Positive Health Online

When a young woman reaches puberty their first menstrual cycle begins, a term known as the menarche.  For some young women their periods can begin as early as the age of 8 or as late as the age of 16.   The average age tends to be 12 years. 

The reason why there is a difference in the age range is continually being researched.  Factors such as genetics, overall general health, nutritional status and socioeconomic conditions may have a bearing on when the menarche occurs.   A study of almost 6,000 girls born across the UK in 20002001, by the University College London, Centre for Longitudinal Studies[1] conducted in October 2016, concluded that females from ethnic minorities were more likely to begin their menstruation earlier than their white peers.  It was also reported that girls with a higher body mass index (BMI) at the age of 7 were more likely to start periods earlier.  Stress and those from single parent families was also taken into account in the study.

https://en.wikipedia.org/wiki/File:Figure_28_02_07.jpg

Female Menstrual Cycle with Hormones Contributing. Courtesy Wikipedia. Republished from Positive Health PH Online Issue 263. Issue 263 - June 2020. Female Hormonal Imbalances

Whilst the body will be showing changes in preparation for the menarche such as breast buds, pubic hair and growth spurt, the first time the female experiences a bleed it tends to come along painlessly and without any warning.   For the first few months the menstrual cycle is unpredictable in that the length between the cycle varies as does the duration of the bleed.  The endocrine system releases chemicals called hormones that are involved in the growth and development of reproduction and metabolism. 

The endocrine system is a complex one.  It maintains the body’s systems in a state of balance so that it can survive and function correctly.  The term for this state of balance is homeostasis.  The hypothalamus is a major endocrine gland[2] situated in one of the four major divisions of the brain, the diencephalon.   The pituitary gland, about the size of a grape, is situated below the hypothalamus at the base of the brain in line with the top of the nose.  

As long as the female’s hypothalamus and pituitary gland are functioning normally, her reproductive anatomy is normal, she has good nutritional status and is not suffering from any chronic illness, the hypothalamus-pituitary-ovarian (HPO) axis will mature and the menarche begins.   By the time a female has reached the age of 15 she will have matured into an adolescent.

The hypothalamus releases a number of hormones controlling the release of anterior pituitary hormones, one of which is the luteinizing hormone (LH) controlled by the hypothalamic gonadotropin-releasing hormone GnRH), another being the follicle stimulating hormone (FSH).   The follicle stimulating hormone (FSH) also controlled by the GnRH stimulates growth of the ovarian follicle and ovulation and stimulates male sperm production.

The function of the LH in the female is to stimulate the development of the corpus luteum, release oocyte (an immature egg cell within the ovary) that can break free from the follicle, travel down the fallopian tube and become known as an egg or ovum ready for fertilisation.  LH also produces progesterone and oestrogen.  In the male the LH stimulates secretion of testosterone.  Oestrogens produced by the ovarian follicle and controlled by FSH affect the development of sex organs and female characteristics.  Progesterone and oestrogens produced by the ovarian corpus luteum controlled by the LH influence the menstrual cycle, stimulate growth of the uterine wall and maintain pregnancy.

Menarche is recognized as a sign of fertility, the menstrual cycle continues on a regular monthly cycle throughout the woman’s life until it is interrupted by either pregnancy or when she reaches the next stage in her life, menopause (around the age of 49). 

The menstrual cycle is twenty-eight days in length corresponding with the lunar cycle.  During the first five days of the menstrual cycle when bleeding occurs, the endometrium (the membrane that lines the uterus) sheds.  Oestrogen and progesterone concentrations are low and GnRH stimulates secretion of FSH and LH and in doing so several ovarian follicles begin to enlarge. 

On day 6 FSH helps several follicles to develop and one ‘dominant’ follicle is selected.  During the next few days (7-12) oestrogen is produced by this dominant follicle and any further production of FSH is prohibited.  At this point in time oestrogen stimulates the thickening of the endometrium.  On days 12-13 raised oestrogen levels set off a surge in LH from the anterior pituitary and the oocyte begins to divide to produce cells for reproduction.

Midway through the cycle (day 14) there is a surge in LH that causes the mature follicle to enlarge and release the oocyte for ovulation and the empty follicle becomes the corpus luteum.  During this time the endometrium continues to develop.

For the next 10 days the corpus luteum secretes oestrogen and progesterone and there is a reduction of FSH and LH due to the high levels of oestrogen.  Consequently, no new follicles can develop.  If the released oocyte is not fertilised (days 25-28) the corpus luteum disintegrates, menstruation occurs, oestrogen and progesterone secretion decrease and the anterior pituitary will actively begin to secrete FSH so that the ovarian cycle can begin again.  

I have worked with a number of clients over the years that have presented with such conditions as amenorrhoea (absence of menstrual periods that is not due to pregnancy), dysmenorrhoea (painful periods), endometriosis and polycystic ovarian syndrome. Below I give below a more descriptive example of those conditions.  

If a woman has never experienced any menstrual bleeding amenorrhoea and it is not due to pregnancy, it could be associated with a rare endocrine disturbance.  When a woman takes the contraceptive pill to prevent an unwanted pregnancy, she could experience a delay in her menstrual cycle returning to her normal pattern as the body takes its time in re-establishing itself.    

The contraceptive pill is often prescribed by doctors as a treatment for teenage acne.  Eating disorders such as anorexia, undertaking excessive exercise, polycystic ovarian disease can also be the reason for the absence of the menstrual cycle.

The homeopathic remedy Pulsatilla is suitable for a lady who has never felt well since puberty and suffer with absent or irregular menses.  They are very sensitive and their moods are changeable but they do feel so much better when they are out in the open air.  Their painful periods begin in puberty and the menstrual flow is clotted and changeable.

When a woman experiences painful periods it is termed dysmenorrhoea. 

The pain she experiences can begin either before or after the menses occurs.  Primary dysmenorrhoea generally starts after puberty and is accompanied by colicky pains and these painful period cycles can continue until childbirth occurs.  Secondary dysmenorrhoea shows as menstrual pain after the woman has experienced a number of years of painless periods.  When this happens uterine fibroids, endometriosis or pelvic inflammatory disease (a serious infection of the female reproductive organs, often caused by sexually transmitted infections), can be the reason for such occurrence. 

The conventional treatment for dysmenorrhoea is NSAIDs (non-steroidal anti-inflammatory drugs) such as Ibuprofen to be taken as soon as the cramping pains begin.  Placing a hot water bottle on the abdomen can also be helpful.

The homeopathic remedy Cimicifuga can be helpful for someone suffering from dysmenorrhoea.  The menstrual flow is dark and profuse, the pain increases with the flow and the person feels debilitated.  The pain travels across the pelvis from hip to hip.  The menses can be irregular or affect the left ovary. 

Endometriosis is the presence of endometrium in places it would not normally be present such as the ovaries, uterus, fallopian tubes, general pelvic area and the umbilicus.   It can also occur at the area of abdominal scars after a hysterectomy.  Because the endometrium sheds at menstruation (hence the bleeding), the areas where the endometrium has formed can also bleed.  Since the blood is unable to escape in the same way it can from the uterus, the old blood collects in the affected areas and severe pain can occur. 

These pools of blood are known as ‘chocolate cysts’. Women who have not had any children are more commonly affected although women who have had a few can also be affected.  

According to Black’s Medical Dictionary [3]endometriosis never occurs before puberty and seldom after the menopause.  The pain tends to be more severe throughout the duration of menstruation and may be accompanied by diarrhoea, vomiting or fainting.   

Lowering the levels of oestrogen may help with the symptoms and ways that this can be achieved are to undertake regular exercise as this can help to reduce the amount of oestrogen circulating in the body.  Restrict the amount of alcohol to just one drink per day since alcohol can raise oestrogen levels.   Some people may be affected by caffeine so limiting the amount of caffeine in the diet can be helpful.[4]

The conventional treatment for endometriosis is painkillers, Ibuprofen or paracetamol but also hormone medication, the combined pill or the contraceptive patch.  Surgery may be performed to remove the patches of endometriosis tissue.  

A news article in The National Institute for Health and Care Excellence (NICE) issued 13 March 2025[5] headlines The First Daily Pill for Endometriosis approved for NHS use.  The article goes on to state that the treatment is called relugolix-estradiol-norethisterone blocks specific hormones that contribute to endometriosis while also providing necessary hormone replacement in a single daily tablet. 

A previous article in Everyday Health in July 2018 stated that the FDA announced their approval for AbbVie to market the drug Orillssa (elagolix) in the U.S. for use in treating pain caused by endometriosis.[6, 7]

As with all medical drugs that are either prescribed or purchased over the counter, please pay careful attention to the leaflets included within the package and read up on the side effects.  

The homeopathic remedy Sepia could help the person who feels they have never fully recovered from childbirth or coming off of hormone pills.   They have a bearing down feeling in the pelvic region, suffer with PMT and generally feel physically and mentally worn out and have a low sex drive.  Their menses can be irregular, early and heavy or late and scanty.

Polycystic Ovarian Syndrome (PCOS). The World Health Organisation states that 6-13% of women of reproductive age are affected by PCOS.[8]  The symptoms are absence or irregular periods, hair growth on the face, acne on the face, chest and upper back, cysts on the ovaries and difficulty getting pregnant.  Although the exact cause is not known it seems to be associated with an imbalance of the reproductive hormones.  The male hormones (androgens) are raised and this in turn stops the ovaries releasing an egg during ovulation.  An excess of insulin (the hormone produced in the pancreas) may increase the production of androgens.  Obesity may also be linked to PCOS and it could be hereditary.

Conventional treatment includes the contraceptive pill specifically for birth control and it is also used to help improve facial acne.  Metformin may help if a woman presents with type 2 diabetes.  Should medication fail to help, cysts may be removed by laparoscopic surgery. 

The homeopathic remedy Apis Mel may be chosen for  someone who experiences pain in the ovaries, worse on the right side and are worse for intercourse.  Periods are painful with a scanty discharge of slimy blood or with pains in the ovaries.  

Female hormone problems can have a dramatic effect on a woman, so what can homeopathy do to offer support and help?  As with any new client a full case history is taken that includes mental, emotional and physical symptoms, diet and lifestyle.   Even when a person presents with a named diagnosed condition, as a homeopath I choose the remedy that matches the symptoms presented by each individual client and not one for a named condition.

https://www.positivehealth.com/article/homeopathy/homeopathy-and-nutrition-working-together

Homeopathic Textbooks: Republished from Positive Health Online Issue 295 June 2025.  Homeopathy and Nutrition Working Together

The homeopathic Repertory[9] and Materia Medica[10] lists a number of remedies that may be suitable for women who are experiencing problems that I have mentioned above and I have only chosen to mention a few remedies since I would emphasise that it is important to seek the help of a professionally qualified homeopath rather than try to undertake self-help.

Homeopathy is gentle, non-toxic and non-addictive and can safely be used by all ages and does not interfere with any prescribed medication.

References:

1. https://cls.ucl.ac.uk/girls-from-poorer-backgrounds-more-likely-to-get-their-period-earlystudy-finds/
2. Van Wynsberghe, Donna, Noback, Charles R, Carola, Robert; Human Anatomy & Physiology 3^rd
3. Black’s Medical Dictionary 37^th
4. https://www.everydayhealth.com/endometriosis/guide/
5. https://www.nice.org.uk/news/articles/first-daily-pill-for-endometriosis-approved-for-nhs-use
6. https://news.abbvie.com/2018-07-24-AbbVie-Receives-U-S-FDA-Approval-of-ORILISSATM-elagolix-for-the-Management-of-Moderate-to-Severe-Pain-Associated-withEndometriosis
7. https://www.orilissa.com
8. https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome
9. Murphy, Robin ND, Homeopathic Clinical Repertory 3^rd Edition
10. Murphy, Robin ND, Nature’s Materia Medica 3^rd Edition