Endometriotic Chocolate Cyst in a Woman of 31

This is a case where the patient was given no option but surgery and she was beautifully cured with homoeopathy.  Note the attention to posology.

Date of consultation – 18/07/2019

Name – Mrs. A.J.T

Female, 31 years

C/C:

1. Heavy menstrual bleeding since past 4-5 months. She was diagnosed as bilateral endometriotic chocolate cyst in May 2019. (reports attached herewith). Patient had profuse menstrual flow, for many days. (Almost more than 10 days, heavy, daily, continuously). Menstrual flow < slightest of exertion. She was operated on for the chocolate cyst a few months ago, but it re-appeared.
2. Back pain – esp. lumbar region due to heavy menstrual flow. Pain > by lying down.
3. AMH – 1.76, (Anti-Müllerian Hormone) patient was advised IVF (in vitro fertilization) so as to conceive as she was told that due to chocolate cyst and low AMH, it is not possible to conceive naturally. This was a major concern to the patient as she was unwilling to opt for IVF.
4. Feels hot flushes over entire body since few months, almost always.

GENERAL REACTIONS-

Appetite– good

Craving– spicy++

Aversion – fruits++

Thirst– very little, would drink hardly 3-4 glasses a day

Food/ drink- agg/amel– NS

Sleep– sound, not disturbed by light noise.

Position- left side.

Dreams– NS

Stools– once/day. Satisfactory evacuation.

Urine– NS

Perspiration– axillae

Menses-

Last Menstrual Period – 09/07/2019

Profuse flow, with clots. Bright red blood, slightest exertion increases the flow, so the patient prefers to rest and lie down. Lying down also relieves the lumbar pain due to excessive menstrual flow.

Obstetrics History-

None

SUN – Exposure to sun causes severe headache, so she avoids going out in the sun. Hardly moves out of the house in the sun light.

MIND:

She had a good childhood with her parents. Father died early age. Mother is a maid. She has grown up mostly in the house where her mother has worked for years.

Post marriage, all her tensions started. (mid 2018)

The mother in law started verbally abusing the patient and she could never answer back. She felt insulted all the time. So, she and the husband left the house and started living in a rented house. She feels all this is the cause of her current illness.

Her husband told me that his wife doesn’t like if anyone opposes her, and she will answer back and be very bold about it. Patient cannot stay alone. She wants someone with her all the time. After shifting to the rented apartment, she was alone the entire day as husband was at work. During that time, she mostly went to a neighbor’s house and sat there or called the neighbor over to watch television.

P/H-  NS

F/H- Mother- cold cough fever, occ back pains

On observation –

Dark complexion+

The patient was currently bleeding profusely the last 20 days and had back pain due to it. Also, she was concerned for her pregnancy.

TOTALITY OF THE CASE –

1. Mind – Ailments From – Indignation
2. Mind – Ailments From – Mental Shock; From
3. Mind – Anger – Contradiction; From
4. Mind – Company – Desire For
5. Head – Pain – Sun – Exposure To Sun; From
6. Stomach – Thirstless
7. Female Genitalia/Sex – Menses – Exertion Brings On The Flow
8. Female Genitalia/Sex – Tumors – Ovaries – Cysts
9. Generals – Food And Drinks – Fruit – Aversion
10. Generals – Food And Drinks – Spices – Desire
11. Generals – Heat – Flushes Of

REPERTORIAL TOTALITY –

TREATMENT GIVEN –  18 July 2019 – NAT MUR 6C   1 Dose Only + Placebo for 7 days

Note: On 28-9-19 Medorrhinum 30- was given as an intercurrent remedy based on the sycotic predominant miasm (cyst). It was given to help clear the case and it helped instantly. The picture again came up of Nat mur. Boericke states:  For women with chronic pelvic disorders, pains intolerable, tensive, nerves quiver and tingle. Ovarian pain, worse left side, or from ovary to ovary. Sterility.
Metrorrhagia. Intense menstrual colic.

FOLLOW UPS –

DATE	FOLLOW UP	TREATMENT GIVEN
25/7/19	Bleeding stopped next day. Flow returned on 24/7/19	NAT MUR 6C in 1st attenuation (1 dose only) + Placebo for 7 days
01/8/19	Flow persisted from 24/7/19 to 27/7/19. But the flow was not heavy. Patient felt as if it was her regular menstrual flow which she used to get a few years ago. Back pain > but persists.	NAT MUR 30C (2P) 1st dry dose, 2nd in 1st attenuation once a week + Placebo for 2 weeks
17/8/19	LMP – 15/8/19, menses within 18 days. But the flow was not heavy. Back pain almost subsided.	NAT MUR 30C (2P) 1st dose in 2nd attenuation, 2nd dose in 3rd attenuation once a week + Placebo for 2 weeks
31/8/19	No heavy menstrual flow, no return of menses. Back pain occasional but better. Weakness+	NAT MUR 30C (2P) 1st dose in 4th attenuation, 2nd dose in 5th attenuation once a week + Placebo for 2 weeks
14/9/19	Back pain better. Menses not appeared yet.	Placebo for 2 weeks
28/9/19	LMP – 24/9/19, extreme pain in back, unable to move due to pain. Menstrual flow was normal.	MEDORRHINUM 30 (2P) 1st dry dose, 2nd in 1st attenuation once a week + Placebo for 2 weeks. (Given as intercurrent)
10/10/19	Pain subsided next day. Flow was normal. Weakness better.	NAT MUR 30C (2P) 1st dry dose, 2nd in 1st attenuation once a week + Placebo for 2 weeks
26/10/19	LMP – 24/10/19, Menses have become regular now. No back pain.	NAT MUR 30C (2P) 1st dose in 2nd attenuation, 2nd dose in 3rd attenuation once a week + Placebo for 2 weeks
09/11/19	Occasional back pain; realizes when remedy stop working.	NAT MUR 30C (2P) 1st dose in 4th attenuation, 2nd dose in 5th attenuation once a week + Placebo for 2 weeks
23/11/19	Sleepless during menses, with severe unbearable abdominal pain. Menses regular flow normal. Back pain occasional.	NAT MUR 200C (2P) 1st dry dose, 2nd in 1st attenuation once a week + Placebo for 2 weeks
05/12/19	Pain subsided within 2 days. Sleep improved. No back pain.	Placebo for 2 weeks
19/12/19	LMP – 10/12/19. No complaints before/during/after menses. Sleep improved.	Placebo for 2 weeks
04/01/20	No complaints	Placebo for 2 weeks
18/01/20	LMP – 6/1/2020. Slight abdominal pain near umbilicus on 2nd and 3rd day of menses. No back pain, no sleeplessness, no weakness	NAT MUR 200 (1P) in 2nd attenuation + Placebo for 2 weeks.
01/02/20	Better, but feels slightly weak.	NAT MUR 200C (2P) 1st dose in 3rd attenuation, 2nd dose in 4th attenuation once a week + Placebo for 2 weeks
13/02/20	No complaints. USG shows no evidence of any endometriotic chocolate cysts on ovaries, and shows early intrauterine gestation of 5 weeks 4 days, but the fetal cardiac activity was not developed as yet. (attached below)	Placebo for 2 weeks.
29/02/20	USG confirms pregnancy with single live fetus of 7 weeks 6 days in variable position, EDD according to USG is 8/11/2020 +/- 10 days. No evidence of any chocolate cyst on ovaries. (attached below) Patient complaints of occasional nausea (due to pregnancy)	NAT MUR 200 (1P) in 5th attenuation + Placebo for 2 weeks. Patient advised to consult a gynecologist for ANC.

REPORTS ATTACHED –

1. Reports at the commencement of treatment

2. Report dated 13/02/2020 which shows no evidence of any cyst on the ovaries

3. Reports dated 26/02/2020 which shows pregnancy with fetal cardiac activity

Follow up on phone – PFA for USG report  – 5/5/2020-

Patient doing well, taking her Supplements as advised by Gynaecologist.

Occasional morning sickness felt, along with aversion to food.

Had an episode of pain over left lumbar region. She mentioned she had not been able to take her Calcium supplements for almost 20-25 days as during the lockdown, she was not able to find the medicine anywhere.

Rx – Nat Mur 200 (1P – in 1st attenuation) and SL for 30 days. Inform SOS.

Baby girl born to the patient on October 1^st, 2020 at 7pm IST.

CONCLUSION –

This case shows that homoeopathy can help in cases where surgery was the only alternative in conventional therapy. It not only cured the patient of her endometriotic cysts, but also helped her conceive naturally. This conception is what makes the cure complete, as that is the greatest improvement we can expect from a case where the only option for conception left was IVF.