Positive Health Online

During this period of enforced lockdown due to Covid19, I have been reviewing my client files and noticing how many times feminine issues are part of the presenting complaint. I am reading comments by people on social media about how they are having issues with conditions such as PMT, endometriosis, polycystic ovaries, menopause etc., often feeling there is not much help available or they are not being taken seriously and decided to do some more research on these somewhat distressing conditions.

Female Menstrual Cycle with Hormones Contributing. Courtesy Wikipedia

The endocrine system is a complex one.  The hypothalamus is a major endocrine gland.[1]  It releases a number of hormones that control the release of anterior pituitary hormones, one of which is the luteinizing hormone (LH).  LH is controlled by the hypothalamic gonadotropin releasing hormone (GnRH).   The function of the LH in the female is to stimulate the development of the corpus luteum, release oocyte (an immature egg cell within the ovary) that can break free from the follicle, travel down the fallopian tube and become known as an egg or ovum ready for fertilization.   LH also produces progesterone and oestrogen.  In the male the LH stimulates secretion of testosterone.

The follicle stimulating hormone (FSH) also controlled by the GnRH stimulates growth of the ovarian follicle and ovulation and stimulates male sperm production.

Oestrogens produced by the ovarian follicle and controlled by FSH affect the development of sex organs and female characteristics.  Progesterone and oestrogens produced by the ovarian corpus luteum controlled by the LH influence the menstrual cycle, stimulate growth of the uterine wall and maintain pregnancy.

The reproductive cycle of a women commences at Menarche (around the age of 14) and continues through to menopause (around the age of 49) on a regular monthly basis.  The menstrual cycle is twenty-eight days in length corresponding with the lunar cycle.  During the first five days of the menstrual cycle when bleeding occurs, the endometrium (the membrane that lines the uterus) sheds.  Oestrogen and progesterone concentrations are low and GnRH stimulates secretion of FSH and LH and in doing so several ovarian follicles begin to enlarge.

On day 6 FSH helps several follicles to develop and one ‘dominant’ follicle is selected.  During the next few days (7-12) oestrogen is produced by this dominant follicle and any further production of FSH is prohibited.  At this point in time oestrogen stimulates the thickening of the endometrium.  On days 12-13 raised oestrogen levels set off a surge in LH from the anterior pituitary and the oocyte begins to divide to produce cells for reproduction.

Midway through the cycle (day 14) there is a surge in LH that causes the mature follicle to enlarge and release the oocyte for ovulation and the empty follicle becomes the corpus luteum.  During this time the endometrium continues to develop.

For the next 10 days the corpus luteum secretes oestrogen and progesterone and there is a reduction of FSH and LH due to the high levels of oestrogen.  Consequently, no new follicles can develop.  If the released oocyte is not fertilized (days 25-28) the corpus luteum disintegrates, menstruation occurs, oestrogen and progesterone secretion decreases and the anterior pituitary will actively begin to secrete FSH so that the ovarian cycle can begin again. 

Looking at some of the problems above experienced by women:

Amenorrhoea is defined as the absence of menstrual periods.  Absence of periods is usually associated with pregnancy.  If a woman has never menstruated it could be associated with a rare endocrine disturbance.  If a woman has been taking the contraceptive pill as a way of preventing pregnancy, when she ceases taking the pill there can be a length of time before her cycle re-establishes itself.   The contraceptive pill is also used as a treatment for acne.  Other factors for absence of periods can be eating disorders such as anorexia, excessive exercise or polycystic ovarian disease.  

Homeopathic remedies that could help:

• Aristochlia Clematis – suited to a person who is fearful of the future or women who are at the menopausal stage.  Mentally they feel worse before and after the menstrual flow as during the flow they feel much better in themselves.   They might experience a watery brownish discharge and infrequent menses.  The menstrual blood can be clotted;
• Ferrum Metallicum – the person that could benefit from this remedy is someone who looks strong but is weak and feeble and could be suffering from anaemia.   Their menstrual flow is pale, watery and the flow is protracted.  The least movement tends to increase the menstrual flow;
• Ignatia – this remedy is suited to ladies where grief plays a big part in the suppression of their menstrual cycle.  Their periods are painful and they suffer with menstrual cramping pains.  The menstrual cycle in these women can leave them feeling very tired and they also experience pre-menstrual tension.  They can be emotional people easily upset, oversensitive and nervous;
• Pulsatilla – this remedy is suitable for a lady who has never felt well since puberty and suffer with absent or irregular menses.  They are more sensitive than Ignatia and their moods are changeable but they do feel so much better when they are out in the open air.  Their painful periods begin in puberty and the menstrual flow is clotted and changeable.

Dysmenorrhoea is the term given to painful periods.  The pain can begin either before or after the menses.  Primary dysmenorrhoea generally starts after puberty and is accompanied by colicky pains and can continue until childbirth occurs.  Secondary dysmenorrhoea shows as menstrual pain after the woman has experienced a number of years of painless periods.  When this happens uterine fibroids, endometriosis or pelvic inflammatory disease can be the reason for such occurrence.
The conventional treatment for dysmenorrhoea is NSAID’s (non-steroidal anti-inflammatory drugs) such as Ibuprofen to be taken as soon as the cramping pains begin.  Placing a hot water bottle on the abdomen can also be helpful.

Homeopathic remedies that could help:

• Cimicifuga – the menstrual flow is dark and profuse, the pain increases with the flow and the person feels debilitated.  The pain travels across the pelvis from hip to hip.  The menses can be irregular or affect the left ovary;
• Colocynthis – the menstrual pains associated with this remedy is a boring pain in the ovary causing the person to want to bend over double accompanied by restlessness; The pain can make the person feel extremely irritable and impatient;
• Mag Phos – the person is oversensitive to pain and the cramping pains are relieved by heat, bending over and by the menstrual flow.   They also experience shooting pains in the ovaries.

Endometriosis is the presence of endometrium in places it would not normally be present such as the ovaries, uterus, fallopian tubes, general pelvic area and the umbilicus.   It can also occur at the area of abdominal scars after a hysterectomy.  Because the endometrium sheds at menstruation (hence the bleeding), the areas where the endometrium has formed can also bleed.  Because the blood is unable to escape in the same way it can from the uterus, the old blood collects in the affected areas and severe pain can occur.  These pools of blood are known as ‘chocolate cysts’.  Women who have not had any children are more commonly affected although women who have had a few can also be affected.  According to Black’s Medical Dictionary[2] endometriosis never occurs before puberty and seldom after the menopause The pain tends to be more severe throughout the duration of menstruation and may be accompanied by diarrhoea, vomiting or fainting.

Once again the conventional treatment is painkillers, Ibuprofen or paracetamol but also hormone medication, the combined pill or the contraceptive patch.  Surgery may be performed to remove the patches of endometriosis tissue.  An article in Everyday Health[3] dated 24 July 2018 states that the FDA announced their approval for AbbVie to market the drug Orillssa (elagolix) in the U.S. for use in treating pain caused by endometriosis.

Homeopathic remedies that could help:

• Sabina – the menses tend to be too profuse, too early with watery, bright blood that is mixed with dark clots.  The pains are from the sacrum up to the pubis and they could find relief from the pain by lying flat on their back with the legs stretched out; 
• Sepia – the person who can benefit from this remedy is one who feels they have never fully recovered from childbirth or coming off of hormone pills.   They have a bearing down feeling in the pelvic region, suffer with PMT and generally feel physically and mentally worn out and have a low sex drive.  Their menses can be irregular, early and heavy or late and scanty.

Polycystic Ovarian Syndrome (PCOS). It is estimated that 1:10 women of childbearing age present with PCOS.[4]  The symptoms are absence or irregular periods, hair growth on the face, acne on the face, chest and upper back, cysts on the ovaries and difficulty getting pregnant.  Although the exact cause is not known it seems to be associated with an imbalance of the reproductive hormones.  The male hormones (androgens) are raised and this in turn stops the ovaries releasing an egg during ovulation.  An excess of insulin (the hormone produced in the pancreas) may increase the production of androgens.  Obesity may also be linked to PCOS and it could be hereditary.
Conventional treatment includes the contraceptive pill specifically for birth control and it is also used to help improve facial acne.  Metformin may help if a woman presents with type 2 diabetes.  Should medication fail to help, cysts may be removed by laparoscopic surgery.

Homeopathic remedies that could help:

• Apis Mel -  pains in the ovaries are worse on the right side and are worse for intercourse.  Periods are painful with a scanty discharge of slimy blood or with pains in the ovaries; 
• Thuja – the menses can be too early or too short.  They experience severe pain in the left ovary and inflammation of the left ovary is worse at every menstrual period. 

Female hormone problems can have a dramatic effect on a woman, so what can homeopathy do to offer support and help?  As with any new client a full case history is taken that includes mental, emotional and physical symptoms so that even with a named diagnosed condition homeopaths choose the remedy that matches the symptoms presented by each individual client.

The Homeopathic Repertory[5] and Materia Medica[6] lists a number of remedies that may be suitable for women who are experiencing problems that I have mentioned above but I would emphasise that it is important to seek the help of a professionally qualified homeopath rather than try to undertake self-help.

Homeopathy is gentle, non-toxic and non-addictive and can safely be used by all ages and does not interfere with any prescribed medication.

References

1. Van Wynsberghe, Donna, Noback, Charles R, Carola, Robert; Human Anatomy & Physiology 3^rd Edition
2. Black’s Medical Dictionary 37^th Edition
3. Everydayhealth.com https://bit.ly/35dJdAA
4. Womenshealth.gov https://bit.ly/2Sf0i84
5. Murphy, Robin ND, Homeopathic Clinical Repertory 3^rd Edition
6. Murphy, Robin ND, Nature’s Materia Medica 3^rd Edition