OLIGOMENORRHEA AND ITS HOMOEOPATHIC TREATMENT


OLIGOMENORRHEA AND ITS HOMOEOPATHIC TREATMENT. Adult oligomenorrheal patients, the subject of the present consideration, almost always come for consultations with a history of more or less defined amenorrheas, and in such cases we must investigate whether the insufficiency is total or definite because of surgical castration, or precocious or natural menopause.


Homoeopathy has a right to say that it is the possessor of truth, which is proven by the efficacy of its results, the simplicity of its application, the promptness of its action and the safety in its cures.–Dr. Higinio G. Perez in Philosophy of Homoeopathic Medicine. Oligomenorrhea is the manifestation of menstrual cycle arrythmia, characterized by an interval longer than normal between two menstruations.

Menstruation fails to occur every 28 or 35 days. This function, instead, takes place with intervals of 40, 50, 70 or more days, in which case, if more than 90 days apart, definite amenorrheal states are involved.

The alterations of the menstrual rhythm of an oligomenorrheal type indefectibly consist of an irregularity if the ovarian function, and we are indebted to Schroeder for the following anatomo-physiological theory, which demonstrates the underlying cause of this ailment: “The menstrual phase is affected at longer intervals due to the fact that one follicle does not begin its evolutional cycle immediately after the menses, but does so at a later time, thereby leaving an interval of 10, 15, 20 or more days, this being the delay with which the following menstrual courses will appear, and it is due to the fact that, as the maturation cycle begins, the follicle has a low vital power, and as it reaches its state of development it becomes involuted and imperforate”.

It should always be borne in mind that each menstrual function is the result of a functional complex in which the hypophysis, the ovary and other glands of internal secretion, as well as the uterus, work in a more or less active manner.

Oligomenorrhea is, nevertheless, the typical manifestation of ovarian insufficiency, either primary or secondary, leading to amenorrhea.

It is frequently observed that oligomenorrheal patients are at the same time hypomenorrheal, or they may, instead, present protracted menses, causing the physician to establish a differential diagnosis in order to ascertain whether an ectopic pregnancy is involved or haemorrhagic metropathy or abortion is implicated.

Oligomenorrhea may be either primary or secondary; that is, in the first case, it affects girls over 18 years of age, whose menses are abnormal either because of lesions proper to the ovary (inflammatory, cystic, etc.), or because manifestations of infantilism, eunuchoidism, lesions of the hypophysis, suprarenal lesions, etc. are present.

Adult oligomenorrheal patients, the subject of the present consideration, almost always come for consultations with a history of more or less defined amenorrheas, and in such cases we must investigate whether the insufficiency is total or definite because of surgical castration, or precocious or natural menopause.

A patient suffering from oligomenorrhea almost always presents psychic inferiority manifestations because such patient has few probabilities of fecundity, in as much as the number of ovulations decreases and her ovarian insufficiency will end in troublesome amenorrhea due to the various endocrine symptoms associated with non-physiological menopause.

Inasmuch as the symptomatic picture of an oligomenorrheal patient is quite complex due to the fact that ovarian insufficiency phenomena are associated with manifestations of the general endocrine, genital and extra-genital state, depending on their origin, I shall mention only such among the most frequent causes of oligomenorrhea as will permit a correct clinical interpretation of this condition.

Most gynecologists have divided into three groups the commoner causes of ovarian insufficiency leading to oligomenorrhea in adult women:

1st–Ovarian insufficiency due to constitutional infantilism,

2nd–Ovarian insufficiency due to constitutional intersexuality, and

3rd–Ovarian insufficiency caused by ovarian hypoplasia.

Ist–Oligomenorrhea by ovarian insufficiency due to constitutional infantilism is clinically characterized by general hypoplasia with infantile manifestations in all forms and, especially, by the lack of development of the uterus, and the smaller the uterus the more serious the prognosis will be.

2nd–Oligomenorrhea due to ovarian insufficiency because of constitutional intersexuality is present in women of a mannish type, robust, having ectopic hair and a tendency to obesity. These women pass in a short time from oligomenorrhea to a precocious climacterium.

3rd–Oligomenorrhea by ovarian hypoplasia is characterized by an infantile uterus, normal or excessive height. It is almost always accompanied by skeletal dysplasias resembling acromegalic states. Mammary aplasia is frequent.

To these three main classifications subdivisions permitting the establishment of a differential diagnosis for each type of functional insufficiency of the ovary leading to oligomenorrhea should be added. Having in mind the conciseness of the present work, I shall mention only such cases which are susceptible of treatment within the scope of homoeopathic medication, inasmuch as the others are subject to opotherapic, surgical and physical agent treatments, etc., etc., depending on each particular case.

The more frequent clinical cases leading to oligomenorrhea and which may be cured through homoeopathic medication are: juvenile anemia, chronic alcoholic intoxications, chronic intoxications caused by morphine, barbiturates, etc., alimentary insufficiency causing avitaminosis, psychic states loaded with emotional stimuli, affective psychoneuroses, melancholia, anguish, schizophrenia, etc.; still more frequent those associated with or originating in hyperthyroidism, or hypothyroidism.

Remedies more frequently indicated within the homoeopathic field are:

Pulsatilla nigricans–Patients of a peaceful, kind, complacent temperament, who weep for any slight reason, always sad and dejected. It suits best patients having blond hair and blue eyes.

All of the symptoms present marked variability. Sensitive women whose genital disturbances are associated with persistent catarrhal states of all the mucosae, with soft, thick, greenish- yellow secretions. Pulsatilla acts best after the abuse of ferruginous tonics.

Menses suppressed by cold or following wet feel. Delayed, scarce or suppressed menstruation appearing every 45 or 60 days, of an intermittent type, with coagula. Chill, nausea, sensation of pressure downwards from the utero-ovarian region.

Pain at the lumbar region, sensation of fatigue. Gastro- intestinal disturbances before and after menses.

WORSE–At night, from heat, by rest and from fats.

BETTER–By motion, in the open air and by cold applications.

Graphites–Powerful anti-psoric remedy having an elective action on the generative organs of both sexes.

Particularly indicated for corpulent individuals with a tendency to skin diseases, predisposed to obesity. Excessively delayed, very scarce, pale menses associated with tenacious constipation with knotty mucous evacuations. Pressure pain at the external genital region. Induration of the left ovary with stone- like hardness, sensibility to touch, in walking or inspiration. Sweat and insomnia. Vulvar prurigo before menstruation. Premenstrual and post-menstrual mastitis. Fissured, sensitive nipples. Hoarseness during the menstrual stage.

WORSE–At night, by heat and during menstruation.

BETTER–In the dark and keeping the patient well wrapped.

Sepia–Medication with an elective action on the pelvic organs and liver. Tall thin persons having black hair and eyes. Yellow-brown spots on nose, cheek bones and about the mouth.

Sensation of heaviness downwards in the pelvic region, clawing pains from the sacrum to the pelvic organs with sensation as if something were trying to come out from the vulva. Extremely scarce delayed menses in adults, heavy pain from the umbilical region to the small pelvis. Flushing with marked weakness, profuse cold sweat even in warm room.

Sclero-cystic ovaritis with sensation of burning and sharp pains. Oligomenorrhea or amenorrhea with congestive hemicrania in the morning, irritable temper with loss of appetite. Scarce menses with dark secretion.

WORSE–After coughing, on inspirating, by washing, from touch, in the morning and in cold weather.

BETTER–From soft pressure, heat and in the evening.

Calcarea carbonica–An excellently constitutional anti- psoric Hahnemannian remedy. It is well indicated for ovarian troubles when decalcification antecedents are present from childhood. Dysfunctions of the thyroid and pituitary. Tendency to obesity. Pretubercular states.

Dysfunctions of the ovary, particularly in younger women of a scrofulous type, who, besides being weak and feeling exhausted, have nocturnal cough with sweating and multiple ganglionic infarcts. Young and adult women easily catching cold with partial abundant sweats and cold perspiration of the hands and feet.

Oligomenorrhea or amenorrhea in puberty. Ardor and itching at the external genitals with profuse cold sweating at the genital level. As menstruation occurs, it is profuse, abundant, of a bright red color with oligomenorrhea from 60 to 90 days. Premenstrual mastitis.

Pain as if the menses were to take place without occurring. Delayed, scarce menstruation with feeling of abdominal enlargement. Cystic ovaritis. Oligomenorrhea or amenorrhea due to anemia.

WORSE–Cold air, motion, damp weather.

BETTER–Dry weather and lying on belly.

Aletris farinosa–Chlorotic patients with hypochromic anemia. Mental and bodily weakness. Distended abdomen and marked lassitude. Oligomenorrhea and amenorrhea due to ovarian insufficiency.

Chlorotic, dyspeptic young women with vertigo and fainting. Delayed, scarce menstruation with labor-like intense pains, dark blood in coagula, sensation of weight in the uterine region spreading to right inguinal region. In Dr. Hale’s opinion, Aletris farinosa is the China off. of pelvic organs.

Helonias dioica–Languid, inactive, tired patients who wish to be left alone. Irritably tempered, these patients reject any suggestion opposing their own ideas. Macrocytic anemia. Patient is conscious of her uterus, that is, all of her troubles are located in the small pelvis.

Oligomenorrhea with atony and functional ovarian insufficiency. Amenorrhea due to general atony with dark, scarce, coagulated, offensive menstruation. Vulvar pruritus and pre- menstrual congestive mastitis with excessive pain in both nipples. The patient does not tolerate garment pressure at level of chest. Oligomenorrhea and amenorrhea of precancerous states. With this condition are frequently associated nephritis, diabetes mellitus et insipidus. Albuminuric nephritis and phosphaturia.

WORSE–By motion and touch.

BETTER–By occupying the mind with thoughts of something different from the disease and by amusing oneself.

Conium maculatum–Best adapted to unmarried women, who are always dejected, timid and inclined to weeping. The patient is indolent and nothing awakens her interest. Diminution of intellectual facilities, the slightest mental effort is exhausting. These patients shun society and are afraid of being alone. Vertigo, that becomes aggravated on turning the head to the left.

Oligomenorrhea with scarce, weak menstruation, which occurs in coagula, with terrible pain in both ovaries with hysterical paroxysms. During and after menstruation, a vesicular urticaria is often associated invading the face and the trunk. Sclerocystic ovaritis. Ovarian insufficiency with sensation of pain and hardness at the level of these organs. Vulvar pruritus.

Generalized lymphangitis. Scrofulism. Precancerous states. Premenstrual mastitis with flaccid, lax glands and contracted nipples.

WORSE–At night, before and after menstruation, in celibacy.

BETTER–By motion, pressure and heat.

Actea racemosa (Cimicifuga)–Irritable, nervous patients with incessant loquacity, variable temper, alternate cheerfulness and profound despair. Fear of death. Hallucinatory phenomena during menstrual stages.

Oligomenorrhea with scarce, dark menstruation in small coagula, offensive, always irregular with lumbar pain and nervousness, sharp pains of a neuralgic type in both ovaries. Menstruation suppressed due to violent emotions, cold weather or catarrhal states. Hysteriform phenomena and epileptic spasms. Hemichorea.

WORSE–During menses, in cold weather and at night.

BETTER–By heat and by taking food.

Viburnum opulus–Sensation of vertigo with headache and heaviness situated in the left supraorbital region if the menstruation does not appear. Irritability, depression. The patient is unable to do any mental work.

Oligomenorrhea with sensation of congestion of the small pelvis and improvement as menstruation appears. Oligomenorrhea with intense sharp spasmodic pains in both ovaries, colic before and during menstruation which presents itself scarce, thin, slightly colored, with cramping and neuralgic pains, and lasts a few hours after which it is discontinued and returns after several hours or days in great coagula and with offensive odor. Membranous dysmenorrhea. Congestive ovaritis. Pelvic pains of a cramping type.

WORSE–By heat, at night and lying on the sick side.

BETTER–In the open air and by rest.

Belladonna–The elective action of this remedy is on the central nervous system and the circulatory system. Great over- excitement. Hallucinations with violent delirium. The patients are always endeavoring to flee. Tendency to bite and tear objects to pieces. Great sensibility, light and noise intolerable. Congestive cephalalgia with pounding in the brain and carotids. Photophobia. Dejection, melancholy, despair. Hysteria that becomes aggravated by the absence of menstruation.

In oligomenorrhea, Belladonna is greatly useful when the menstruation appears with congestive or neuralgic pain of the ovaries, the right ovary being more affected. Delayed menses with lancinating pains invading the hip and thighs. The menstruation has a bright red or a very dark color. It comes in coagula and has a marked offensive odor.

Pain in the small pelvis, uterus and ovaries occurs with such sensitivity that the patient suffers terrible pains at each step. The slightest pressure is intolerable and pains are of heaviness and fullness at ovary level, especially on the right. Sensation as if the full contents of the abdomen were to come out through the vulva. Acute premenstrual mastitis.

WORSE–By motion, touch, noises, air drafts, light and by lying down.

BETTER–With rest, by sitting down, heat and darkness.

Ignatia amara–Extremely sensitive, nervous, melancholic patients of a changeable, inconstant, irresolute character. Mental variability from anger or indifference to laughter or tears, anxiety and hastiness in action. Imaginary fear as to one’s health. The patient needs being alone. Concentrated anguish with sighs and tears.

In oligomenorrhea, pains are of a spasmodic type, with black blood in coagula and with offensive odor when the menstruation presents itself. The pain in the uterus is of a spastic or a cramping type, with anguish, laxity which may result in fainting.

Oligomenorrhea or amenorrhea with heaviness in the head, frontal pain with stomach emptiness, photophobia, ear buzzing, tachycardia and nervousness during menstruation. Menses suppressed by emotions, with sighs and sobbing, precordial anguish.

WORSE–In the morning, in the open air, by drinking coffee and after some trouble or emotion.

BETTER–Heat and change in position of body.

Hyoscyamus niger–It acts deeply on the cerebrospinal nervous system, causing illusions and hallucinatory phenomena. Mania with agitation, high loquacity, delirium and lasciviousness.

Weak, melancholic patients with great difficulty in expressing their own thoughts. Jealousy, fear of being alone, fury with desire for striking and killing, delirium with agitation. The patient is inclined to undress and show her genitals.

Hyoscyamus niger is indicated in oligomenorrhea when the nervous system is more affected. Hysterical spasms and pains precede the menses. Oligomenorrhea with suppressed menstruation with convulsive phenomena of the hands and feet. Profuse transpiration with headache and rigidity of the jaws. Enuresis and spasms of an epileptic form type. Mydriasis, amaurosis and amblyopia of short duration with stupor. Sometimes the menstruation presents itself with abundant flow with vesical paralysis.

WORSE–At night, during menses, after eating and on going to bed.

BETTER–By standing up and in the day.

Valeriana officinalis–Hysterical, very sensitive patients presenting phenomena of a spastic type in general, marked restlessness, excitability and insomnia. Hysterical globus. Mydriasis with visual scotomae. Dyspepsia with aerophagia and constant choliphagia.

Oligomenorrhea with scarce menstruation and large coagula, with which are associated neurasthenic phenomena, cephalalgias with sensation of intense cold in the head and back. Ovarian in-

sufficiency of unmarried young women.

Oophorinum (ovarian extract)–Menses appearing every 40 or 65 days, with congestive premenstrual and postmenstrual mastitis. The menstruation is painful, in coagula, and has a short duration. Adiposogenital syndrome. Vulvar pruritus. Acne rosacea, which becomes aggravated during the premenstrual stage. (Drs. Alexander L. Blackwood, John H. Clark and William Boericke.).

Conclusions.

1st–In order to secure a healing effect in oligomenorrhea, a frequent syndrome in feminine genital life, it is essential, before prescribing a homoeopathic medication, to establish a differential diagnosis in connection with disturbances akin to this ailment.

2nd–Oligomenorrhea, which has been considered by gynaecologists as a manifestation of second degree ovarian insufficiency, IS SUSCEPTIBLE TO COMPLETE CURE THROUGH HOMOEOPATHIC MEDICATION, and

3rd–THE CURE OF OLIGOMENORRHEA HAS A DEFINITE SUCCESS WHEN THE REMEDY INDICATED FOR EACH PARTICULAR CASE IS PRESCRIBED UNDER THE LAW, “SIMILIA SIMILIBUS CURENTUR”, DISCOVERED BY THE IMMORTAL DR. SAMUEL CHRISTIAN FREDERICK HAHNEMANN.

AMSTERDAM NUM.21.

COL. HIPODROMO-CONDESA.

ZONA 11. MEXICO, D.F.

Hilario Luna Castro