Menorrhagia

Causes of Menorrhagia

Menorrhagia is a symptom of some underlying pathology—organic or functional.

Organic

Due to congestion, increased surface area, or hyperplasia of the endometrium

• Fibroid uterus
• Adenomyosis
• Pelvic endometriosis
• IUCD inutero
• Chronic tubo-ovarian mass
• Tubercular endometritis (early cases)
• Retroverted uterus—due to congestion
• Granulosa cell tumor of the ovary

Systemic

• Liver dysfunction—failure to conjugate and thereby inactivates the estrogens
• Congestive cardiac failure
• Severe hypertension

Endocrinal

• Hypothyroidism
• Hyperthyroidism

Hematological

• Idiopathic thrombocytopenic purpura
• Leukemia
• Von Willebrand’s disease
• Platelet deficiency

Emotional upset

Functional

Due to disturbed hypothalamo-pituitary-ovarian endometrial Axis

Dysfunctional uterine bleeding

• Fibroid uterus
• Adenomyosis
• Chronic tubo-ovarian mass [1]

Sign & Symptoms menorrhagia

• Soaking through one or more sanitary pads or tampons every hour for several consecutive hours.
• Needing to use double sanitary protection to control your menstrual flow.
• Needing to wake up to change sanitary protection during the night.
• Bleeding for longer than a week.
• Passing blood clots larger than a quarter.
• Restricting daily activities due to heavy menstrual flow.
• Symptoms of anemia, such as tiredness, fatigue or shortness of breath.[1]

Investigation of menorrhagia

• Blood tests to check for disorders that cause bleeding, nutritional deficiencies, infections, markers of inflammation, and other findings
• Tests to check your hormone levels also thyroid function
• Urine samples to check for pregnancy, infection, or STIs
• Ultrasounds of your abdomen and pelvis, including transvaginal ultrasounds

other investigation

• Either CT scans or MRIs
• A pap smear  to test for cervical cancer
• Other tissue biopsies to look for other types of cancer
• Surgery (for example; laparoscopy or laparotomy) [7]

Diagnosis of menorrhagia

Long duration of flow, passage of big clots, use of increased number of thick sanitary pads, pallor, and low level of hemoglobin give an idea about the correct diagnosis and magnitude of menorrhagia.[1]

Treatment of menorrhagia

The definitive treatment is appropriate to the cause for menorrhagia.[1]

• Nonsteroidal anti-inflammatory drugs (NSAIDs) i.e.-

  NSAIDs, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), help reduce menstrual blood loss. NSAIDs have the added benefit of relieving painful menstrual cramps (dysmenorrhea).

• Tranexamic acid i.e.-

  Tranexamic acid helps reduce menstrual blood loss and only needs to be taken at the time of the bleeding.

• Oral contraceptives i.e.-

  A side from providing birth control, oral contraceptives can help regulate menstrual cycles and reduce episodes of excessive or prolonged menstrual bleeding.

• Oral progesterone i.e.-

  The hormone progesterone can help correct hormone imbalance and reduce menorrhagia.

• Hormonal IUD (e.g. Liletta, Mirena) i.e.-

  This intrauterine device releases a type of progestin called levonorgestrel, which makes the uterine lining thin and decreases menstrual blood flow and cramping.[6]

Procedures-

You may need surgical treatment for menorrhagia if medical therapy is unsuccessful.

Treatment options include:

• Dilation also curettage (D&C)
• Uterine artery embolization
• Myomectomy
• Focused ultrasound surgery
• Endometrial ablation
• Endometrial resection
• Hysterectomy [6]

Homoeopathic Treatment:

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines selected after a full individualizing examination and case-analysis.

Which includes

• The medical history of the patient,
• Physical and mental constitution,
• Family history,
• Presenting symptoms,
• Underlying pathology,
• Possible causative factors etc.

A miasmatic tendency (predisposition/susceptibility) also often taken into account for the treatment of chronic conditions.

What Homoeopathic doctors do?

The disease diagnosis is important but in homeopathy, the cause of disease not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness also looked for. Now a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition.

The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can greatly improve with homeopathic medicines.

Homeopathic Medicines for Menorrhagia: 

The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications also taken into account for selecting a remedy, potency and repetition of dose by Homeopathic doctor.

So, here we describe homeopathic medicine only for reference and education purpose. Do not take medicines without consulting registered homeopathic doctor (BHMS or M.D. Homeopath).

Medicine:

1. Cal-c –

• Menses too early, too profuse, too long-lasting; over-exertion or least excitement causes return of menses. Additionally, Inward coldness.
• Lastly, Sensation if she had on cold, damp stockings.

2. China-

• Menses too early, too profuse; discharge especially dark, clotted; ringing in ears; loss of sight, fainting.

3. Ferr-m-

• Menses too early, too profuse, too long-lasting; fiery red face; cease for a day or two and then return; flow pale, watery also debilitating.
• In detail, Metrorrhagia with red, flushed face partly fluid also partly clotted blood; labour-like pains.

4. Secale –

• Generally, Best adapted to thin, scrawny women. In detail, Copious dark fluid, flow may come in gushes and is preceded by strong bearing down pains.
• Continuous, bloody, watery discharge between two periods or rather prolonged periods, so that it is practically speaking a continuous flooding.
• Thin, black, horribly offensive flow. Additionally, Great debility.
• Flow or hemorrhage of the aforesaid character after either delivery or abortion.

5. Thalspi-

• Basically, Uterine hemorrhage with violent uterine colic also cramps; consequent on abortion or labor; at menopause.
• In detail, Premature menstruation; on the first day she hardly had a show, second day, hemorrhage with severe colic, vomiting and expulsion of large clots.[3]

6. Sabina –

• Retained placenta; intense after-pains. Additionally, Menorrhagia in women who aborted readily. Inflammation of ovaries and uterus after abortion.
• Menses profuse, bright. Uterine pains extend into thighs. In detail, Threatened miscarriage.
• Sexual desire increased.
• Besides this, Leucorrhea after menses, corrosive, offensive. Discharge of blood between periods, with sexual excitement. Promotes expulsion of moles especially from uterus.
• Pain from sacrum to pubis, also from below upwards shooting up the vagina.
• All in all, Hemorrhage; partly clotted; worse from least motion.[5]

7. Pulsatilla-

• Hemorrhage ceases for a little while also then recommences with redoubled force.
• Blood may be dark also mixed with coagulated lumps. [4]

Diet & Regimen Menorrhagia

• Avoid saturated fats such as butter, cream, bacon and potato chips.
• Limit salt and caffeine.
• Drink more water and herbal teas such as chamomile.
• Increase your intake of calcium-rich foods such as nuts, low-fat dairy products, fish with bones such as salmon and sardines, tofu, broccoli and bok choy.[2]

Frequently Asked Questions

What is Menorrhagia?

Menorrhagia is defined as cyclic bleeding at normal intervals; the bleeding is either excessive in amount (> 80 mL) or duration (>7 days) or both.

Homeopathic Medicines used by Homeopathic Doctors in treatment of Menorrhagia?

• Cal carb
• China
• Ferr met
• Secale
• Thalspi
• Sabina
• Pulsatilla

What causes Menorrhagia?

• Fibroid uterus
• Adenomyosis
• Pelvic endometriosis
• IUCD inutero
• Liver dysfunction
• Congestive cardiac failure
• Severe hypertension
• Hypothyroidism, Hyperthyroidism
• Leukemia
• Emotional upset

What are the symptoms of Menorrhagia?

• Soaking through one or more sanitary pads or tampons every hour for several consecutive hours.
• Needing to use double sanitary protection to control your menstrual flow.
• Needing to wake up to change sanitary protection during the night.
• Bleeding for longer than a week.
• Passing blood clots larger than a quarter.
• Restricting daily activities due to heavy menstrual flow.
• Symptoms of anemia, such as tiredness, fatigue or shortness of breath

References use for Menorrhagia

[1] DC DUTTA’s GYNECOLOGY

[2] https://www.thewomens.org.au/health-information/periods/healthy-periods/exercise-diet-periods#:~:text=Avoid%20saturated%20fats%20such%20as,tofu%2C%20broccoli%20and%20bok%20choy.

[3] The Homoeopathic Prescriber By K. C. Bhanja

[4] The Homoeopathic Prescriber By K. C. Bhanja

[5] Materia Medica By Boericke W.

[6] https://www.mayoclinic.org/diseases-conditions/menorrhagia/diagnosis-treatment/drc-20352834

[7] https://www.verywellhealth.com/an-overview-of-metrorrhagia-4584380#toc-diagnosis