Clinical Cases

Menorrhagia and Hypothyroidism in a Woman of 34

Menorrhagia and Hypothyroidism in a Woman of 34

Dr. Shrikant Talari presents a case of menorrhagia and hypothyroidism in a woman of 34. Want of confidence, ailments from domination and metrorrhagia were rubrics used to find the simillimum.

This is a case of a 34 year old female, complaining of menorrhagia and hypothyroidism. Her menses are very profuse and prolong and she was advised hysterectomy for the same. In the past she had a history of psychiatric disorder and presented with symptoms of depression, hysterical behavior, screaming, shouting, yelling, hitting and mood swings. For this reason, she took psychiatric treatment. Along with psychiatric complaints there was severe headache. She presently does not need the psychiatric medications but is on thyroid medication. All her complaints started since the depression.

When asked the reason for her depression, she said that all her complaints started after her engagement. Her father in law showed unusual interest in her. He used to call her, inquire about her, and meet her instead of her fiancé. Due to this behavior, she did not want the marriage, but due to family pressure, especially from her father she got married. Her father was very strict, so she could not say no to the marriage, as he would usually get very violent and aggressive if contradicted. She married the same person against her wishes. After marriage the father in law did not give them private space. The father in law never let her alone, he used to constantly narrate all his life incidences and stressful situations and at the same time he would ask her to take care of him as he felt he had suffered a lot in life. As father in law was with her for every single minute, she started feeling pressured and suffocated.

During, this kind of pressure patient felt she could not express herself, feeling that she could not breathe freely. There was complete domination of whatever she did during the day. She could not even think of doing anything without his consent.

When asked why she would not express her disapproval, she answered because in childhood also her father was very strict and domineering. Her father would became violent and hit her. “I learned never to express myself. Due to this same feeling, I still got married in the family that I didn’t want to. I have a complete lack of confidence and indecisiveness. I cannot do anything on my own. I even cannot choose my own clothes or school for my children. I could not assert myself in public due to no confidence. I am never been able to express myself.

Analysis

  • Mind; ailments from domination by others, a long history of: carc, foll, lyco, sep) – From overall history of domination is a prominent factor in the case, therefore this is main rubric for selection of the remedy.

This domination has given way to lack of confidence and no self assertion in any choice she makes, like in choosing a husband. Indecisiveness is another expression of the low confidence.

Therefore the other rubrics are:

  • Mind, confidence want of self
  • Mind, delusion, imaginations, influence is under a powerful
  • Mind, Indecisive – (Cannot even choose cloths for her children, cannot choose school for children).
  • Mind, unhappiness prolonged, due to others

I chose the rubric :

  • Female, bleeding, uterus, metrorrhagia, menses between

The remedy that comes up is Folliculinum

Rx: Folliculinum 1M. She received a total of 2 doses in 6 months

Differential remedies

  1. Carcinocin – Domination is from parents. It is a situation where parents are quarreling and the child has no control over his parents so he tries to bring some control, sanity in the parent’s relationship by being perfectionist. Therefore, carcinocin is very hard working, sympathetic affectionate, fastidious, disciplined, meticulous. They feel the constant pressure to perform and be the ideal child for the family to stay together. For this case, we do not see the perfectionist in her.
  2. Lycopodium – Feels dominated by the person in power, so the adaptation mechanism is pleasing his boss and manipulating his inferiors to gain power. However, he feels he lacks the confidence and ability to achieve that power.

In this case, the aspect of manipulating or pleasing others is absent in her.

  1. Sepia – The female is very passionate, enthusiastic to become a professional. But due to violent domination from husband or family, she is not allowed to do what she wants to. Therefore, she slowly loses all the passion, enthusiasm, gives up, which gives way to lack of interest and indifference to loved ones. In this case, loss of passion is not her issue.

Follow up

The patient started having regular menses with normal bleeding. She did not require hysterectomy. Her mental state improved and she started meeting more people and making friends. Her confidence slightly improved but her indecisiveness and need for her husband to make any decisions continued even after 6 months of treatment. She discontinued treatment after 6 months.

Interestingly, immediately after the first dose she developed a past complaint – headache. We just waited until the headache passed off on its own after 2-3 days. Following that, all the improvement began. This was in line with Kent’s remedy reaction, where he says that when an old complaint reoccurs it is a good sign and will be followed by relief.

FOLLICULINUM

Folliculinum is a female remedy, affecting primarily the female hormonal system. It is made from oestrogen, a synthetic form of oestrogen, secreted from ovarian follicles.

  • Abuse –
  • It is suited to women who have been abused sexually, psychically, or physically either now or at any time in the past, especially from loved ones
  • Oestrogen abuse , the women who prolonged use birth control pills
  • Domination-
  • Pressure from parents, friends, religious dominance or in work place from boss or workload.
  • Patient feels controlled by another, no sense of freedom. It may be due to various restrictions, orders, domineering attitude imposed by the parents or others in past or in present circumstances. She feels she’s living out someone else’s expectations, has forgotten who she is, has no individuality and loses a sense of herself. Loss of energy, exhausted, drained, doormat, feels taken advantage of, feels used.
  • In women whose creativity has been blocked by domineering person which leads to depression, anxiety, hypersensitivity and instability, panic attacks, dizziness, faintness, becomes aggressive then depression. Gets easily upset, easily hurt. Indecisive, confused can’t make decisions.
  • Care –
  • Feel they have to take care of everyone, mother everyone, be a perfect mother.
  • Rescue
  • Want to be helpful, help others, rescuing people (orphans), charitable projects, even save the world.
  • Recovery from previous illness is difficult, either on mental plane i.e. domination, or on physical plane i.e. continued ill health after recurrent or severe infection.
  • Menstrual disorders –
  • Premenstrual syndrome-
  • Weight gain without excessive eating, worse before menses or during ovulation (both fat & water retention).
  • Premenstrual migraine
  • Acne on face and seborrhea of nostrils which worse before menses
  • Congestive mastitis, swollen and painful breasts, cannot bear being touched
  • Abdominal flatulence and distention before menses
  • Backache before menses or during menses
  • Nausea vomiting
  • Weepy, depressed, indecisive, panic attacks, mood swings
  • Pruritus vulva
  • Very low or high libido
  • Leucorrhea before menses
  • Irregularities of menses in every form, scanty, profuse, dysmenorrhoea , flow between menses, PCOD, in menopausal complaints, fibroid uterus with metrorrhagia. Spotting and pain during ovulation
  • Post-natal problems: depression, difficulty in bonding with baby; difficulty in breast feeding.
  • Complaints aggravate before menses, during ovulation, better with flow and in open air
  • Congestive headaches, either with redness of the face or the opposite with pallor, but still with the sensation of chilliness at the limbs.
  • Swallowing liquid is very painful, cannot bear pressure on pharynx.
  • Stubborn constipation alternate constipation and diarrhea.
  • Recurrent cystitis in women.
  • Takes long breath and sighs deeply; craves for fresh air. Cough aggravation in company with sensation of constriction around heart.
  • Palpitations with faintness. Sensation of constriction around the heart with feeling of a bar in the precordial region, spreading to the left arm.
  • Hypersensitive to heat, noise and contact.

References:  

www.interhomeopathy.com

Homoeopathic Materia Medica Of Sarcodes – Chaturbhuja Nayak, Smita brahmachari, Syed Afsar Ali.

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About the author

Shrikant Talari

Shrikant Talari

Dr. Shrikant Talari is a dedicated young homoeopath practicing in Pune. He has earned good repute for his work in rural and urban India especially in the acute management of cases. He has organised various educational seminars and workshops for students and practitioners. Presently he is working in the field of oncology, at Prana Pune. Prana is world's first homoeopathy yoga centre, with world class infrastructure. He also has worked at cancer clinics in kolkata and is in charge of the Gastroenterology and Cancer Clinic at Prana.At Prana he is responsible for the various courses run by "the other song” academy.

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