Amenorrhoea and its homoeopathic treatment

Dr Neha Bhagat 

Abstract
Amenorrhoea is the absence or abnormal cessation of spontaneous menstruation in a woman of reproductive age. Amenorrhoea is a symptom, not a disease, and has a variety of causes. It may be physiological and pathological. Physiological states of amenorrhoea are, seen most during pregnancy and lactation. This article emphasis on incidence, clinical features and management of Amenorrhoea with homeopathic medicines.

Keywords: Amenorrhoea, Homoeopathy, Therapeutics.

Introduction – Amenorrhoea literally means absence of menstruation. It is a normal feature in prepubertal, pregnant, lactating and postmenopausal women and should be excluded before diagnosis.

Types of Amenorrhoea
1.Physiological Amenorrhoea:-This type of amenorrhoea occurs
During pregnancy
During lactation
Before puberty
Following menopause

2.Pathological Amenorrhoea:-
Cryptomenorrhoea
Primary Amenorrhoea
Secondary Amenorrhoea

PRIMARY AMENORRHEA
A young girl who has not yet menstruated by her 16 years of age is having primary amenorrhoea rather than delayed menarche. The normal upper age limit for menarche is 15 years.
In view of lower mean age of menarche, currently a cut off value at 14 years (in the absence of secondary sexual characters) and 16 years (presence of secondary sexual characters) is being considered.

SECONDARY AMENORRHEA
It is the absence of menstruation for 6 months or more in a woman in whom normal menstruation has been established. It causes stress, contraceptive pills, pcos, premature ovarian failure, weight gain and weight loss, poor nutrition, thyroid. (1) (2)

AMENORRHOEA SYMPTOMS
Besides not having periods, there are some other symptoms depending upon the cause of amenorrhoea;

• Pain in pelvic region.
• Changes in vision.
• Headache
• Acne
• Hair loss
• More hair growth on face
• A milky discharge from nipples
• No breast development (in primary amenorrhoea)

HOMOEOPATHIC THERAPEUTIC APPROACH FOR AMENORRHOEA:
There are number of homoeopathic medicines which can be helpful in case of Amenorrhoea. Some medicines are:

Aconitum Napellus – Amenorrhoea during puberty. Suppressed menses from fright, cold. Menses too protracted, late. Frenzy, fury on appearance of menses.

Apis Mellifica – Amenorrhoea of puberty. Menses suppressed with mental and head symptoms, especially in young girls. Hysterical girls at puberty.

Graphites – Menses too late, with constipation; pale and scanty, with tearing pan in epigastrium, and itching before. Menses scanty, pale, irregular, painful.

Ignatia Amara – Amenorrhoea, suppressed menses from grief, sighing before menses. Constant burning heat in vagina worse before menses.

Kali Carbonicum – Amenorrhoea with backache. Difficult first menses. Menses delayed in young girls with chest symptoms & ascites. Suppressed menses with anasarca or ascites.

Natrium Muriaticum – Delayed first menses, amenorrhoea. Suppressed menses from grieg, from putting feet in cold water.Menses irregular usually profuse.Hot during menses, Menses painful from getting feet wet.

Pulsatilla – Amenorrhoea, from wet feet, nervous debility, anemia or chlorosis. Menses delayed at puberty. Suppressed menses. Dark, thick menses. Menses too late, scanty after bathing. Menses clotted, changeable flow more during day while walking about menses intermittent, irregular, or vicarious, Tardy menses, bearing down pain, worse
lying.

Sepia – Menses too late & scanty, irregular, early and profuse, sharp clutching pains. Violent stitches upward in the vagina from uterus to umbilicus.

Sulphur – Amenorrhoea, Suppressed of menses from excitement. Menses preceded by headache or suddenly stopped. Menses too late, short, scanty & difficult, thick, black, acrid, making parts sore. (3)(4)

Case Profile :

Personal Information –

a.)  Name  –  A. Sharma

b.)  Age  –  18 years

c.)  Sex  – Female

d.) Address  –   Barewal, Ludhiana

e.) Marrital status –  Unmarried

f.)  Religion   – Hindu

Date – 2.3.2018

Presenting  Complaints –

• Complaints of  Absence  of  menstruation.
• Absent  of  axillary  and  pubic  hair  and undeveloped breast.

History Of Present  Complaints –

• Absence  of  menstruation.  Severe  cramping pain in abdomen. since 2 years.

Personal History –

Marital relations – Single

Past History –  Anaemia  with lack  of  appetite,

history of taking iron pills.

Family History –

Mother  –  Diabetes,  Hypertension,  Ovarian cyst

Father – Diabetes

Sister – PCOD

Grandmother – Diabetes, Uterine fibroid

Grandfather – Diabetes

Menstrual History – Menses does not appear

Physical Generals –

1. a) Appetite-Decreased.
2. b) Thirst- Thirtless
3. c) Desire – Fruits
4. d) Aversion – Meat
5. e) Stool- Soft stool at night
6. f) Urine- Nothing abnormal detected
7. g) Sleep- Normal
8. h) Thermal Reaction – Hot

Mental Generals –

• Sensitive  girl,  weeps  easily;  weep  when
• mother  mother  scolds  her.  Fear  to  be  alone.
• Does  not  want  to  talk  with  anyone.  Cannot share her feelings. Patient is emotional.

General Physical Examination-

1. a) Body weight – 40 Kg
2. b) Built – Normal
3. c) Nutritional status – Poorly nourished
4. d) Pallor – Present
5. e) Cyanosis – Absent
6. f) Clubbing – Absent
7. g) Lymphadenopathy – Absent
8. h) Edema – Absent
9. i) Thyroid enlargement – Absent
10. j) Tongue – white coated
11. k) Skin – Dark
12. l) Nails –  Pale
13. m) Pulse – 80/min
14. n) Respiratory rate – 20/ minute
15. o) Temperature – 98.4°F

Systemic Examination

1. Cardiovascular System – NAD
2. Gastrointestinal System – NAD
3. Respiratory System – NAD
4. Central Nervous System – NAD
5. Locomotor System – NAD

Laboratory investigation –

Blood – CBC

Diagnosis- Primary amenorrhoae

Analysis And Evaluation Of The Symptoms

Mental general

Does not want to talk with anyone

Fear to be alone

Physical general

Aversion to meat

Soft stool particular absence of menstruation

Conversion Of the Symptom Into Rubrics
Does not want to talk with anyone – Talk, indisposed to
Fear to be alone – Fear, alone of being
Aversion to meat – Aversion, food, meat
Soft stool – soft, stool
Absence of menstruation – Menses, absent amenorrhea.

Rubrics in Kent Repertory- 

Ruberic Taken	Chapter	Page No
Talk,Indisposed to	Mind	86
Fear, Alone of being	Mind	43
Aversion, Food ,Meat	Stomach	481
Soft Stool	Stool	642
Menses absent , Amenorrhea	Genitalia – Female	724

Repertorization (Kent Repertory)(5)

Ruberic Taken	Puls.	Sulph.	Ars.	Lyc.
Talk,Indisposed to	3	3	2	2
Fear, Alone of being	2		3	3
Aversion, Food ,Meat	3	3	2	2
Soft Stool	2	3	2	1
Menses absent , Amenorrhea	3	3	2	3
Total	13/5	12/4	11/5	11/5

Repertorial Result

Puls. – 13/5

Sulp – 12/4 Ars – 11/5

Lyc – 11/5

Analysis Of Result –

As seen in repertorial chart,

Pulstilla 13/5 and Sulphur 12/4, Arsenic album 11/5 and lycopodium 11/5are very close to each other. Pulstillla medicine prescribed because patient is sensitive, fear to be alone. As patient suffering from amenorrhea.

Final Prescription –

Pulstilla Nigricans 200

Dose – Single

Mode of administration – Oral

Date – 10.5.2022

Follow Up       

Date	Follow up	Prescription
10.05.2022	As per repetorization	Puls 200/1Dose,Sl-2 Dram- 4Globules/Tds for 1 month
12.06.2022	No Menses appear	Sl-2 Dram-4 Globules /Tds for 1 month
13.07.2022	Menses Scanty	Puls 200/1 Dose, Sl-2 Dram -4 globules for 1 month
15.08.2022	Menses Appear	Sl-2 Dram -4 Globules/Tds for 1 month

RESULT-Patient Improved

Conclusion
This case show that  homoeopathic medicines are used frequently in Amenorrhoea with good results. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach.This is the only way through which a state of complete health can be regained by removing all the sign and symptoms. The aim of Homoeopathy is not only to treat amenorrhoea but to address its underlying cause and susceptibility.

References

• Dutta’s DC. Textbook of Gynaecology. New Delhi. Jaypee brothers medical publisher(p) ltd. 2011
• Salhan S. Textbook of Gynecology. First edition. New Delhi: Jaypee brothers medical publisher(p) ltd. 2011.
•  Boericke W. Boericke OE. New manual of Homoeopathic Materia medica with repertory. 3rd Revised and Augmented Ed. New Delhi: BJain Publishers;
• MurphyR.Lotus Materia Medica. Third edition.New Delhi.BJain publishers;2010
• Kent James Tayler. Lectures on Homoeopathic  Philosophy. Memorial Edition   Reprint . B.Jain Publishers Pvt. Ltd New Delhi,2004

Dr Neha Bhagat
P G Scholar, Homoeopathic Materia Medica
Shri Guru Nanak Dev Homoeopathic
Medical College and Hospital, Ludhiana