Spotlight on Women’s Health

by Janet Gray

As a female doctor, it comes as no surprise that the majority of my “clientèle” are female. I have always told any female medical students who have come to sit in with me for training, that there is no point in being a doctor if you do not like treating women!

I have very recently retired from nearly 30 years of General Practice, and for 20 of those years I have incorporated the use of homeopathy in my treatment of female complaints – I do not know how I would have managed without it! There are so many situations for which conventional medicine does not have a satisfactory treatment, and this is where homeopathy comes into its own.

Although I am a great advocate of equal opportunities and rights for women, I would also be the first to admit that being a woman does have its problems! We are the weaker sex in terms of muscle strength – no one would expect Sally Gunnell to compete against Linford Christie! We also have a complex system of hormones which causes a fluctuating environment, producing a monthly cycle. This creates a system which has the potential to cause “distress” both emotionally and physically, if the hormones are not in balance.

It goes without saying that women are the receptacles of new life – pregnancy is a whole area of complex emotional and physical changes and the symptoms experienced by pregnant women are particularly difficult to treat conventionally because of the potential for damage by drugs to the foetus. Here one can reassure the woman one hundred per cent that homeopathic medicines are completely harmless to the unborn child.

During and after the menopause, the hormonal milieu again undergoes a huge upheaval, with some women faring better than others. Now that hormone replacement therapy is less popular, again homeopathic medicines can come to the rescue. There are also many other aspects of health peculiar to women – for example, breast problems, recurrent thrush, vaginal soreness and discharge and pain on intercourse. This article will attempt to address some of these problems.

Healthy lifestyle
There are a lot of common sense things a woman can do to remain healthy. It is obvious that all women need a healthy, well-balanced diet, and should not allow themselves to become overweight. As soon as young girls start to menstruate, more dietary iron is needed to replenish the stores lost each month. This is more difficult for vegetarians, as the most concentrated source is meat, but iron is also found in dark green vegetables, molasses, tomato paste, bran flakes, chick peas, soya and haricot beans, dried apricots and figs, and oily fish.

Being overweight upsets the hormonal balance, as oestrogen, one of the female hormones, is stored in fat cells. The body can become insulin-resistant and this triggers a complicated chain process of hormonal change leading to irregular periods. This is now thought to be the basic problem in polycystic ovarian syndrome and one of the simplest treatments for this condition is weight loss. I do realise this is easier said than done, but it is facilitated with the addition of a regular exercise programme.

It is also very important throughout life to eat a diet rich in calcium, in order to lay down a good strong bone structure. This again should be started early on, because oestrogen is needed to stop the excretion of calcium in the urine. Once the menopause is past, much higher amounts of calcium are required daily to protect against osteoporosis, but if the intake has been adequate throughout life, the bones will already be good and strong. The best sources of dietary calcium are cheese and milk, but of course these foods are also high in cholesterol, so should only be eaten in moderation. (Skimmed milk has much less cholesterol, but just as much calcium, so is to be preferred.) Other foods high in calcium are whitebait, sardines, tofu, black beans, chocolate (!), seeds and nuts, and again, dark green vegetables. As a rule of thumb, five portions of calcium containing foods should be consumed per day.

I mentioned regular exercise as an aid to weight control, and I can hear you all groaning already. The problem with writing an article on healthy living is that it turns into a lecture on – “Don’t do this, and don’t do that!” Don’t eat too much, and certainly nothing that you enjoy. Don’t smoke, don’t drink alcohol to excess, don’t sit around watching television. What spoil sports we are! The trick is to turn all this advice into something positive. Try to educate your palate into enjoying savoury foods – it is amazing how quickly you will start disliking the taste of very sweet things once you have cut sugar out of your diet. As for exercise – try to find something to do that you enjoy. It’s no good trying to make yourself go out for a run three times a week if you hate it. You may prefer swimming – or take up a new sport such as badminton.

You are probably protesting here “But I haven’t got time”. No – no one has the time. It is a question of priorities and, if you really care about your health, you will make it a priority. It is no good waiting until you have time, because that will not happen. Everyone can fit something into their busy schedule – even if it is just getting off the bus at a bus-stop earlier, walking upstairs instead of taking the lift, or doing the housework faster – which is, in fact, excellent exercise as the stooping and bending stretches lots of different muscle groups. Also, try to do something with a friend. It is much more fun going out for a jog or fast walk with a friend, than on your own: you can encourage each other to keep it going and monitor each other’s weight.

Alcohol-wise – again it is moderation in all things. A glass of red wine a day is good for you, but all alcohol is fattening. Also, there is a danger of using alcohol as a stress reliever, which can then escalate into addiction. So be careful. Cigarettes, too, are stress-relievers, but no one these days needs to be told of the health hazards associated with smoking. So give it up! All GP surgeries these days have specially trained “Stop smoking” nurses who will put you through a programme. They will advise on the best way of quitting for you and support you along the way. You will feel better for it.

Talking of stress – this is a modern scourge which takes its toll on a woman’s health. With the high cost of living, it is virtually impossible these days to buy a house and support a mortgage on one person’s wages, which means that women are now forced into going back to work after having had a baby, even if they would rather choose to stay at home with their child. However much the partner takes a share in running the home, the woman tends to be the one who has to juggle childcare and a job. It is therefore vitally important that the woman does not take on too much, and recognises that pre-menstrually she will not cope as well as usual and puts in place, if possible, other support mechanisms. None of this is easy to achieve, but a healthy balance is important for a healthy mind and body.

Pre-menstrual tension (PMT)
Often it is the woman’s partner who recognises the link between an impending period and a decrease in coping abilities or increased irritability. I have seen many patients who were sent by their partners, to “go and do something about it”.

Hormonally it is difficult to work out the basis for PMT, as studies have failed to show any difference in hormone levels pre-menstrually in women who suffer from PMT and those who do not. It seems to be the balance between oestrogen and progesterone (the two female hormones, secreted mainly by the ovaries) which causes the trouble. The pattern varies from woman to woman, with some showing increased anger and irritability, very quick to fly off the handle, and blaming everything on her partner, while others are weepy and pathetic, changing from hour to hour, and needing constant reassurance and cuddles. You may recognise two distinct homeopathic types in those descriptions – the former picture needing Sepia and the latter, Pulsatilla. These remedies are also useful for the menopause. Indeed these are just two of the remedies so useful for PMT, which have literally saved marriages.

Menopause
The menopause is defined as the time when regular menstruation ceases and with it fertility. The average age now for the menopause is 51 years. There is a length of time called the peri­menopause, during which the periods become increasingly irregular (can be either more frequent or less frequent, heavier or scantier, there is no fixed pattern), when it is not always realised that the menopause is impending. The reason for the irregularity is that ovulation is by now not always occurring every month, because the ovaries are failing. This is accompanied by a massive increase in secretion of the pituitary hormone, follicular stimulating hormone (FSH) which is trying to force the ovaries into continuing to produce eggs. The raised FSH levels are probably responsible for the hot flushes experienced at this time.

Both the peri-menopause and menopause proper may be a time when the woman realises that she is not coping as well as she used to and finds herself unusually emotionally unstable. It is often a difficult time in a woman’s life, because the children may well have left home, causing the “empty nest syndrome”, and she may find herself having to define a new role for herself. She may have elderly dependent parents by this time and also may have reached the zenith of her career, with a demanding and competitive job. Just when she needs all her emotional strength, it may desert her. Her sleep may be disturbed by the hot flushes, adding to the feeling of tiredness. Also, especially if the menopause is occurring younger than usual (premature menopause) she may be grieving for her lost fertility.

Some women may find that they have become unusually suspicious, accusing their partner of infidelity, or being jealous if he is out with his work colleagues. The hot flushes are very uncomfortable, making her avoid wearing tight clothes, preferring open necks and loose waists. Such a woman would benefit from Lachesis. Other women will find they are becoming more reclusive, keeping themselves to themselves and not talking about their feelings, especially about past losses. They will prefer cool weather, and find that they are craving salt. This type of woman will need some Natrum mur.

Other very good hot flush remedies are Sepia and Pulsatilla (as above) and Belladonna, Sulphur, Glonoine or Amyl nitrite. These remedies are also very helpful for women who have had breast cancer and are taking drugs such as Tamoxifen, which causes hot flushes.

Painful periods
In General Practice I often saw girls with painful periods, which were causing difficulties at school, especially during examination times. In the last issue of Health & Homeopathy, Mollie Hunton wrote a very interesting article on endometriosis, which can be a cause of painful periods at any age. However, the majority of girls with painful periods do not have to be referred to a gynaecologist for investigation and many cope simply by taking pain-killers, which do not need a prescription.

However, homeopathy can offer more than just pain-relief. If the correct remedy is found, it will improve the periods dramatically. The pain is caused by the uterine muscle contracting in a cramp-like way. As always, when trying to find the simillimum for the patient, a full history must be taken, as the description of the type of pain is always different.

In the most extreme cases, the girl may be completely wiped out by the pain, with fainting, clamminess, diarrhoea and vomiting. In this case, Veratrum album is magical.

In other cases the pain may be colicky, relieved by pressure and being curled up with a hot water bottle. The remedy here is Mag phos or Colocynth if the heat modality is less marked. Kali phos is useful if the pain is felt more in the back or radiates down the thighs. A magnesium supplement and omega oils are also very useful for preventing the uterine muscle from cramping.

Heavy periods
Some women experience heavy periods throughout their life, and others develop them when in their 40s. In this case a physical examination often reveals the presence of fibroids, which can be confirmed on a scan. Fibroids are an overgrowth of the muscle that forms the wall of the womb, that grow in “whorls” and can cause growths the size of an orange. These are entirely benign, but can produce symptoms by pressing on organs such as the bladder.

In the past, heavy periods were a common cause of hysterectomy, and many a “normal” womb was removed because nothing else could be done. These days, there are drugs which can reduce the bleeding, or a progesterone-bearing coil (Mirena) can be inserted which acts by thinning down the lining of the womb.

A coil cannot be inserted in the presence of fibroids, so management is more difficult, and although new techniques are being tried to remove the fibroids, these are not altogether successful and hysterectomy is often offered. After the menopause, the fibroids shrink and cease to be a problem. Homeopathic treatment can reduce the amount of blood flow, and help the woman avoid an operation. Some homeopaths claim to be able to shrink fibroids, but I’m afraid I was never that successful. However the text books contain mention of remedies said to reduce the size of them, such as Aurum muriaticum, Calcarea carbonica, Cacaria iodatum and Fraxinus americana. I found these remedies (and others) helped to reduce the bleeding and improve the quality of the patient’s life.

It is also important to take iron supplements to replace the iron loss each month. Any bleeding that occurs between periods, or after the menopause must always be investigated by a gynaecologist.

Vulval problems
This was another reason that I was frequently consulted in General Practice. Vulval problems can occur at any age, and have several different causes.

The commonest cause is vaginal thrush and it can be very difficult to eradicate. The symptoms are commonly a whitish discharge, like curds, associated with intense itching and soreness of the vulva. However, the presentation can be misleading, as the only complaint may be soreness on intercourse or vulval swelling. Adding to the complication is that vaginal swabs for thrush can often be negative, so many a patient has been told that they do not have thrush and are left with miserable complaints, not knowing what the problem is, or what to do about it. I have always worked on the assumption that the problem is thrush, unless a different cause can be found. The fungal organism causing thrush, called Candida albicans, likes to live in warm, moist places, so the vagina is ideal. It does not survive well on a swab being transported to a laboratory, hence the frequency of negative tests. It also needs a substrate to live on, as do all fungi, so if the woman has a high sugar intake, it will thrive. This is why it is a common in women who suffer from diabetes.

The first line of attack, therefore, is dietary. I put my patients on a no-sugar diet, much to their dismay. I also stop fruit for the first two weeks in severe cases, but after that fruit can be re­introduced, as fructose, the sugar in fruit, is less harmful. Patients are reluctant to comply at first, but life is so miserable for a sufferer from recurrent thrush, that once they have proved for themselves the connection, they will never touch sugar (or chocolate) again! I could always guarantee a stream of patients suffering from thrush coming in to consult me after Easter every year, for obvious reasons! Sugar – that is the culprit.
Women have often bought for themselves the usual anti-thrush treatments available, in the form of pessaries and cream, but they find that the thrush always comes back. Along with the dietary advice, I also give Candida 30c, three doses once a month to prevent attacks, with the advice to start taking it frequently, two-hourly, if they feel a bout coming on. This usually stops the attack in its tracks.

Other causes of vulval soreness are allergies, eg to perfumes in toiletries or even to the dye in toilet paper. Other infections can cause it, such as herpes genitalis. Post-menopausally, the cause can be oestrogen lack and an oestrogen pessary can safely be used, as it will not be absorbed sufficiently to cause any effects around the body. Alternatively, phyto-oestrogens (ie plants with oestrogenic properties) can be consumed or applied, such as soya milk or wild yam cream.

In conclusion, following a healthy life-style will help to support a woman’s health, both mentally and physically, and the judicial use of homeopathy can alleviate many of the problems that beset the fairer sex!

Dr Janet Gray MA MB BCh FFHom MRCGP DRCOG has recently retired from General Practice and, together with her husband, is taking a sabbatical from her homeopathic practice and teaching this year.