Homoeopathy has a right to say that it is the possessor of truth, which is proven by the efficacy of its results, the simplicity of its application, the promptness of its action and the safety in its cures.–Dr. Higinio G. Perez in Philosophy of Homoeopathic Medicine. Oligomenorrhea is the manifestation of menstrual cycle arrythmia, characterized by an interval longer than normal between two menstruations.
Menstruation fails to occur every 28 or 35 days. This function, instead, takes place with intervals of 40, 50, 70 or more days, in which case, if more than 90 days apart, definite amenorrheal states are involved.
The alterations of the menstrual rhythm of an oligomenorrheal type indefectibly consist of an irregularity if the ovarian function, and we are indebted to Schroeder for the following anatomo-physiological theory, which demonstrates the underlying cause of this ailment: “The menstrual phase is affected at longer intervals due to the fact that one follicle does not begin its evolutional cycle immediately after the menses, but does so at a later time, thereby leaving an interval of 10, 15, 20 or more days, this being the delay with which the following menstrual courses will appear, and it is due to the fact that, as the maturation cycle begins, the follicle has a low vital power, and as it reaches its state of development it becomes involuted and imperforate”.
It should always be borne in mind that each menstrual function is the result of a functional complex in which the hypophysis, the ovary and other glands of internal secretion, as well as the uterus, work in a more or less active manner.
Oligomenorrhea is, nevertheless, the typical manifestation of ovarian insufficiency, either primary or secondary, leading to amenorrhea.
It is frequently observed that oligomenorrheal patients are at the same time hypomenorrheal, or they may, instead, present protracted menses, causing the physician to establish a differential diagnosis in order to ascertain whether an ectopic pregnancy is involved or haemorrhagic metropathy or abortion is implicated.
Oligomenorrhea may be either primary or secondary; that is, in the first case, it affects girls over 18 years of age, whose menses are abnormal either because of lesions proper to the ovary (inflammatory, cystic, etc.), or because manifestations of infantilism, eunuchoidism, lesions of the hypophysis, suprarenal lesions, etc. are present.
Adult oligomenorrheal patients, the subject of the present consideration, almost always come for consultations with a history of more or less defined amenorrheas, and in such cases we must investigate whether the insufficiency is total or definite because of surgical castration, or precocious or natural menopause.
A patient suffering from oligomenorrhea almost always presents psychic inferiority manifestations because such patient has few probabilities of fecundity, in as much as the number of ovulations decreases and her ovarian insufficiency will end in troublesome amenorrhea due to the various endocrine symptoms associated with non-physiological menopause.
Inasmuch as the symptomatic picture of an oligomenorrheal patient is quite complex due to the fact that ovarian insufficiency phenomena are associated with manifestations of the general endocrine, genital and extra-genital state, depending on their origin, I shall mention only such among the most frequent causes of oligomenorrhea as will permit a correct clinical interpretation of this condition.
Most gynecologists have divided into three groups the commoner causes of ovarian insufficiency leading to oligomenorrhea in adult women:
1st–Ovarian insufficiency due to constitutional infantilism,
2nd–Ovarian insufficiency due to constitutional intersexuality, and
3rd–Ovarian insufficiency caused by ovarian hypoplasia.
Ist–Oligomenorrhea by ovarian insufficiency due to constitutional infantilism is clinically characterized by general hypoplasia with infantile manifestations in all forms and, especially, by the lack of development of the uterus, and the smaller the uterus the more serious the prognosis will be.
2nd–Oligomenorrhea due to ovarian insufficiency because of constitutional intersexuality is present in women of a mannish type, robust, having ectopic hair and a tendency to obesity. These women pass in a short time from oligomenorrhea to a precocious climacterium.
3rd–Oligomenorrhea by ovarian hypoplasia is characterized by an infantile uterus, normal or excessive height. It is almost always accompanied by skeletal dysplasias resembling acromegalic states. Mammary aplasia is frequent.
To these three main classifications subdivisions permitting the establishment of a differential diagnosis for each type of functional insufficiency of the ovary leading to oligomenorrhea should be added. Having in mind the conciseness of the present work, I shall mention only such cases which are susceptible of treatment within the scope of homoeopathic medication, inasmuch as the others are subject to opotherapic, surgical and physical agent treatments, etc., etc., depending on each particular case.
The more frequent clinical cases leading to oligomenorrhea and which may be cured through homoeopathic medication are: juvenile anemia, chronic alcoholic intoxications, chronic intoxications caused by morphine, barbiturates, etc., alimentary insufficiency causing avitaminosis, psychic states loaded with emotional stimuli, affective psychoneuroses, melancholia, anguish, schizophrenia, etc.; still more frequent those associated with or originating in hyperthyroidism, or hypothyroidism.
Remedies more frequently indicated within the homoeopathic field are:
Pulsatilla nigricans–Patients of a peaceful, kind, complacent temperament, who weep for any slight reason, always sad and dejected. It suits best patients having blond hair and blue eyes.
All of the symptoms present marked variability. Sensitive women whose genital disturbances are associated with persistent catarrhal states of all the mucosae, with soft, thick, greenish- yellow secretions. Pulsatilla acts best after the abuse of ferruginous tonics.
Menses suppressed by cold or following wet feel. Delayed, scarce or suppressed menstruation appearing every 45 or 60 days, of an intermittent type, with coagula. Chill, nausea, sensation of pressure downwards from the utero-ovarian region.
Pain at the lumbar region, sensation of fatigue. Gastro- intestinal disturbances before and after menses.
WORSE–At night, from heat, by rest and from fats.
BETTER–By motion, in the open air and by cold applications.
Graphites–Powerful anti-psoric remedy having an elective action on the generative organs of both sexes.
Particularly indicated for corpulent individuals with a tendency to skin diseases, predisposed to obesity. Excessively delayed, very scarce, pale menses associated with tenacious constipation with knotty mucous evacuations. Pressure pain at the external genital region. Induration of the left ovary with stone- like hardness, sensibility to touch, in walking or inspiration. Sweat and insomnia. Vulvar prurigo before menstruation. Premenstrual and post-menstrual mastitis. Fissured, sensitive nipples. Hoarseness during the menstrual stage.
WORSE–At night, by heat and during menstruation.
BETTER–In the dark and keeping the patient well wrapped.
Sepia–Medication with an elective action on the pelvic organs and liver. Tall thin persons having black hair and eyes. Yellow-brown spots on nose, cheek bones and about the mouth.
Sensation of heaviness downwards in the pelvic region, clawing pains from the sacrum to the pelvic organs with sensation as if something were trying to come out from the vulva. Extremely scarce delayed menses in adults, heavy pain from the umbilical region to the small pelvis. Flushing with marked weakness, profuse cold sweat even in warm room.
Sclero-cystic ovaritis with sensation of burning and sharp pains. Oligomenorrhea or amenorrhea with congestive hemicrania in the morning, irritable temper with loss of appetite. Scarce menses with dark secretion.
WORSE–After coughing, on inspirating, by washing, from touch, in the morning and in cold weather.
BETTER–From soft pressure, heat and in the evening.
Calcarea carbonica–An excellently constitutional anti- psoric Hahnemannian remedy. It is well indicated for ovarian troubles when decalcification antecedents are present from childhood. Dysfunctions of the thyroid and pituitary. Tendency to obesity. Pretubercular states.
Dysfunctions of the ovary, particularly in younger women of a scrofulous type, who, besides being weak and feeling exhausted, have nocturnal cough with sweating and multiple ganglionic infarcts. Young and adult women easily catching cold with partial abundant sweats and cold perspiration of the hands and feet.
Oligomenorrhea or amenorrhea in puberty. Ardor and itching at the external genitals with profuse cold sweating at the genital level. As menstruation occurs, it is profuse, abundant, of a bright red color with oligomenorrhea from 60 to 90 days. Premenstrual mastitis.
