. In either cases anaemia may supervene.
3. Premenopasual Menorrhagia :- Premenopausal menorrhaiga is often seen in womenwith anovulatory cycles. It is essential to rule out uterine aspiration or hysteroscopic an directed biopsy. Blood pressure and blood sugar should be checked.
4. Metropathia Haemorrhagica :- Metrophathia haemorrhagica should be regarded as a specialized form of dysfunctional uterine haemorrhage.

In this disease, the endometrium is thick and polypoidal and one or other ovary contains cyclic follicle. The disease is most prevalent in women over age of 40, the maximum incidence being between the ages of 40 and 45. Occasionally it develops in young girls under the age of 20. Parity is not related to its incidence.

Treatment in Ayurveda

Principles of treatment

1. Hemostatic drugs should be used.
2. Treatment prescribed for diarrhoea with blood bleeding diathesis, bleeding piles, disease of reproductive system and abortion is also useful.
3. An young woman, using congenial diet, having use complications should be treated on the line of Adhograktapitta
4. Use of Basti is beneficial.
5. Purgation cures menstrual.

General treatment

1. Drugs for external use
2. Drugs for internal use.

Drugs for external use

1. Use of satapuspa oil in the form of inhalation and massage is beneficial.
2. Roots of vyaghranakhi grown in sacred place, unrooted during uttarphalguni naksatra and tied in the waist cures Menorrhagia.
3. Use of bastis- Chandanadi or Rasnadi Niruha Basti i.e.

• Madhukadi anuwasana Basti i.e. cleaning enema.
• Mdhukadi anuwasana Basti i.e. nutritine enema.
• Kusadi asthapna Basti
• Rodhuadi asthapana Basti
• Rasnadi
• Mustadi yapana Basti

Drugs for internal lose

Decoction – Darvyadi decoction

• Use of properly prepared decoction of flowers of dhataki and pugi for three days definitely cures Menorrhagia.
• Use of decoction prepared with equal quantity of ila, samanga, salmali, haritaki and magadhika and mixed with sugar and honey cures immediately vaginal bleeding.
• Decoction prepared with nyagrodhadi group of drugs is beneficial.

Paste and Powder 

1. Pasted root of tanduliyaka mixed with honey with rasanjana should be taken with rice water.
2. Powdered rasanjana or laksha should be taken with goat milk.
3. Use of powdered madhuka and sugar each one karsha with rice water cures menorrhagia.
4. Powdered root of atibala mixed with sugar and honey should be used.
5. Powdered bharngi and nagara if used with rice water cures dysponea and bleeding.
6. A women using root of Kusa pestled with rice water gets relief from Menorrhagia with in 3 days.
7. Use of juice of unripe fruits of udumbara mixed with honey followed by diet consisting of milk and rice sweetened with sugar cures excessive bleeding
8. A woman using root juice of stem bark of asoka and rasanjana pestled with rice water and mixed with honey gets relief from Menorrhagia.
9. Powder or paste of Bhunyamalaki with rice water Cure it with in 3 days.
10. Pusyanuga Churna with honey followed by rice water should be used.

Electvaries

• Jirakawalehaa
• Khankusmandwaleha
• Brhatkusmanduwaleha
• Khandakusmandaka

Ghritas

• Mudgadya Ghrita
• Salmali ghrita
• Satakalyanaka Ghrita
• Satawari ghrita

Oils

• Satapuspa oil
• Satawari oil

Rasa

• Pradarripu rasa
• Bol parpati

Tablets

• Gokshuradigugglu
• Chandraprabha vati

Other treatment of Menorrhagia in Ayurveda

1. Sugarcane should be peeled, cut, crushed slightly and put into new daypot filled with cold water. The pot should be placed in open space for whole night. In the morning juice obtained by squeezing these pieces and mixed with utpala and honey should be used.
2. Cold percolation of stem bark of jambic, amra and Arjuna mixed with honey is beneficial.
3. Draksha, Ushira,padmaka and sugar each one pala should obtained after crushing the drugs should be used with equal quantity of milk.
4. In case of excessive bleeding, the blood of deer or goat etc. animals should be given and uncooked liver alongwith bile of a goat should be taken.
5. Use of cold percolation of nilotpala, sugar, yasthimadhu padmakesara and chinnodbhava is beneficial.

Decoction

• Decoction of bark of kutaja and nagara with ghrita.
• Decoction of bark of jambu, Arjuna and amra.
• Decoction of Chandana, kiratatikta dhanvayavasa and nagara.
• Decoction of atarusaka, mudurika and pathya mixed with sugar and honey.
• Decoction of stem bark of dadima, shunthi and chandana with ghrita.

Paste powders or juices

• Paste of ywasa and root of bhrangaraja mixed with juice of cow dung and rice water.
• In case of clotted bleeding, powdered feces of pigcon with honey
• Powders of srongataka, laja, musta, kharjura and padmakesara mixed with honey.
• Powdered of karanja with honey and ghrita.
• Juice of onion with honey and ghrta.
• Expressed juice of unripe fruits of udumbara with honey.
• Powdered and paste of chandana with honey and sugar with or without rice water.
• Powdered fruits of Kharjura or else other fruits having similar properties (Kashmari etc) with honey.
• Paste of phalini with madhu.
• Powders of darvi, kiratatikta, musta and duhasparsa.

Use of milk - Goat milk is excellent remedy.
Use of Ghrita - Ghrita medicated with paste and decoction of satawari.

Pathya (Beneficial diet)

Cooled decoction of drugs of uttapaladi group, meat soup of wild birds or animals i.e. ena (specific type of deer) or quail and soup of satina (Vartulakalaya) is beneficial in raktpitta having predominance of pitta, association vata of kapha respectively. Cooked shali or shastika rice should be given in diet. Vegetable of tender leaves of patola, selu, sunisannaka, yuthika, vata, atimukta alongwith fruits of sinduwara prepared with ghrita is beneficial in raktapitta as also very useful in Menorrhagia.

Soup of meat of pigeon, couch, tortoise mixed with good quanity of ghrta, santanika (upper thick part of milk with cream especially of boiled milk) of milk boiled the drugs of utapaladi group and mixed with honey and sugar, irrigation with cooled decoction of nyagrodhadi group of drugs and ghrta medicated with the drugs of Kakolyadi group etc. are beneficial.

Ghrita made of butter from milk should be taken with milk and meat soup of Kapinijala (Sparrow) or only milk should be taken in diet, meatsoups of rabbit, Kapinjala (Sparrow) or pigeon, soup of tandulyaka, mudga and seeds of kasmari should be used blood of goat or deer cooked with ghrta should be taken.

Apathya

Excessive salty, sour, heavy, hot food which produces burning sensation, uncutuous substances, meat of domestic aquatic and fatty animals, kshara, rice cooked in milk and sugar (pyasya) curd, sukta, mastu, wine.