A CLINICAL EXPERIENCE: NATRUM MUR CURES A FEMALE WITH MENORRHAGIA

Gyandas G. Wadhwani MD (Hom)Chief Medical Officer (Homoeopathy), Directorate Of Ayush, Government of National Capital Territory of Delhi. India. E-mail: homoeopathygyan@gmail.com

AbstractA 20 years old girl presented with menorrhagia of one and a half months duration after allopathic and ayurvedic treatment had failed to provide relief. On the basis of Falls in love with the coachman, a characteristic described by James Tyler Kent, single homoeopathic remedy Natrum mur, was prescribed in ascending LM potencies. Pain relief occurred after the 2nd dose and by 3rd day bleeding stopped. The sonography report had revealed a 51x52x53mm 76 ml hemorrhagic ovarian cyst (pre-treatment), which also cleared during subsequent ultrasound 3 months later. She has continued to be well ever since with regular cycles of normal duration. This is a model case study for psychosomatic medicine.

KeywordsMenorrhagia, hemorrhagic ovarian cyst, homoeopathy, psychosomatic medicine, natrum mur

IntroductionHeavy or prolonged menstrual periods, or menorrhagia, are the most common type of abnormal bleeding from the uterus. There are many possible causes of heavy menstrual bleeding, which include[1]: Hormonal imbalance, particularly in estrogen and progesterone; Fibroids Miscarriage Use of blood thinner medication Use of IUCD, OCP etc Adenomyosis Pelvic inflammatory disease Uterine, ovarian, cervical malignancies Liver, Kidney or Thyroid diseases or platelet disorders that may prevent clotting from happening Psychological stress Etc.

These patients often require reassurance and support. The allopathic treatment is usually symptomatic and includes NSAIDs to reduce pain and blood loss along with hormonal preparations or drugs that favour clotting.

Hemorrhagic ovarian cysts usually result from bleeding into a corpus luteum or other functional cysts. Pain and/ or a pelvic mass are common presentations and many cases may remain asymptomatic. They typically resolve within eight weeks (2 menstrual cycles) and require monitoring only if size of cyst is >5cm or in peri-menopausal women or if the woman is post-menopausal. The latter may require surgical assessment and intervention.[2]

The homoeopathic approach in gynaecological conditions is not restricted to/ guided by the female genitilia and its symptomatolgy or condition alone. It advocates the treatment of the entire female personality, which can be easily understood as mere removal of uterus or ovaries (viz. in cases of pan-hysterectomy) or mammae does not make her a male! It is a well known fact that the subjective experience of physical pathology is profoundly affected by the psychologic and social context within which the disease process occurs.

Like homoeopathy, the evolving discipline of psychosomatic medicine considers it necessary to include both the psychosocial concomitants of physical disease and the cases in which psychosocial issues are core factors in the etiology of physical complaints and/or disabilities.[3]I share with you a case of young girl who presented with menorrhagia and responded to a single homoeopathic remedy, which was selected on the guidelines of homoeopathic philosophy, when allopathic and ayurvedic medicines had failed.

Case studyA lean built 20-years-old girl, with a long, thin and wrinkled neck, consulted on 14-9-12 at DGHD WUS Health Centre, South Campus (Regn no 2393) for protracted heavy menses for last one and a half months along with severe pain in lower abdomen. On the advice of gynecologist she had undergone serological investigations (TSH etc.), which were normal.

Ultrasound report dated 9-9-12 revealed a 51x52x53mm hemorrhagic ovarian cyst in left ovary having volume 76 cc.(see below)

She had taken ayurvedic and allopathic medication with temporary relief.

The homoeopathic consultation further revealed a strong craving for extra table salt, which she added to her food without even tasting.

She also described herself deeply attached to an 8-10 years older man who was already committed to another girl. She met this person while his relationship was going through a rough patch about 6 months previously and he found comfort in her company. She soon found herself becoming deeply attached to him and expressed her feelings within a month. Around the same time his previous relationship restarted, but, seeing the intensity of her feelings, he told her to continue as a second relationship, to which she agreed. Though the guy would only occasionally take her calls, never call back, meet only when the other girl wasn't around, she continued with the relationship, even when she realised that he was taking advantage of her. The problems started when he abruptly reduced all communication about 2 months back. In spite of all the painful experiece/ suffering she could not stop thinking about him or loving him. She also could not discuss this with any of her friends or family members as she knew they wouldn't understand.

Analysis & PrescriptionThe case history at once brought to my mind the Lectures on Homoeopathic Materia Medica by James Tyler Kent wherein he has written, Unrequited affection brings on complaints. She is unable to control her affections and falls in love with a married man. She knows that it is foolish, but lies awake with love for him. She falls in love with a coachman. She knows that she is unwise, but cannot help it[4]

Her strong craving for salt further confirmed the remedy selection.

Natrum mur prescribed in LM1 potency twice daily stooped the pain after 2nd dose and her bleeding on the third day. She received the remedy in ascending LM potencies after LM1 was consumed. The following menstrual cycles were regular of 4-5 days duration and without pain.

In spite of being informed about the spontaneous recovery of the hemorrhagic ovarian cysts, her parents took her for a repeat ultrasound on 2-12-12, which turned out to be a normal study. (See below)

Investigation reports9-9-12 (pre-treatment)2-12-12 (post-treatment)

Discussion and conclusionThe girls serological markers were within the acceptable limits and barring the 51x52x53 mm (76 ml) hemorrhagic ovarian cyst, there was no abnormality detected on sonography. The most probable diagnosis for her condition (menorrhagia) can therefore be dysfunctional uterine bleeding, which may result from stressful experiences in life.[5]

Her psycho-emotional state strongly reflected the mental make up of a Natrum mur personality, which has been described beautifully by James Tyler Kent above, Unable to control her emotions and.Falls in love with a coachman... [4] She fell for an 8-10 years older guy who was already committed to another person. Though she understood the impossible situation, she could not control her feelings.

During the follow-up we could also identify what James Tyler Kent has further written under the remedy, In cases of this kind Natrum mur will turn her mind into order, and she will look back and wonder why she was so silly.[] A few months after the remedy, she was able to overcome her feelings and get over the relationship and its pain.

The homoeopathic treatment aided her not only at the physical level but also healed the root cause of the ailment, which was in her unrequitted affection.

This case study is an example of what is identified by psychosomatic medicine as clinical conditions in which psychosocial issues are core etiological factors. Similar case studies need to be compiled for the posterity.

As homoeopathic physicians we are nurtured by the fundamental teachings, which proclaim the unity of life and consider life, health and disease to be mind-body phenomenon.

I conclude my experience with a quote by Kahlil Gibran, There must be something strangely sacred in salt. It is in our tears and in the sea.[6]

References1. http://www.webmd.com/women/guide/heavy-period-causes-treatments as accessed on 23-2-152. http://radiopaedia.org/articles/haemorrhagic-ovarian-cyst as accessed on 23-2-153. Stotland N.Principles of Psychosomatic Medicine. Glob. libr. women's med.,(ISSN: 1756-2228)2008; DOI 10.3843/GLOWM.104104. Kent JT. Lectures on Homoeopathic Materia Medica. B Jain Publisher (P) Ltd, India. Reprint Edition 2005; pp 7675. Tudiver F. Dysfunctional uterine bleeding and prior life stress. J Fam Pract, 1983; 17; 6 pp 999-10036. Gibran K. Sand and Foam. As accessed on 23-2-15 at http://www-personal.umich.edu/~jrcole/gibran/sandfoam/sandfoam.htm