Homoeopathic Management of Oligomenorrhoea: A Holistic Approach to Menstrual Irregularities

Abstract
Oligomenorrhoea, a condition characterized by infrequent menstrual cycles, often reflects
underlying hormonal or systemic imbalances. Conventional treatment primarily involves
hormonal therapy, which may carry side effects. Homoeopathy, with its individualized
approach and minimal adverse effects, offers a promising alternative. This article explores the
effectiveness of homoeopathic remedies in treating oligomenorrhoea, supported by clinical
experience and repertorial analysis. The study emphasizes constitutional prescribing and the
importance of miasmatic consideration for long-term regulation of menstrual cycles.
Keywords:
Oligomenorrhoea, Homoeopathy, Menstrual Disorders, Constitutional Treatment, Hormonal
Imbalance

Introduction
Oligomenorrhoea refers to infrequent menstruation, with menstrual intervals exceeding 35
days and fewer than nine menstrual periods per year. It commonly arises due to polycystic
ovarian syndrome (PCOS), thyroid dysfunction, stress, excessive exercise, or weight
fluctuations. While allopathic treatments typically involve hormonal regulation, they often do
not address the root cause.
Homoeopathy views oligomenorrhoea not merely as a local disorder but as a systemic
imbalance. Remedies are selected based on totality of symptoms, mental disposition,
miasmatic background, and causative factors.

Aetiology of Oligomenorrhoea
 Polycystic Ovary Syndrome (PCOS)
 Hypothyroidism or Hyperthyroidism
 Hyperprolactinemia
 Eating disorders or malnutrition
 Excessive physical training
 Emotional stress
 Pituitary or hypothalamic dysfunction

Clinical Features of Oligomenorrhoea
Oligomenorrhoea typically presents with the following signs and symptoms:

Symptoms Description
Infrequent menstruation Menstrual cycles longer than 35 days;
Scanty menstrual flow Reduced amount of bleeding during periods
Delayed menarche Late onset of first menstruation, especially in adolescents
Acne or oily skin Common in PCOS-related oligomenorrhoea
Hirsutism Excessive facial or body hair due to hormonal imbalance
Weight gain or obesity Especially central obesity in cases of PCOS
Emotional disturbances Irritability, mood swings, anxiety, or depression
Breast tenderness Occasionally reported before menstruation
Infertility In chronic cases, due to anovulatory cycles
Acanthosis nigricans Dark, velvety patches on the neck

Diagnosis of Oligomenorrhoea
Diagnosis of oligomenorrhoea involves a combination of clinical evaluation, menstrual
history, physical examination, and investigative tests to identify underlying causes such as
PCOS, thyroid dysfunction, or hormonal imbalances.

1. Clinical Evaluation
    Detailed menstrual history (age at menarche, cycle length, duration, flow)
    Family history of menstrual or endocrine disorders
    Lifestyle assessment (diet, stress, exercise, sleep patterns)
    Evaluation for signs of androgen excess (acne, hirsutism, alopecia)
2. Physical Examination
    Body Mass Index (BMI) measurement
    Pelvic examination (if appropriate)
    Assessment for acanthosis nigricans (indicative of insulin resistance)
3. Laboratory Investigations
   Test Purpose
   Serum LH and FSH LH/FSH ratio >2:1 suggests PCOS
   Serum Prolactin To rule out hyperprolactinemia
   Thyroid Profile (TSH, T3, T4) To detect hypothyroidism or hyperthyroidism
   Serum Testosterone (Free/Total) Elevated levels may indicate PCOS

Fasting Blood Sugar and Insulin To check for insulin resistance
DHEA-S To rule out adrenal hyperplasia
Progesterone (mid-luteal phase) To assess for ovulatory cycles

4. Imaging
   Pelvic Ultrasound (TVS/Abdominal)
   To evaluate ovarian morphology; multiple peripheral follicles suggest PCOS (≥12 follicles of
   2–9 mm and/or ovarian volume >10 cm³)
5. Diagnostic Criteria (Based on Cause)
    PCOS (Rotterdam Criteria – any 2 of 3):
    Oligo/anovulation
    Clinical/biochemical hyperandrogenism
    Polycystic ovaries on ultrasound
    Thyroid Dysfunction:
    Altered TSH, T3, or T4 levels
    Hypothalamic Amenorrhoea:
    Low gonadotropins, history of stress, exercise, or undernutrition
   
   Conventional Treatment and Its Limitations
   Treatment Approach Examples
   Hormonal Therapy Oral contraceptives to regulate cycles
   Ovulation Induction Agents Clomiphene citrate, Letrozole for fertility
   Insulin-sensitizing Drugs Metformin in PCOS cases
   Thyroid Medication Levothyroxine for hypothyroidism
   Surgical Intervention Ovarian drilling in resistant PCOS (rare cases)

Limitations:
 Side effects such as weight gain, nausea, mood swings
 Suppression of symptoms without addressing the root cause
 Temporary regulation, often recurrence after discontinuation

Homoeopathic Approach
The homoeopathic approach focuses on individualized medicine. It considers:
 Menstrual history (age of menarche, flow, frequency)
 Emotional and mental state
 Physical generals (sleep, appetite, thermals)
 Miasmatic background

Commonly indicated remedies include:

Medicine Indication
Pulsatilla Scanty, delayed menses; emotional, tearful girls; desires open air
Sepia Irregular, scanty periods; indifference to family; bearing-down sensation
Lachesis Left-sided complaints; suppressed menses with congestion and headaches
Natrum Mur Delayed menses with grief; introverted, reserved patients
Calcarea Carb Scanty periods; obesity; fear of misfortune; profuse perspiration
Sulphur Irregular cycles; lazy yet philosophical; tendency to heat

Clinical Evidence
Case 1
A 21-year-old female with a menstrual cycle of 45–60 days presented with mild hirsutism
and weight gain. She was prescribed Pulsatilla 200 based on her weeping disposition, delayed
menses, and aggravation in a closed room. After three months of treatment with weekly
repetition and appropriate intercurrent remedy (Thuja 1M), her cycles regulated to 32 days.
Case 2
A 28-year-old woman with thyroid-induced oligomenorrhoea showed great benefit with
Sepia 200, selected on the basis of bearing-down pelvic pains, chilliness, and irritability.
After six months, menses became regular and thyroid levels normalized.

Discussion
Homoeopathy not only targets the symptoms but also balances the endocrine system.
Remedies like Pulsatilla, Sepia, and Natrum mur have been clinically effective in regulating
menstrual cycles without hormonal support. Early intervention can prevent complications like
infertility or endometrial hyperplasia.The constitutional approach also enhances general well-
being, reduces stress, and treats associated conditions like acne or weight gain commonly
seen in PCOS-related oligomenorrhoea.

Conclusion
Oligomenorrhoea, when managed through individualized homoeopathic treatment,
demonstrates a significant improvement in menstrual regularity and overall health.
Homoeopathy provides a safe, non-hormonal alternative to allopathic intervention and
addresses the condition holistically.

References

1. Boericke W. Pocket Manual of Homoeopathic Materia Medica. B. Jain Publishers.
2. Kent JT. Lectures on Homoeopathic Materia Medica. B. Jain Publishers.
3. Dutta DC. Textbook of Gynaecology. New Central Book Agency.
4. Clarke JH. A Dictionary of Practical Materia Medica.
5. Indian Journal of Research in Homoeopathy – articles on PCOS and menstrual
   disorders

AUTHOR:
DR. SARITA PURBIYA
Fellowship In Gynaecology & obstetrics
GHMC BHOPAL

GUIDED BY:
DR. BABITA SAXENA
MD. (HOM)
Professor& H.O.D Department of Gynaecology and obstetrics
G.H.M.C Bhopal.