Concept of Kasrat-e-Tams (Heavy Menstrual Bleeding)

Heavy Menstrual Bleeding (HMB), also referred to as Kasrat-e-Tams in Unani medicine, is a common gynecological concern that significantly affects the quality of life in reproductive-age women. HMB is a clinical condition marked by excessive menstrual blood loss, either in volume or duration, that interferes with physical, social, emotional, and maternal well-being. Approximately 90% of women with an underlying bleeding disorder and 70% of those on anticoagulant therapy experience HMB. The presence of large blood clots, frequent pad or tampon changes, and night-time bleeding are key diagnostic indicators. In Unani literature, the condition is attributed to su-e-mizaj (abnormal temperament) of the uterus, weakness of uterine vessels, humoral imbalances (dominance of Safra, Balgham, or Sawda), and altered uterine functions such as impaired retentive and expulsive powers. This paper reviews the modern and traditional perspectives on HMB, outlines its aetiologies and symptoms, and proposes a hierarchical approach to management beginning with lifestyle and dietary changes, progressing through medical therapy, and concluding with surgical interventions when necessary. Unani management focuses on restoring humoral balance, detoxification, strengthening the uterus, and using astringent formulations such as Qurs Habis and Safoof Habis