Hormonally it is difficult to work out the basis for PMT, as studies have failed to show any difference in hormone levels pre-menstrually in women who suffer from PMT and those who do not. It seems to be the balance between oestrogen and progesterone (the two female hormones, secreted mainly by the ovaries) which causes the trouble. The pattern varies from woman to woman, with some showing increased anger and irritability, very quick to fly off the handle, and blaming everything on her partner, while others are weepy and pathetic, changing from hour to hour, and needing constant reassurance and cuddles. You may recognise two distinct homeopathic types in those descriptions – the former picture needing Sepia and the latter, Pulsatilla. These remedies are also useful for the menopause. Indeed these are just two of the remedies so useful for PMT, which have literally saved marriages.
The menopause is defined as the time when regular menstruation ceases and with it fertility. The average age now for the menopause is 51 years. There is a length of time called the perimenopause, during which the periods become increasingly irregular (can be either more frequent or less frequent, heavier or scantier, there is no fixed pattern), when it is not always realised that the menopause is impending. The reason for the irregularity is that ovulation is by now not always occurring every month, because the ovaries are failing. This is accompanied by a massive increase in secretion of the pituitary hormone, follicular stimulating hormone (FSH) which is trying to force the ovaries into continuing to produce eggs. The raised FSH levels are probably responsible for the hot flushes experienced at this time.
In General Practice I often saw girls with painful periods, which were causing difficulties at school, especially during examination times. In the last issue of Health & Homeopathy, Mollie Hunton wrote a very interesting article on endometriosis, which can be a cause of painful periods at any age. However, the majority of girls with painful periods do not have to be referred to a gynaecologist for investigation and many cope simply by taking pain-killers, which do not need a prescription.
However, homeopathy can offer more than just pain-relief. If the correct remedy is found, it will improve the periods dramatically. The pain is caused by the uterine muscle contracting in a cramp-like way. As always, when trying to find the simillimum for the patient, a full history must be taken, as the description of the type of pain is always different.
Some women experience heavy periods throughout their life, and others develop them when in their 40s. In this case a physical examination often reveals the presence of fibroids, which can be confirmed on a scan. Fibroids are an overgrowth of the muscle that forms the wall of the womb, that grow in “whorls” and can cause growths the size of an orange. These are entirely benign, but can produce symptoms by pressing on organs such as the bladder.
In the past, heavy periods were a common cause of hysterectomy, and many a “normal” womb was removed because nothing else could be done. These days, there are drugs which can reduce the bleeding, or a progesterone-bearing coil (Mirena) can be inserted which acts by thinning down the lining of the womb.
It is also important to take iron supplements to replace the iron loss each month. Any bleeding that occurs between periods, or after the menopause must always be investigated by a gynaecologist.
This was another reason that I was frequently consulted in General Practice. Vulval problems can occur at any age, and have several different causes.
The commonest cause is vaginal thrush and it can be very difficult to eradicate. The symptoms are commonly a whitish discharge, like curds, associated with intense itching and soreness of the vulva. However, the presentation can be misleading, as the only complaint may be soreness on intercourse or vulval swelling.
Other causes of vulval soreness are allergies, eg to perfumes in toiletries or even to the dye in toilet paper. Other infections can cause it, such as herpes genitalis. Post-menopausally, the cause can be oestrogen lack and an oestrogen pessary can safely be used, as it will not be absorbed sufficiently to cause any effects around the body. Alternatively, phyto-oestrogens (ie plants with oestrogenic properties) can be consumed or applied, such as soya milk or wild yam cream.