Endometriosis

Dr Mollie Hunton discusses the homeopathic treatment of a condition that affects so many women

Endometriosis is a gynaecological complaint that seems to be becom­ing  more common. It is defined as the presence of endometrium (the lining of  the womb) outside the uterus. The main symptoms are painful periods,  heavy periods, pelvic pain, pain on inter­course, ovarian cysts and  sometimes bowel symptoms. It currently affects two million girls and  women in the UK.

So how does it occur? There are a number of theories to account for  the condition which involves retrograde spillage of endometrium down the  fallopian tubes during menstruation. The normal situation is that  spillage is absorbed by the body, but in endomet­riosis it is not and so  it sits around in the pelvis wherever it lands, often on the ovaries.  That suggests that the immune system in the pelvis is not working well.  As it can lead to blockage of the tubes and interference with ovarian  function, it can also cause fertility problems.

Diagnosis is made by the gynaecol­ogist carrying out a laparoscopy  and having a look inside the pelvic cavity. As this method of diagnosis  is available now, it is readily used and as a result more cases are  identified than 30 years ago when it was not available. It is car­ried  out on teenagers who complain of severe painful periods and is often  found at that age. The youngest patient in my first study of this  condition was 13 when it was diagnosed in her.

Usually in conventional treatment, hormones are used to suppress  men­struation – no periods, no endometrio­sis. It seems to work well in  some people despite merely suppressing symptoms and for those people  badly affected, laser surgery may be advised. However, a lot of people  have side-effects to one of the main treatments, Danol. Others are not  helped and for some women the symp­toms return after stopping the  conven­tional treatment. For these women and those with fertility  problems (the treat­ment means they have no hope of preg­nancy whilst on  the medication) homeopathy is particularly useful.

Patient audits

As I was seeing a number of patients with endometriosis I decided to  study their histories closely to see what I could learn. In homeopathy  we are interested in everything about the patient so each person had  provided a lot of informa­tion about themselves, including their past  histories. This proved to be the most helpful aspect because it led me  to a much better insight into their condition.

My first study of eight patients was to investigate whether  homeopathic treatment was effective. The patients were seen in both  general and private practice. I used the Glasgow Homoeo­pathic Hospital  outcome score to assess the patients’ responses, where +4 is cure of  symptoms, 0 is no change and -4 is death. From my results, all patients  had considerable relief of symptoms, espe­cially of heavy periods,  painful periods and pelvic pain. All felt very well in themselves.  However, I followed them up afterwards and some had had relapses. I  needed to find out why.

Homeopathic remedies prescribed were for pelvic pain of which Apis  helped but Belladonna did not seem to. The most useful remedies were  Folli­culinum and Oophorinum, both made from different parts of the  ovary. These two remedies are given in a sequence that I worked out in  studying this group of patients. One tablet of Oophorinum 30c is given  daily from days five to nine inclusive and Folliculinum 30c is given,  one daily, from days 10 to 14 of the men­strual cycle. The remedies are  indicated where there is irregularity of the cycle, ovarian cysts or  infertility. This regime is also used to good effect by other doc­tors  as previously reported by Dr Sara Eames. I also prescribed Candida 30c,  Carcinosin for one woman who had a strong family history of cancer,  Lachesis, Pulsatilla, Sepia, Sulphur, Nux vom and Calc carb I prescribed  for locals and for the constitutional remedy.

I noticed that endometriosis can occur at any age between puberty and  the menopause and there was often a history of multiple repeated  courses of antibiotics and recurrent attacks of thrush. Women  experienced a lot of stress and often had poor diets high in sugar. I  thought that this could be related to poor immune system function, poor  or uncoordinated tubal and uterine motility function which would cause  pain and what I came to call the “tough ovary syndrome”. This seemed to  fit in with the observations of absent, poor or late ovulation. The ovum  could not escape, or found it difficult, from an ovary with a tough  capsule. In this sit­uation the regime of Oophorinum 30c and  Folliculinum 30c were indicated, and in fact produced two pregnancies in  three women who were trying. Why did the condition relapse? Both the  people who became pregnant relapsed, one after stopping breastfeed­ing  and both after relaxing their diets.

Second group

Encouraged by the information I dis­covered by auditing the patients  I had already treated, I decided to do a second audit some years later.  I wanted to find out what I had learned from the first audit and how  this knowledge would affect my approach to handling the sit­uation in  future. Also, could I learn any­thing more?

From the first audit I had learned that:

  • All the patients consulted me because  of the failure of their medical treatment or because of side-effects  from their medication.
  • Endometriosis responds well to the homeopathic method.
  • Pregnancy could be achieved.
  • Remedies needed to be prescribed on all levels: locals, nosodes, isodes and constitution.
  • Diet and supplements are very important.

The second group of eight patients had  once again all been diagnosed by laparoscopy and all had their own  vari­ation on the symptoms and signs. At this point I took an in-depth  look at the Repertories – Synthesis and Cara – to see if I could find  more useful remedies. It is quite complicated in that there are at least  five rubrics (lists of remedies) that could be used for painful  periods; for example in the “female” chapter – menses, painful and pain,  uterus, menses before; and in the “abdomen” chapter – pain, site,  menses before, pain, menses before or during and pain, cramping, menses  before. It meant that case history-taking needed to be very exact.

It also made me look closely at the actual remedies needed to see how  they related to the pelvic organs. I had not realised that the doctors  who compiled the repertories knew so much. We know very little about  ovarian pain and its causes, but these are frequently mentioned in the  Repertory. We also think that pre-menstrual syndrome is a modern  disease, but it is all there in the Repertory, which was first published  in 1912. It helped to find unusual sym­ptoms, like “the more the flow,  the greater the pain” which has only one remedy for it – Cimicifugia.

I had the feeling following up the first group of patients that this  problem was more difficult than I had first envisaged. Over time women  had returned with relapses. I decided to take a more care­ful look at  the second group to see what it was that brought them back. The problems  were likely to be that my pre­scribing had not been accurate enough,  there were obstacles to cure or new problems had arisen which once again  had depleted the immune system.

This analysis showed that painful and heavy periods were easier to  treat and all patients felt better after the first consultation. Pelvic  pain seemed more difficult to treat and was often the symp­tom that made  people return for another consultation. The interesting thing which  seemed to emerge was how many peo­ple had a history of frequent  antibiotic usage from childhood. I therefore com­pared this group of  patients with another group matched for age, but with differ­ent  problems. Only one of the matched group had had antibiotics, whereas all  the endometriosis group had. Relapses occurred after dietary lapses  with sugar intake and with stressful life events.

The remedies I used this time fell into three groups:

Constitutional:
Sulphur and Nux vom seemed to be frequently needed  in view of the problems with previous antibiotic usage. The question is,  does being a Sulphur type of patient make you more likely to have a  condition that needs antibiotics, or does having a lot of anti­biotics  cause a Sulphur state?

Nosodes and isodes: remedies made from diseased tissue or  harmful med­ication for example Oophorinum (ovar­ian gland) Folliculinum  (ovarian follicle), Candida.

Locals: remedies for symptoms or signs – Lachesis for left-sided ovarian cysts or pain, Palladium for right sided problems.

Conclusions

Relapses follow stressful events and dietary lapses. Pregnancy is  difficult to achieve if the patient is older; has had endometriosis for  some time; has asso­ciated pelvic problems like fibroids; has a poor  diet or has problems with alco­hol or cigarettes.

Treatment with homeopathy is on all levels, locals, generals, nosodes  and constitutional, and is well worth con­sidering. No one became  worse. Patients should be able to reduce or stop their conventional  medication.

Anne’s story

Aged 37, Anne had had a laparoscopy and D&C and had been told  she had endometriosis stage III (I is mild and IV is severe). She  complained of severely painful, heavy periods with clots, pelvic pain  and infertility. She had been pre­scribed Danazol which caused her  peri­ods to disappear. This was no help as she wanted to become pregnant  and time was running out. She had joined the Endometriosis Society and  had read about homeopathy in their newsletter.

Previously she had been on the pill for seven years which would have  masked the symptoms of endometrio­sis, so she only noticed the symptoms  when she stopped taking it 18 months previously. In her teens she had  had recurrent throat infections and had had repeated courses of  antibiotics. She experienced recurrent attacks of thrush ever since. She  also suffered from premen­strual migraine.

I advised Anne to follow a no-sugar diet to help the gut recover from  Candida. (Thrush is yeast and only grows in the presence of sugar.)  This means reading packets and tins for glu­cose, sucrose, maltose and  dextrose. Fructose, a fruit sugar, does not seem to affect the Candida.  Anne decided to stop taking the Danazol. I prescribed Candida 30c, one  daily for 10 days and Sulphur 30c one three times in one day, every two  weeks. I also suggested she take Magnesium OK daily because a high dose  of magnesium would help with uterine and tubal spasm and there­fore  pain, and omega oils (fish and evening primrose oils) which provide the  raw materials to make prostaglandins – hormones which govern the  contractions of the uterine muscle.

After four months Anne returned not having had another attack of  thrush. She now complained of pain and numbness in both groins, heavy  periods, bright red with clots. For the next cycle she took Oophorinum  30c daily on days 10 to 14, and Belladonna 30c as required for pelvic  pain or migraine. The following month she became pregnant; her  preg­nancy progressed normally and pro­duced a baby girl. She was  delighted and breastfed the baby for a year. After stop­ping  breastfeeding her symptoms returned and needed Oophorinum for three  cycles to bring relief. She also took Lachesis 30c for her migraine and  pelvic symptoms. A year later she had an early miscarriage followed by  another normal pregnancy.

Julia’s story

Now aged 41, Julia remembers having recurrent thrush all her adult  life. She had her first baby aged 25, who took a year to conceive. A  second child then took eight years to conceive. Whilst hav­ing  infertility investigations she had a laparoscopy which showed the  endometriosis. Her left tube was blocked and her right scarred. She  became preg­nant after treatment with Clomiphene which is a conventional  drug to aid ovu­lation. She now complained of a left sided ovarian  pain. She had a past his­tory of taking antibiotics for acne and  Chlamydia infection (which scarred her tubes) and for recurrent cysts on  the eye­lids. She had, unfortunately, been a chocoholic. She was  fastidious, chilly and a worrier.

I prescribed Candida 30c one daily for 10 days then weekly, and  Arsenicum album 10M one day’s dose of three tablets and Oophorinum 30c  days nine to 14 of the cycle. Six weeks later she felt considerably  better. The ovarian pain had considerably improved, but she had had a  return of her old symptom of an infected eye cyst which had got better  without the need for antibiotics. When next seen seven months later she  had reduced the Candida tablets to monthly and had no pain from the  endometriosis. She consulted about another problem.

Mollie Hunton MB BS  DRCOG FFHom teaches homeopathy to undergraduates at Birmingham Medical  School. She is President of the Midlands branch of the Faculty of  Homeopathy and has a private practice.