FEMALE GENITAL SYSTEM COMPLAINTS
ENDOMETRIOSIS
What is endometriosis?
The presence of functioning endometrium (glands and stroma) in sites other than uterine mucosa is called endometriosis. It is not a neoplastic condition, although malignant transformation is possible.
Types of Endometriosis
- ENDOMETRIOSIS INTERNA OR ADENOMYOSIS
- ENDOMETRIOSIS EXTERNA OR GENERALLY REFERRED TO AS ENDOMETRIOSIS
SITES
- Abdomen- rectum and pelvic lymph nodes.
- Rare sites are gut, appendix, ureter and urinary bladder.
- Extra-abdominal- the abdominal scar ofcaesarean section, tubectomy, and myomectomy, umbilicus, episiotomy scar, vagina and cervix.
- Remote sites are – pleura,lungs, deep tissues of arms and thighs
CLINICAL FEATURES
- Painful menses and painful sex
- Abnormal menstruation- Heavy menses with premenstrual spotting
- Infertility
- Chronic lower abdomen pain because of inflammation which increases during menses
- Abdominal pain
- Other symptoms – frequent painful urination, hematuria [blood in urine], painful stool, diarrhea, rectal bleeding,fatigue, premenstrual symptoms
COMPLICATIONS OF ENDOMETRIOSIS
- Endocrinopathy
- Rupture of chocolate cyst
- Infection of chocolate cyst
- intestinal obstruction-ureteral obstruction
- Malignancy is rare , the commonest one being adenoacanthoma
HOMOEOPATHIC MANAGEMENT
Homoeopathy has a good role in treating female complaints. There are wide sets of homoeopathic medicines which help the patient to overcome the severe bleeding and pain during the menses.In this condition of endometriosis there will be thickening of the uterus so, homoeopathic medicines will be acting on the uterus and will be helpful in reducing the thickness of uterus. Homoeopathic medicines also help to build up immunity and thus preventing recurrent bouts of infection.
FIBROID
Fibroids are the commonest benign [non-cancerous] solid tumors in female. 20% of women at the age of 30 have got fibroid in their wombs. The prevalence is higher between 35-45 yrs.
Risk factors
- Females who have not given birth
- Obesity
- Black women
- smoking
TYPES OF FIBROIDS BASED ON LOCATION
- Body-fibroids are most commonly located in the uterus and are usually multiple
-Interstitial or intramural
-Subserous
-Submucous
- Cervical-anterior
-Posterior
-Central
-Lateral
SYMPTOMS OF FIBROID UTERUS
- Asymptomatic- majority of cases
- Menstrual abnormality- heavy bleeding, bleeding between menses
- Painful menses
- Painful sex
- Infertility
- Pressure symptoms, when fibroid is big and presses on the bladder then it can cause frequent urination
- Recurrent pregnancy loss(miscarriage, preterm labor)
- Lower abdominal or pelvic pain
- Abdominal enlargement
COMPLICATIONS OF FIBROIDS
- Degenerations
- Necrosis
- Infection
- Sarcomatous change
- Torsion of subserous pedunclated fibroid
- Hemorrhage
- Polycythemia
HOMOEOPATHIC MANAGEMENT
Homoeopathy is a holistic system. In conditions like fibroid uterus initial ultrasound scanning is advised to the patient and further medicines will be given to reduce the size of the fibroid uterus and medicines are given for pain and bleeding. These medicines don’t have any side effects and are very safe. The homoeopathic medicines will help in increasing the immunity of the patient.
DYSMENORRHOEA [PAINFUL MENSES]
Dysmenorrhea means painful menstruation to incapacitate day-to -day activities
TYPES OF DYSMENORRHOEA
- PRIMARY DYSMENORRHOEA (SPASMODIC)
- SECONDARY DYSMENORRHOEA
PRIMARY DYSMENORRHOEA
The primary dysmenorrhoea is one where there is no identifiable pelvic pathology
CAUSES OF PAIN
- Psychosomatic factors-due to tension and anxiety during adolescence, lower pain threshold is often attributed as an aggravating factor in pain perception.
- Abnormal anatomical and functional aspect of uterus
-Stenosis or narrowing of the cervical canal
-Unequal development of mullerian duct, such as septate or bicornuate uterus
-Uterine hypoplasia
-Imbalance in the autonomic nervous control of uterine muscles
- Role of vasopressin-It causes uterine hyperactivity, and disrhythamic contractions –ischemia and hypoxia – pain
- Role of prostaglandins –progesterone is a strong vasoconstrictor, which causes ischemia of the myometrium
- Other-endothelins and leukotriene are vasoconstrictors and stimulate myometrium contractions
CINICAL FEATURES
- Pain begins a few hours before or just with the onset with menstruation
- The severity of pain usually lasts for few hours, may extends to 24 hrs but seldom persists beyond 48 hrs
- The pain is spasmodic and confined to lower abdomen, may radiates to the back and medial aspect of thighs
- Systemic discomforts like nausea, vomiting, fatigue, diarrhea, and headache may be associated
- Pallor, cold sweat and occasional fainting
- Syncope and collapse in severe cases
SECONDARY DYSMENORRHOEA
Secondary dysmenorrhea is normally considered to be menstruation – associated pain occurring in the presence of pelvic pathology
CAUSES OF PAIN
- Chronic pelvic infection,
- pelvic endometriosis,
- pelvic adhesions, adenomyosis,
- uterine fibroid,
- endometrial polyp,
- IUCD in utero and pelvic congestion
CLINICAL FEATURES
- Pain is dull, situated in the back and in front without any radiation.
- Patient may have got some discomfort even in between periods
MEMBRANEOUS DYSMENORRHOEA
It is one variety of primary dysmenorrhoea but is rare. There is shedding of big endometrial casts during period.it is probably due to the deficiency in the tryptic ferment normally secreted in the endometrium.
OVARIAN DYSMENORRHOEA
The pain usually appears 2-3 days before menstruation. The pain is continuous and dull, it is distributed to either one or both quadrants innervated by T10 to l1 segments
HOMOEOPATHIC MANAGEMENT
Homoeopathic system has got wide varieties of medicines for dysmenorrhoea; the severity of pain will differ from patient to patient in this system of medicine the importance is given to the patient and their sufferings. Initially a detail investigation is advised for the patient and the cause of pain is found out and the treatment will be based on it. These medicines are very safe and do not have any side effects. Usually two sets of medicines are given, one acute to take during the periods to control and decrease pain and associated complaints and the second regular medicine which is given to reduce the pain, correct the underlying disease condition and in turn reduce the pain for forthcoming periods.
POLYCYSTIC OVARIAN SYNDROME
Polycystic ovarian syndrome was originally described in 1935 by stein and eventual as a syndrome manifested by amenorrhea [absent menses], hirsutism [excessive hair growth on face and other parts of body], obesity associated with enlarged polycystic ovaries.
This heterogeneous disorder is characterized by excessive androgen [testosteron] production by the ovaries mainly, which interferes with the reproductive, endocrine and metabolic functions.PCOS is a multifactorial and polygenic condition
SYMPTOMS–
- Obesity
- Menstrual abnormality-oligomenorrhoea or scanty menses, amenorrhoea [absent menses], DUB and infertility
- Hirsutism and acne, virilism is rare
- Acanthosis nigricans-by specific skin changes due to insulin resistance. The skin is thickened and pigmented. Commonly affected sites are nape of neck, inner thigh and axilla
- Hair an syndrome – in patients with PCOS characterized by hyperandrogenism,insulin resistance and acanthosis nigricans
INVESTIGATIONS
- Sonography – Transvaginal sonography specially in obese patient
- Serum values-LH is elevated and or the ratio LH: FSH is > 3:1
-Raised level of oestradiol and oestrone, the oestrone level is markedly elevated
-SHBG level is reduced
-Androstenedione is elevated
-Raised serum testosterone and DHEA-s may be marginally elevated
-Insulin resistance-raised fasting insulin level >25 Iu/ml and levels of serum insulin
-Laparoscopy-bilateral polycystic ovaries are characteristic of PCOS
HOMOEOPATHIC MANAGEMENT
PCOS is very common disease seen now adays. The medicines given will help the patient in attain their regular menses and the patient should follow the strict diet and exercise advised by the physician. Initial scanning will be advised for the patient and a regular monitoring is done in every 4 months. Homoeopathic medicine will help u in regularizing the menses and correcting the polycystic ovaries.
MENORRHAGIA
It is defined as cyclic bleeding at normal intervals, the bleeding is either excessive in amount (>80ml) or duration or both.
CAUSES
Menorrhagia is a symptom of some underlying pathology
- ORGANIC
- FUNCTIONAL
ORGANIC CAUSES
Pelvic pathology
- Fibroid Uterus
- Adenomyosis
- Pelvic Endometriosis
- IUCD
- Chronic Tubo-Ovarian Mass
- Tubercular Endometritis (Early Cases)
- Retroverted Uterus- Due to Congestion
- Granulosa Cell Tumour of the Ovary
Systemic
- liver dysfunction
- Congestive cardiac failure
- Severe hypertension
Endocrinal
- Hypothyroidism
- Hyperthyroidism
Blood dyscrasias
- idiopathic thrombocytopenic purpura
- Leukemia
- Von willebrands disease
Emotional upset
FUNCTIONAL CAUSE
- Dysfunctional uterine bleeding
- Fibroid uterus
- Adenomyosis
- chronic tubo-ovarian mass
- Severe hypertension
HOMOEOPATHIC MANAGEMENT
Homoeopathic system is a holistic system. The medicines given will help in reducing the pain and reduce the bleeding. Once when the medicines act on the body it will reduce the uterine bleeding. These medicines will help in improving the immunity of the patient and correct the diseased uterus. These medicines are very safe and do not have any side effects.
LEUCORRHOEA
It is defined as an excessive normal vaginal discharge.
The term leucorrhoea should fulfill the following criteria
- The excess secretion is evident from persistent vulva moistness or staining of the undergarments (brownish yellow on drying) or need to wear a vulval pad
- It is non- purulent and non-offensive
- It is non-irritant and never causes pruritis
CAUSES
The excessive secretion is due to
- Physiologic excess
- Cervical cause (cervical leucorrhoea)
- Vaginal cause (vaginal leucorrhoea)
PHYSIOLOGIC EXCESS
The normal secretion is expected to increase in condition when the estrogen level become high such conditions are
- During puberty-increase levels of endogenous estrogen lead to marked over- growth of the endocervical epithelium which may encroach onto the ectocervix producing congenial ectopy –increased secretion.
- During menstrual cycle-around ovulation, peak rise of estrogen, increase in secretory activity of the cervical glands.
- Premenstrual pelvic congestion and increased mucus secretion from the hypertrophied endometrial glands.
- Pregnancy-there is hyperoestrinism with increased vascularity this leads to increased vaginal transudate and cervical gland secretion.
- During sexual excitement, when there is abundant secretion from the bartholins gland
CERVICAL CAUSE
- Non- infective cervical lesion may produce excessive secretion which pours out at the vulva. Such lesions are –cervical ectopy, chronic cervicitis, mucous polyp and ectropion.
VAGINAL CAUSE
Increased vaginal transudation occurs in conditions associated with increased pelvic congestion. The conditions are uterine prolapse, acquired retroverted uterus, chronic pelvic inflammation, pill use and vaginal adenosis.
DIAGNOSIS
General examination may reveal ill health. The patient often states the discharge as the cause of ill health but in reality, the reverse is true, the ill health producing leucorrhoea
- Vulval inspection reveals
-white or creamy discharge
-no evidence of pruritus
- Bimanual including a speculum examination reveals ;
-Either a negative pathology
– Associated pelvic lesions mentioned earlier causing cervical or vaginal leucorrhoea
- To exclude the infective nature, the discharge is subjected to microscopic examination for detection of pus cells
HOMOEOPATHIC MANAGEMENT
Homoeopathy has good role in treatment of cases like leucorrhoea. There are wide set of homoeopathic medicines which help in overcome the back pain and irritation during the time of discharge. Homoeopathic medicines may help to remove leucorrhoea and allow the patient to lead a normal life. Homoeopathic medicines have action on the uterus which reduces the excess mucus production. Homoeopathic medicine help to build up immunity and thus preventing the recurrence of the disease.effects.
Experience a Healthier Life With Your Homeopath in Kerala.
CALL NOW TO BOOK YOUR APPOINTMENT +91(471)2345050 +919995205050
Your Homeopath Kerala
Restore Your Health Naturally With Homeopathy.
Homeopathic Specialist
(BHSc (Comp Med), Adv. Dip. Homeopathy)