Management of Abnormal uterine bleeding in a perimenopausal woman through Ayurveda: An experience

Abnormal uterine bleeding in perimenopausal women is mostly due to disturbance in the Hypothalamic–pituitary–ovarian axis, which leads to an anovulatory cycle. There is an unopposed action of estrogen on the endometrium without progesterone. Ayurveda explains the condition as Asrigdara (~menorrhagia or metrorrhagia). The Doshika (~regulatory functional factors of the body) predominance in the perimenopausal period is Pitta pradhana, Vata madhya, and Kapha heena (~Pitta dominant with moderate Vata and low Kapha), and any deviation from this leads to Dosha vaishamya (~derangement of Dosha), eventually responsible for various menstrual-related disorders in females. During the perimenopausal period, menstrual irregularities commonly result from the vitiation of Apana Vayu (~one of the five subtypes of Vata, situated in the pelvic region), caused by its obstruction due to aggravated Pitta and described as Pitta-avrita apana vayu. Here, a case of Asrigdara, which was successfully managed with Ayurveda intervention for 95 days, is being presented. After the completion of treatment, the menstrual cycle became regular with normal duration and interval, and endometrial thickness reduced from 12 mm to 6 mm. Furthermore, the haemoglobin level increased from 9.8 to 11.4 g/dl, Pictorial Blood Loss Assessment Chart score decreased from 382 to 83, and Menstrual Bleeding-related Quality of Life score improved from 52 to 12. The case report demonstrates the efficacy of Ayurveda treatment in menstrual disorders, further inferring the role of Ayurveda treatment modalities in improving the overall well-being of the patient, without any adverse effects.