1SAI FPE “The postgraduate doctors’ training institute” Chuvashia Ministry of Health, Russian Federation
2Federal State Budgetary Educational Institution of Higher Education “Chuvash state university named after I.N. Ulyanov”, Russian Federation
3Federal State Budgetary Educational Institution of Higher Education “Mari state university»
4Homeopathy medicine center “Zdorov’ye”, Russian Federation
⁵Centre For Classical Homeopathy, Bangalore, India
6University of the Aegean, Greece
7International Academy of Classical Homeopathy Alonissos, Northern Sporades, Greece
Premenstrual syndrome is a common cyclic disorder affecting women in reproductive age irrespective of geographical and ethnic background1. It is characterized by appearance of physical, emotional and behavioral symptoms that significantly deter the quality of life.
Premenstrual symptoms occur during luteal or late-luteal phase and typically cease with the beginning of menstruation. Although the etiology remains unclear, theories suggest that the most probable cause might be due to the enhanced receptivity to the fluctuating concentrations of prostaglandins, oestradiols, oestrogen, endorphins and progesterone2. While the conventional treatment options are limited to Serotonin reuptake inhibitors, hormonal interventions, vitamin supplements and cognitive behavioral therapy, most methods are associated with side effects and subsequent withdrawal effects leading to hesitation to consume them.
In such cases, alternative treatment methods pose as a solution. Presented below is a case of a severe form of premenstrual syndrome, with infantile uterus, successfully treated with individualized classical homeopathy, following which improvements in physical, emotional and behavioral complaints were noticed.
The patient, a twenty-year-old female, presented to the gynaecologist with complaints of irregular menstrual cycles (35-46 days), vertigo shortly before her menstrual cycle, swelling during her premenstrual period, frequent mood changes, weeping disposition, susceptibility to offence, easy fatigability, sleepiness, increased anxiety, emotional tension, aggression, hysteria, appearance and aggravation of eruptions on the face several days before the menstruation and decreased appetite. She had enlargement of mammae with hardening and pain, abdominal distention in premenstrual days and lower abdominal pain 2-3 days before the menstruation.
Past Medical History
Patient attained menarche at the age of 13 years and 8 months. The regularity of cycles occurred 14 months later (28-30 days). She faced menstrual cycle irregularity (35-46 days) when stressed about exams.
There is no significant history of epidemic diseases. She has a history of allergies. She rarely smokes or drinks alcohol and has never taken drugs.
Family History: Mother has diabetes mellitus and hypertensive disease.
Eumorphic pudendum, female pattern of hair distribution.
Gynecologic speculum investigation: Mucus membranes are pink, conical shape cervix, uterus anteverted and has a small body. No enlargement seen and is painful while shifting. Mucous leucorrhoea.
Enlarged thyroid gland without signs of hyperthyroidism.
Ultrasound: Small pelvic organs.
The laboratory tests showed increased TSH level
Thyrotropin –5.7 mU/L. (N 0.4-4 mU/L.);
FSH – 14.2 mU/L (N 3.5-12.5 mU/L).
Estriol level 11.3 ng/L (N 15-60 ng/L).
Diagnosis: Premenstrual syndrome, severe form. (ICD 10 – N 94.3 Premenstrual syndrome tension. Sex infantilism. ICD -10 E30.0 Sexual development delay).
Recommended therapy: sedative therapy, vitamin therapy, consultation of a homeopath.
The patient consulted a homeopath on the 20th of November 2018 for severe premenstrual syndrome. Presented to the homeopath were the following complaints:
- Premenstrual Syndrome: changeable mood, weepiness alternating with irritability, mammae hardening, headaches, swelling of the body, sleepiness, weakness, vertigo, changeable appetite —ravenous appetite alternating with lack of appetite, pains in the abdomen, bodily temperature increases at times up to 37.2°C
Menses are copious, bright-red, thin (watery), irregular.
Amelioration while lying or during slow motion. Standing and sitting is worse. Current symptoms appeared 3 years ago (at the age of 19 years).
- Anemia (hemoglobin 90 g\L).
- Right shoulder pains, in the area of deltoid muscle, pain while lifting the arm and putting the arm behind her back – the pains have been constant since 1 year.
- Infantile uterus (Small pelvis ultrasound).
- Chilly (her hands and soles are always cold)
She is ambitious, it is always important to her to be the best. She considers herself to be responsible, executive, strong-willed, self-reliant. She gets easily irritated, especially when someone is not right and contradicts. Demanding. She easily becomes angry, especially with her parents, shrieks, considers herself right and tries to command (according to her parents). Sensitive to criticism.
She loves listening to the music but is sensitive to noise as it irritates her.
Easily blushes, her face is pale.
Desire: Sweets, bananas, chicken, tomatoes (++)
Aversion: Fat, pork, meat, milk.
Fig. 1 Repertorisation of initial symptoms and result
Ferrum metallicum 30C, once a week for 5 weeks, follow up in three months.
|22nd January 2019
|– Menstrual cycles are regular since three months. The cycle in January was copious.
– Vertigo absent.
– Headache frequency decreased, headache during change in weather.
– Pain in lower abdomen before menses persists.
– Irritability before menses is of lesser intensity.
– Right shoulder pain slightly better, worse on motion.
– Hemoglobin increased to 134g/L
– Increased thirst in evening for warm water.
– General amelioration with improvement in energy.
Ferrum metallicum 200C one dose.
|14th August 2019
|– Headaches absent. Pain in deltoid absent. Appetite stable. Energy better.
– Mood is changeable.
– Menstruation painful: pain in the uterus, in the back, irradiating into the anus, coccyx, pubis.
– Menstrual blood is thin with big dark clots.
– Increased libido during menstruation.
– Increased sensitivity to noise and voices; worse from music.
– Warm blooded.
|Sabina 200С three doses per 36 hours, at an 8- week gap.|
|14th September 2019||– Severe headache with nausea, fever (up to 38°C) for 3 days; diarrhea with abdominal pain; abscesses on the buttock: after intake of Sabina 200 in 14 days.
– Menstrual cycles are regular, milder, and without clots.
– Changeability of mood is better, is not susceptible to offence and hysteria.
– Confidence is better; could manage her stresses well.
– General state is satisfactory.
– Painful menstruation during the last cycle, pain radiating to anus and pubis with the passing of big dark clots. Patient had leucorrhoea within the cycle. Desire for sweets before menses increased.
– All laboratory results are normal.
|Sabina 1M, one dose.|
|13th May 2020||– Changeability of mood persists.
– Menstrual cycles irregular; clots absent, and not profuse. Premenstrual aching pain in lumbar region noticed.
– Presence of multiple moles all over body
– Nasal discharge during defecation
– Fear of strangers
– Suspicious and distrustful of people.
– Consolation aggravates her mind symptoms
– Complaints after multiple vaccinations
– Thermally chilly
– Aggravation from smoking
– Desire for sweets++
– Aggravation from onion++
– Aversion to meat++
|Thuja occidentalis 200|
|10th July 2020||Laboratory findings:
– External genitalia formed correctly with female pattern of hair growth. Mucosae are pink, cervix is conical, and the size of uterus is normal and is anteverted.
– Ultrasound revealed the correspondence of changes in endometrium and ovarian follicles with respect to the menstrual phase.
– Haemoglobin content= 133g/L.
|27th July 2020||– Rise in temperature up to 37.5°C one week after remedy administration.
– Menstrual cycles regular without clots, dysmenorrhea and discomfort.
– Complete resolution of PMS observed.
– Mental and emotional symptoms are much better. No fear of strangers; distrust and suspicion have decreased.
- Appleton SM. Premenstrual Syndrome: Evidence-based Evaluation and Treatment. Clin Obstet Gynecol. 2018;61(1):52-61. doi:10.1097/GRF.0000000000000339
- PJ S, LK N, MA D, LF A, DR R. Differential behavioral effects of gonadal steroids in women with and in those without premenstrual syndrome. N Engl J Med. 1998;338(4):209-216. doi:10.1056/NEJM199801223380401
Amazing. Very informative. Thanks