Clinical Cases

Premenstrual Syndrome Treated with Classical Homeopathy – Case Report

Dr. Tamara Denisova et al present a case of premenstrual syndrome in a woman of 20, treated through classical homeopathy. The patient’s symptoms included vertigo before menses, frequent mood changes, weeping disposition, susceptibility to offence, increased anxiety, emotional tension, aggression.

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.

Case Presentation

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.

Clinical Examination:

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.

Laboratory findings:

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.

Homeopathic intervention:

The patient consulted a homeopath on the 20th of November 2018 for severe premenstrual syndrome. Presented to the homeopath were the following complaints:

  1. 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).

  1. Anemia (hemoglobin 90 g\L).
  2. 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.
  3. Infantile uterus (Small pelvis ultrasound).
  4. 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.


  1. Appleton SM. Premenstrual Syndrome: Evidence-based Evaluation and Treatment. Clin Obstet Gynecol. 2018;61(1):52-61. doi:10.1097/GRF.0000000000000339
  2. 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

About the author

Tamara Denisova

Dr. Tamara Denisova graduated from the faculty of medicine from the Chuvash State University in 1991 and is a professor of the Department of Obstetrics and Gynecology, and Surgery of the federal state Budgetary Educational Institution of higher education. She is a member of editorial board of its scientific journal, Deputy Editor in Chief of the Scientific and Practical Journal of Health of Chuvashia, Interactive plus, Acta Medica Eurasica. She has been a full member of Russian Academy of Natural Sciences since 2014 and has been given multiple awards for her service in Medical and scientific works. She contributes regularly to the work of the IACH research team

About the author

Nadezhda Pakhmutova

Dr Nadezhda Pakhmutova graduated from the medical faculty of the Chuvash State University in 1989 with a degree in general medicine. She has worked as a psychotherapist since 1992 at various institutions. She is the Director of Homeopathic Medicine LLC since 2014 and has been awarded for her achievements in healthcare. She has attended the International Annual Conference of Classical Homeopathy with the report "Analysis of the Living Case as a Necessity in Teaching Modern Homeopathy" (2015). She is an active contributor to the IACH research work.

About the author

George Vithoulkas

George Vithoulkas is an Honorary Professor of the Moscow Medical Academy, Professor in the Kiev Medical Academy, Honorary Professor at the University of the Aegean, Greece, Collaborating Professor in Basque Medical University (2001-2004) and Doctor Honoris Causa of "Doctor ViktorBabes" University of Medicine and Pharmacy of Timisoara in Romania. In 1995, he established International Academy of Classical Homeopathy in Alonissos, of which he is the director. In 1996, he was honored with the Right Livelihood Award (also known as Alternative Nobel Prize) "for his outstanding contribution to the revival of homeopathic knowledge and the training of homeopaths to the highest standards".

About the author

Seema Mahesh

Dr Seema Mahesh (BHMS, MD (hom) Dip IACH (Greece), MSc Medical Sciences (Malaysia) is a classical homeopath from Bangalore, India, practicing for the past 20 years. She completed homeopathic medical education at the Rajiv Gandhi University and her PG diploma at the International Academy of Classical Homeopathy (IACH), Greece, under Prof George Vithoulkas. She then turned to research and trained at the Taylor’s University Malaysia for her research post-graduation degree in Medical Sciences. She has been involved in the research committee of IACH and is currently the Director of Research at IACH Greece, collaborating with clinicians and researchers from 95 countries. She is instrumental in taking the core concepts of classical homeopathy to the medical journals and conferences. Having published 22 research papers in peer reviewed medical journals, and hundreds of articles on other platforms, she has also presented her research on concepts of health, disease and cure at medical conferences of immunology and autoimmunity, at NewYork USA, Fiji, Dublin Ireland, Krakow Poland, Stockholm Sweden, Harvard Medical School USA, Amsterdam Netherlands, London UK, Madrid Spain,Vancouver Canada, Tel Aviv Israel, Istanbul Turkey, New Delhi, Athens Greece, Basel, Switzerland and Paris, France. Her presentation at Harvard won her an award of excellence. Her research papers have been downloaded a record number of times.

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