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

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 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, 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 confict 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

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