{"paper_id":"cac2d0e3-8ca7-4237-baa6-4917d962be62","body_text":"~ 298 ~ \nInternational Journal of Homoeopathic Sciences 2021; 5(4): 298-300\n \nE-ISSN: 2616-4493 \nP-ISSN: 2616-4485 \nwww.homoeopathicjournal.com \nIJHS 2021; 5(4): 298-300 \nReceived: 05-07-2021 \nAccepted: 02-09-2021 \n \nDr. Munazza Shaikh \nMD Homeopathy Scholar, \nPractice of Medicine, \nGuru Mishri HMC, Jalna, \nMaharashtra, India \n \nDr. Rashmi Desarda  \nGuru Mishri HMC, Jalna, \nMaharashtra, India\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \nCorresponding Author: \nDr. Munazza Shaikh \nMD Homeopathy Scholar, \nPractice of Medicine, \nGuru Mishri HMC, Jalna, \nMaharashtra, India\n \n \nHeavy menstrual bleeding and homoeopathic \nmanagement \n \nDr. Munazza Shaikh and Dr. Rashmi Desarda \n \nDOI: https://doi.org/10.33545/26164485.2021.v5.i4e.487 \n \nAbstract \nMenorrhagia is a symptom denoting excessively heavy menstrual bleed ing. It is a complaint that is \ndifficult to verify objectively in many cases, even with a detailed case history. Issues of perception and \ntolerance of symptoms are important in whether a patient presents to a doctor, and this varies \nconsiderably from one society to another. Research studies indicate tha t the upper limit of normal \nblood loss is between 60 and 80 ml/month. Above this level women  tend to become progressively iron \ndeficient. Hence, any development which may help the precision of this assessment is valuable, and \nseveral of these will be discussed. Causes of menorrhagia can be div ided into three groups: (1) pelvic \ndiseases, such as myomata and adenomyosis; (2) systemic disorders, such a s coagulopathies and \nhypothyroidism; and (3) dysfunctional uterine bleeding —a diagnosis of exclusion. Investigations are \nmainly aimed at improving the precision of the underlying diagnosis, de fining the severity of the \ncondition and excluding anaemia. Hence, the most important investig ations are a full blood count, a \ndiagnostic hysteroscopy and endometrial sampling. In clinical practice, other specific investigations \nneed only be carried out if there are unusual features in the history or examination, or if previous \ntreatments have failed. In a research situation there have been numerous studies aimed at elucidation of \nthe mechanisms of heavy bleeding and some of these will be reviewed. \n \nKeywords: myomata, adenomyosis, coagulopathies, hypothyroidism, dysfunctional uterine bleeding \n \nIntroduction \nMenorrhagia is defined as heavy but regular menstrual bleeding. Idiopathic ovulatory \nmenorrhagia is regular heavy bleeding in the absence of recognisable p elvic pathology or a \ngeneral bleeding disorder. Objective menorrhagia is taken to be a total men strual blood loss \nof 80 mL or more in each menstruation. Subjectively, menorrhagia m ay be defined as a \ncomplaint of regular excessive menstrual blood loss occurring over  several consecutive \ncycles in a woman of reproductive age. \n \nIncidence/Prevalence \nIn the UK, 5% of women aged 30-49 years consult their general pr actitioners each year with \nmenorrhagia. In New Zealand, 2-4% of primary-care consultations by pr emenopausal \nwomen are for menstrual problems. \n \nAetiology/Risk factors \nIdiopathic ovulatory menorrhagia is thought to be caused by disordered  prostaglandin \nproduction within the endometrium. Prostaglandins may also be implica ted in menorrhagia \nassociated with uterine fibroids, adenomyosis, or the presence of an IUD.  Fibroids have been \nreported in 10% of women with menorrhagia (80-100 mL/cycle), and i n 40% of women with \nsevere menorrhagia (at least 200 mL/cycle). \n \nPrognosis \nMenorrhagia limits normal activities and causes iron-deficiency anaemia in t wo thirds of \nwomen proven to have objective menorrhagia. One in five women in the UK and one in \nthree in the USA have a hysterectomy before the age of 60 years; meno rrhagia is the main \npresenting problem in at least half of these women. About half of wom en who have a \nhysterectomy for menorrhagia are found to have an anatomically normal uterus. \n \n \n\n\nInternational Journal of Homoeopathic Sciences http://www.homoeopathicjournal.com \n~ 299 ~ \nAims of intervention \nTo reduce menstrual bleeding; improve quality of life; and \nprevent or correct iron-deficiency anaemia, with minimum \nadverse effects. Women may regard amenorrhea as a benefit \nor a harm of treatment, depending on their perspective. \n \nOutcomes \nMenstrual blood flow (assessed objectively [mL/cycle] or \nsubjectively); haemoglobin concentration; quality of life; \npatient satisfaction; incidence of adverse drug effects; and \nincidence of postoperative complications. Whether a \nparticular percentage reduction in menstrual blood loss is \nconsidered clinically important will depend on pre-treatment \nmenstrual loss and on individual women's perceptions of \nacceptable menstrual loss. \n \nDisclaimer \nThe information contained in this publication is intended for \nmedical professionals. Categories presented in Clinical \nEvidence indicate a judgement about the strength of the \nevidence available to our contributors prior to publication \nand the relevant importance of benefit and harms. We rely \non our contributors to confirm the accuracy of the \ninformation presented and to adhere to describe accepted \npractices. Readers should be aware that professionals in the \nfield may have different opinions. Because of this and \nregular advances in medical research we strongly \nrecommend that readers' independently verify specified \ntreatments and drugs including manufacturers' guidance. \nAlso, the categories do not indicate whether a particular \ntreatment is generally appropriate or whether it is suitable \nfor a particular individual. Ultimately it is the readers' \nresponsibility to make their own professional judgements, \nso to appropriately advise and treat their patients. To the \nfullest extent permitted by law, BMJ Publishing Group \nLimited and its editors are not responsible for any losses, \ninjury or damage caused to any person or property \n(including under contract, by negligence, products liability \nor otherwise) whether they be direct or indirect, special, \nincidental or consequential, resulting from the application of \nthe information in this publication. \n \nHomeopathic approach \nBovista \nPremenstrual problems with puffiness in the extremities, \nfluid retention, and a bloated feeling often indicate a need \nfor this remedy. The woman may feel very awkward and \nclumsy, and may constantly be dropping things because of \nswollen-feeling hands. Diarrhea occurring around the time \nof the menstrual period strongly indicates this remedy. \n \nCalcarea carbonica \nPMS with fatigue, anxiety, and a feeling of being \noverwhelmed suggest a need for this remedy. The woman \nmay have problems with water-retention and weight gain, \ntender breasts, digestive upsets, and headaches. Periods \noften come too early and last too long, sometimes with a \nflow of bright red blood. A general feeling of chilliness, \nwith clammy hands and feet, and cravings for sweets and \neggs are other indications for Calcarea. \n \nLachesis \nWomen who need this remedy are usually intense, with a \ntremendous need for an outlet, both physically and mentally. \nSymptoms of PMS include congestion, headaches, flushing, \nsurges of heat, and an intense outspoken irritability —often \nwith strong feelings of suspicion or jealousy. When the flow \narrives, it may be heavy, but brings relief of tension. \nIntolerance of restrictive clothing around the waist or neck \nis another indication for Lachesis. \n \nLycopodium \nPMS with a craving for sweets and a ravenous appetite \n(sometimes a bulimic tendency) suggests a need for this \nremedy. Digestive upsets with abdominal bloating and \nflatulence are often seen, with the person feeling worst in \nthe late afternoon and evening. Menstrual periods may be \ndelayed, followed by a heavy flow that goes on for extra \ndays. A woman who needs this remedy often wears a \nworried look and lacks self-confidence —although she may \nbe irritable and bossy to pets and family members. A desire \nto be alone, but with someone in the other room, is another \nindication for Lycopodium. \n \nNatrummuriaticum \nA person who needs this remedy usually seems reserved to \nothers, but is deeply emotional inside. She may feel \nextremely sad and lonely, but gets affronted or angry if \nothers try to console her or sympathize. Depression, anger \nover minor things, and a need to be alone to cry are often \nseen when Natrummur is needed. Menstrual problems can \nbe accompanied by migraines, or a backache that feels \nbetter from lying on something hard or pushing a solid \nobject against the painful place. A craving for salt, strong \nthirst, and a tendency to feel worse from being in the sun are \nother indications for this remedy. \n \nNux vomica \nWhen a woman with PMS is extremely impatient, pushy, \nand intolerant, this remedy may be of use. Uncomfortable, \nirregular menstrual periods can be experienced, often with a \nnagging urge to move the bowels before the flow begins. \nConstipation is common, and constricting pains may extend \nto the rectum or tailbone region. Anger, mental strain, \nphysical exertion, and overindulgence in coffee, alcohol, or \nfood can aggravate the problems. The woman often feels \nchilly and improves from warmth and rest. \n \nReferences \n1. Hallberg L, Hogdahl A, Nilsson L et al . 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