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Non-Pharmacologic Treatment of Heavy Menstrual Bleeding in Persian Medicine

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Non-Pharmacologic Treatment of Heavy Menstrual Bleeding in Persian Medicine GMJ.2020;9:e1725 www.gmj.ir Received 2019-09-30 Revised 2019-10-26 Accepted 2019-11-24 Non-pharmacologic Treatment of Heavy Menstrual Bleeding in Persian Medicine Fatemeh Yousefi 1, Jale Aliasl 2, Fataneh Hashem-Dabaghian 1 1 Research Institute for Islamic and Complementary Medicine, School of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran 2 Traditional Medicine Clinical Trial Research Center, Shahed University, Tehran, Iran Dear Editor, fective treatments such as complementary and traditional medicine is essential. In Persian enorrhagia is abnormal heavy or pro- medicine, Non-pharmacological treatments Mlonged vaginal bleeding with 19.24% including nutrition modification and dry cup- prevalence in Iranian women [1]. HMB can be ping recommended for management of HMB diagnosed based on excessive (more than 80 [6-9]. In fact, nutrition plays a very important ml) or prolonged (more than 7 days) uterine role in the menstruation management and ane- bleeding per menstrual cycle [2]. The cause mia caused by it [10]. In PM view point as- of HMB may be structural and nonstructural tringent food, such as lentil (Lens culinaris), problems [2]. There are nine main categories, quince (Cydonia oblonga) fruit paste, apple arranged according to the acronym PALM (Malus domestica) paste, rhubarb (Rheum -COEIN (polyp, adenomyosis, leiomyomas, rhabarbarum) paste, barberry (Berberis vul- malignancy, hyperplasia, coagulopathy, ovu- garis) paste, pomegranate (Punica granatum) latory dysfunction, endometrial disorders, iat- paste, bird’s meat with sumac (Rhus coriaria), rogenic causes and not-yet-classified entities) lentil, barberry and almond (Prunus dulcis), [2]. Severe anemia is the most important prob- Purslane (Portulaca oleracea) and coriander lem of HMB that induced signs and symptoms (Coriandrum sativum) can decrease bleeding such as fatigue, headache, palpitation, dizzi- [6-9]. Eating lentil, especially with vinegar, ness, pallor and pica [3] and decreases the is effective in chronic uterine bleeding [6, quality of life in women [4]. There are medi- 7]. In PM, some nutrients can increase blood cal treatments to decrease bleeding including production in the body. Therefore, their con- antifbrinolytics, nonsteroidal anti-inflamma- sumption are useful for improvement anemia. tory drugs, hormone therapy and tranexamic These foods include: chicken, lamb, kebab, acid [5]. Although these drugs have effect on broth, half boiled egg, milk, grape (Vitis vinif- bleeding, but their several adverse reactions era) syrup, white mulberry (Morus alba) and such as cerebrovascular infarction, myocardi- fig (Ficus carica) [6-9]. Nutrition can have al infarction and pulmonary embolism are also negative effects on diseases. On the other significant [5]. Due to the side effects of med- hand, consumption of some food can increase ications, finding non-pharmacological and ef- vaginal bleeding that should be avoided [6- GMJ Correspondence to: Fataneh Hashem-Dabaghian, Associate Professor, Re- Copyright© 2020, Galen Medical Journal. This is search Institute for Islamic and Complementary Med- an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International icine, School of Persian Medicine, Iran University of License (http://creativecommons.org/licenses/by/4.0/) Medical Sciences, Tehran, Iran Email:[email protected] Telephone Number: +98 21 3395 0152 Email Address: [email protected] Yousefi ,F et al. Persian Medicine Treatment for Heavy Menstrual Bleeding Persian Medicine Treatment for Heavy Menstrual Bleeding Yousefi ,F et al. 9]. Therefore, patients with HMB should the endometrial vascular homeostasis with be avoided these foods including: cabbage various mechanisms such as suppressing va- (Brassica oleracea var. capitate), red beans sodilator (prostaglandins), increasing platelet (Phaseolus vulgaris), sesame (Sesamum in- aggregation, thromboxane, and PGF2a (vaso- dicum), onion (Allium cepa), celery (Apium constrictors) [13, 14]. Clinical studies confirm graveolens), turnip (Brassica rapa subsp. the efficacy of the cupping to reduce menstru- Rapa), carrot (Daucus carota subsp. Sativus), al bleeding [13, 15]. Recommended dietary garden cress (Lepidium sativum), radish (Ra- plan and dry cupping based on Persian Med- phanus raphanistrum subsp. Sativus), ginger icine can be effective in women with HMB. (Zingiber officinale), fenugreek (Trigonella Clinical studies was suggested for assessment foenum-graecum), cinnamon (Cinnamomum of the above dietary plan and dry cupping on verum), black seeds (Nigella sativa), date women with HMB. (Phoenix dactylifera), pennyroyal (Mentha pulegium) and bitter and spicy foods [6-9]. In Acknowledgement addition to nutrition, one of the non-pharma- cological methods for treatment of HMB is This study was a part of the Ph.D. thesis of dry cupping [6-9]. In this way, the glasses are Fatameh Yusefi. Fataneh Hashem-Dabaghian placed just below each breast and the vacuum was the supervisor and Jaleh Aliasl contribut- was created with a mechanical suction pump ed to the writing the manuscript. for reducing the menstrual bleeding [6, 7]. Ibn Sina believes that the dry cupping below the Conflict of Interest breast can moves substances including blood, from the uterus and can lead to reduced men- The authors declare that there is no conflict of strual bleeding [7]. On the other hand Razi interests. believed the uterus vessels is associated to the breast vessels therefore for stopping exces- [GMJ.2020;9:e1725] sive menstrual bleeding, you should put cups DOI:10.31661/gmj.v9i0.1725 below the breasts [6]. Various mechanisms have been proposed to reduce the severity of Keywords: Herbal Therapy; Heavy Menstru- menstrual bleeding with cupping. One of the al Bleeding; Hypermenorrhea; Complemen- mechanisms is the change in endometrial vas- tary Therapies; Traditional Medicine; Persian cular homeostasis [11, 12]. Cupping affects Medicine References 1. Samani RO, Hashiani AA, Razavi M, Vesali 5. Maybin JA, Critchley HO. Medical S, Rezaeinejad M, Maroufizadeh S, et al. The management of heavy menstrual bleeding. prevalence of menstrual disorders in Iran: A Women Health. 2016;12(1):27-34. systematic review and meta-analysis. Int J 6. Razi M. Alhavi-fi al- Teb. Beirut: Reprod Biomed. 2018;16(11):665. Darolkotob-e-elmia; 2000. 2. Hapangama DK, Bulmer JN. 7. Avicenna. Al Qanun Fi Al-Tibb(Arabic). Pathophysiology of heavy menstrual Beirut: Alaalami library; 2005. bleeding. Womens Health. 2016;12(1):3-13. 8. Azam Khan M. Exsir Azam (Persian). 3. Nelson AL, Ritchie JJ. Severe anemia Tehran: The Institute for Medical History- from heavy menstrual bleeding requires Islamic and Complementary Medicine, heightened attention. Am J Obstet Gynecol. Tehran University of Medical Sciences;; 2015;213(1):97. e1-. e6. 2004. 770- 4 p. 4. Peuranpää P, Heliövaara-Peippo S, Fraser I, 9. Arzani M. Tebe Akbari. Ehyae Tebe Tabiei Paavonen J, Hurskainen R. Effects of anemia Institute, editor. Qom: Jalaleddin; 2008. and iron deficiency on quality of life in 10. Jahangir A. Do nutritional deficiencies lead women with heavy menstrual bleeding. Acta to menstrual irregularities?. Int J Nutr Sci & Obstet Gynecol Scand. 2014;93(7):654-60. Food Tech. 2018; 4(3): 27-31. 2 GMJ.2020;9:e1725 www.gmj.ir Persian Medicine Treatment for Heavy Menstrual Bleeding Yousefi ,F et al. 11. Al-Kazazz FF, Abdulsattar SA, Mohammed 14. Chen B, Li M-Y, Liu P-D, Guo Y, Chen Z-L. K. Study effect of wet cupping on hemato- Alternative medicine: an update on cupping logical parameters and inflammatory proteins therapy. Q J Med. 2015;108:523-5. of healthy Iraqi men. Am J Phytomed Clin 15. Sultana A, Rahman KU. Effect of traditional Ther. 2014; 2(5): 644-9. dry cupping therapy on heavy menstrual 12. El-Sayed S, Mahmoud H, Nabo M. Medical bleeding in menorrhagia: A preliminary and Scientific Bases of Wet Cupping study. TANG (Int J Genuine Tradit Med. Therapy. Light of Modern Medicine and 2012; 2(4):e33. Prophetic Medicine. Altern Integr Med. 2013; 2(5). 13. Azizkhani M, Dastjerdi MV, Arani MT, Pirjani R, Sepidarkish M, Ghorat F, et al. Traditional Dry Cupping Therapy Versus Medroxyprogesterone Acetate in the Treatment of Idiopathic Menorrhagia: A Randomized Controlled Trial. Iran Red Crescent Med J. 2018; 20(2): e60508. 2 GMJ.2020;9:e1725 GMJ.2020;9:e1725 3 www.gmj.ir www.gmj.ir.
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