Clinical Cases

Four Cases of Dysmenorrhea Treated Constitutionally

Dr. Sudhakar Tirupathi shares four cases of dysmenorrhea treated constitutionally. The cases all responded well to 30 and 200 potencies, often with single doses.

The prevalence of dysmenorrhea or painful menstruation varies between 16% and 91% in women of reproductive age, with severe pain in 2%-29% of the women. Women’s age, parity, and use of oral contraceptives were inversely associated with dysmenorrhea and high stress increased the risk of dysmenorrhea was the opinion of those studies.

The treatments mainly suggested are nonsteroidal anti-inflammatory drugs and oral contraceptives, particularly for those cases associated with pelvic pathology (secondary dysmenorrhea). Many nonspecific and vague medicines and practices are suggested in literature like Thiamine, Magnesium, fish oils, herbal products, heat therapy, and even surgery for refractory cases.

If I was trained only in conventional medicine, I might think the same, but my experience in homeopathy using the constitutional approach gives me the  confidence, that if proper attention and time (both are essential) are given, the majority of these women can be successfully cured with permanent results.

I hear many of my patients quoting the response of gynecologists to the problem: “Do not worry, many women will have this problem, apply a hot pack or take pain killer”, but why should women should suffer every month?

The following case examples from my practice will illustrate that if any homeopath understands a woman and her constitution, most of this “unnecessary suffering” can cured with homeopathic remedies and without any side effects. Additionally, the constitutional medicine not only cures dysmenorrhea but also many other ailments of the patient.

CASE 1: 38-year-old nulliparous woman, attained menarche at the age of 9 years suffered with horrible pains for 29 years consulted me on 13th September 2019 with following complaints.

  1. Before periods – Two days before period, pain in the thigh, more on left side and sole of left heel. One day before period, pain in left buttock in a small spot and she used to have sensation of swelling at the same spot. All these pains use to persist during periods and 2-3 days after periods
  2. During periods – Pain in hypogastrium, drawing internally maximum on second and third days of periods and unbearable twisting pain, intermittent used to last 2-15 minutes, pain coming and going suddenly.

During paroxysms of pain she use to wonder what will happen to her during pain. She is an MBA graduate working woman, did not go to work at least for a week every month. Pain was aggravated  in afternoon, by hunger,  stooping, lying on back and left side, relatively better lying right side but unable to sleep on right side because she cannot sleep facing the wall. Cannot wear undergarments, unable to lie down on abdomen because of abdominal pain. Pain ameliorated by pressure to some extent.

When she first consulted me on 13th September, she had viral pyrexia 2 weeks before and periods started on 2nd September 2019. Spot pain in left buttock was troubling her even 10 days after periods. It does not allow her to sit or lie down. She goes on changing positions as no position was comfortable to her.

She was sensitive to sunlight, stretches body frequently, is afraid of heights. Intertrigo between toes. She had dreams of murder, marriage (husband marrying her again), of dead people (walking with father) and snakes. Menstrual blood was dark red (maroon) in color often with clots changing quantity, quality, and duration frequently.

She did not conceive for 4 years after marriage, treated for infertility and conceived. She fell in washroom because of vertigo, severe pain in right lower abdomen, tubal pregnancy was diagnosed. Laparoscopy done: right fallopian tube was ruptured so it had to be removed.

She took Infertility treatment for one more year and as abdomen pain worsened, Laparoscopy was repeated which showed all adhesions in lower abdomen. She was treated for Kochs for one year and endometriosis. In 2014, pain started on the left side of abdomen after vaginal bleeding and again tubal pregnancy was confirmed on left side which was terminated.

Case 1 – 1. Date if first dose- on day of consultation in my clinic 13th September 2019
2. During night time when she was sitting on smooth surface – In gluteal area she used to feel as if she was sitting on hard surface { though she was sitting on smooth surface)

I have some questions to ask you please clarify

  1. I gave 4 case examples from my experience , is it extensive or do you want me to add few more cases ?
  2. to cut short I did not give repertory reference for cases 3 &4 , Is it ok
  3. Do you have any more questions regarding same article

Thanks & Regards
Dr.Sudhakar Tirupathi

Based on totality of symptoms (repertorization below), she was given her constitutional medicine Pulsatilla 30 potency, single dose. 13th September 2019

Review on 1st November – The following observations were made. Next period started on 3rd October 2019, feels as if sitting on hard surface during night, no issue during the day, cannot tolerate sanitary pads, 2nd and 3rd day of periods there was no pain.

Next period was on 26th October 2019 – No pain, bleeding reduced, clots only on first day, no twisting pain, no pain in spot left buttock, no sensation of swelling, able to wear undergarments. No heel pain and thigh pain. She used to have abdominal distension after eating which she does not have and feels her dresses fit her. I reviewed her on 9th February 2022, she says she adopted a baby girl and in last 2 years and 5 months she is totally pain free.

Reportorization :  Homeopathic medical repertory, Robin Murphy, third revised edition

Pain, general, menses during page                 950
Pain, spots, small, painful                                 951
Twisting pain                                                       981
Pressure, ameliorates                                        953
Stooping aggravates                                           973

Adhesions tissue                                                 371
Sun exposure, ailments from                            469

position of body, abdomen on                        1985

Dysmenorrhea, convulsive, spasmodic, neuralgic    766,767
Pain, menses during                                                         798
Paroxysmal                                                                     798
Cry out, compels her to, during                                  798
Clotted blood                                                                  755
PELVIS, pain buttocks, ulcerative                                1806
PREGNANCY, fetus abnormal position                        1839

CASE 2: 48 year old woman consulted me on 22nd October 2019 with pain in abdomen, hypogastrium, starts one day before menses, digging as if overturned with shovel or crowbar, intermittent every 10 minutes, used to last 1 minute or so, maximum at start of periods, lasts for 2 days, pain more if bleeding is more,   associated with perspiration, weakness, restlessness and dryness of mouth.  Pain comes suddenly but goes gradually. Red and black color bleeding follows with abdominal pain.

She also gets frequent headaches, drawing pain in right temple, sometimes sharp, pulsating sometimes with heaviness in head. She used to get anger during headache, associated with perspiration and pressing pain in abdomen with nausea felt in abdomen with urge to pass stool which relieves headache.

Headache aggravated by washing hair, traveling, perfumes and sunlight.  Head hot and perspiration mainly on head, palms are hot. She is a courageous and secretive woman. Difficulty in breathing while walking, trembling of legs, lower part and palms. Flatulence during menses, feels anxiety below left breast. Dryness of mouth during menses and headache. Sleeps on right side, uncomfortable to sleep on left side. Palpitations when lying on back

Repertorization : Robin murphy
Breast, anxiety in breast, as if below left, trembling with palpitations and
bitter eructation’s                                                                                      247
Breathing, difficulty in breathing, walking                                             271
Vertigo, rising seat from                                                                            2271
Sleep, position of body, right side, left side impossible                          1987
Perspiration, at the beginning, during and before menses                  1821
Weakness during, after and before menses                                             2310
Restlessness, during menses                                                                        1676
Generals, digging pain                                                                                   920
Female, flow agg.                                                                                           766
Bathing aggravates                                                                                         908
Headache, Sharp, temples, right                                                                 1146
Pulsating                                                                                                          1138
Based on totality of symptoms she was administered Phosphorus 30 single dose on 22nd October 2019.

Review on 30th November 2019, decreased intensity of symptoms: Pain before menses decreased by 25%, associated perspiration, restlessness and weakness, flatulence during menses, dryness of mouth, difficulty in breathing on walking reduced.

Her main symptom, digging pain as if by shovel reduced significantly. No headache from perfumes, able to sleep on back, heartburn decreased. She used to get drawing pain from right big toe extending to right hip and stiffness leg reduced to once a week, earlier she used to get once in 2-3 days. This signifies single medicine for multiple problems unlike conventional medicine giving multiple medicines for a  single problem.

2 Years 4 months now since she consulted me, she is happy now, no more dysmenorrhea

CASE 3: 35-year-old, obese woman weighing 88 kgs, mother of 2 children, hypothyroid, history of PCOD consulted me on 22nd June 2019 with following complaints

  • After menarche she had mild abdominal pain and backpain before periods. Her symptoms became worse since last 2 -3 years. Gynecologist diagnosed thick endometrium and endometrial polyp. Endometrial thickness was reduced by D&C (dilatation & curettage) in 2016.

As pains did not subside transvaginal ultrasonography done on 19th June 2019, revealed bulky uterus with thickened endometrium with possible diagnosis of either submucosal fibroid or endometrial polyp. Radiologist told her that inside uterus was dark, and endometrium was very thick.

Gynecologist advised Hysterectomy. When she refused surgery, she was prescribed Deviry 10 mg (Medroxyprogesterone) daily one tablet and Kstat (Ethamsylate) 500mg if bleeding wass not controlled. She did not take any of theset and consulted me.

  • Her main complaints were at least 5 days before menses, lower abdominal pain, in a small spot in hypogastrium right side, cramping, intermittent lasting 10 seconds, aggravated by sneezing and rising from sitting position suddenly, ameliorated by bending forward. Swelling of body with tightness of abdomen, particularly after eating like a stone and painful breasts. All these symptoms would subside once bleeding started.
  • Body pains – started with pain in right knee for one year, then right heel sharp as if poking with needles, stiffness of fingers especially in morning hours, stiff back, and sensitive scalp. Drawing pain in right upper arm extending to fingers except thumb.
  • Since last 2-3 months she suffered with prolonged and persistent bleeding which only stopped for 5-6 days in a month, passing dark brown painful clots.
  • Dreams – She had frightening dreams particularly when she was mentally upset. Dreams of snakes, suicide as if she was hanging and ghost dreams. These three dreams occur at least once in 2-3 days, which disturbs her sleep and drains her emotionally. Other dreams are arguing with God in a village and relatives attempting witchcraft on her.

Prescribed Lachesis 200 potency single dose on 22nd June 2019. Even though Lachesis presents with left sided complaints usually, this patient had them all on the right side.

Symptoms which pointed to Lachesis

  • Female, pain uterus menses ameliorates
  • Female, pain uterus, menses before
  • Female, menses, protracted
  • Female, bleeding, uterus clotted blood
  • Generals, pain; spots, small, painful
  • Abdomen, pain; bending double ameliorates
  • Abdomen, swelling sensation, tension sensation
  • Arm, pain upper arm; extending downwards
  • Hands, stiffness fingers, morning
  • Dreams, nightmares
  • Dreams, snakes
  • Dreams, death
  • Dreams, ghosts

Review on 23rd July 2019 – She mentioned an interesting observation. While she was bleeding during previous menses, she felt membrane passing as clots, dark brown or maroon and she feels some indescribable odor similar to that of a wound in skin for next 2 days, then fishy odor.

Once all clots are passed, she feels peaceful and the thickness of abdominal wall which she feels before menses goes away and her abdomen becomes light. Such observation made me conclude that homeopathic medicine removed all unnecessary thickness and polyp because she never complained of such severe symptoms in last two and half years.

All symptoms reduced in intensity, spot pain right side of abdomen reduced by at least 80% which was there continuously since last 3-4 months, was not subsiding even after periods. Now she has intermittent sharp pain in same area, mild intensity and decrease in tongue dryness. Drawing pain right arm and stiffness of fingers reduced by at least 80%.  Hair loss decreased. She experienced great relief  emotionally with good sleep without those dreams of snakes, hanging and ghosts signifying that  homeopathic medicines act even at subconscious level!

Ultrasound scan of abdomen on 8th January 2020 revealed no cysts in ovary and no evidence of PCOD.

Unlike first two patients she was not symptom free totally. Even though major symptom pain was reduced, she presented with the following complaints since last 2 years:

18th February 2020 – Burning during urination, dry mouth, heat in body, pain in breasts and hoarseness of voice before menses – Lachesis 200 single dose.

1st May 2021 – She consulted me on 22nd June 2019 morning hours, normal flow along with hardness of abdomen, flatulence with loud belching’s responded to Graphites, Sepia and Lachesis

11th October 2021 – Metallic taste in mouth, heat in body at night, heaviness in abdomen, pain in inguinal region, responded to Kali carbonicum, Pulsatilla and Lachesis.

CASE 4: This patient took a single dose of homeopathic remedy 30 potency, could not consult me again for 6 months for some personal reasons. This case illustrates how a single dose affected her main symptom of menstrual cramps and associated health problems.

40-year-old, thin build, schoolteacher, mother of two children consulted me on 18th July 2021 with following complaints

  • Menstrual cramps since last 25 years
  • Severe giddiness during periods
  • Blurred vision during periods
  • Back pain and leg pains before and during periods
  • Low Blood pressure – This last symptom I do not consider as a symptom. She was made to believe (by her physician) that low blood pressure was the reason for her giddiness.
  • Watery discharge from nose while eating
  • Hair fall agg. after child birth
  • Frequent urination – hourly

She used to get severe cramps in hypogastrium and labor like pains extending to thighs and legs during periods, along with vertigo, blurred and dim vision, only ameliorated to some extent by lying on abdomen and pressing abdomen with pillows.

She consulted doctors who referred her to area hospital where chief gynecologist told her “You are mentally weak that’s why you are getting such symptoms”. What a pathetic statement to cover their ignorance.

She had facial hair (moustache area & chin), varicose veins with itching, fissure in rectum, cracked lower lips. Averse to wetness of hands and feet, vertigo on rising from bed and stooping, does not like being alone and dislikes cloudy weather, likes chocolates. She used to get many dreams and for eight years she had continuous dreams of dead people, meeting family and friends, religious praying.

Based on totality of symptoms she was given Sepia 30 potency single dose on 18th July 2021.

Symptoms which were pointing to Sepia were

  • Vertigo, menses during
  • Vertigo, rising from bed, stooping
  • Dim vision, menses during
  • Dislikes hands, feet getting wet
  • Cloudy weather aggravates
  • Cramping pain abdomen , menses during
  • Back pain, lumbar, menses before, during
  • Pain legs, menses before, during
  • Lying on abdomen, ameliorates
  • Face, facial hair, moustache hair in woman
  • Fissure in rectum
  • Varicose veins, itching
  • Hair loss, child birth after
  • Desires chocolates
  • Dreams – many, family, praying
  • Cracked lips, middle

She had next period after 2 days on 20th July. She was amazed to see those menstrual cramps, blurring of vision, giddiness and weakness reduced in intensity at least by 40% (who says homeopathy works slowly). This she told me when I called her on 23rd July because I was so confident of the medicine I had prescribed.

She was reviewed on 12th February 2022 – reduced intensity of pain before and during periods from July 2021 to January 2022. In October 2022, she had slightly   aggravated menstrual cramps (not as severe as pains before starting Sepia). Periods in February – pains further reduced by 70%. Urination frequency reduced to 4-5 times during day and twice at nighttime. Nasal discharge while eating persisting. No dreams at all and sleeping peacefully. Hair fall reduced significantly.

I included this patients’ details to share my experience that even a small dose like 30 potency can have long lasting effect after 6 months in all aspects of her sickness.

All the above patients were reviewed in February 2022 and all were pain free since treatment was started, and there are many more cases I treated with successful and permanent results.

About the author

Sudhakar Reddy Tirupathi

Dr. Sudhakar Reddy Tirupathi 62 year old, was previously an allopathic doctor completed M.B;B.S in 1981 from Kakatiya medical college, Warangal, D.C.H in 1986 and M.D.(Pediatrics) in 1987 from Gandhi Medical College, Secunderabad, Telangana . Received Dr. G. Venkateshwar Rao award for best paper in state pediatric conference in 1986. After completion of my Post graduation, I worked as an assistant Professor of Pediatrics in Gandhi medical college/ Gandhi hospital from 1988 to 1995. I left government service and continued private practice as Consultant Pediatrician from 1988 to 2011. I worked as Specialist Pediatrician at Al -Hekma Medical complex, Doha, Qatar for 5 years. I was introduced to homeopathy in 2006 because of my chronic health problems. I studied homeopathy and was awarded D.I.Hom by British Institute of Homeopathy in 2008 and I have been practicing homeopathy for the last 13 years. I treated thousands of patients successfully, read extensively homeopathy literature and homeopathy is my passion. I presented a paper in the State Homeopathy conference.

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