A lady aged 45 came to clinic for heavy post-menopausal bleeding. Her complaints were:
Heavy bleeding the last for 9-10 days from the last eight months. Her menses stopped at age of 42 but for the last eight months bleeding started again . She consulted a gynecologist and had taken hormonal treatment but there was no satisfactory response. Finally, her doctor advised her to have a D&C so that further evaluation could be done. She refused that and consulted me.
Summary of case
She is a normally built woman, active and cheerful before this complaint. During normal menses she would bleed for three days. Bleeding was always profuse and 3-4 days early of the expected date.
White vaginal discharge after 2-3 days of menses that would last for one to two days. During menopause her menses was two to three months delayed and very scanty and lasted for one day.
After menopause when vaginal bleeding started again, it was profuse, and lasted for 8-9 days. Initially she thought that might be normal, but when bleeding continued her gynecologist advised her to get a USG and diagnosed the condition.
At present she didn’t like anything, even the food and music that she enjoyed most. Easy satiety and nausea on eating. Thirst decreased. She becomes easily irritated from every little thing. She would dream of urination and wet her bed every night.
I prescribed Sepia 200 on 15/11/18 and placebo for one week. There was not any noticeable change in her condition. I retook the case but there was nothing additional. Again Sepia 1000 given in clinic on 23/11/18 and placebo for three weeks.
24/ 12/ 2018 – Her appetite and irritability was much improved. No bed wetting and no profuse vaginal bleeding, but in between clotted pieces were expelled through va-gina and continued wetness of vagina.
Placebo prescribed for two months. She didn’t come to clinic for the next four months. She visited again in May offensive light-yellow vaginal discharge and offensive bleeding. I asked why she didn’t continue the medicines. She replied that “Everything was fine so I didn’t come.”
Kreosotum 30 prescribed on 2/5/19 for one week and I advised for USG. The USG found endometrial thickness reduced and not normal.
Vaginal discharge was better. Placebo continued. In July she said that everything was fine but once again bed wetting started along with the dreams of urination, but she would wake after a few drops passed.
Once again, I prescribed Sepia 1000 and placebo for one month. Thereafter on subsequent follow ups her condition improved.
When two months passed without any complaints on placebo, I advised she get another USG. This time the endometrial thickness was normal.