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M.S.

M INSTITUTE OF AYURVEDA

KHANPUR KALAN
SONEPAT

DEPARTMENT OF KAYA CHIKITSA

COMPILATION ON

ABNORMAL UTERINE BLEEDING

Guided by: Presented by:


Dr.A.Neelima (Incharge) Shaveta Mittal
Dr.G.K.Panda Roll no.
Acknowledgement

I Shaveta Mittal from BAMS Final proff hereby


very thankful to our respected teachers
Dr. A.Neelima,Dr.G.K.PANDA for their
kind help to complete my compilation on topic
‘ABNORMAL UTERINE BLEEDING’.

I am able to complete this task with your guidance


only.

Guided by: Presented by:


Dr. A.Neelima (Incharge) Shaveta Mittal
Dr. G.K.Panda Roll no.
DEPARTMENT OF PRASUTI TANTRA
& STREE ROGA
M.S.M.INSTITUE OF AYURVEDA
KHANPUR KALAN (SONEPAT)
DATE ………..

CERTIFICATE

Certified that this is the bonafide compilation done by


Shaveta Mittal in the subject PRASUTI TANTRA
&STREE ROGA prescribed for the final profession of
BAMS course during the years 2009-2010 with registration
no. ……….. .Her work is satisfactory.

Signature of lecturer Signature of Incharge

Signature of Internal Signature of external


Examiner examiner
INDEX
*ABNORMAL UTERINE BLEEDING
*MENORRHAGIA
*AARTVA
*PRADRA
*POLYMENORRHOEA
*METRORRHAGIA
*OLIGOMENORRHOEA
*HYPOMENORRHOEA
*DYSFUNCTIONAL UTERINE BLEEDING
*VAATAJ AARTVA DUSHTI
*AARTVA KSHAY
*NASHTAARTVA &ANAARTVA
*VAATAJ YONIVYAPADA
*PITAJ YONIVYAPADA
*KAFAJAARTVA DUSHTI
*PARIPLUTA YONIVYAPADA
Abnormal Uterine Bleeding
 
A normal menstrual period lasts from 2 to 7 days. The normal cycle
patterns can range from 21 to 35 days. When bleeding occurs that is not
part of the regular cycle; periods are longer or heavier than normal;
occurs between periods; time between periods is longer than normal; or
there is an absence of periods, this is called abnormal uterine
bleeding.

There are various causes of abnormal bleeding. At both ends of the


menstrual life of a woman, periods may be irregular. Reasons for
abnormal periods can be both normal and abnormal. The most normal
reason is pregnancy.

Hormone imbalance can also be a common reason. This can occur


as a result of weight loss or gain; heavy exercise; stress; illness; or
certain medications. The most common result of a hormone imbalance
is loss of ovulation. If this occurs over a long period of time, a
condition called endometrial hyperplasia can occur. Endometrial
hyperplasia is the result of constant oestrogen bombardment of the
endometrium (the lining of the uterus shed every month with the
period). Untreated, endometrial hyperplasia (when the lining of the
uterus becomes too thick) can sometimes turn into cancer. 
Menorrhagia (Heavy Periods)  
Menorrhagia is the term for excessive menstrual bleeding i.e. blood
loss greater than 80ml during a menstrual period. Population studies
show that the typical menstrual blood loss is 30-40ml, and that 90%
of women have losses of less than 80ml.
Related conditions that may overlap with menorrhagia include:

 Metrorrhagia - irregular or frequent flow, noncyclic


 Menometrorrhagia - frequent, excessive, irregular flow
(menorrhagia plus metrorrhagia)
 Polymenorrhea - frequent flow, cycles of 21 days or less
 Intermenstrual bleeding - bleeding between regular menses
 Dysfunctional uterine bleeding (DUB) - abnormal
endometrial bleeding of hormonal cause and related to
anovulation.

 Causes-
Possible causes include those associated with hormone
changes such as too much oestrogen or prolactin, too little or
poorly timed luteinizing hormone, and polycystic ovarian
disease.
 Physical causes include obesity or the presence of fibroids,
endometrial hyperplasia, polyps, cancer, endometriosis,
ectopic pregnancy, and IUD use.
 Bleeding disorders such as a deficiency of vitamin K or the
use of blood thinners can be contributing factors. iron
deficiency, and vitamin A deficiency.When it has been
determined that the cause is not organic (a physical
condition), laboratory testing (bleeding time, complete blood
count, and thyroid function) should be done, and any
abnormalities corrected.
 Heavy bleeding can be caused by too much oestrogen or
possibly too little progesterone. Too much oestrogen causes
excessive growth of the blood rich endometrial lining which
will be shed each month.

General diseases causing menorrhagia-

1)Blood dyscrasia

i.e.leukaemia,coagulopathy,thrombocytopenic purpura,severe
anaemia

Local pelvic causes are:-

1) Uterine causes: Uterine fibroids,fibroid polyp

2) ovarian feminizing tumours

3) salpingo-oophoritis,PID

Systemic causes-
1)Liver dysfunction

2)Congestive cardiac failure

3)severe hypertension

Endocrinal causes-

Hypothyroidism and hyperthyroidism.


Diagnosis ->
(1). Ultrasound
(2). A diagnostic curettage
(3). A full general examination with special reference to thyroid
dysfunction and a full blood count.
(4). A diagnostic curettage, primarily to obtain material for
histology.

Treatment ->
(1). First of all hormone therapy should be given for this
Oestrogen -Administration of ethinyl oestradiol is given – 0.25 mg
tds
(2). Newer orally active progestational steroids such as nor
ethisterone are used as an alternative and these are safer than
oestrogen.
(3). GnRH ->
Used as a last drug.
Depot Inj – 3.6 mg given monthly for 4-6 months is nearly 100%
successful.
(4). Operation -> Currettage -> 30-40 % patients are cured by this.

Polymenorrhoea/Epimenorrhoea (frequent periods)


Polymenorrhoea is the term used to describe frequent periods.
Classically it describes women who have a period more
frequently than every 21 days.

Causes :-

This can occur in the climacteric (period leading to the


menopause) and in women with polycystic ovaries. When no
cause is found, this and other menstrual symptoms form part of
the condition known as dysfunctional uterine bleeding.

It is seen predominnanatly during adolescence,preceding


menopause and following delivery and abortion.Hyperstimulation
of the ovary by the pituitary hormones may be the responsible
factor.
 
Diagnosis & Treatment-

The pituitary ovarian axis is often responsible and hormonal


study may be useful.
Treatment lies in rectifying the underlying cause when no cause
is found;
Cyclical hormone therapy should restore the menstrual cycles.

  Metrorrhagia  

can be defined as 'off schedule' bleeding. The bleeding,usually


of normal or slight amount,occurs at either irregular/ regular
intervals outside of the normal menstrual flow. Metrorrhagia is
one of many conditions sometimes caused by hormone
irregularities, which can be labeled by the more general term,
DUB.

Signs, symptoms & indicators of Metrorrhagia:

Symptoms -   Irregular menstrual cycles


   

Risk factors for Metrorrhagia:

Hormones   -Lowprogestrone
  -Low Adrenal
Function / Adrenal
Insufficiency

Infections    -PID
-Lyme Disease

Medications -Birth Control Pill /


Contraceptive Issues
Risks -Increased Risk of
Ovarian Cancer

Tumors, Benign  -Ovariancysts


  -Fibroids

 
 

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