A Classical Homoeopathic Approach in Case Management of Endometriosis with Myomas and Pelvic Congestion Syndrome

by Dr. A. Gayathri BHMS, Dip.Psy

Abstract

Endometriosis is a difficult gynecological condition linked with chronic pelvic pain, dysmenorrhea, infertility, and poor quality of life. Conventional care (hormones, surgery) offers temporary relief but no cure. This case reports successful management of a 30-year-old female with confirmed abdominal wall endometriosis, bulky uterus with intramural myomas, and later suspected pelvic congestion syndrome, using classical homoeopathy. Remedies selected on totality, miasmatic background, and follow-up led to marked clinical and sonological improvement.

Case Presentation

Patient Details

Age/Gender: 32, Female
Constitution: Well-built/nourished; 64 kg, 161 cm
Thermal State: Hot patient

Presenting Complaints

Severe abdominal pain during menses × 3 years
Vomiting during menses
Vertigo, worse on waking
Difficulty urinating/defecating during menses
Backache with dysmenorrhea
Irritable during menses

Menstrual/Gynecological History

Menarche: Irregular since onset
Cycle: 3/45–60 days
PCOS history, irregular allopathic treatment
Obstetric: P2 L1
- 1st pregnancy – full term LSCS, living child (6 yrs)
- 2nd pregnancy – APH, Hysterotomy (2021)

Past/Family History

Hypothyroidism in pregnancy (Eltroxin 100 mcg), now euthyroid, no meds
No DM, HTN, seizures
Family history negative

Investigations

Initial USG: Scar endometriosis, bulky uterus, intramural myomas
3rd month USG: No myomas/endometriosis; impression – pelvic congestion
Thyroid: Normal

General Features

Mental: Irritable around menses
Thermal: Hot
Generals: Normal appetite/digestion except menses aggravation.

Analysis of Case

Totality of Symptoms

Severe congestive dysmenorrhea
Pain with nausea, vomiting, vertigo
Difficult urination/defecation during menses
Irritability during menses
Irregular cycles, PCOD background
Hot patient
Uterine pathology (endometriosis, myomas, pelvic congestion)

Miasmatic Background

Psora: Irritability, irregular cycles, vertigo
Sycosis: Myomas, PCOS, congestion tendency
Syphilis: Endometriotic lesions, tissue destruction
Overall: Syco-syphilitic with psoric overlay

Prescription & Rationale

Belladonna 200C – 1 hrly × 3 doses (acute, up to 5/day)
- Covers violent congestion, dysmenorrhea, hot patient
Magnesium phosphoricum 6X – 2 hrly till pain relief
- Supportive for spasms
Nux vomica 200C – 1 dose daily × 3 days, mid-cycle repeat
- Irritability, oversensitivity, GI/urinary issues, morning aggravation, pelvic congestion
Lapis albus 3X – 2 TDS × 1 month
- Affinity for uterine fibroids/myomas, long-term support

Repertorial Chart

Rubrics	Bell.	Nux-v.	Lach.	Lapis-alb.
Mind – Irritability – menses	2	3	2	–
Female – Dysmenorrhea – congestive	3	2	3	–
Stomach – Vomiting – menses	2	3	1	–
Vertigo – morning	1	3	1	–
Bladder – Difficult urination – menses	2	2	2	–
Rectum – Difficult stool – menses	1	3	–	–
Generals – Heat, hot patient	2	2	3	–
Generals – Tumors/myomas	–	–	2	3

Totals

Belladonna: 13 (acute congestion, hot)
Nux vomica: 16 (constitutional, congestion, irritability)
Lachesis: 12 (differential, less stool/urine affinity)
Lapis albus: 3 (organ remedy for fibroids)

Final Remedy Selection

Acute: Belladonna
Chronic: Nux vomica
Supportive: Lapis albus

Follow-up

1st month: Pain ↓ 70%, no hospitalization
2nd month: Period delayed 1 week, pain manageable
3rd month: Pain returned when Nux omitted mid-cycle
1. USG: No myomas/endometriosis; impression – pelvic congestion
2. TSH: Normal
Plan: Continue Nux (mid-cycle), Lapis albus, lifestyle advice (walking, yoga, diet, weight control)

Discussion

Acute vs. chronic: Belladonna for acute crises; Nux for constitutional state; Lapis albus for fibroids
USG follow-up: Showed disappearance of myomas/endometriosis → objective evidence
Miasmatic view: Syco-syphilitic predominance guided remedy depth
Lifestyle role: Yoga, diet, exercise, enhanced outcome

Conclusion

This case demonstrates classical Homoeopathy’s role in endometriosis and uterine pathologies. With individualized remedy choice and miasmatic assessment, the patient achieved major symptomatic relief and sonological improvement. Belladonna, Nux vomica, and Lapis albus addressed acute, constitutional, and organ levels respectively. Lifestyle support proved essential for sustained results.