Homoeopathic Management of Primary Dysmenorrhoea: A Case Series

Homoeopathic Management of Primary Dysmenorrhoea: A Case Series

Abstract: Primary dysmenorrhoea is defined as a crampy pain in the lower abdomen before or during the menstrual period in the absence of any pelvic pathology.  Females of age group 18-25 years are most commonly affected. The common symptoms include lower abdominal pain, diarrhoea, Nausea, Vomiting, headache, dizziness, disorientation, fatigue and hypersensitivity to sound.

The diagnosis is purely clinical based on the symptoms and excluding causes of secondary dysmenorrhoea by Ultrasonography. Modern medicine offers treatment by the administration of Non-steroidalAnti-inflammatory drugs and hormonal medicines to reduce menstrual cramps but the treatment is momentary and the symptoms reappear with another cycle.

Case summary,3 cases of Primary dysmenorrhoea without any underlying pathology successfully treated by individualized Homoeopathic medicine. The cases were followed up regularly and the improvement was noticed for 3-4 months using VAS and WaLIDD scale.

Keywords:Primary Dysmenorrhoea, Individualized Homoeopathic medicine, VAS, WaLIDD scale.

Case 1. A young female Aged 23/Unmarried presented in the out-patient department for the treatment of primary dysmenorrhoea for 11 years.  There is pain in the lower abdomen with severe bleeding. Pain is radiating to thighs with bodyache and extreme weakness with feeling of vertigo. The pain is < by motion and is > by application of a hot waterbag. The pain starts 1-2 days before menses and remains on the first and second day of menses. She feels very weak during the first 2 days and there is extreme desire to lie down. She becomes irritable during menses. On the VAS Scale she describes her pain on scale 9 from rating of 1-10 and on WaLIDD scale the pain is on criteria 10 from scale of 1-12. She complains of Severe spasmodic pain and profuse bleeding of bright red colour. There is a desire for spicy food during menses. Sometimes she has dreams at night which causes palpitations and disturbed sleep. She cannot remember the dreams on waking up.

Treatment History

During menses she used to take NSAIDS for pain relief and apply Hot fomentations which provided some relief from pain. Based on the repertorization and consulting the materia medica. Phosphorus was selected. Single dose of Phosphorus 200 was administered to the patient according to the susceptibility of the patient followed by Placebo for 1 month. After the administration of Phosphorus in the next cycle the symptoms were markedly improved. The intensity of pain was reduced and improvement was noticed on both VAS and WaLIDD scale. (table attached). The relief was so prominent that no other Homoeopathic remedy was required. She did not even take any NSAIDS during pain although hot fomentations were allowed as it did not interfere with the remedy response.

Table . Case 1 timeline

VisitVisit DateLMPVASWaLDD scaleSymptomsMedicine
120 July 202213/7/2022910Abdomen pain lower abdomen radiating to thighs with weakness and vertigo, Irritability, sleep disturbed due to pain and dreamsPhosphorus 200/1d stat Placebo 30 tds for 1month
220/8/202215/8/202276Pain >+, Weakness >+, Sound sleep during menses, Vertigo >+Placebo 30 tds for 1month
317/8/202213/9/202233Pain >++, Weakness >++, Vertigo >+Placebo 30 tds for 1month
415/10/202210/10/202212Pain markedly improved, Slight pain in beginning with no other complaint noticedPlacebo 30 tds for 1month

Case 2A female aged 22 years of age, Unmarried suffered from primary dysmenorrhoea for 10 years.  She complained of severe and spasmodic pain in lower abdomen. The pain starts 1 day before commencement of menses and lasts till 2nd day of menses. The flow is profuse dark, clotted and non offensive but acrid on passing making the parts raw. The pain radiated to the thighs and during menses she became very irritable. The appetite diminishes during menses and she has no desire to eat anything. She also complains of persistant nausea. There is desire for sweets and chocolates and aversion to milk.The perspiration is scanty and non offensive. She also complained of slight leucorrhoea before menses but on USG no pelvic pathology was found. On VAS scale the pain is on 9 scale from 1-10 and on WaLIDD scale it is 10 on scale of 1-12. 

Treatment History

Before approaching the OPD she used to take NSAIDS during the pain. On repertorization and after consulting Materia Medica Sepia Officinalis was selected as her constitutional remedy.Sepia Officinalis200 single dose was given and the follow-ups were taken for 3 consecutive months. Marked improvement in the symptoms of pain, discomfort, bleeding and leucorrhoea was observed by the patient. There was marked improvement of appetite during menses and she could drink milk with ease.

Table . Case 2 timeline

VisitVisit DateLMPVASWaLDD scaleSymptomsMedicine
130 July 202224/7/2022910Severe Spasmodic pain in lower abdoemen. Blood dark, clotted, acrid non offensive, Pain radiating to thighs, irritable during menses, Appetite diminished, nausea and aversion to milk, Leucorrhoea before mensesSepia Officinalis 200/1d Stat, Placebo 30tds for 1month
227/8/202222/8/202267Pain >++, Leucorrhoea >+, Nausea not present, appetite marginally improved, aversion to milk still presentPlacebo 30tds for 1month
328/8/202223/9/202245Pain >++, Leucorrhoea not present, Nausea not present, could drink little bit of milkPlacebo 30tds for 1month
426/10/202221/10/202223Complaints are much better although pain is present but markedly improved, can drink milk upto half glass at a time. Other complaints not presentPlacebo 30tds for 1month

Case 3 A Female age 24 years/Unmarried consulted for complaints of Primary Dysmenorrhoea for 10 years. She has pain in lower abdomen on first and second day of menses. During menses she wants to rest, does not wish to do anything. There is great weakness. The flow of blood is bright red, acrid and slightly clotted. There is severe spasmodic pain at the commencement of menses. Radiation of pain takes place to the back and lower abdomen. During menses she becomes irritable and gets angered easily. She also complains of leucorrhoea before menses. The appetite during menses is markedly diminished with no thirst and the abdomen feels full with flatus. She wants to go outdoors. On the rating scale the VAS score is found to be 7 from 1-10 and the WaLiDD score is 9 from 1-12.

Treatment History

Pulsatilla Nigricans 200 single dose was prescribed based on the totality of symptoms and after consulting Materia Medica. The symptoms covered by Pulsatilla Nigricans on repertorization are attached. Follow up was taken for 3 months and marked improvement in the symptoms was observed. The pain was reduced, there was much improvement in the weakness. The irritability and anger reduced. The appetite and thirst was improved. The VAS and WaLIDD Scale also showed marked improvement in the symptoms (table attached).

Table . Case 3 timeline

VisitVisit DateLMPVASWaLDD scaleSymptomsMedicine
118/8/202213/8/202278Pain abdomen during menses, appetite diminished, weakness, leucorrhoea before menses, anger and irritability, thirstless, flatulencePulsatilla Nigricans 200/1d stat Placebo 30 tds for 1month
217/9/202212/9/202256Pain >+, Leucorrhoea not present, anger >+, irritability >+, Thirst >+, Apptetite>+Placebo 30 tds for 1month
319/10/202214/10/202223Pain >++, No leucorrhoea, No anger or irritability during menses, Thirst >++, Appetite >++Placebo 30 tds for 1month
420/11/202217/11/202212Normal pain without any other discomfort, feeling better with no complaintPlacebo 30 tds for 1month


Primary dysmenorrhoea is a major problem affecting a large number of females of reproductive age group. The conventional treatment only offers partial relief of the symptoms by administration of NSAIDS, painkillers which further increases their sufferings in terms of gastritis, drowsiness,etc. Despite all these treatments the females especially students are forced to take this treatment for unbearable sufferings. 

All the 3 cases mentioned here had no pelvic pathology reported from Ultrasound findings. They started their treatment and individualized homoeopathic medicine was selected for them based on the totality of symptoms. The potency and repetition were selected based on the Homoeopathic principles based on the susceptibility of the patients.

On administration of Individualized homoeopathic medicine marked improvement in the symptoms of patients were observed. In this study 3 cases have been treated by Phosphorus, Sepia officinalis and Pulsatilla Nigricans respectively. Marked improvement in the symptoms of pain intensity and duration was observed. Other symptoms associated with the disease condition like irritability, anger, leucorrhoea, anorexia, flatulence and sleeplessness were also improved. The changes in the symptoms were elicited by using VAS and WaLIDD scale.

Individualized homoeopathic treatment can contribute to the management of primary dysmenorrhoea. This case series is limited to 3 cases; a large sample is warranted for further validation of the results.


Individualized homoeopathic treatment is found to be effective in the management of primary dysmenorrhoea. There was no underlying pathology but the complaints were lasting for a very long duration and still homoeopathic medicines were able to give a positive response in no time. It suggests that a well-designed study with larger sample size could draw conclusive results.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. Proper consent had been taken for using the clinical record and images of the reports for the publication in a journal. The names of the patients have not been published to conceal their identity, but anonymity cannot be guaranteed.

Declaration of scale consent

Proper consent to use the scale has been used wherever required.

Financial Support and Sponsorship


Conflict of interest

 Not Declared


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Authors Detail:

1. Dr A N Mathur, President Homoeopathy University, Jaipur

2. Dr M P Sharma – Dean & Director Faculty of Homoeopathic Science Jayoti Vidyapeeth Women’s University Jaipur

3. Dr Ruchi Singh – Professor, Department of Organon of Medicine Homoeopathy University Jaipur

4. Dr Ravi Jain – PhD Scholar Department of Organon of Medicine Homoeopathy University Jaipur. Associate Professor & HOD Department of Practice of Medicine Faculty of Homoeopathic Science Jayoti Vidyapeeth Women’s University Jaipur

About the author

Dr Ravi Jain

I Dr Ravi Jain working on the Post of Associate Professor & HOD Department of Practice of Medicine in Faculty of Homoeopathic Science at Jayoti Vidyapeeth Women's University Jaipur Rajasthan. I am also PhD Scholar in Department of Organon of Medicine at Homoeopathy University Jaipur Rajasthan