Primary Healthcare, Nursing and Neonatal Screening

Statement of the Problem: Menopause, the term in itself brings many thoughts in a female’s life. Especially if, it is related to

the excessive hemorrhage during menstrual periods. Dysfunctional uterine bleeding (DUB) is a variety of manifestations of

the anovulatory cycle (in the absence of pathology or medical illness).

(a) DUB in menarche i.e. puberty menorrhagia

(b) DUB in middle age female as metropathia hemorrhagic

(c) DUB in premenopausal female i.e. heavy bleeding in a woman approaching menopause.

Of these, the third point affects women the most as they are in troubles related to menopause itself.

Cause: As approaching menopause time ovaries start devoid of mature follicles. So, FSH start increasing as a result initially

proliferative endometrium grows up to 5-6 mm size which is very fragile, only estrogenic primed endometrium. So, as soon as

estrogen level decreases, tissues undergo spontaneous breakage and bleeding as one site heals another, yet another new site of

breakdown will appear. Endometrial control mechanism is missing. So, excess blood loss is due to disorderly, abrupt, random

breakage of tissue- with opening of multiple vascular channels. (a) No vasoconstriction (b) No tight coiling of spiral vessel (c)

No collapse to induce stasis. As a result, a most common treatment program for such cases is: (i) Hormones OCP (ii) Estrogen

therapy (iii) Maintenance of hemoglobin (iv) Use of antiprostaglandins (v) GnRH (gonadotropin-releasing hormone) agonists

(vi) Ablation of the endometrium (vii) Surgical removal of uterus i.e. hysterectomy

An agent from this entire homeopathy -an alternative science is a better choice where without hormonal side effects bleeding

and the cycle can be controlled satisfactorily. Few things to take care like: (a) Proper case taking (b) Selection of similimum

(c) Selection of good potency (d) Selection of intercurrent remedy (e) Selection of mother tinctures for acute conditions (f)

Re-case taking- taking miasm behind into consideration (g) Give mental symptoms top priority (h) Reassurance to patient (i)

Spending some extra time with patient alone then with husband and children counseling them (j) See the response of cases.

So, managing DUB in the premenopausal female is time taking with best results.