Dysfunctional Uterine Bleeding / HEMORRHAGE
DUB is defined as a state of abnormal uterine bleeding without any clinically detectable organic, systemic, and iatrogenic cause (Pelvic pathology, e.g. tumor, inflammation or pregnancy is excluded). Heavy menstrual bleeding (HMB) is defined as a bleeding that interferes with woman's physical, emotional, social and maternal quality of life.
Causes of Dysfunctional Uterine Bleeding
1. Abnormalities of the reproductive tract
- Benign pelvic lesions
- Polyps, cervical or endometrial
- Malignancy [cancer of the uterus, cervix, vagina or ovaries]
- Trauma [injuries such as post coital injuries]
2. Complications related to pregnancy
- Ectopic pregnancy
- Molar pregnancy
- Placental polyp
- Spontaneous abortion (threatened, incomplete, missed)
3. Iatrogenic factors [due to medicines or medical procedures]
- Anticoagulation therapy – drugs given for patients who have had heart valve replacements etc]
- Contraceptive use
- Intrauterine device
- Levonorgestrel implant (Norplant System)
- Medroxyprogesterone contraceptive injection (Depo-Provera)
- Oral contraceptives
- Hormone replacement therapy
- Some psychiatric drugs
4. Systemic disease
- Cirrhosis [liver failure]
- Coagulation disorder
5. Dysfunctional uterine bleeding
When no other cause can be found. Dysfunctional uterine bleeding is a diagnosis of exclusion. In the vast majority of cases, it is secondary to anovulation [a condition where the follicle does not burst and therefore does not release the egg], which is more common at the extremes of reproductive age ie: teenage girls an women between 40-50 years of age
Diagnose of Dysfunctional Uterine Bleeding
To diagnose DUB, your doctor will ask questions about your medical history and the history of your cycle. These answers will help them determine your risks for certain reproductive disorders, like PCOS and endometriosis.
If you’re taking any medication, including birth control, mention this to your doctor, as such drugs can cause abnormal bleeding.
Your doctor may recommend an ultrasound to view your reproductive organs. This examination can help reveal whether you have any abnormal growths, such as polyps or fibroids. It can also help to rule out internal bleeding.
Blood tests are used to measure your hormone levels and your complete blood count. Your hormone levels can often give quick insight into the cause of your bleeding.
If you’ve had heavy or prolonged bleeding, a complete blood count reveals whether your red blood cell count is too low. A low red blood cell count can indicate anemia.
If an abnormal growth is causing the bleeding, or your uterine lining is unusually thick, your doctor may take a sample of the uterine tissue for testing.
If there are any abnormal cell changes in the lining, a biopsy may reveal it. Abnormal cells can indicate hormone imbalances or cancer, among other things.
Complication of Dysfunctional Uterine Bleeding
Generally, DUB is a temporary condition. Once the sex hormones are regulated, abnormal bleeding usually subsides.
Anemia is one of the main complications of heavy bleeding. If you develop anemia due to significant blood loss, your physician may treat it with minerals and vitamin supplements.
In rare cases where the bleeding has caused significant blood loss, you may need a blood transfusion.
Managment of Dysfunctional Uterine Bleeding
Because of diverse etiopathology of DUB in different phases of woman’s life, the management protocols have been grouped accordingly. Pubertal and adolescent menorrhagia <20 years (see p. 54, 55). Reproductive period (20–40 years). Premenopausal (>40 years). Postmenopausal.
Homeopathic Medicine for Dysfunctional Uterine Bleeding
SABINA 30 - Useful medicine for dysfunctional uterine bleeding with sexual excitement.Given when blood is partly fluid and partly clotted.There is too profuse,too early mense with gushing of hot watery bright red blood mixed with clots. There is severe uterine pain extend into thighs.Also there is pain from sacrum to pubis and from below upwards.There is shooting pain up the vagina with increased desire for sex.
THLASPI BURSA PASTORIS 3X - Very effective medicine for dysfunctional uterine bleeding with violent uterine pains , which is colicky or cramping in nature.Useful for Leucorrhea before and after menses which is bloody,dark & offensive. There is sore pain in uterus on rising.Useful for scarcely recovers from one period before another begins.There is backache accompanied with bleeding with large clots may accompanying the blood.
TRILLIUM PENDULUM Q - Very very useful medicine for dysfunctional uterine bleeding with severe pain in hip and back.Useful for uterine haemorrhages with sensation as though hip and back were falling to pieces, better tight bandages.There is gushing of bright blood on least movement. Also useful for hemorrhage due to uterine fibroids. There is a feeling of bearing down sensation, prolapsed uterus.
CHINA OFF 30 - Useful for dysfunctional bleeding with fainting, convulsions and great weakness.Given for menses which is too early, dark, profuse, clotted with abdominal distension.
CALCAREA CARB 30 - Excellent medicine for dysfunctional uterine bleeding with headache, colic , chilliness and leucorrhea.There is cutting pain in uterus during menstruation. Useful for menses which is too early, too profuse, too long with vertigo, toothache and cold damp feet, the least excitement causes their return.Suited for fat, flabby and fair person who have a special craving for boiled eggs and indigestible things like chalk, pencils etc. Bleeding due to uterine fibroids.
PHOSPHORUS 200 - Useful for frequent and profuse or short uterine bleeding between the periods due to fibroids, uterine polyps or cancer.Recommended for too early and scanty mense which is not profuse , but last too long.
SEPIA 30 - Effective for dysfunctional uterine bleeding during menopause. Along with bleeding menopausal symptoms like hot flushes, irritability and sadness are seen.There is indifference to her loved ones. There is a feeling of bearing down sensation in the uterus.
CHAMOMILLA 30 - Effective for dysfunctional uterine bleeding from anger with forcing pains. There is flow of dark and clotted.
AMBRA GRISEA 30 - Useful for discharge of blood between periods , due to exertion, at least incident. Worse after hard stools, walking a little longer
Ipecac - Very useful medicine for dysfunctional Uterine Bleeding (DUB) with too early, profuse, bright flow of menses, accompanied with nausea and vomiting with pain starts from the navel to the uterus.
RL - 5
RL - 37