Nutraceuticals and abnormal uterine bleeding

Abnormal uterine bleeding (AUB) is irregular uterine bleeding that occurs in the absence of pathology or medical illness. It reflects a disruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining. The bleeding is unpredictable in many ways. It might be excessively heavy or light, prolonged, frequent, or random.
This condition usually is associated with anovulatory menstrual cycles but also can present in patients with oligo-ovulation. AUB occurs without recognisable pelvic pathology, general medical disease, or pregnancy. It is considered a diagnosis of exclusion.
AUB is a common diagnosis, making up 5-10% of cases in the outpatient clinic setting. Patients with abnormal uterine bleeding (AUB) have lost cyclic endometrial stimulation that arises from the ovulatory cycle. As a result, these patients have constant, non-cycling estrogen levels that stimulate endometrial growth. Proliferation without periodic shedding causes the endometrium to outgrow its blood supply. The tissue breaks down and sloughs from the uterus. Subsequent healing of the endometrium is irregular and dyssynchronous.
Chronic stimulation by low levels of estrogen will result in infrequent, light AUB. Chronic stimulation from higher levels of estrogen will lead to episodes of frequent, heavy bleeding. Anovulatory cycles are associated with a variety of bleeding manifestations. Estrogen withdrawal bleeding and estrogen breakthrough bleeding are the most common spontaneous patterns encountered in clinical practice. Iatrogenically induced anovulatory uterine bleeding might occur during treatment with oral contraceptives, progestin-only preparations, or postmenopausal steroid replacement therapy.
It should also be noted that some chemicals in the environment and natural compounds found in the diet can affect the activity of hormone receptors, particularly the estrogen (female sex hormone) receptor. Such interaction can potentially lead to disturbances in hormone homeostasis and inappropriate regulation of target genes.
These xenobiotic ‘endocrine disrupting chemicals’ have the potential to impact many body systems by inappropriately activating or interfering with the activity of hormone receptors. As a result, endocrine disruption is a growing concern that is being studied intensively in many laboratories around the world.
Nutraceuticals help in hormone synthesis as well as their regulation and balance. Trace elements zinc and selenium have an important role in synthesis of thyroid hormone. Selenium not only helps in synthesis, it is also important for conversion of thyroid hormone to biologically active form in the body.
Vitamins and minerals are essential components which play important role in hormonal regulation. One such example is magnesium. Magnesium is used in the body in hundreds of reactions and in everything from proper hormone function, to cell regeneration and healthy bone formation.
They suffer from postmenopausal symptoms like mood changes, hot flushes etc. due to reducing level of estro gen (female sex hormone). As a result, lots of studies are being conducted to study the effect of various nutritional supplements to restore the balance. Nutraceuticals like Vitamin E, bioflavonoids and Vitamin C have shown to have some effectiveness in treating Dysfunctional uterine bleeding.
A deficiency of Iodine affects not only the thyroid gland but also the adrenals, ovaries and testes. It is therefore a major factor in fertility and other hormonal problems. One of the most common reasons for fertility problems, such as failure to get pregnant and miscarriage, is simply a chronic iodine deficiency which can be treated with iodine supplementation.
It should be noted that menstrual disturbances can be due to different pathologies and may vary from person to person. They are also changeable and may transform into each other over time. There is no exclusive therapy for dysfunctional uterine bleeding; each regime is customised from the independent conditions that exist within each individual; It may also need adjustment during the course of treatment so as to fit the changing condition.
Thus, in view of largely inadequate dietary habits and growing evidence implicating role of nutritional supplements in hormonal regulation, nutraceuticals form an integral part of today’s lifestyle for replenishing the deficits and ultimately able to keep up the body homeostasis.