Clinical Cases

Adenomyosis and Metrorrhagia During Menopause

Written by Kavita R. Chandak

Dr. Kavita Chandak shares a case of adenomyosis and metrorrhagia during menopause in a woman of 48.

Menopause-change of life
Menopause is the last milestone in the journey of womanhood. The most common time for the cessation of the menses is between the 40th and 50th years of life, generally from 42nd to 45th year; but similar to the first appearance, its termination is influenced by the varied temperament, constitution, and habits of the ladies themselves, or by a variety of climates.

The below paragraph about symptoms, rubrics and homeopathic management is taken from my book ‘Healing Women with Homeopathy.’

Symptoms 1
As the change progresses, there is commonly more or less functional disturbance, such as vertigo, headache, flushes of heat, nervousness, urinary difficulties, pain in the back extending to loins, down the thighs, a part of the abdomen, occasional swelling of the extremities, itching of the parts, etc.

Clinically observed important changes include retraction of nipples, mass gain over the lumbar and hip region, increased hair growth over the chin and upper lip.

The change of life is one of the most important phases in a woman’s existence, second only to the first appearance of the menses. This safely passed period-continued health and long life

are generally before her, but now her path surrounded with danger, and she must tread it with careful footsteps. It is during this period that the seeds of any future suffering may be sown in the system, and those old predispositions to disease, perhaps long forgotten spring up in luxuriant growth. The menses become irregular concerning both time and quantity, returning once in two or three weeks, or delaying three or four months. At times, the discharge is scarcely perceptible, while sometimes as profuse as to amount to a hemorrhage. Sometimes, the menstrual fluid may mix up with mucus.

The Two Ways of Menopause
1. Abrupt cessation of menstruation
The monthly discharge may be arrested by cold, fright, or general illness. Earlier in life, restoration to general health would attend by the reappearance of the menses; now, however, nature takes this opportunity to terminate the function.

2. The gradual termination is the most frequent and is attended with the least disturbance of health. It has two types as follows:

  1. Menses disappear for a couple of months and then return with heavy bleeding.
  2. Regular menses with a gradual reduction in menstrual discharge.

With gradual extinction, one period may be missed, which afterwards return; then for a longer time, elapses with an excessive flow. Then some months may pass away without any reappearance, there may be a scanty discharge, followed perhaps by flooding. At last, the discharge becomes so scanty and slightly colored that it scarcely attracts notice, and then finally disappears.

Rubrics
If menopause is induced, for example due to hysterectomy, consider the following rubric.
Generals – Convalescence; ailments during – menopause; after
graph. kreos. lach. puls. sep.

Other useful rubrics-
Mind – Sadness – menopause, during
Female Genitalia/Sex – Metrorrhagia – menopause – after
Female Genitalia/Sex – Metrorrhagia – menopause – before
Female Genitalia/Sex – Metrorrhagia –menopause – during
Generals – Heat – flushes of – menopause, during

Homeopathic Management
Remedies
Lachesis mutus, Sepia, Pulsatilla nigricans, Sulphur, Cimicifuga racemosa, Kali bromatum,Calcarea carbonicum, Ferrum metallicum, Vinca minor and Argentum metallicum are the frequently used remedies in menopause.

In my experience, homeopathy plays an important role in helping patients suffering from menopausal discomfort. However, menopause is a phase not a disease but few women may suffer from heavy bleeding or intolerable hot flushes or extreme mood swings.  Below, I share the transformative healing journey of a patient from the practice who has been advised immediate hysterectomy.

Case Study
A woman of 48 consulted me at 12 July 2021 with the complaint of heavy and prolonged menses for 3 years. She tried allopathic, ayurvedic and homeopathic treatment for the same. A few months back, she underwent hormone replacement therapy.

When she met me, she said “This time I am suffering from heavy menses since June 10, 2021 until today. It’s been one month. I am tired!”

The uterine bleeding was bright red and thin. She complained of hair falling.

Past history- Oral contraceptive pills (birth control) has taken.

She has two children but conceived five times. First child died soon after birth. Second and fourth children are alive. Third and fifth child died few days after birth.

Two years back, she had dark clotted menses.

On observation- swelling in lower eyelid.

That’s all!   It was a one-sided disease. How to proceed in such cases when you have only one or two symptoms? It is a common picture we see in our clinic especially in the menopausal phase. It was not just menorrhagia, it was metrorrhagia.

I suggested some hormonal blood tests and ultrasound of abdomen and pelvis as I needed a hint to enter in the case.

Her blood tests were normal.

U/S Abdomen and pelvis performed at July 17, 2021 showed adenomyosis and right simple ovarian cyst.

In this case, heavy bleeding during menopausal phase was due to hormonal intake in the past and adenomyosis. Study evaluates the symptoms commonly attributed to adenomyosis in women undergoing the menopausal transition.2

Uterine adenomyosis is a condition in which the endometrial uterine cells grow into the muscular wall of the uterus, causing uterine enlargement and painful, heavy bleeding, usually begin in perimenopausal phase. Hormonal therapies can help to reduce the disease but the only cure for adenomyosis is surgical removal of the uterus (hysterectomy).

Analysis and evaluation-

I had a woman suffering from heavy bleeding during menopause due to adenomyosis, who already took hormonal treatment with no result and did not want surgery.

There was scarcity of symptoms to begin the treatment.

Considered rubrics-

Prescription-
Medorrhinum 10 M one aqua dose given in July 2021.

Criteria for selection of remedy- In this case, I decided to go according to the hierarchy of symptoms. Here, endocrine was the first layer which got damaged due to oral contraceptive pills. (Everything is regulated by hormones. This is why the liberal use of steroids and contraceptives is so damaging to long-term health.)

Why I chose Medorrhinum :
1) For initiating the treatment in conditions where you get only one or two clear cut symptoms (like in one-sided diseases) where remedy selection is difficult; we use a nosode to open up the case.
2)Medorrhinum rectifies the obscure metabolic defects in the mother, when her children come in for infantile death one after another as mentioned by Dr. Ghosh.
3) I wanted to address the present dominating miasm, syco-syphilis.
(Though Medorrhinum is king of anti sycotic remedies, it covers all miasms.)

Why 10 M potency?
When the problem is deep, disturbing the energetic level, higher potencies are required to push the toxin out from the vitality.

Follow up after one month-
Bleeding stopped
Hair falling same
Prescription- Placebo
Advise- high protein die.

Follow up after three months-
Menses- Bright red, heavy and prolonged.

Prescription- Phosphorus 30 BD for 30 days.
I could have prescribed Phosphorus in the beginning, why did I not?

Phosphorus is an anti-hemorrhagic remedy and covers all miasms, but until and unless we address the dominant present miasm, the action of any remedy cannot be long lasting. Recurrence of symptoms will be the outcome. It is like you are sowing seeds in bad soil!

Follow up after six months-
Meanwhile she visited me every month with less or more bleeding issues. This month, she had scanty but extremely painful menses.

She said, I felt like something wanted to come out but got blocked.

Prescription-Placebo
Scanty menses during menopause is not unusual. But as she said, something got blocked, I thought it could be due to Phosphorus, hence just gave placebo and allowed the vitality to be itself.

Follow up after seven months
Menses heavy and clotted.

She said she used to have such bleeding 2 years back. “I was so scared as two months back my menses was scanty and now so much bleeding! It was like an abortion! “

Prescription-

Medorrhinum 10 M given in 6 cups plussing method.
(I suggested to put 2 globules in half cup of water, stir well, take 1 drop and put it into second cup of water; same procedure has to be followed till the sixth cup. Patient has to consume one table spoon of water from the sixth cup.)

I chose Medorrhinum again as I understood that I reached where the present complaint began; just wanted to push the remaining toxins if any.

The abortion like menses is the homeopathic D&C (dilatation and curettage procedure) without touching the patient!

Follow up after eight months-
Menses was adequate. No pain.
She said, “Every time I am scared of menses. If menses will be like this, I am ready to menstruate till my death!”
Prescription- Placebo.

Follow up after ten months-
Her U/S report showed- Right simple ovarian cyst.
No adenomyosis!
No endometrial interface!

 

However simple ovarian cyst is not harmful.
The complaint for which patient visited me, metrorrhagia during menopause due to adenomyosis got solved.
Who says surgery is the only treatment for adenomyosis?

References

  1. Dr. Kavita Chandak- ‘Healing women with Homeopathy” B. Jain Publishers (P) Ltd.’s: 978-81-319-2596-6. 2022
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2680233/

About the author

Kavita R. Chandak

Dr. Kavita Chandak MD(India)PG.HOM(London), Ph.D. (France), achieved first merit position in homeopathy in 1998, honored by two Golden Book Of World Records for treating kidney disorders and success in a case of mucormycosis. She is an author, international trainer, speaker, practicing since 1999. She specializes in autism, psychiatric and behavioral disorders, addiction, infertility, allergic disorders, kidney disease, and cancer. She is on the board of directors for the Afghanistan Homeopathic Medical Association and the advisory board for the Turkiye Klinikleri Journal in Istanbul. She is a scientific committee member at Duzce University, Turkey, and LMHI 2022. Dr. Chandak is associated with P.D. Jain HMC (Parbhani) and she is PG Guide at Nashik University. A speaker at national and international seminars and conferences, Dr. Chandak will be speaking at the International Congress of homeopathy in New Zealand and Latvia in 2022. She has written six books and 294 articles and teaches several online courses, including How to Master Psychiatry with Homeopathy, Womanhood – A Power Pack of Homeopathic Solutions in all Disorders including Cancer, as well Homeopathy and Autism – In and Out. For her socio-medical contribution, she received various prestigious awards including the recent ‘Excellence in Homeopathy-2022” by Hpathy.com

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