Metrorrhagia

Metrorrhagia or dysfunctional uterine bleeding (DUB), can be the result of several causes. Endometrial hyperplasia is a possible cause, the result of excessive estrogen and deficient progesterone secretion, resulting in an excessive stimulation of endometrial cells. Uterine cancer is a more common cause of DUB in postmenopausal women over 40. The aggravation of cervical or endometrial polyps after sexual intercourse or medical examination is another cause of DUB. Cervical dysplasia may also be the cause of metrorrhagia, and is a precancerous change in the cervical tissue, with bleeding indicative of a progression of dysplastic changes. Cervicitis is another possible cause of DUB, and is often secondary to chronic pelvic inflammation. Sometimes the bleeding is the result of cervical abnormalities such as cervical eversion, which can be congenital or the result of chronic infections. Other possible causes include ovarian cysts, oral contraceptive use, and excessive exercise. (Trickey 1998, 192-97; Berkow 1807-08)

If the above causes have been ruled out, the treatment of DUB is similar to menorrhagia. In many cases of metrorrhagia ovulation is sporadic or absent, suggesting a progesterone deficiency. Progesterone and estrogen maintain the delicate balance of the menstrual cycle, and when progesterone is deficient there is nothing to counter the estrogenic effects. Thus, the endometrium proliferates but without the progesterogenic effects, impairing circulation within the endometrium and resulting in endometrial fragility.

The holistic treatment for metrorrhagia is similar to that of menorrhagia, and besides using the therapies already mentioned to astringe the tissues, tone the uterus and enhance liver function, the treatment for DUB involves ovulatory support, often with a focus to treat the underlying issues of emotional stress that are common to this condition. Thus, progesterogenics such as Chaste berry (Vitex agnus castus) and White Peony (Paeonia lactiflora) are taken throughout the cycle, including menstruation. Additional support includes the use of relaxing nervines such as Ashwagandha (Withania somnifera), St. John's Wort (Hypericum perforatum), Vervain (Verbena officinalis), and Motherwort (Leonorus cardiaca). Useful supplements include vitamin C (to bowel tolerance), and vitamin B6 (50-150 mg b.i.d., 7-10 days before the period, taken with vitamin B complex, 100 mg daily). Iron (20 mg daily) is also important, as are the inclusion of lipotropic factors such as inositol and phosphatidyl choline to enhance the hepatic clearance of estrogens. See menorrhagia for more information.