HERBAL DRUG “AYAPON” (ALARSIN)
IN DYSFUNCTIONAL UTERINE BLEEDING

HERBAL DRUG AYAPON (ALARSIN)
IN DYSFUNCTIONAL UTERINE BLEEDING

It is becoming increasingly evident now that in a number of diseased conditions, indigenous herbal medicines can offer an equivalent or often better chance of cure as compared to an allopathic formulation.

One such striking example is the use of Ayurvedic herbal drugs to treat Dysfunctional Uterine Haemorrhages. The Dysfunctional Uterine Bleeding may be defined as abnormal and excessive uterine bleeding for which a gross organic cause cannot be found.

Moreover, in the recent period, a number of cases come with excessive uterine bleeding where the loop has been inserted as a contraceptive measure.

These days due to various factors incidence of Dysfunctional Uterine Haemorrhages is surprisingly high both in general as well as consulting practice.

MATERIAL & METHODS

This study was carried out on 150 cases of Dysfunctional Uterine Haemorrhage and Haemorrhage after abortion, miscarriage or delivery.

No apparent case with an organic pathologic condition, such as Fibromyomas, Adenomyosis, Tube-ovarian masses etc., was selected.

100 cases were used as controls, wherein the usual modes of treatment were employed. The study was carried out over 3½ years from July 1968 to December 1971.

DRUG USED

Tablet AYAPON (ALARSIN) was used in the trial.

PHARMACOLOGY

1. AYAPAN: (Eupatorium ayapana): Is prepared from the dried leaves of Eupatorium ayapana, contains ayapin (6 : 7 methylene dioxycoumarin), ayapanin (7-methylene coumarin) and an essential volatile oil. Both ayapin and ayapanin possess haemostatic property when applied locally or taken internally. Ayapan has been used effectively to check internal haemorrhage.
2. ASHOKA: (Saraca indica): is the bark of the tree possessing strongly astringent and uterine sedative properties. It acts on the muscular fibres of the uterus and exerts a stimulating effect on the endometrium and the ovarian tissue, and has been used in uterine affections, specially menorrhagia, due to uterine fibroids and other causes.
3. GODANTI: (Gypsum): Is hydrated calcium. It has been recommended in Ayurvedic literature for treatment of menorrhagia.
4. NAGKESHAR: (Mesua ferrea): It is astringent and haemostatic. It decreases acute bleeding and is therefore useful in Uterine Bleeding. Ashoka and Nagkeshar combination give pronounced haemostatic effect in arresting Functional Uterine Bleeding.

DOSAGE

TABLE-I : AGE GROUP & PARITY

TABLE-II : AETIOLOGY

RESULTS

Results were evaluated depending upon the degree of response. They were classified as:

Excellent — Good — Fair — Poor (Little or no response)

DISCUSSION

Functional Uterine Haemorrhage has so far been treated with haemostatics and hormones. All the three sex hormones have been used by various authors and in varying dosage.

The original and best tried mode of therapy is using Estrogenic preparations especially in pubertal menorrhagia, while progesterone is used in premenopausal bleeding; i.e. in cases of metropathia haemorrhagica to induce the medical curettage.

Parenteral preparations has been tried time and again, but do not seem to have any major advantage over oral treatment, though premarine injection is given successfully in some cases.

These forms of therapy have certain disadvantages, one of the most discomforting being nausea during the administration of estrogens. Moreover these drugs must be taken very punctually failing which another bout of withdrawal bleeding results.

Androgens are used mainly parenterally and given in Intramuscular Injections of 25 mg. per day. This is capable of completely arresting haemorrhage in 48-72 hours.

Androgens act by antigonadotropic activity through the hypothalamic hypophysial effect on the ovary (inhibition of follicle formation), by direct action on the estrogens in the blood and endometrium or by local haemostatic action on the endometrium.

Sometimes androgens are combined with Oestrogens and sometimes with both Oestrogens and Progesterone.

However, the use of androgens is necessarily restricted because of the ever present danger of virilisation which can never be completely reversed, and so androgens can only be used in women over 35.

Recent reports show encouraging results with the use of non-virilising androgens which have still to be substantiated.

Progesterone by itself was sometimes used in the initial treatment of functional uterine haemorrhage. The advent of the newer progesterones has radically altered this and today the mainstay of treatment is the use of various contraceptive tablets in various doses.

All these drugs however if used for a long time have a number of side effects which are very well known by now like migraine, thrombo embolic phenomena etc. Moreover menorrhagia recurs as soon as the drugs are withdrawn.

For long term use therefore all these drugs do not achieve the maximum safety and effectiveness desired. Here lies the usefulness of an indigenous drug which is both safe and effective either for short or long term therapy.

CONCLUSION

In cases of dysfunctional uterine haemorrhages AYAPON (Alarsin):

1. Controls irregular and profuse uterine
2. Restores the normal function of the uterus.
3. Restores normal rhythm of the menstrual cycle.

ACKNOWLEDGEMENT

I am thankful to M/s. ALARSIN, Bombay-1 for their continued co-operation for completion of these trials.

REFERENCES

1. Ghosh: Pharmacology (1957), Materia Medica and Therapeutics; 20th Edition, Hilton & Co., Calcutta.
2. R. Jahagirdar (1970) Place of Indigenous drug AYAPON in D.U.B.; Paper before XVI Conference of International College of Surgeons, Hyderabad.
3. Javeri Veenaben: (1965) Treatment of Functional Uterine Bleeding (A clinical study with AYAPON); Indian Practitioner, 18: 783.
4. Kodkany Kamal B (1968) Use of ‘AYAPON’ in Uterine Bleeding after IUCD; Indian Practitioner, 21: 901.
5. Mehta A. (1964) Use of an Eupatorium AYAPAN combination in Functional Uterine Bleeding; Paper before the Scientific session of 40th All India Medical Conference at Kakinada.
6. Rama Mitra: (1968) Value of Herbal drug in Functional Uterine Bleeding; Mediscope, 11: 11.
7. Pandya C. et al: (1963) Value of indigenous drugs in Menorrhagia; Current Medical Practice, 7: 8, 543.
8. Phadnis N.: (1964) Use of Ayapon Compound in Functional Uterine Haemorrhages; Antiseptic, 61: 10, 683.
9. Rohatgi Pratibha (1966) Functional Uterine Bleeding: Treatment with an Indigenous Drug AYAPON; Antiseptic, 63: 11, 674.
10. Shelat Ramesh and Shah Usha (1966) Value of Herbal Drugs in Functional Uterine Bleeding; Indian Practitioner, 19: 11, 697.