Dr Neha Bhagat
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
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.
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)
Besides not having periods, there are some other symptoms depending upon the cause of amenorrhoea;
- Pain in pelvic region.
- Changes in vision.
- 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
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 –
- a) Appetite-Decreased.
- b) Thirst- Thirtless
- c) Desire – Fruits
- d) Aversion – Meat
- e) Stool- Soft stool at night
- f) Urine- Nothing abnormal detected
- g) Sleep- Normal
- 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-
- a) Body weight – 40 Kg
- b) Built – Normal
- c) Nutritional status – Poorly nourished
- d) Pallor – Present
- e) Cyanosis – Absent
- f) Clubbing – Absent
- g) Lymphadenopathy – Absent
- h) Edema – Absent
- i) Thyroid enlargement – Absent
- j) Tongue – white coated
- k) Skin – Dark
- l) Nails – Pale
- m) Pulse – 80/min
- n) Respiratory rate – 20/ minute
- o) Temperature – 98.4°F
- Cardiovascular System – NAD
- Gastrointestinal System – NAD
- Respiratory System – NAD
- Central Nervous System – NAD
- Locomotor System – NAD
Laboratory investigation –
Blood – CBC
Diagnosis- Primary amenorrhoae
Analysis And Evaluation Of The Symptoms
Does not want to talk with anyone
Fear to be alone
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|
|Fear, Alone of being||Mind||43|
|Aversion, Food ,Meat||Stomach||481|
|Menses absent , Amenorrhea||Genitalia – Female||724|
Repertorization (Kent Repertory)(5)
|Fear, Alone of being||2||3||3|
|Aversion, Food ,Meat||3||3||2||2|
|Menses absent , Amenorrhea||3||3||2||3|
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
|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|
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.
- 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