Correlation of Mizaj (Temperament) with Clinical Outcomes in the Treatment of Kasrat-e-Tams (Heavy Menstrual Bleeding) Using Unani Pharmacopeial Formulation QursHabis

Background: Heavy menstrual bleeding (Kasrat-e-Tams) affects 4-51.6% of women globally, significantly impacting quality of life. The Unani concept of Mizaj (temperament) offers a personalized approach to treatment, yet its correlation with clinical outcomes remains underexplored. Objective: To investigate the correlation between Mizaj assessment and clinical outcomes in patients with Kasrat-e-Tams treated with the Unani formulation QursHabis. Methods: A secondary analysis was conducted on data from a multi-centric, open-label clinical trial involving 168 women aged 18-45 years with menorrhagia. Participants were classified into four temperamental categories: Damvi (Sanguineous), Balghami (Phlegmatic), Safravi (Bilious), and Saudavi (Melancholic). QursHabis(250mg) was administered twice daily for 9 days per menstrual cycle over three consecutive cycles. Outcomes measured included menstrual blood loss reduction, pain scores, and overall treatment response. Results: The majority of patients had Balghami temperament (60.7%), followed by Damvi (25.0%), Safravi (13.1%), and Saudavi (1.2%). The overall treatment success rate was 75.0%. Damvi temperament patients demonstrated the highest response rate (48.7±22.3%) and success rate (81.0%), with 60.0% reduction in menstrual blood loss and 69.1% reduction in pain scores. The correlation between Mizaj and treatment response was statistically significant (χ²=6.847, p<0.05). Additionally, 73.8% of patients showed improvement in temperament balance post-treatment. Conclusion: Mizaj assessment serves as a significant predictor of treatment outcomes in managing Kasrat-e-Tams with QursHabis. Patients with Damvi temperament showed superior therapeutic responses, supporting the implementation of temperament-based personalized treatment protocols in Unani medicine.