DYSFUNCTIONAL UTERINE BLEEDING/ DUB/ IRREGULAR PERIODS/ ANOVULATORY BLEEDING/ HEAVY BLEEDING

DYSFUNCTIONAL

WHAT IS DYSFUNCTIONAL UTERINE BLEEDING?

Dysfunctional uterine bleeding, also called Anovulatory bleeding, is any bleeding from the vagina that varies from a woman’s normal menstrual cycle. The normal cycle is triggered by signals from hormones. Dysfunctional uterine bleeding occurs when the cycle’s hormonal signals get thrown off. This can include alternating periods that are heavy and light, spotting or unpredictable shorter and longer cycles.

AYURVEDIC ASPECT FOR DUB

DUB is elaborated in Ayurvedic texts as ASRIGDHARA.

According to Ayurveda, DUB is caused mainly by the vitiation of the Pitta Dosha with Rakta Dhatu and Vata.

TYPES OF DUB

Ovulatory DUB

10% of cases occur in women who are ovulating, but progesterone secretion is prolonged because estrogen levels are low. This causes irregular shedding of the uterine lining and break-through bleeding. Some evidence has associated ovulatory DUB with more fragile blood vessels in the uterus.

Anovulatory DUB

About 90% of DUB events occur when ovulation is not occurring (Anovulatory DUB). Anovulatory menstrual cycles are common at the extremes of reproductive age, such as early puberty and perimenopause (period around menopause). In such cases, women do not properly develop and release a mature egg. When this happens, the corpus luteum, which is a mound of tissue that produces progesterone, does not form. As a result, estrogen is produced continuously, causing an overgrowth of the uterus lining. The period is delayed in such cases, and when it occurs menstruation can be very heavy and prolonged. Sometimes anovulatory DUB is due to a delay in the full maturation of the reproductive system in teenagers. Usually, however, the mechanisms are unknown.

DUB is similar to several other types of uterine bleeding disorders and sometimes overlaps these conditions.

DUB

Menorrhagia

Menorrhagia is another term for abnormally long, heavy periods. This type of period can be a symptom of DUB, or many other diseases or disorders. In menorrhagia, menstrual periods occur regularly, but last more than seven days, and blood loss exceeds 88.7 ml. Passing blood clots is common. Between 15-20% of healthy women experience debilitating menorrhagia that interferes with their normal activities. Menorrhagia may or may not signify a serious underlying problem.

Metrorrhagia

Metrorrhagia is bleeding between menstrual periods. Bleeding is heavy and irregular as opposed to ovulatory spotting which is light bleeding, in mid-cycle, at the time of ovulation.

Polymenorrhea

Polymenorrhea describes the condition of having too frequent periods. Periods occur more often than every 21 days, and ovulation usually does not occur during the cycle.

CAUSES OF DUB

1. Abnormalities of the reproductive tract

Benign pelvic lesions
Adenomyosis
Endometriosis
Polyps, cervical or endometrial
Fibroids
Infections
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
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
Hypothyroidism

SYMPTOMS OF DUB

Heavy menstrual bleeding
Bleeding that contains many clots or large clots
Bleeding that lasts more than 7 days
Bleeding that occurs less than 21 days from the last cycle
Bleeding that occurs later than 35 days from the last cycle
Spotting
Bleeding between periods
Pelvic pain or pressure
Dizziness
Fainting
Weakness
Pale skin
Pain
Passing large clots
Soaking a pad every hour
Bleeding with a positive pregnancy test

MANAGEMENT FOR DUB

DIET PLAN

Green, leafy vegetables: They have the most nutrients per calorie than any other food. They are rich in iron, calcium, potassium, and magnesium, as well as vitamins K, C, E, and many of the B complex vitamins. Vitamin B in particular plays a vital role in managing Dysfunctional Uterine Bleeding symptoms.
Fruits: They are rich sources of Fibre, Vitamins and Minerals and are very helpful for managing Dysfunctional Uterine Bleeding.
Vegetables: Vegetables like bell pepper, pumpkin, carrots, artichokes and purple cabbage are rich sources of anti-oxidants and must be included in your diet.
Healthy Fats: Healthy fats are found in nuts and seeds, oily fish, avocado and olive oil so be sure to incorporate those into your diet.

FOOD TO AVOID:

Foods with high starch and carbohydrates should be strictly avoided. For e.g. White rice, mashed potatoes, rice cakes, muffins and cakes, bread.
Soy Products : Soy has been shown to delay ovulation, and so should not be had by females who want to conceive.
Bad Fats: Bad fats found in red meat, cooking oil, margarine and processed foods increase the chances of obesity and in turn, Dysfunctional Uterine Bleeding.