1. DISORDERS AND APPROACHES

2. SYNTHETIC VS NATURAL Patent law- only synthetic allowed not natural – so drug companies forced to concentrate on active ingredients only. The 3 main oestrogens are – OESTRONE, OESTRADIOL & OESTRIOL. Oestradiol is most commonly used in pill/ cream and patch – Vivelle, Climara, Estraderm, Estrace

3. What happens with synthetics Using synthetic hormones block natural production = affects the delicate balance Sources – contraceptive pill, HRT Loss of ovarian function leading to-  Dec immune response  Dec sleep response  Inc ulcers  Anxiety, panic attacks

4. Synthetic oestrogens Mestranol – converted to ethinyaoestradiol Stops production of FSH so follicle not matured or released – no ovulation Synthetic = stilbestrol – used for  Birth control  Regulate menstruation, amenorrhoea  Osteoporosis treatment – post menopausal

5. Side effects As not enough progesterone to balance it Weight gain, Fluid retention Migraines – nausea vomiting Mood swings, depression, PMS Block thyroid function, Infertility with long term use, and change in cycle High BP, Thrush, skin rashes Increase risk of stroke and cancer, gall stones, fibroids

6. Synthetic Progesterone used for – HRT, to offset cancer effects of oestrogen, as contraception, to stop uterine bleeding, regulating cycles, endometriosis Those related to Testosterone Norethisterone Acetate (Norgestrel, Agestin ) Behave like Androgens and steroids Dydogesterone (Duphaaston) Hydroxyprogesterone (Depo-Provera, Provera)

7. Side Effects Strokes Loss of vision Photosensitivity Migraines Excess hair growth Weight gain Fluid retention Acne Changes in libido Insomnia Breast tenderness Ovarian cysts Ectopic pregnancy Birth defects Depression, fatigue Jaundice

8. Hormonal Imbalance Anovulatory cycles – normal menstruation, causes include poor nutrition, stress and extremes of exercise, exposure to unopposed estrogens - xenoestrogen Dysmenorrhoea – painful menses. Before, at onset or during menses. Primary – since menarche, usually > after childbirth. Secondary – appearing later, due to hormonal imbalances, fibroids, PID, etc

9. Amenorrhoea Absence of menses Investigations – blood tests, scan, x-ray Primary – no menarche, unusual associated with endocrine disorders. Secondary – later in life.  Pregnancy  Stopping the pill – recovery long  Nutritional states – anorexia etc  PCOD  Endocrinal abnormalities

10. Dysmenorrhoea Painful menses – lower abdomen and back, may radiate down legs Usually cramping in nature, also griping or twisting, squeezing Associated symptoms include – nausea, vomiting, headaches, diarrhoea, constipation, weakness, frequent urination Conventionally treated with painkiller, or the pill.

11. Patho- physiology

12. Secondary/ Pathological causes

13. Homeopathic approach Mag phos Bell Puls Sabina Sepia Cimic Viburnum op

14. P.I.D PELVIC IFLAMMATORY DISEASE Causes – STD IUD Less commonly during douching, vaginal delivery, surgical procedures, abortions  Vaginal discharge – yellowish, smelly  Frequent urination (UTI)  Painful intercourse

16. ENDOMETRIOSIS Growth of abnormal endometrial cells outside the uterine cavity Ovaries, fallopian tubes, pelvic areas, scar tissue after hysterectomy. This tissue bleeds during menses, but that blood cannot escape and thus pain is severe Associated with tampons, intercourse during menses, abdominal surgery and use of coil IUD.

17. Endometriosis Symptoms Pain – begins about 12 days before menses, and very painful during. May be diffused in the lower abd/ pelvic area and cause pain during sex and stool. Bleeding between periods, painful intercourse Allopathic treatment – to stop menses using Danazol ( side effects are masculinisation), Norerthisterone; induce early menopause or simulate pregnancy; laser surgery

18. Common Locations

19. MENOPAUSE HOT FLUSHES Dryness, atrophy Weight gain, water retention Insomnia Decreased libido Mood swings, depression Headaches Thinning of skin and hair Osteoporosis Memory loss

21. Common remedies Lachesis Nat Mur Sepia Bell Agnus castus Pulsatilla Bowel Nosodes

22. FIBROIDS BENIGN tumours of the muscular walls of uterus. Vary in size and location Grow in groups and develop slowly over many years Shrink after menopause Causes include – exposure to excess oestrogen, genetic, pregnancy, overweight, pelvic congestion (exercise>)

23. Common locations

24. signs/symptoms Asymptomatic when small Abnormal bleeding during and between menses; longer and heavier menstrual flow depending on location of fibroid. Anaemia – weakness, body pain, dizziness etc Obstruction to bowels and urethra leading to colon/ kidney damage If large – bloating, abdominal swelling Pelvic congestion – varicose veins and piles

25. Major Remedies Thuja Aur Mur Nat Thlaspi Bursa Sepia Sabina Calc carb