Dr (Mrs.) Daxa V. Vaishnav
I have been exclusively treating cases of gynaecology and obstetrics since 1985, both in my private practice as well as my OPD (Out Patient Department) at Shree Mumbadevi Homoeopathic Hospital (a teaching hospital attached to CMP Homeopathic Medical College) at Bombay.
The cases described below are just a few of the hundreds that have proved to my allopathic colleagues that homoeopathy has a lot to offer in cases of infertility, PCOD, DUB, etc.
The approach to the selection of the remedy is different for each of the following cases- the prescriptive point is either the totality or the cause or a keynote.
Case no. 1 (Primary infertility): Mrs. JAB, a known case of Rheumatic Heart Disease (RHD), came to us on December 30, 2002 with the diagnosis of Primary infertility. She had oligomenorrhoea since 2 years. Her menses were late, coming every 40-45 days and would last 3-4 days. This was also associated with a dysmenorrhoea.
She also had complains of distension of abdomen for almost 15 years. This is < after eating, from rice3, potatoes3 and > lemon juice.
She has a good appetite and can tolerate hunger well. She likes rice3, potatoes3, tea3 and sweets. She has an aversion to meat and fish. The thirst is increased and she drinks large quantities of water frequently. She also drinks 6-7 glasses of lemon juice every day. Her bowel and bladder movements are normal. She does not sweat much, and if at all, mainly on the head. Her sleep is refreshing and she usually sleeps on her side. She is a hot patient.
The patient has 4 siblings. She has studied only till the seventh grade because of her cardiac problems (RHD). She does not mix easily with others- quite asocial. She has dreams of making a lot of money-“If I have money, my future will be bright. I will not need to ask others for help.”
“I like to talk- make fun….”
“I do not like to sit idle. I like to work a lot. I do not like to sit at home. If I am idle, I get unnecessary thoughts. I think the doctor will tell me that I should not conceive (because of the heart disease).”
“I don’t hide things from anyone. I feel that in future I will have problems, so if I have done something wrong, I tell it to my husband or my parents”
“I get stressed easily. To avoid this stress and anxiety, I tell all my problems to others. I keep thinking, why did I get this (heart) disease?”
The happiest moment in her life has not yet come. When quizzed about the saddest moment in her life, she said “I was in love with a boy about 4 years ago and we were going steady for quite some time. But, when he came to know of my heart complaints he started avoiding me. I understood and let him go. This was the saddest moment. I feel he has deserted me. I feel if the person whom I loved and chose did not support me, how could I expect an unknown person to care for me? Why did he do that?”
She is now married to someone her parents chose for her. He is a sweeper by occupation.
She has no other significant history of illness. Her mother has a uterine prolapse.
Investigations: Echocardiography (19-8-2002) shows mild to moderate mitral valve regurgitation.
Examination: PA: NAD; Ut: anteverted, normal size, Fx: clear
[Husband’s semen analysis: Sperm count 32 million/ml, 25% Grade IV motility. He was referred to a surgeon who ruled out hydrocoele, varicocoele, hernia or any testicular abnormalities.]
Treatment: 2 doses of Natrum mur 1M and placebo for 2 weeks.
January 16, 2003: Feels > in general. LMP- Dec. 8, 2002. Distension of abdomen >. Placebo given for 2 more weeks.
February 1, 2003: >3 LMP- 16-1-2003. 2 doses of Natrum mur 1M were repeated with placebo for 2 weeks.
February 15, 2003: No distension of the abdomen. Dizziness, since the past 3-4 days. Placebo was continued for 2 more weeks.
March 7, 2003: No menses as yet. (LMP: 16-1-2003) No distension of the abdomen but nausea and retrosternal burning since 10 days. Dizziness for almost a month. A Urine Pregnancy Test (UPT) was performed which showed a positive result. 1 dose of Natrum mur 1M was repeated along with placebo for 2 weeks.
March 23, 2003: Dizziness >3, Retrosternal burning and nausea >3, appetite, stools, urine- normal.
On examination: PA: mild tenderness; PV: Cx tubular, os closed
Placebo was repeated for 2 more weeks.
This patient was followed up during her pregnancy and the minor discomforts of pregnancy were treated with infrequently repeated doses of Natrum mur 1M.
Discussion: The history of grief and disappointment in love tilted the scales in favour of Natrum muriaticum.
Case no. 2 (Secondary infertility): Mrs. R. D., a 21 years old female, married since 1-½ years, came with a history of polymenorrhoea since the past 6-7 months. This followed a D&C (Dilatation & Curettage) after an abortion during the fourth month of her pregnancy. The menses were irregular, usually appearing every 15 days, lasting one day with a scanty flow. The bleeding was like the washings of meat but was not clotted. She also had a thin, watery, profuse, non-offensive, non-irritating leucorrhoea about 6-7 days before the menses. The leucorrhoea was always preceded by a body ache. Since the mast 6 months she also could not retain the semen after an intercourse.
Her appetite had reduced since the past 6 months and she craved pungent food. She drank 4-5 glasses every day, mostly with her meals. She did not sweat much and her bowel and bladder functions were normal. She sleeps for 8-10 hours at night and 3-4 hours in the afternoon. She wakes up unrefreshed from her sleep and does not feel like getting out of bed in the morning. She does not remember her dreams.
The patient came to Bombay three months ago with her husband who works as a driver. She has studied till the sixth grade. She cannot tolerate dishonesty. She will get angry and feels like beating the other person. She will always express herself and will never keep things in her mind.
Treatment: On November 18, 2002 she was prescribed a dose of Natrum carb 200.
Follow up: She was seen again on November 25 (LMP was Nov. 11) and December 2 when she was given placebo. Meanwhile, she had been advised an ultrasound examination of the pelvis. This showed minimal free fluid in the pelvis, suggesting a pelvic inflammatory disease (PID). Other investigations like blood glucose, urine, VDRL, HIV, HbsAg were normal. The haemoglobin was 10.1 gm/dl.
December 23, 2002: The LMP was Dec. 12. Bleeding was for 3 days, bright red. Leucorrhoea was >. She had a mild back ache and pain in the abdomen. 2 doses of Natrum carb 200 were repeated.
January 1, 2003: Feels >. Backache with a pain in the abdomen- as if about to menstruate. 2 doses of Natrum carb 200 were repeated.
January 20, 2003: LMP was Jan 7. Menstrual complaints and backache were >. She had also put on some weight. It was decided that we would give her coital advise at the next visit. 3 doses of Natrum carb 1M were prescribed.
February 14, 2003: Nausea at the sight of food since 1 week. Distension of abdomen and constipation (no urge for stools). Thirst had increased a lot. There was some headache and dizziness. The tongue had a thin, white coating. Per vaginum examination showed a firm cervix and external os. A Urine Pregnancy Test (UPT) was done which was positive. Diagnosis- Pregnancy. Arsenicum album 200 t.i.d. was prescribed for the next 7 days for the nausea and the abdominal discomfort.
March 21, 2003: No distension of abdomen. Nausea persisted and was < smell of food, on eating, on lying down. She could tolerate water, and had an aversion to vegetables and pulses. Colchicum 200, q.i.d. was prescribed for the next 7 days.
Doses of Natrum carb 1M were repeated infrequently during her pregnancy and she had an uneventful pregnancy.
Discussion: In this patient, the menses first became regular and then she was able to conceive with the help of Natrum carb.
The drugs that are commonly indicated in sterility are Borax, Natrum mur, Agnus, Natrum carb, Sepia, Phos, etc. When sterility is from non-retention of semen, the drug is Natrum carb; acrid, pungent secretions cause sterility in Natrum phos; Iodium has sterility from atrophy of the breasts and the ovaries; Agnus has sterility from suppressed menses and with loss of sexual desire; Phos has sterility with too early or too late menses.
Case no. 3 (Repeated abortions with secondary infertility): Mrs. MAR visited the clinic in June 2000, seeking help for her inability to conceive. This was a case of secondary infertility because she gave a history of two missed abortions on July 11, 1996 and March 1, 1999. She had a dilatation and curettage done after each episode of missed abortion.
She was extremely anxious to conceive. A sense of hopeless had set in and she was usually sad and depressed. She used to weep due to the sadness. This reached a point where she had now developed an aversion to coition due to her sadness. She did not like her husband playing with other children and she would be filled with jealousy when she saw other mothers.
She was dark complexioned and grossly obese. She was constipated and had an aversion to sweets. Her menses were usually late, dark red and clotted.
This lady had come to Bombay to visit her relatives and while she was here, she was referred to me for the treatment of her infertility. She did not have her investigation reports with her but said that all the biochemical tests including the hormonal assays were normal. The ultrasound had shown Poly Cystic Ovarian Disease. Her husband had also been thoroughly investigated and was found to have oligospermia (low sperm count) and hyperthyroidism. [All this was later confirmed when she sent a set of photocopies of the investigations.]
Treatment: Syphilinum 1M (2 doses) were prescribed for her. This was followed one month later (July 2000) by Graphites 200, t.i.d. for the next 2 months. The patient’s husband was prescribed Thyroidinum 30 t.i.d for 2 months.
Follow up: The patient conceived in October 2000, without any artificial aid by her gynaecologist. She was advised complete bed rest in view of the previous missed abortions.
She had a full term normal delivery in July 2001 and became the proud mother of a healthy baby boy.
Discussion: Syphilinum was prescribed to the patient considering the history of 2 missed abortions. This is a miasmatic influence and the drug was given to counter the same.
A fat, costive female with delayed menses usually suggests Graphites as the remedy. This patient also had another physical general symptom- aversion to sweets, which helped to confirm the remedy. The mental symptoms were not given much importance in this case because these were the result of the stress of the recurrent abortions and subsequent infertility. In this case, these symptoms can be classified as common symptoms.
In our clinic, we have found Thyroidinum to be a near specific in cases of oligospermia. We have had many patients whose sperm counts increased significantly after the use of Thyroidinum. ‘Arrested development’ is the key word for this remedy.
Case no. 4 (Secondary infertility with oligomenorrhoea): Mrs. YM, a 22 years old patient came to us on April 5, 2003 for the treatment of irregular menses (Nov. 25, 2002, Dec. 30. 2002, March 24, 2003) that had been bothering her for the past 2-3 years. Her menstrual history was as follows:
Menses appear every 2-3 months. The bleeding lasts 6-7 days. It is irregular, profuse, dark red, non-offensive and non-staining.
She has pain in the abdomen before menses and backache during menses.
She had a Caesarean section 4 years ago and delivered a male child (breech presentation). If she does not get the menses on time, she would have pain in the limbs, dizziness, fullness of the abdomen and a feeling that she was pregnant. This usually lasts for a couple of days.
She craves fish3, sweets3, salty3 food and ice cream. She dislikes bitter food. She is thirst less.
She sweats on the face and in the axillae. It is non-offensive but stains yellow.
Her bladder and bowel movements are normal. She is a hot patient.
She lives in a joint family with her husband, son, mother-in-law and brother-in-law. She has studied till the tenth grade.
She is very irritable. Trifles will anger her. She will not control herself and shouts at the other person. “When I am angry, my hands tremble.”
She likes to keep her home clean. If anyone makes a mess at home, it irritates her and she then shouts even if it is her husband or mother-in-law.
She is also very emotional. Small things affect her and she weeps easily. But, she will not weep in front of others.
She is also obstinate and strong willed- “If I am right, I will not change at all”.
She is very social and likes making friends. Likes to be happy and jovial.
She gets anxious when she goes to any hospital. “In the municipal hospitals, the staff do not behave well with patients, they shout at us and it scares me.”
There is no significant past or family history of any illness.
On examination: PA: NAD; PV: Ut- retroverted, Cx- healthy, Fx-clear
Treatment: (April 5, 2003) 1 dose of Pulsatilla 1M and placebo for 2 weeks.
Follow up: April 30, 2003: Menses not yet (LMP- 24-3-2003). 3 doses of Pulsatilla 1M and placebo for 2 weeks.
August 16, 2003: Lost to follow up for 3 months. Menses are now regular (30-5-2003, 1-7-2003). Pain in both lumbar regions. Occ. Pain in the hands and feet. UPT- positive
On examination: PV- Ut enlarged (6-8 weeks size).
3 doses of Pulsatilla 1M were repeated.
September 3, 2003: Pain in lumbar region > but persists. Pain in the hands and feet >. Thirst less.
On Examination: PV- Ut 8-10 weeks size.
3 doses of Pulsatilla 1M were repeated.
The patient is being followed up currently and has had an uneventful pregnancy.
Discussion: Pulsatilla was prescribed because the patient was fastidious, often peevish, delayed menses, felt she was pregnant whenever the menses were delayed, thirstlessness and past history of malpresentation of the foetus.