Menorrhagia Ayurvedic Treatment

Abnormally heavy or prolonged menstrual bleeding in women causing severe blood loss is medically known as menorrhagia. The women feel difficulty to perform daily activities due to severe bleeding and cramps. Although there are unidentified causes of menorrhagia, the common reasons are hormonal imbalance (due to PCOS, obesity, thyroid disorders, insulin resistance), anovulation (non-release of egg from ovaries), uterine fibroids, adenomyosis, uterine polyps, complications of pregnancy, side effect of intrauterine devices, inherited bleeding disorders, uterine or cervical cancer, certain  medicines (eg: hormonal medicines, anti-inflammatory drugs, anti-coagulants etc) and other medical conditions like liver or kidney diseases. Menorrhagia in adolescent girls is normal as the menstruation during first year after menarche (onset of menstruation) is usually anovulatory (without ovulation). 

Signs and symptoms

 The common signs and symptoms of menorrhagia include soaking of many sanitary pads or tampons several times in an hour that may interfere with daily activities, need to use double sanitary pad or extra-large pads to control bleeding and avoid staining dress, need to change sanitary pad during night due to over-flow, prolonged bleeding for more than one week, big blood clots in menstrual blood, unable to do daily activities due to heavy bleeding, symptoms of anaemia like fatigue, shortness of breath etc. 

Ayurvedic analysis

 Asrugdara (heavy menstrual bleeding) or raktapradara is a symptom of streeroga (gynaecological disorder) mentioned in Ayurveda. It is often associated with other symptoms such as body aches, cramps, burning sensation in groin/pelvic region/ low back/ flanks, intermenstrual bleeding, weakness, giddiness, fainting, black outs, increased thirst, burning sensation, anaemia, etc. 

Raktayoni is a yonivyapad (disorder of female reproductive system) characterised by excess vaginal bleeding. 

Causative factors (Ayurveda)

 Causes of asrigdara are excess intake of lavana (salty), amla (sour), katu (spicy), vidahi (food items causing burning sensation in stomach during and after digestion) ahara, milk and dairy products, curd, heavy and oily food, incompatible food, emaciation, over-exertion, day sleep, sedentary habit, mental stress, etc. 

In pitta avrutha apana (apana vayu overlapped by pitta) and rakta vruddhi (aggravation of rakta dhatu/ blood) asrugdara is a symptom. 

Possible complications

 Anaemia and severe pain are the major complications of menorrhagia. 

Other systemic diseases and precautions to be taken

 Consider other conditions like obesity, insulin resistance, uterine or ovarian cancer, thyroid dysfunctions etc before planning treatment for menorrhagia. 

Management 

 Treat the cause of asrugdara for better results. The principle of management is balancing tridosha, removing avarana of apana vayu by pitta and Arthava vahasrotorodushti if any, combat raktakshaya (blood loss), and treatment of raktapitta, rakta arsha and rakta atisara. Internal medications are enough in some cases. In chronic and complicated cases associated with risk factors such as obesity, insulin resistance etc, procedures like virechana (purgation therapy), nasya (nasal instillation of medicine), vasthi (enema therapy), uttaravasthi (infiltration of lipid formulation of medicine through vagina) etc. In associated mental stress, psychotherapy is provided. 

Diet

 The diet in asrugdara include easy to digest semi-solid or liquid food containing millets, green vegetables (especially from creepers- eg: ivy gourd, snake gourd, etc), small fishes, nuts, dry fruits, citrus fruits, garlic, fenugreek, sesame etc. Avoid the intake of curd, sweets, heavy to digest and oily food, white rice, spicy food, food items that cause bloating etc. 

Exercise

 Avoid exercise during bleeding. Mild to moderate exercises are recommended to do in between bleeding days. Yoga, meditation, and pranayama are effective in correcting hormonal imbalance and thereby reduce heavy bleeding. 

Preventive aspects

 Avoid sedentary habit, over-activity, excess intake of spicy/ oily/ heavy food, junk and processed food, stress etc. Limit the consumption of curd, sugar, salt, tubers, fried food, dairy products etc. Exercise regularly and maintain healthy body weight. Include more millets, green vegetables, citrus fruits, sesame, dry fruits, small fishes, egg etc in diet.

Importance of diet

 Right diet can regulate the hormones and thereby prevent menorrhagia. Choose the food items that maintain the balance of tridosha with the help of physician. 

Lifestyle 

  • Drink enough water, fruit juices etc to avoid dehydration and anaemia. 
  • Take proper rest during menstruation.
  • Maintain healthy body weight.
  • Exercise regularly in non-bleeding days.
  • Follow a healthy diet plan.
  • Avoid stress.
  • Ensure a regular sleep-wake cycle. 
  • Avoid day sleep and sedentary habit.

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