Adenomyosis is characterized by uterine enlargement caused by ectopic rests of endometrium located deep within the myometrium. It has 2 types.
- Diffuse –ectopic rests scattered throughout the myometrium
- Focal – ectopic rests form circumscribed nodular focal collection with a pseudo capsule
Pathogenesis:
- Downward invagination of endometrial basalis layer deeply into myometrium due to myometrial weakness caused by decreased immunological activity at the endometrial – myometrial interface. –Frenczy & Levgur 2000
- Oestrogen – progesterone play role in development & maintenance of the condition. As evidenced in adenomyosis – develops during reproductive age & regresses after menopause.
Case – Mrs. J, aged 50yrs
Presenting Complaints:
Menses profuse, clotted since 2 years but regular 4/30 day cycle. But for the past 6 months – bleeding dark with large clots, painful and protracted flow for 8 days.
Pain lower abdomen, cramping, before & during menses
Pain left breast, drawing, <before menses since 6 months, > after menses.
Family History
- Father- Diabetes with Hypertension & died of uremia 15 years back.
- Mother- Alive, diabetic, and hysterectomy done for fibroid uterus
- Sisters – 2- healthy ; Brother – 1- Diabetic
Past History
- Measles at age of 6 years.
- 2 normal deliveries PS done.
- No H/O of abortion or contraceptive use.
Physical General
- Appetite – normal.
- Thirst, Stool, Urine – Normal.
- Sleep – refreshing.
- Desires – salt++, fanta++, sour food
- Aversion – milk++
- Perspiration – profuse on least exertion
Mental General
- She cannot tolerate contradiction. She gets angry when contradicted.
- She suppresses her anger by keeping quiet and rarely lets out by shouting.
- Broods over the problems and doesn’t share.Desire for company.
- Suppressed sexual feelings. – husband is working in foreign country and visited her once in 3 years.
Evaluation of symptoms
Mental – Company desire for
Contradiction intolerant of
Suppressed sexual feeling
Brooding
Physical – Desire sour drinks, food, salt
– Aversion milk
– Menses protracted, dark, clotted, painful
– Perspiration profuse on least exertion
Particulars – Pain lt mammae, drawing,
<menses before
> after menses
– Uterus induration
1 |
1234 |
1 |
MIND – BROODING |
80 |
2 |
1234 |
1 |
MIND – COMPANY – desire for |
190 |
3 |
1234 |
1 |
MIND – CONTRADICTION – intolerant of contradiction |
129 |
4 |
1234 |
1 |
FEMALE GENITALIA/SEX – INDURATION – Uterus |
41 |
5 |
1234 |
1 |
FEMALE GENITALIA/SEX – MENSES – clotted – dark clots |
45 |
6 |
1234 |
1 |
FEMALE GENITALIA/SEX – MENSES – protracted |
166 |
7 |
1234 |
1 |
FEMALE GENITALIA/SEX – SEXUAL DESIRE – suppressed |
13 |
8 |
1234 |
1 |
CHEST – PAIN – Mammae – menses – before – agg. |
68 |
9 |
1234 |
1 |
PERSPIRATION – EXERTION – agg. – slight exertion |
151 |
10 |
1234 |
1 |
GENERALS – FOOD and DRINKS – milk – aversion |
130 |
11 |
1234 |
1 |
GENERALS – FOOD and DRINKS – salt – desire |
160 |
12 |
1234 |
1 |
GENERALS – FOOD and DRINKS – sour drinks – desire |
45 |
13 |
1234 |
1 |
GENERALS – FOOD and DRINKS – sour food, acids – desire |
185 |
con. |
sep. |
bell. |
phos. |
calc. |
nat-m. |
puls. |
ign. |
chin. |
sulph. |
|
12/22 |
11/20 |
11/14 |
9/23 |
9/20 |
9/20 |
9/19 |
9/17 |
9/15 |
9/15 |
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13 |
2 |
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1 |
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1 |
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Follow up
- 28/06/08 – LMP – 16/06/08.
Rx. Conium 0/1 –BD for 1 month
- 24/07/08 – LMP – 12/07/08. Bleeding reduced on 2nd day. No pain in breast before and during menses.
Rx. Conium 0/1- BD for 1 month
- 09/09/08 – Menses on 8/8/08, 5/09/08. Flow reduced to 5 days. No pain in breast.
Rx. Conium 0/1 – OD for 1 month.
15/10/08 – Feeling better. Menses on 5/10/08. Normal flow for 5 days. No other c/o. USG reveals normal study. Rx. SL for 1 month.
(See ultrasound tests below)
hello dr anandhi,
is it possible to communicate with you privately?
recent ultrasound indicates mild-moderate adenomyosis.
i am very interested to ask you your opinion for a homeopathic treatment protocol- is this possible?
i would be very grateful for any and all help you may offer.
thank you
ra
very good paper thanks.
add more papers on adenomyosis
Hello, checking to see if anybody checks these messages? Looks like it’s been a few years… I have a dear friend with adenomyosis and I desperately want her to avoid surgery and try homeopathy first. I need more information for her. Please help.
Hello Dr Anandhi,
We need to consult you for my spouse as she has been diagnosed with the following:
1. Bulky Uterus with Heterogeneous Myometrium. Suggestive of mild Adenomyosis.
2. Mildly thickened Endometrium
3. Simple LEFT OVARIAN CYST.
My contact number: 7010853231
recent ultrasound indicates mild-moderate adenomyosis.
i am very interested to ask you your opinion for a homeopathic treatment protocol- is this possible?
i would be very grateful for any and all help you may offer.
thank you
Nicely managed case…
That’s why be simple and specific while managing a homeopathic case…