Climacteric Ailments

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climacteric, menopauseAbstract: Climacteric is a common phenomenon of women. It is a physiological process but, lots of women suffer very seriously. This article is an attempt to explore its aetiology, symptoms, diagnosis, management, conventional treatment & it’s side effect and Homoeopathic approach.

 

Introduction

Adjustment and compromise are the two components to survive in nature. Our internal body constantly adjust to combat situation, called as homoeostasis. The best example of adjustment in a female life is transition from the active to inactive reproductive life. Adjustment involves on three basic levels: Physiological, Physical & sexual. This change of life period is called climacteric period. It begins around three years before final stoppage of menstruation and continue for two-five years after it.

 

 Stoppage of menstruation is called menopause. It may be defined as cessation of ovarian function around the age of 47 years, resulting in permanent stoppage of menstruation. Menstruation means crying of uterus during the period of reproductive life of a female where blood and bits of endrometrium is coming (instead of tear) for failure of giving birth to a new life (funeral of the unfertilised ovum).

 

Demography

 

60 million women in India are above age of 55 years. Majority of women spend 1/3 of their life in post-menopausal period.

 

Aetiology

Climacteric period is a physiological process of life. But millions of women suffer lots of problem due to:

Fundamental cause

As per Homoeopathic philosophy, latent miasms are responsible for manifestation of symptoms. History of past illness, family history and present manifestation of symptoms give the miasmatic diagnosis which is essential for a particular patient to treat.

Organic Causes

  • Deficiency of Oestrogen.
  • Surgical removal of ovary.
  • Pituitary hypoplasia leads to deficient secretion of FSH & LH.

 

Premature menopause: Below the age of 40 years is caused by

  • Genetic factors.
  • Tuberculosis of genital tract.
  • Autosomal diseases.
  • Smoking
  • Chemotherapy
  • Hystectomy
  • Prolong GnRH therapy.
  • 17α hydrolase deficiency.

 

Delayed menopause: Above 50 years of age is caused by-

      Physiological:

  • Good nutrition
  • Good health
  • Mental peace.

 Pathological:

  • Uterine fibroid
  • Endometrial carcinoma
  • Vulva trauma
  • DUB

 

Pathophysiology

Oestrogen and Progesterone are the fundamental hormones for a female reproductive life. Oestrogen comes mainly from graafian follicle and small amount from corpus luteum; progesterone comesis coming from corpus luteum of ovary. Graafian follicles originate from primordial follicles, 80 lakh in number during intra-uterine life, but only 450 to 500 primordial follicles mature to form graafian follicles. Around the age of 40years primordial follicles decrease in number, leading to decrease in the production of these two hormones. When all the primordial follicles are atrophied oestrogen secretion from ovary stops completely. But, F.S.H & L.H from anterior Pituitary is secreted continuously due to negative feedback mechanism. The symptoms start to appear soon after the stoppage of ovarian function.

 

Age:45 -50 years; average 47years.

 

Anatomical changes during climacteric period

  • Genital organ: atrophied
  • Ovaries: Shrinks
  • Uterus: Small
  • Cervix: Small in size
  • Breast: Pendulous due to less amount of glandular tissue but more amount of fat.
  • Skin: Wrinkles.
  • Hair: Abnormal hair grows around the chin and lips.

 

Symptoms:

60- 70 % women do not suffer any problem. Some do:

  • Stoppage of menstruation either suddenly or gradually.
  • Hot flushes < Night.
  • Headache
  • Palpitation
  • Sleeplessness
  • Depression
  • Irritability
  • Lack of concentration
  • Pseudocyesis
  • Cancer phobia
  • Pin mania.
  • Sexual desire usually decreased but sometimes may be increased.
  • Parasthenia
  • Dysuria
  • Recurrent infection
  • Stress incontinence
  • Vaginal bleeding
  • Dry vagina leads to dyspareunia.

 

Late symptoms

  • Oesteoporosis
  • Arthrites
  • Stroke
  • Alzhimer disease
  • Tooth decay
  • Prolapsed
  • Cataract

 

Investigation

  • History of the patient & general examination.
  • Hormonal assay
  • Endometrial biopsy
  • S.G
  • Mammography

 

Management

  • Assurance
  • Counselling

 

Conventional treatment: Hormone Replacement Therapy (H.R.T)

 

Adverse side effects of HRT:

  • Endometrial carcinoma.
  • Breast Cancer.
  • Venous thrombo embolic disease.
  • Gallbladder disease.
  • Hypercholesterolemia
  • Heart disease.
  • Alzheimer disease.

 

Homoeopathic treatment:

 

Climacteric period is a physiological process and 60- 70% women have no complaints.  No  medicinal treatment is needed, only counselling is sufficient. Homoeopathic treatment is required when sufferings are intolerable and women become sick It is a border line to differentiate physiological and sick condition and only experienced person can  do it. Homoeopathic treatment is based on individualisation, law of similia, law of minimi and theory of miasm. It is my experience that climacteric ailments may be treated successfully if we follow the Homoeopathic laws. Homoeopathic medicines acts on vital principal. It has no evidence, but my understanding of the knowledge of physiology and Homoeopathy concludes that: Vital principal probably acts on adrenal gland to secrete oestrogen to make the minimum fulfilment of body demand.( The adrenal glands, perched on top the kidneys, produce small quantities of both male and female sex hormones.  At the menopause, the adrenal glands should produce adequate estrogens, progesterone and other needed hormones in the correct balance and amounts to avoid symptoms that can occur when ovarian hormone production of these hormones diminishes)

 

 Therapeutics:

According to  §153,” more  striking, singular, uncommon and peculiar(characteristic) signs and symptoms of the case of disease are chiefly and most solely to be kept in view” in the search of a Homoeopathic remedy. So any medicine from A to Z may be effective.

 Repertorial approach

 

In different repertories, we find, lots of medicine under rubric menopause, ailment from, example :

 

In J.T. Kent Repertory: Chapter- Genitalia female – Menopause.

 

In Robin Murphy’s Repertory: Chapter Female. Menopause, Period, ailments from- etc.

 

Case study

 

O.P.D ticket no: 42777 of Mahesh Bhattacharyya Homoeopathic Medical College and Hospital.

Name- xxx

Religion: Hindu. Sex: Female. Age: 47 years.

Date of first Visit: 29/07/2015.

 

Chief Complaints

Hot flashes < night.

 

Associates Complaints

  • Loss of sleep since last 2 yrs.
  • Headache < day time.

 

Past History

Repeated U.T.I, Appendectomy at the age of 39 yrs. Eczema treated by ointment at the age of 40 yrs.

 

Family History

 Mother- Rectal Ca.  Father- Hypertension.

 

Physical generals

Thermal Reaction: Hot patient.

Appetite: decreased.

Craving: Sweet, warm food.

Thirst:Increased.

Prespiration: Profuse.

Sexual Desire:absent.

 

Mental: Irritable. Depressed. Supressed anger. Forgetfulness.

Rx

Staphysagria 200/ 1dose.

After 1 month no change. Rx Staphysagria 1M/ 1dose. After 2 months no change.

Then, repertorised  the case,

Rx

 Sulphur 200 / 1dose.

 Improvement started after 1 month.

 Then, waited for 2 months and prescribed,

 Rx

Sulphur 1M/ 1dose.

After 3months, Lachesis 200/1 dose.

After 2 months, Lachesis 1M/1dose.

Now, the patient is free from suffering. Continued with placebo.

 

Conclusion

 

Climacteric ailments are a physiological process but, treatment is needed when women suffers from intolerable signs and symptoms. At first, counselling is needed, then treatment. Conventional treatment recommends HRT (Hormone Replacement Therapy). Lots of hazards may start after HRT. To avoid it, Homoeopathic treatment is the best choice. It has no adverse side effects. Treatment of Climacteric ailments is not a big challenge for Homoeopathy. Lots of Homoeopath treat thousands of patients in their day to day practice with great success.

 

Bibliography

  1. Hahnemann, Samuel. “Organon of Medicine”, Translated from 5th edition with an appendix by R.E. Dudgeon; with Additions and Alterations as per Sixth edition translated by William Boericke,B.Jain Publishers Pvt.Ltd, New Delhi,2003.
  2. Hahnemann, Samuel. “The chronic Diseases-Their Peculiar Nature and Their Homoeopathic cure”, Translated from 2nd Enlarged German edition by Prof.Louis H.Tafel; B.Jain Publishers Pvt.Ltd, New Delhi,1977
  3. Kent, J.T. “Lecture on Homoeopathic Materia Medica” B.Jain Publishers Pvt.Ltd, New Delhi,2003.
  4. Howkins & Bourne. “Shaw’Textbook of Gynaecology 15th edition;edited by VG Padubidri; Shirish N Daftary; Elsevier,New Delhi,2011.
  5. Dutta, D.C. “Text Book Of Gynaecology including contraception” 4th edition; edited by Hiralal Konar; New Central Book Ageny (P) LTD. Kolkata 2007.
  6. http://drlwilson.com/Articles/MENOPAUSE.htm( visited on 18/05/2016)
  7. Sembulingam,K., Sembulingam, Prema. “Essentials of Medical Physiology” 6th edition; Jaypee Brothers Medical Publisher(P) LTD. New Delhi ,2013.

 

Author: 

Dr. Sanjoy Kumar Roy

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About Author

Dr Sanjoy Kumar Roy is M.D (hom.) Materia Medica From National Institute of Homoeopathy (Govt. of India). He is also Ex. Lecturer- Rajkot Homoeopathic Medical College, Gujarat. At Present he is working as a Homoeopathic Medical Officer, in West Bengal Homoeopathic Health Service, Detailed as Lecturer in the Dept. of Physiology including Biochemistry, Mahesh Bhattacharyya Homoeopathic Medical College & Hospital, Howrah, Govt. of West Bengal.

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