Dysfunctional Uterine Bleeding (DUB), also known as Abnormal Uterine Bleeding (AUB) refers to bleeding from the uterus occurring outside pregnancy in reproductive-aged women that is abnormal in the parameters of regularity, frequency, volume, or duration that results from an ovarian endocrinopathy. DUB is a common condition that significantly affects the quality of life. DUB includes all varieties of menstrual disturbances except amenorrhea. DUB is found mostly at both the ends of reproductive life, i.e. Puberty and Menopause, with 75% cases occurring during menopause age.
What are the risk factors and causes?
The PALM-COEIN classification, established by FIGO (International Federation of Obstetrics and Gynecology) , organizes the potential causes of AUB into the following structural and nonstructural categories, which aids in diagnosing and managing AUB effectively:
Structural Categories:
Polyp (P): Endometrial or endocervical polyps are focal outgrowths of tissue that may be asymptomatic or cause intermenstrual bleeding.
Adenomyosis (A): a condition in which there is presence of endometrial tissue within the uterine muscles, this is often associated with heavy, painful, or prolonged menstruation.
Leiomyoma (L): Commonly known as fibroids, these benign smooth muscle tumors can lead to heavy or prolonged menstrual bleeding, particularly if large or submucosal.
Malignancy and Hyperplasia (M): These include endometrial hyperplasia and cancers, often presenting with unpredictable bleeding. Risk factors include prolonged estrogen exposure without opposition by progesterone.
Non-structural Categories:
Coagulopathy (C): Systemic bleeding disorders, eg, von Willebrand disease, are common causes of heavy menstrual bleeding, particularly in adolescents and young girls.
Ovulatory dysfunction (O): PCOS, hypothalamic disorders, or thyroid dysfunction can lead to infrequent, irregular, heavy, or prolonged bleeding due to inconsistent ovulation.
Endometrial disorder (E): These involve localized issues in the endometrium’s ability to control bleeding, possibly due to inflammation, infection, or vasoconstriction abnormalities.
Iatrogenic (I): Certain Medications (eg, hormonal contraceptives, anticoagulants, or tamoxifen) or surgical injury (eg, Asherman syndrome) can induce abnormal bleeding.
Not otherwise classified (N): Rare or poorly understood causes comprise this group, including arteriovenous malformations, chronic endometritis, or cesarean scar defects.
What are the symptoms?
DUB is unpredictable. Bleeding maybe heavy or light and frequent or random depending upon the underlying disease. However, common symptoms include,
1. Irregular menstrual periods
2. Heavy/ prolonged or light/ infrequent menstrual bleeding.
3. Spotting/ bleeding between periods.
4. Pelvic pains and discomfort or cramps.
How homeopathy helps?
Homeopathic medicines act on uterine muscles and stimulate contractions, this tonic effect on uterine wall help in controlling DUB due to atony of uterus.
Micro doses of homeopathic medicines are believed to modulate vascular tone and reduce capillary congestion and thus, reduces excessive bleeding.
Though not directly altering hormones, homeopathic medicines work through the neuro-endocrine reflex arc to improve the uterine response during menstrual cycles.
Anti- inflammatory property of homeopathic medicines helps reduce uterine congestion.
in homeopathy, Potentization changes crude drug substance from a chemical agent to a dynamic remedy (by dilution method), which signals the vital force to restore balance in uterine tone and bleeding without the toxic effects of crude drug substance.
Commonly used homeopathic remedies for DUB are:
Ipecac
Sabina
Trillium
Millefolium
Secale cor
Sepia
Kali carb
Note: Homeopathic medicines should never be self-administered. For safe and effective treatment, it is essential to consult a qualified and experienced homeopathic practitioner. A skilled homeopath conducts a comprehensive evaluation, which includes:
Past and present medical history
Family history
Constitutional assessment (physical build, temperament, and unique characteristics)
Lifestyle factors
Mental and emotional state
Based on this detailed case-taking, the most appropriate remedy is prescribed.
Always seek professional consultation for accurate remedy selection and continuous monitoring, ensuring treatment that is both safe and tailored to your individual needs.
