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Vaginal discharge is also known as Leucorrhea. The flow of leucorrhea can be smooth or lumpy and sticky. This is a normal phenomenon that affects all women but may increase or decrease with age and when travelling. Vaginal discharge is the body’s way of removing dead cell and toxic material from the vaginal tract. It requires medical attention only when it changes colour and becomes darker or when the flow increases to a point where it cannot be stopped even when using a sanitary napkin.

There are a number of reasons why this flow may become excessive. These include:

Infections: The vagina is very susceptible to fungal, bacterial and parasitic infections. These infections can be promoted by poor hygiene, the use of synthetic underwear and unprotected sexual intercourse. An increase in vaginal discharge is usually one of the first signs of a vaginal infection.
Injury: Giving birth to a child, having an abortion or excessive sexual intercourse may irritate the lining of the vagina and cause an injury. This in turn can trigger leucorrhea.
Diseases: Diseases such as diabetes or anaemia may weaken the immune system and trigger vaginal infections causing an excessive discharge. A UTI (Urinary Tract Infection) or worms in the stomach may also spread infection to the vagina.

Contraceptives: Contraceptive sprays and jellies used during intercourse can irritate the vagina and cause excessive discharging. In some cases, irritation of an intra-uterine contraceptive device can also cause discharge and pain.
Bad hygiene: Not changing your underwear often enough, forgetting to change tampons or sharing public toilets can also increase vaginal discharge.
Leucorrhea can be prevented by keeping the genital area clean and dry, wearing cotton underwear, avoiding the use of cosmetics on the genital area and having safe intercourse. Drinking plenty of water will also help flush toxins from the body and control the flow of vaginal discharge.

If left untreated, this condition can spread to the uterus, fallopian tubes and cervix and can trigger pelvic inflammatory disease. In the case of post-menopausal women excessive vaginal discharge can also be considered a symptom of cervical cancer and hence must be analysed as soon as possible. However, this condition can be easily treated at home. Avoid eating sugar, hot and spicy food and alcohol to treat discharge. Eating curd can also help treat vaginal discharge as it contains lactic acid that cools the body. Also, avoid stress and strain as this can increase the discharge. If you wish to discuss about any specific problem, you can consult a gynaecologist.

Menstruation is a healthy experience of a woman’s life, and it must come habitually every 28 days, for a period of 3-4 days without coagulating, and the blood loss should correspond to about a quarter of a cup. For a woman, menstrual cycle is a virtuous indicator of her overall wellbeing. Some women get irregular periods that appear at longer intervals, an unpredictable discrepancy in the duration of the cycle and the normal twenty-eight day cycle is missing. Some women have very insignificant problems with menstrual cycles, while others experience a monthly torture.

Irregular menses is typical in early puberty and not generally perturbing. Women should be alarmed when periods are spaced out for more than two months, as this may suggest hormonal imbalance and ovulation problems. A woman’s customary hormonal cycle is contingent upon a subtle equilibrium between different hormones. Several potential triggers can stimulate hormonal imbalance leading to irregular menses. If a woman fails to ovulate, her ovaries will not receive a signal to produce a hormone called progesterone. Progesterone is essential in regulating the Uterine lining called endometrium, which is discarded during menstruation. Without progesterone, the endometrium persistently grows until it starts to break down and is disposed off as a very heavy uterine bleeding. The endometrium may also shed partially and intermittently, and bleeding becomes irregular or prolonged.

Causes of Irregular Menses:

-Puberty.
-Birth control pills.
-Stress.
-Poor diet due to anorexia, bulimia can influence your hormones.
-Excessive weight loss or gain.
-Intense exercise.
-Breast-feeding.
-Anxiety regarding pregnancy.
-Anemia.
-Menopause.

-Excessive production of Androgen (a steroid hormone such as testosterone that controls the development and maintenance of masculine characteristics).

-Uterine fibroids, cysts, polyps.

-Polycystic Ovarian Syndrome (in this condition the ovary does not make all the hormones needed for any egg to mature fully, due to which some follicles remain as cysts, ovulation does not occur and the hormone progesterone is not made. Without progesterone a woman’s menstrual cycle is irregular or absent).

-Endometriosis (this is a condition where cells similar to those found inside the uterus grow and are attached outside the uterus forming implants. This can lead to infertility and irregular menses).

-Pelvic infection.
-Ovarian cancer.
-Inflammatory Bowel disease.
-Thyroid disease.
-Heart disease.

Symptoms of Irregular Menses:

-Inconsistency in the length of menstrual cycle.
-Acne.
-Bloating.
-Low energy levels.
-Sore breasts.
-Fever.
-Chills.
-Changes in sexual desire.
-Infertility.
-Depression.
-Osteoporosis.
-Uterine cancer.

-Endometrial Hyperplasia (excessive cell growth in the inner lining of the uterus due to excessive estrogen production as a result of delayed ovulation).

Homeopathic Approach to Irregular Menses:

Homeopathy offers an extensive range of options than conventional medicine. Homeopathic treatment for Irregular Menstruation is very competent, non-invasive, safe and inexpensive. Homeopathy treats the patient as a whole and looks deeper into the problem, promotes the immune function and maintains uterine health by eliminating the causative factor. Homeopathic Constitutional treatment based on the holistic approach stimulates the natural hormonal balance without administering any harmful hormone preparations. The goal of this Homeopathic approach is to enliven the body's natural healing and self-repair ability to treat the underlying condition, to prevent it and to create the highest state of health and well-being.

Constitutional Homeopathic treatment with the management of an experienced and professional Homeopath is an excellent choice for Irregular Menstruation. Some Homeopathic remedies that are commonly used to treat Menstrual Irregularities are given below. These are just a few of the commonly used Homeopathic remedies and are mentioned only to create awareness about the effectiveness of Homeopathic medicines in Menstrual Irregularity. It is not advisable to resort to self-medication for any disease.

Homeopathic remedies for Irregular Menses:

Pulsatilla: Pulsatilla is one of the first remedies thought of, in affection, peculiar to women. It's essentially feminine disposition of gentleness timidity, mildness, docility – “excellent thing in woman” – is most characteristic of the drug; even tearfulness, another feminine attribute, strongly points to Pulsatilla. Then, we have fickleness, indecision and changeableness, which are certainly characteristic of Pulsatilla and of some women. Dark menses which are delayed and accompanied with this severe menstrual colic and the characteristic temperament will be the indications. The menses of Pulsatilla, besides being scanty, are quite apt to appear too late.

Caulophyllum: This is a valuable remedy in treating irregular periods, difficulty becoming pregnant or slow childbirth due to weak muscle tone of the uterus. The patient feels menstrual discomfort with heavy bleeding and drawing pains in the pelvic region, thighs, and legs. These patients complain of habitual abortion due to uterine debility.

Cimicifuga Racemosa: This remedy is intended for irregular and painful menses, with shooting pains that go down the hips and thighs, or cramps similar to labor-pains that are felt in the pelvic area. Women become restless, fearful, and depressed before a menstrual period. These women are strong, talkative, depressed, they try to injure themselves, and have dreams of impending evil, with fear of riding in a closed carriage.

Lachesis: This remedy is suggested to women who are passionate, with a tremendous need for an outlet, both physically and mentally. The menstrual flow is irregular, heavy and brings relief of tension. These patients are very outspoken with strong feelings of suspicion or jealousy. They have an intolerance of restrictive clothing around the waist or neck.

Lycopodium: This is an outstanding remedy for delayed menses that follows a heavy flow lasting more days. These patients have a ravenous appetite with a strong craving for sweets. They complain of abdominal bloating and flatulence, and always have a worried look with lack of confidence, though they may be bossy with their family.

Murex Purpurea: This remedy works amazingly in Irregular Menstruation with large clots and feeling of protrusion. These patients feel very weak, are very conscious of a womb, and feel as if something is pressing on a sore spot in the pelvis. This sore feeling is worse on sitting, hence the patient always sits with legs tightly crossed. Least contact of parts causes violent sexual excitement in these women.

Secale Cornutum: This is a useful remedy for Irregular menses in thin, shriveled skinned women. Their whole body is pervaded by a sense of great heat and they have burning pains in the uterus. Menses is irregular, dark and at times, there is continous oozing of watery blood until the next period. Their pregnancy concludes in a threatened abortion in the third month

Sepia: This remedy is best suited to women who feel weary and dragged-out, and are indifferent to their own family members. She feels taken for granted and overworked, becomes irritable and sarcastic if demands are made. Menses is delayed with a feeling that the pelvic floor is weak, or as if the uterus is sagging.
Self-care measures for Irregular Menses:

-Relax and ease stress.
-Avoid exhausting physical exercise.
-Eliminate any eating disorders.
-Eat a balanced diet with lots of fresh fruits and vegetables.
-Reduce your intake of salt and caffeine.

Hence, appreciate a natural way to a healthy uterus, convalesce healthy living and curtail the changes that happen during your menstrual years.

The word is no longer taboo. Both women and men, in recent times, have spoken out about menstrual health and there has been quite a lot of awareness over it through films and other medium.

Unfortunately, there is not as much awareness about the 'long lasting', 'stain free', 'soft' sanitary pads which different multinationals promote and which are easily available in any chemist. Experts point to the harm that these plastic-based sanitary napkins have been causing -- both to the environment and health.

"Most of the sanitary napkins in India are just thrown in the garbage or flushed down the toilet. It is a havoc environmental challenge as these pads take around 500-800 years to biodegrade," Swati Singh Sambyal, Waste Management Manager of Centre for Environment Science, told IANS.


"And every used sanitary napkin carries two grams of non-biodegradable plastic. So the amount of non-biodegradable plastic accumulated every month is very high, a factor strong enough to raise concern over the crisis which environment is facing currently," Sambyal noted.

According to the National Family Health Survey (NFHS) 2015-16 report, around 48 percent rural women use sanitary napkin while in urban areas the percentage is around 77 percent.

Recent data provided by Menstrual Health Alliance India states that menstrual waste collected across the country, primarily consisting of sanitary napkins which is disposed of as routine waste along with other household garbage, is 45 percent.

According to the Municipal Solid Waste (Management and Handling) Rules, 2,000 soiled napkins and blood-soaked cotton are disposed of after segregation into biodegradable and non-biodegradable components.

However, the Bio-Medical Waste (Management and Handling) Rules, 1998, says that items contaminated with blood and body fluids, including cotton, dressings, soiled plaster casts, lines and bedding, are bio-medical waste and should be incinerated, autoclaved or microwaved to destroy pathogens.

"If the pads are burnt it can produce dioxine and phuron. Categorisation of sanitary pads has always been a major issue. The products used in making a pad make it under Solid Waste Management Rule but it has got blood in it," Sambyal said.

She further explained that the longer used pads are kept in the open and kept in contact with air, the more they are prone towards becoming pathogenic". "Stagnant natural blood accumulates a lot of bacteria like Escherichia coli, which rapidly multiplies at an exponential rate," she explained.

And not just on environment, but health experts also raised concern over the problems that can arise with the use of plastic based sanitary napkins.

"There are high chances of getting fungal infections due to collection of moisture. Plastic-based sanitary pads might also lead to pelvic infection which can cause allergies and irritation in the vaginal area," said Anuradha Kapur, Director and Head of Unit - Institute of Obs and Gynae, Max Smart Super Speciality Hospital, Saket."

"In extreme cases, it may also cause vaginitis or vulvitis (also known as vaginal or vulva inflammation) and in some cases, might lead to pelvic inflammatory disease," she added.

However, in recent times, there has been some awareness about the damage being done to environment and methods are being adopted to dispose of sanitary napkins through disposal machines.

"MNCs who are coming up with many types of pads should also collectively or individually take up some initiatives; they need to come up with collective centres or provide with proper disposal system," Sambyal said.

Recently, Union Minister for Women and Child Development Maneka Gandhi also expressed her concern over improper disposal of sanitary napkins, saying that it can lead to serious consequences.

"They are often disposed of in ponds, rivers, which lead to blockage of drains. And if disposed of on the ground, it creates hygiene problems as it carries infection," Gandhi had said earlier.

She had also said that her ministry is in talks with Niti Aayog and other ministries for introducing a policy regarding setting up of sanitary napkin vending and disposal machines. As a measure to curb the damage being done to environment, the government on International Women's Day launched a biodegradable sanitary napkin called 'Suvidha' under the Pradhan Mantri Bharatiya Janaushadhi Pariyojana (PMBJP).

Launched by Union Minister for Chemicals and Fertilizers Ananth Kumar, the sanitary napkins will be available for Rs 2.50 per pad at over 3,200 Janaushadhi Kendras across India by May 28, 2018, which is also the World Menstrual Hygiene Day.

Other biodegradable napkins are also available. Mostly produced by small-scale manufacturers or NGOs, these biodegradable ones are based on natural products like banana or jute fibre or even re-usable clothes.

Anshu Gupta's Not Just a Piece of Cloth (NJPC) was amongst the first to start off with the concept of clean cloth pad. Recently a few more have joined the league like Ahmedabad-based Saathi and Tamil Nadu-based EcoFemme.

Polycystic ovary disease or PCOD is a kind of hormonal disorder in which a woman produces a surplus of male hormones like testosterone.
High levels of male hormones produce symptoms like irregular ovulation or no ovulation at all. In simple words, women with PCOD or PCOS don’t release a mature egg from their ovaries every month resulting in infertility. PCOD affects one in 10 women worldwide.

Women suffering from PCOD suffer from symptoms like heavy vaginal bleeding. This is because, as they don’t ovulate and produce the hormone Progesterone like normal women do and have normal periods, the lining of their uteri becomes thick leading to heavy bleeding and sometimes uterine cancer.

The other common symptoms of PCOS are:

Acne
Weight gain
Oily skin
Heart problems
Irregular periods
Migraines
Hirsuitism
Infertility
Mood swings and depression

There is a propensity for developing diabetes as well in PCOS affected, as a number of women with PCOD are resistant to the action of the hormone insulin used for sugar metabolism. This means that it takes larger than normal amounts of insulin to maintain normal blood sugar levels. Though fairly common, PCOD has no surefire cure in mainstream allopathic medicine but Ayurveda can help alleviate PCOD symptoms in a big way.

PCOD - How Ayurveda Can Help?

In Ayurveda, PCOD is caused due to an imbalance of any of the two doshas - Pitta (Fire) and Kapha (Water). Aggravated Pitta causes contamination of the dhatus or tissues like blood and plasma. This causes a buildup of toxins or ama in the body.

In PCOS patients, these toxins get accumulated in the channels of the mind, leading to an imbalance of hormones secreted by the pituitary gland. This results in an imbalance of female hormones and causes the formation of ovarian cysts which is nothing but a collection of fluids within the ovary, anovulatory periods or periods with no ovulation etc.

Ayurvedic herbal remedies for PCOD

Ayurveda works on these problems:
-Correcting hormonal imbalance
-Reducing obesity
- Reducing high cholesterol levels
-Treatment for insulin resistance
Herbs like Ashoka (saraca asoca), Dashamoola are amongst a group of herbs which are used to prepare Sukumara Kashaya like Ashwagandha, Eranda, Shatavari etc for correcting hormonal imbalance.

Other drugs for curing PCOS are-

1. Shatavari or Asparagus racemosus
This helps mainly in promoting normal development of ovarian follicles. It also regulates periods and aids in revitalizing the female reproductive system. Shatavari also helps in controlling high levels of insulin due to PCOS, due to its phytoestrogen or natural plant based estrogen levels.

2. Guduchi
Guduchi is a powerful anti- inflammatory herb. We know that chronic inflammation in body tissues is the root cause for insulin imbalance and ovarian cysts in women. This herb helps in revitalizing body tissues and lowering insulin resistance.

3. Shatapushpa or fennel
Fennel seeds are used as a supplement as the phytoestrogens in them bring down inflammation and control insulin resistance.

4.Triphala
Triphala is rich in vitamin C- a powerful natural antioxidant that helps in reducing inflammation by reducing free radicals. Hence this remedy is excellent for cleansing and detoxifying systems and is therefore best taken prior to taking any other Ayurvedic medicines to improve outcome.

5. Aloe Vera- Kumari (Aloe barbadensis)
Aloe Vera is yet another Ayurvedic herb that is extremely beneficial in treating PCOS as it helps in regularizing menstrual cycles and promote normal menstruation. It also normalizes hormonal imbalance.

Each woman has her own menstrual cycle pattern. Some women have almost same menstrual cycles that begin and end almost in a synchronized manner with little problem, but some women face various difficulties in menstruation period due to major fluctuations. Although minor fluctuations usually occur but there is a medical condition called menstrual disorder which is characterized by some peculiar signs and symptoms.

The menstrual disorder is actually diagnosed when a woman is facing a problem of irregular periods along with profoundly painful cramps, premenstrual syndrome, abnormally high bleeding and missing their menstrual cycles very often.

There can be different causes due to which menstrual disorder occur which are listed as following:

There can be certain problems associated with ovulation in females

There can be abnormal secretion of hormones which can cause imbalance in hormonal levels

There can be genetic link to this disorder such as abnormality in chromosomes or genes

There can be clotting issues

Stressful situations cause a major effect in regulation of menstrual cycles. The more the women feel stressful, the more irregularities in menstrual cycles are observed.

MenstrualThyroid problems and eating disorders are also associated with menstrual disorder.

Menstrual disorder is not only about heavy bleeding but in certain condition, there could be be no bleeding at all. This condition is called as amenorrhea. It is usually diagnosed when a girl does not get her periods even after 16 years of age. It can occur due to hyperthyroidism, cysts in ovaries, not controlling birth frequencies, pregnancy, recurrent pregnancy loss, eating disorders etc.

Hence, to diagnose this medical condition, the affected female should immediately contact the gynecologist. The doctor can speculate the symptoms and for how long they are persisting. The gynecologist may conduct a pelvic exam in order to ensure if there is any inflammation in the vagina or cervix region. The blood tests can also determine the hormonal imbalances. The possibility of cancer in cervical region can be checked by conducting Pap smear test. In order to diagnose the additional menstrual disorder, the gynecologist or the respective medical healthcare provider may conduct additional tests such as endometrial biopsy, hysteroscopy and ultrasound.

Once the diagnosis is performed, the treatment can be given maybe in terms of medicines or other alternatives to treat this problem effectively. Make sure that certain irregularities in periods are completely normal, but as soon as you may see the menstrual cycle patterns going abnormally for persistently more extended periods of time, then you should immediately contact your healthcare practitioner.

Dr. Jyoti Kumari
Dr. Jyoti Kumari
BDS, Chest Physician Child Abuse Pediatrician, Ranchi
Dr. Amol Sonawane
Dr. Amol Sonawane
BHMS, Homeopath, 10 yrs, Pune
Dr. Anjanikumar Malempati
Dr. Anjanikumar Malempati
MBBS, ENT Specialist, 10 yrs, Pune
Dr. Manisha Garud
Dr. Manisha Garud
BDS, Dental Surgeon Dentist, Pune
Dr. Pallavi U Bhurse
Dr. Pallavi U Bhurse
BAMS, Ayurveda Family Physician, 5 yrs, Pune
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