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                                            HOT FLASHES

Hot flashes are one of the most distressful symptoms that a woman faces after the stoppage of menses (menopause).

The patient in menopause suddenly experiences burning heat on face and body with severe perspiration and sometimes redness of the face. It may accompany with palpitation.

If it occurs at night, it will cause sleeplessness. Hot flashes are also known as hot flushes, and occurs with sweating at night is known as night sweating. 

Hot flashes may occur several times during a day and may extend up to 2 to 20 minutes.

Causes

The exact cause is still unknown. However, it is believed to be due to the changes in hormonal balance during menopause and subsequent reactions in the thermal regulation system in the hypothalamus. During menopause, the estrogen level falls down.

Symptoms

  • Severe, burning hot sensation that begins from face and extends downwards.

  • Sweating

  • Palpitation

Triggering factors

  • Very hot foods

  • Spicy foods

  • Tight-fitting clothes

  • Alcohol

  • Stress

  • Obesity

Treatment

Use loose cotton dress

Mild exercise like walking, swimming

Avoid alcohol

Homeopathic treatment

For hot flashes, homeopathic medicines are very effective. And also for night sweat separate group of remedies are mentioned in homeopathic materia medica. Treatment depends on the disease modalities. The aggravating factors for hot flashes and also the ameliorating factors are given importance in homeopathic prescription.

The main remedies are Lachesis, Ars alb, Secale cor etc.

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                                         FIBROID UTERUS

Fibroid is the commonest non-cancerous tumour of the uterus and also the commonest benign solid tumour in females.

It has been estimated that about 20% of women over the age of 30 have fibroid in their wombs.

These are more common in nulliparous or in those having one-child infertility.

The prevalence is highest between 35-45 yrs.

Risk factors 

  • Increased risk is seen in nulliparity, 

  • Obesity

  • Women over the age of 30

  • Family history of fibroid

However, the fibroid grows rapidly during pregnancy or among pill users. However, after delivery the size reduces to normal. In menopausal age also the fibroid shrinks.

Types of Fibroid

Fibroid on the body of the uterus: fibroid are mostly located in the body of the uterus and are usually multiple.

Types: 

1) Interstitial  

2) Subserous  

3) Submucous

Interstitial or intramural (75%): these fibroid appear in the lining of the uterus (endometrium), and this is the commonest fibroid. The importance is that when the fibroid enlarges it stretches the uterus. 

Subperitoneal or subserous (15%): the subserous fibroid grows out of the uterus (serosa). 

Pedunculated fibroid. When the subserosal fibroid develops a stem like structure then it is called as Pedunculated fibroid.

Submucous (5%): the submucosal fibroid grows on the body of the uterus (myometrium). Usually, they are not common and when it occurs, causes heavy bleeding and causes a problem to become pregnant. Submucous fibroid can make the uterine cavity irregular and distorted.

                                               fibroid.jpg                       


Symptoms of the fibroid uterus

  • The majority of fibroid are asymptomatic; a small submucous fibroid may produce more symptoms than a big subserous fibroid.

  • Menstrual abnormalities like-

  • Menorrhagia (30%) is the classic symptom of symptomatic fibroids. The menstrual loss is progressively increased with successive cycles.

  • Metrorrhagia or irregular bleeding may be due to ulceration of submucous fibroid, torn vessels, associated endometrial carcinoma.

  • Dysmenorrhea: the congestive type- it is due to pelvic congestion or endometriosis. Spasmodic type is associated with extrusion of polyp and its expulsion from uterine cavity.

  • Infertility: infertility may be the major complaint due to distortion of the uterus, preventing rhythmic contractions, congestion and dilatation of the endometrial venous Plexus.

  • Dyspareunia-(painful coition)

  • Abdominal swellings (lump): sense of heaviness in the abdomen.

  • Pressure symptoms: pressure of the fibroid in the posterior wall may cause constipation, dysuria, and retention of urine.

Signs of the fibroid uterus

  • Pallor-due to heavy menses 

  • On palpation may the fibroid may feel in the abdomen when the size is increased, it is soft in consistency. 

Investigation

Complete blood count

USG abdomen

Treatment. 

Usually seedling fibroid and small fibroid if symptoms free no treatment is needed. Usually, fibroids won’t cause any problems during pregnancy. 

But large fibroid needs surgery.

Homeopathic treatment

Medium-sized tumors respond very well to homeopathic treatment. The symptoms such as dysmenorrhea, heavy and prolonged bleeding, painful coition, etc.; can be managed by homeopathic medicines. Homeopathy not only removes the symptoms but cures the fibroid. But large and multiple fibroid need surgery.

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                          DYSMENORRHEA

Dysmenorrhea is painful menstruation.

Dysmenorrhea may be-

1) Primary

2) Secondary

PRIMARY DYSMENORRHEA

Here there is no identifiable cause and using oral contraceptive pills and non-steroidal anti-inflammatory drugs there is a marked relief of the symptom. Primary dysmenorrhoea is usually confined to the adolescent girls, and it appears within two years of menarche, it is more common for girls from affluent society.

Causes of pain -

  • Mostly confined to the adolescents.

  • Almost always confined to ovulatory cycles.

  • The pain is usually cured following pregnancy and vaginal delivery.

  • The pain is related to uterine contractions and uterine hypoxia.

- Psychosomatic factor

Tension and anxiety during adolescence, lower the pain threshold.     

-Uterine muscle hyperactivity has been observed for the case of primary dysmenorrhea.

-Role of prostaglandins

Either due to the increased production of prostaglandins, or increased sensitivity of the myometrium to the normal production of prostaglandins, there is increased myometrium contraction.

- Role of hormone vasopressin

There is increased vasopressin release during menstruation in women with primary dysmenorrhea.

So many other theories also there.

Clinical features

  • The pain begins a few hours before or just with the onset of menstruation. The severity of pain lasts for few hours may extend to 24 hours or beyond 48 hours.

  • The pain is spasmodic and may confine to the lower abdomen, may radiate to the back and medial aspect of thighs.

  • Systemic discomforts include nausea, vomiting, fatigue, diarrhoea headache and tachycardia and may be accompanied by cold sweats, pallor and occasional fainting.


SECONDARY DYSMENORRHEA

 Secondary dysmenorrhea occurs due to the pelvic pathology. The patients' suffering is in the age group of thirties.

Causes of pain

It may be due to the increased tension in the pelvic tissues due to the premenstrual pelvic congestion or increased vascularity in the pelvic organs.

Causes of secondary dysmenorrhea

  • cervical narrowing

  • chronic pelvic infection

  • pelvic endometriosis

  • pelvic adhesions

  • uterine fibroid

  • endometrial polyp

Clinical features

The pain is dull, and is in the back and front without radiation. It usually appears 3-5 days prior to the period and relives with the start of bleeding.

The patients may get some discomfort even in between periods.

 PREMENSTRUAL SYNDROME

Psychological, neurological, hormonal factor is responsible for this. It often occurs just prior to menstruation. There is a cyclic appearance of the large number of symptoms during the last 7-10 days of menstrual cycle.

Criteria for PMS- 

  • Not related to any organic lesions.

  • It regularly occurs during the luteal phase of each ovulatory cycle.

  • Symptoms must be severe enough to disturb the life-style of the women, or she requires medical help.

  • Symptom-free period during rest of the cycle.

CLINICAL FEATURES

  • abdominal bloating

  • breast tenderness

  • swelling of the extremities

  • weight gain

  • irritability

  • depression

  • anxiety

  • fear

  • tension 

  • confusion

  • anger

  • restlessness 

  • forgetfulness 

  • increased appetite

  • fatigue

  • tiredness 

  • insomnia 

  • dyspareunia

Homeopathic treatment

Dysmenorrhea and Premenstrual syndrome is really a nuisance to the female community. It is especially true for the working class females and students. The work tension is one of the main factors behind it. Homeopathic medicines work wonders in the treatment of both conditions. With homeopathic medicines, the results are quick and permanent. After a few months of treatment the complaints can be controlled permanently.

The acute episodes of pain are controlled by medicines like Puls, Mag phos, Colcynthis, etc., and the permanent cure is based on the mental and physical aspect with the help of family history and past history of the patient. Usual remedies to prevent recurrence are Medorrhinum, Pulsatilla in high potency, Natrum mur etc.

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