An Observational Study to establish relationship between Anaemia and Primary Dysmenorrhoea

Ruchi Mehta¹, Anju Bishnoi²

ABSTRACT: Primary dysmenorrhoea is defined as menstrual pain not associated with macroscopic pelvic pathology. An observational study was undertaken by the homoeopathy university, at saipura,Sanganer.

KEY WORD- dysmenorrhoea, anaemia, homoeopathy.

Aim: To establish the relationship between Anaemia and primary dysmenorrhoea.

Objectives: To study the effectiveness of holistic approach in cases of primary dysmenorrhoea.

Introduction: The term ‘Dysmenorrhoea’ is derived from the greek words ‘dys’ meaning difficult/painful/abnormal; ‘meno’ meaning month and ‘rrhoea’ meaning flow^[1]

• Worldwide prevalence of primary dysmenorrhoea -Among the limited studies identified, the prevalence of dysmenorrhea varies substantially from 16% to 91%. The lowest prevalence of 16% reported in a random sample of Japanese women aged 17–51 years was attributed to   the short study period (1month) and potential under reporting of mild menstrual pain. Disregarding this lowest rate and that of 28% reported in women with a mean age of giving birth at 19.9 years from a traditional society in Mexico, the prevalence of 37%– 91% reported in other studies is very similar to the range of 45%–97% reported from community-based studies in the World Health Organization review and the range of 43%–90% reported in earlier literature.^[2]
• In India, prevalence of dysmenorrhoea varies from 33% – 79.67%. However the true incidence & prevalence of dysmenorrhoea are not clearly established in India. Due to dysmenorrhea sickness absenteeism (28-48%) and perceived quality of life losses are prevalent among adolescent girls.^[3]
• In Rajasthan-A Cross-sectional study of 200 urban and 200 rural school going adolescent girls held at Udaipur and Bedla Districts, Rajasthan shows the prevalence of dysmenorrhea was found to be very high (81.5 % rural and 76 % urban).^[4]

• A review article named-Primary Dysmenorrhea and Menstrual Symptoms in Indian Female Students: Prevalence, Impact and Management shows the Prevalence of dysmenorrhea was 70.2%.^[5]

Primary dysmenorrhoea is purely functional and homoeopathic medicines both constitutional anti miasmatic and specific medicines are highly effective in its treatment.^[6] Painful menstruation affects many women. For a small number of women, such discomfort makes it next to impossible to perform normal household, job, or school-related activities for a few days during each menstrual cycle. It is the leading cause of lost time from school and work among women in their teens and 20’s.^[7] 

Materials And Method: 25 patients of age group 13-40 suffering from primary dysmenorrhoea were enrolled in the study. It was a 9 months study. VAS scale was used for analysis of each case.

And blood routine investigations (Hb%, WBC, TLC and DLC) were done for at first visit and repeated after 3 months of treatment

Homoeopathic medicines, based on the totality of symptoms and repertorization were prescribed. Result was analyzed using statistical method of SPSS version 20.

Observations And Results: During the study, we took 25 patient of age group 13-40 with primary dysmenorrhea. Out of that, 8 patients (32%)  were with Hb level above 10 gm % and there VAS score was 4, 7 patients (28%) with Hb level below 9gm % and there VAS score was 6, 5 patients (20%) with Hb level above 9gm% and there VAS score was 5, 2 patients (8%) with Hb level 7gm% and VAS score was 7,2 patients (8%) with Hb level 11gm% and there VAS score was 3, 1 patient (4%) was with Hb level 7gm% and its VAS score was 9. In the case taking we took all symptoms of the patient including symptoms regarding character and intensity of pain during menses, location and extension of pain & associated symptoms.

After homoeopathic treatment 4 patients were completely cured with Hb level 14gm% and there VAS score was 0, 7 patients improved a lot with Hb level 12 gm% and there VAS score was 2, 10 patients with Hb level 13gm% and there VAS score is 1, 4 patients still had dysmenorrhea with Hb level 11gm% and there VAS score was 3.

After the study of 25 patients we can say primary dysmenorrhoea is definitely related to anaemia, because when the level of Hb is decreased, the intensity of pain during menses is high and when the patient is cured with anaemia, intensity of pain during menses is also gradually decrease.

THERAPEUTICS ANALYSIS ^[8]

S.no.	Name Of Medicine	Mental Generals	Physical Generals	Particulars
1.	Xanthoxyllum fraxineum	Nervous, frightened, mental depression.	Women of spare habit, Delicate. Nervous temperament. Dream of suffocation wakes her. Thirst marked.	Ovarian pain with scanty and retarded menses, extending down genito-crural nerves. Menses appeared one week before. Bright red profuse flow, Bearing down pain. With headache specially over left eye commencing day before menses.
2.	Viburnum opulus	Irritable, wishes to be alone. Confusion & inability to concentrate thoughts. Depressed.	Nervous rheumatic diathesis. Tongue- broad & white with brown centre & imprints of teeth.	Crampy, colicky pains in both ovarian regions, extending down thighs. Menses too early profuse & offensive; too late scanty, thin light coloured, lasting but a few hours. Membranous dysmenorrhoea.
3.	Magnesium phosphoricum	Laments all the time about the pain. Inability to think clearly.	Suited to tired, languid, exhausted subjects. Thirst for very cold drinks.	Membranous dysmenorrhoea. Menstrual colic, pain precedes flow. Flow dark, fibrinous, stringy. Worse right side. Better from heat, bending double, pressure, friction & by flow. Great weakness with menses.
4.	Ustilago maydis	Depression of spirits in afternoon. The day seems like a dream.	Tongue- coated in morning.	Menses too scanty with ovarian irritation; too profuse & too early. Blood clotted; as if everything would come out.
5.	Coffea cruda	Oversensitiveness; weeping mood. Great anguish; cannot be composed.	Suited to tall, lean, stuped persons with dark complexions. Temperament choleric & sanguine.	Menses too early & long lasting. Dysmenorrhoea, large clots of black blood. As if abdomen would burst; cannot suffer the clothes to be tied on the abdomen.

References:

1. Dawn CS. Text book of gynaecology, described for students and practitioners.12th       ed.Calcutta:Dawn;1963.
2. Ju H,Jones M,Mishra G. The Prevalence and Risk Factors of Dysmenorrhoea. Epidemiologic  reviews. Epidemiol Rev 2014[cited 2018 may 26] ;36:104–113.Available from:https://www.researchgate.net/publication/258958436 .
3. Kumbhar SK,Reddy M,B S,et al. Prevalence Of Dysmenorrhea Among Adolescent Girls (14-19 Yrs) Of Kadapa District And Its Impact On Quality Of Life: A Cross Sectional Study. National Journal of Community Medicine 2011[cited 2018 may 26];2(2):265-268.Available from:https://www.researchgate.net/publication/285633389.
4. Chauhan M,Kala J. Relation Between Dysmenorrhea and Body Mass Index in Adolescents with Rural Versus Urban Variation.J Obstet Gynaecol India.2012 Aug[cited 2018 may 26]; 62(4): 442–445.Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC350094
5. Omidvar S,Bakouei F,Nasiri Amiri FN,et al. Primary Dysmenorrhea and Menstrual Symptoms in Indian Female Students: Prevalence, Impact and Management .Global Journal of Health Science2016[cited2018may26];8(8):135-144.Available from:http://www.nlm.nih.gov/pmc/articles/PMC5016343.
6. Jose L.Efficacy and significance of homoeopathy in Primary Dysmenorrhoea.2012.[Internet].Available from:https://www.homeobook.com/efficacy-and-significance-of-homoeopathy-in-dysmenorrhoea/[cited 2018 may 26].
7. Saem.The effect of Viburnum opulus 3X on females with primary dysmenorrhoea.2017.Available from:http://hdl.handle.net/10210/231599.
8. Clarke JH.A Dictionary of Practical Material Medica.3^rded.NewDelhi:B Jain   (P)Ltd;volume 3,2005.

Dr. Ruchi Mehta PhD, MD (Hom)  
Assistant Professor, Department Of  Obstetrics and Gyneacology,Homoeopathy University, Jaipur.
Email: drrruchimehta1980@gmail.com

Dr. Anju Bishnoi  PGT
Department Of Materia Medica       
Dr. MPK Homoeopathic Medical college Homoeopathy University, Jaipur
Email:- anjubishnoi129@gmail.com