Introduction:

   Dr.Anuradha Raja is a leading practitioner, graduated from Government Homoeopathic Medical College, Tirumangalam. She worked for Bahola laboratories for five years and practices at Trichy for the past eleven years. She involves herself in social activities for the development of Homoeopathy. Here she presents a case of uterine fibroid

A female aged 40 years consulted me for her menstrual irregularities since one year. She presented her complaints as follows.

Irregular periods- once in 15-45 days, highly erratic, profuse , watery, bright red with clots

Severe pain++ in lower abdomen during the 2nd day of every periods

Frequent urging to urinate

Pain in both loins on and off

Both legs – painful.

She seemed to be easily irritable in nature and she narrated her complaints in agony.

Past History:
She had enteric fever last year , had vaccinations for Hepatitis B Virus

Treatment History:
For irregular periods she got allopathic treatment and took tablets for 3 months not satisfied. She gained lot of weight after taking Hormone Replacement Therapy

Family History:
Father is diabetic and hypertensive.
Appearance: Dark complexioned / good looking lady / obese+

Physical Generals:
Appetite : Increased
Thirst : Normal
Sweat : Profuse sweat on least physical exertion.
Stool : Constipated at times.
Urine : Burning micturition on and off.
Sleep : Normal.
Craving : For acidic drinks (Bottled cool drinks)

Mental Generals:
Great aversion towards her husband, at the same time unable to accept if a third person comments on him. Sensitive and emotional

Physical Examination:
W t : 80Kg
B.P. : 120/80
Pulse : 72/Min
CVS/RS : NAD
O/E abdomen : soft/pain – lower abdomen on palpation
Pain in loins+
Skin on back : There are many hypo- pigmented patches on upper back.
(The patient gave least importance to the skin problem as she considered menstrual problems as a prime thing).

Investigation :
She showed her blood investigation which was recently taken. She was anemic, Hb- 9.6gms%.
Ultra sonogram of the abdomen and pelvis showed (Before)
– Fatty Infiltration of the liver
– Anterior wall uterine fibroid.
– Bilateral renal calculus.

First Prescription              18.01.09
Rx
Sepia 200/7d. O.D., to be taken in empty stomach,
Followed by SL/ 7 doses OD.
Ber. Vulg Q/30m/ 10 – 0 – 10 drops.

Follow up I                        05.02.09
She got her periods with flow for three days
Profuse flow with many clots
She had severe pain on the 2nd day of periods and experienced severe leg pain.
Rx
SL/ 15 days.

Follow up II                        20.02.09
Pain both legs reduced this time.
Small hypo pigmented patches disappeared (75%) in the upper back.
Rx
SL/15 days.

Follow up III                       05.03.09
Again she got her periods after 22 days.
LMP 24.02.09. But flow was normal
No clots.
Pain on the 2nd day also reduced this month.
Mental irritability ++
Rx
SL/ 1 month

Follow up IV                       05.04.09
This time she came with depressed mood.
She has not yet got the periods. LMP- 40 days.
Rx
Nat mur 1m/ water dose

Follow up V                       10.04.09.
She came with a smiling face.
She got her periods on 07.04.09.
Normal flow – 3 days –
No pain this time.
Rx
SL/1month.

Follow up VI                       10.05.09
She got her periods on the 28th day
Normals flow.
No clots
This time she c/o pain loins both sides and had burning micturition.(? due to Renal calculus)
Rx
Berberis vulg 200/ one dose o.d
Followed with SL

Follow up VII                      10.06.09
Periods was normal.
No pain in loins.
No burning micturition.
Rx
SL/ 1 month
Scan taken on 18.07.09 reported (After)
The Ultrasongram of the Abdomen and pelvis shows normal findings

Discussion
Sepia was prescribed based on uterine affections and her mental symptoms. Berberis Vulgaris Q was continued along with the course of treatment . The patient was advised to reduce weight with dietary instructions –avoidance of greens and tomato, milk, meat and consume plenty of water as an auxiliary treatment .