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by Beth MacEoin(more info)

listed in symposium - menopause, originally published in issue 27 - April 1998

A Transcript     Contents     Introduction: Dr Goodman     Dr Bond (Intro)     Dr Lee

Dr Bond     Q&A: Drs Lee and Bond     Dr Smallbone     Dr Griffin     Beth MacEoin

Q&A: Smallbone, Griffin & MacEoin     Leslie Kenton     Q&A: All     Exhibitors & Speakers



Introduction: Dr Sandra Goodman

Beth MacEoin is a professional homoeopath. She has written a number of books, some of which are Practical Homoeopathy, Homoeopathy for Women and Homoeopathy and the Menopause and all of these books are available on the concourse as well. I look forward very much to hearing Beth's talk.




Homoeopathic Approaches to the Menopause
We live in exciting times with regard to the alternative medical choices that are available to us. A recent article in a well-known magazine estimated that approximately five million patients in Britain consult a practitioner every year, while forty per cent of GP partnerships in England provide complementary healthcare for NHS users. Women's magazines increasingly give up column inches to alternative and complementary self-help hints, while sales of aromatherapy oils, herbal medicines, and homoeopathic remedies are extraordinarily healthy. In 1995, it was estimated that nineteen million pounds were spent on homoeopathic remedies alone.

In theory, we have greater freedom of choice than ever with regard to the medical options open to us. However, in order to make sense of this information, we must have a basic idea of what each therapy has to offer with regard to solving our own particular health problem. This is especially important when we confront the challenge of the menopause, since this can be a time of indecision and confusion.

One of the most attractive aspects of homoeopathic medicine is the way it can be used in an extremely flexible way, depending on our requirements as patients. It can be used as a genuine alternative to conventional treatment as a full system of medical care in its own right, or as a vitally important supplementary treatment option for those of us who want to integrate it with a broader plan of therapies and approaches. As we shall see, this is of particular relevance and importance to those of us who are seeking positive strategies for dealing with problems as we make our journey through the menopause.

Before we consider the practicalities of homoeopathic treatment for women who are experiencing menopausal problems, I would like to spend a little time exploring some general ideas with regard to our interpretation of the menopause and its conventional treatment.

The theme of this symposium must surely be that the menopause need not be a life event that has to lead to fear and trepidation, but can be experienced as a watershed that can lead to a positive sense of change and liberation.

A pessimistic attitude towards the menopause is not entirely modern, although I believe that modern medicine has brought a particular twist to it. It's not uncommon to speak of the menopause as a rite of passage, or more correctly, as a passage from one stage of life to another. What is interesting is that there is no widespread public celebration of the menopause in the way that we acknowledge birth, circumcision, puberty, marriage, or death. As a result, the menopause tends to remain an individual passage with no real public recognition.

In some cultures, illness is treated with public ceremony and in serious cases becomes another rite of passage. Many of the interventions of alternative medicine, particularly those originating in places like China, Tibet, India, North America and elsewhere are also ritualistic and often public, and impress on the patient that he or she is undergoing a transition of some kind.

It is significant that just as the ritualistic content of traditional medicine has been abandoned by modern conventional doctors (who have adopted their own rituals), scientific medicine has embarked on a subtle path of medicalising as many areas of life as possible. There is now a medical answer to situations that no one thought needed intervention before. As a result, childbirth may be viewed as an illness (and the high-tech birth becomes the norm); what used be regarded as sins or weakness (such as alcoholism or drug addiction) become illnesses for which drugs are prescribed, and medicine has the potential to be used as a means of social control.

The significant stages of human life have all been medicalised in some way, and in the process the experiences associated with each transition have been eradicated or suppressed, with the aim of making our passage through life as trouble-free as possible. Childbirth too readily becomes a surgical procedure, infants are no longer given the opportunity to give their immune systems a 'trial run' through childhood infections but are vaccinated en masse, puberty is celebrated by a prescription for oral contraceptives, death can be postponed by life-support machines, and the menopause can be masked by the use of hormone replacement therapy.

When we consider these issues we are immediately struck by the common threads of control and suppression that run through each form of intervention described above. However, there is a price to be paid for achieving this degree of control over physical symptoms and mental and emotional distress. Part of this price is connected to the effective elimination of distinctions between one state and another, leaving us with an experience of life that can be unnaturally flat.

And this leads me straight to homoeopathy. It is not a ritualistic form of medicine since its links are much closer to modern scientific medicine than to any other form of alternative therapy. Its multiple dilutions, succussions and repertorisations are distinctly unnatural. And yet the results achieved make it a totally natural resource for patients.

At the heart of homoeopathy's relationship with orthodox medicine lies precisely the feature we have just been considering: suppression. When Samuel Hahnemann developed homoeopathy in the early nineteenth century, he did so in reaction to his own experience as a doctor, and to the heavily toxic and suppressive side-effects of the medicines he was trained to administer.

Homoeopaths look on symptoms of illness in a benign light, since they are seen as the body's way of showing that the self-healing mechanism it possesses is unable to accomplish its task and needs an extra boost in order to deal decisively with the situation. Homoeopaths regard appropriately-prescribed remedies as giving the body the 'kick start' needed to renew the healing process.

Of course, if we take a practical and realistic view of medical treatment, there are situations where suppressive treatment may be the most appropriate course of action. This may be due to the speed of development and seriousness of an acute condition such as meningitis, where radical intervention is required. However, in situations that are not life-threatingingly acute, it makes sense to consider the appropriate medical alternatives before deciding to automatically opt for suppressive treatment.

Let's now move on to considering how homoeopathic medicine relates to the challenging concept of holistic medicine.

Homoeopathy and the Holistic Approach
Homoeopathy in common with other energy-based systems of healing such as acupuncture, works from the basic premise that the body is animated by a field of vital energy that cannot be detected by instruments. Whether this is called chi (as in traditional Chinese medicine), prana (as in yoga), or the vital force (from the homoeopathic perspective), this unseen field of energy is regarded as being of crucial importance to the maintenance or absence of good health in body, mind and emotions.

Systems of medicine that work along these lines concentrate on bringing the whole system back into a state of basic balance or harmony, rather than concentrating on the piecemeal, discrete treatment of individual symptoms. As a result, once improvement takes place, the whole system should respond, resulting in improved energy levels, greater clarity of thought, an increased sense of well-being, and a corresponding relief of symptoms of physical distress. While this may in principle sound a very tall order, it is noticeable that patients who respond well to holistic forms of treatment are often quite amazed at the depth of the changes and improvements that can occur. Common symptoms that occur at menopause can include severe anxiety, depression, rapid mood changes, fatigue, insomnia, hot flushes, heavy periods, tender breasts, vaginal dryness and lack of libido. This being so, we can immediately appreciate how a holistic approach to healing can be especially valuable at this time.

This is due to its emphasis on the need to consider emotional, mental, and physical levels alike in an attempt to stimulate the whole system into an optimum state of balance and harmony. Within this context, women who respond positively to an holistic approach, are delighted to discover that they are the recipients of a system of healing that encourages them to think of themselves as individuals who have reached a state of ill health, rather than a series of body parts that have begun to malfunction, with each problem requiring a different drug or treatment option. The latter can, of course, become even more complex when extra drug treatments are added to counteract the side effects of an earlier medicine.

From my own experience as a practitioner, it is overwhelmingly the case that women who respond well to an holistic approach welcome the way that they begin to see their therapy as providing positive strategies for health promotion, rather than being restricted to a form of disease management. Sadly, the latter can encourage us to adopt a passive approach, while a genuinely holistic perspective encourages us to feel empowered and supported in taking an active stance in enhancing the quality of our health at all levels.

This positive perspective is invaluable to women who are facing the challenge of the menopause, since this can be a particularly alarming experience for those of us who feel as though our bodies are spinning out of control. Although this may also seem to be the case at other crucial periods of transition such as puberty, or during or following pregnancy, the associations with the transitional period of the menopause have often been perceived to be negative rather than positive. In other words, puberty and pregnancy are often associated with looking forward to a fresh phase of life, while the menopause is regarded by many as a time of ending, closure, and decline.

The Conventional Medical Perspective
Unfortunately, the conventional medical answer of prescribing hormone replacement therapy can encourage this negative perspective on the menopause. This is because many of the promises that are held out to women if they opt for this route of treatment, are very much concerned with holding on to the past in an effort to make time stand still. We can see this in the way that a great deal of the publicity surrounding the use of HRT is linked to the idea that we can maintain our youthful looks, vigour, and sexual attractiveness if we choose this treatment.

To be fair, while some women have gained positive results from using HRT, and are happy to speak out in its favour, there are many others who have felt let down and deeply disappointed when they have not found it to be the elixir of youthful promise that they were led to believe it should be. It could be argued that the whole approach of using HRT involves a basic denial or suppression of the reality of menopause, which can discourage us from moving onwards to a fresh phase of experience.

This is a most unfortunate state of affairs, since by attempting to make time stand still, we can be left with a powerful sense of conflict and dissatisfaction. This is further compounded by the way that when we stop using HRT, these conflicts often emerge with renewed force, causing even more havoc than they might have done if they had been confronted years before. Sadly, this may also be true of some of the claimed benefits of HRT such as protection against loss of bone density, since, at best, this is likely to be the case only for as long as HRT is taken. Once continued use of HRT stops, it has been suggested that bone loss will occur as though the drug had never been used.

The Homoeopathic Perspective
The homoeopathic approach provides a sharp contrast to the conventional interpretation of the menopause. From an orthodox medical perspective, the menopause is regarded as an oestrogen deficiency state that needs appropriate supplementary treatment through HRT in order to deal with troublesome symptoms. A more holistic therapeutic option approaches the issue from a radically different perspective, by looking on the menopause as a natural phase of development that requires appropriate treatment and support in order to be experienced with the minimum amount of distress and trauma.

Homoeopathic practitioners work very much within the context of this holistic framework, viewing the menopause as a natural phase of life that can be extremely stressful on emotional, mental, and physical levels, or quite otherwise, depending on a variety of factors. These latter include inherited characteristics, the strength and resilience of the individual constitution, lifestyle factors, and the degree of external stress encountered at menopause such as bereavement, marital problems, or the strain of caring for an ageing relative.

From the homoeopathic perspective, the gentlest and most effective way of providing relief during the transitional phase of the menopause and beyond, is to utilise a treatment option that provides support for the whole system to accomplish the task it is attempting to do as quickly as efficiently as possible.

Homoeopaths believe that symptoms tend to become most troublesome and problematic when the body is struggling to accomplish a natural process of self-healing, but lacks sufficient impetus to resolve the situation completely. This can apply equally to acute problems such as coughs and colds, as well as to more protracted problems such as menopausal symptoms. For instance, if we take the simple example of a cough, the body is attempting to expel mucus by initiating the coughing reflex. When this is accomplished effectively and decisively, the body is able to rid itself of mucus discharges that can lead to congestion and infection.

However, if the body is unable to resolve the situation, the result can be an irritating and exhausting recurrent, unproductive cough that can begin to have a negative, rather than a positive effect. If an appropriately prescribed homoeopathic remedy is given in a situation such as this, the self-healing mechanism that the body possesses appears to be given a boost, enabling the lungs to expel the offending mucus gently and effectively.

This same simple principle applies to successful homoeopathic treatment for any medical problem, whether it is of a short-lived acute nature, or if it has a protracted, chronic history. Within this context we can regard menopausal problems as occupying a broad spectrum of disorder that may be regarded as neither clear-cut acute or chronic conditions, but are best classified as sub-acute problems such as hot flushes, general fatigue, anxiety, and mood swings. These conditions are not true acutes in that they do not have a limited, short life span within which we can expect them to clear up such as the average cold or fever. However, they do not fall easily into the category of chronic conditions either, since they are unlikely to stay with us in a lifelong way such as eczema or asthma. For this sub-acute category of condition the same rules as outlined above still apply, so that when homoeopathic treatment is successful, symptoms are resolved rather than being temporarily suppressed. As a result, long-term dependence on medicines should not as a rule occur, since once the system as a whole has gained a renewed state of equilibrium, further treatment should not be needed unless symptoms recur at a later stage.

When menopausal problems respond well to homoeopathic treatment, they are most unlikely to disappear within a short period of time. Instead, homoeopaths regularly witness the pattern of a positive response which involves cumulative reduction of the severity of symptoms, longer intervals of relief between episodes of the problem, plus an improved sense of well-being and energy levels due to a sound and more restful night's sleep. As the intervals between episodes expand in length, the patient gains confidence, and is delighted to find at some point that the symptoms have phased themselves out altogether. Once this stage of resolution has been established for some time, homoeopathic support is no longer needed to keep the situation under control, unless a different problem emerges, or a relapse occurs at a later date.

Practicalities of Homoeopathic Prescribing: Who Can Benefit?
As we have suggested above, there is a broad spectrum of potential use of homoeopathic treatment, depending on the needs, medical history, and personal approach of each patient. In this way, homoeopathy offers up an exciting and flexible approach to medical treatment that can be tailored to the needs of each individual. Any of the following options are available to those of us who are motivated to seek homoeopathic support for the treatment of menopausal problems:

Homoeopathic Treatment as an Alternative Approach to Treatment
An increasing number of patients are seeking a different approach to medical treatment, having discovered that orthodox medical options are unsatisfactory for them. These patients include ever-growing numbers of women who are approaching or experiencing the menopause, and who have strong reservations about the use of conventional medication such as HRT. They may have tried orthodox treatment and found it was unsatisfactory, or were unhappy with undesirable side effects, or may have felt generally uneasy about potential health risks associated with drug therapy. Homoeopathic treatment also appeals greatly to women who feel they want to take an active role in protecting their overall experience of health and maximising overall vitality, since this approach often results in the patient making positive improvements in lifestyle. These may involve adopting a more nutritious eating plan, engaging in more regular exercise, or taking up relaxation techniques or meditation. In any event, feeling that we can take positive, dynamic action at this stressful time can be an essential tool in transforming the uncertainty of the menopause into an empowering experience.

The availability of homoeopathy as a therapeutic option can be of tremendous psychological and practical value to those of us who suffer from medical problems that can make the use of HRT inadvisable or risky. Strong contraindications include a history of cancer of the breast or womb, or problems with liver disease. The appropriateness of using HRT can also be called into question where disorders exist such as circulatory problems, or chest disorders that are linked to heavy cigarette consumption. Many patients can feel extremely distressed and powerless if they are told their menopausal problems cannot be treated by HRT, but are also not given any positive advice or treatment to put in its place.

Extra problems can arise if a disorder such as endometriosis has developed, with the condition having spread outside the confines of the womb and ovaries. I have treated a number of women suffering from endometriosis who have been in the unenviable position of being given a hysterectomy and follow up treatment with HRT, who discover that the conventional treatment relieves their hot flushes and insomnia, but find to their dismay after a short interval, that the pain of endometriosis is reactivated. This can lead to a vicious cycle of treatment where HRT makes symptoms of endometriosis worse, but contemplating abandoning hormone therapy and risking a return of menopausal symptoms is a most unattractive option. In such a dilemma, homoeopathic treatment can provide an invaluable source of alternative medical help, alleviating both symptoms of menopausal distress as well as the pain and discomfort of endometriosis. The practicality of successful use of homoeopathic prescribing in this precise context may be conveyed by the following words of a patient who found herself in this cul de sac with regard to conventional medical help: "I don't know how I would have survived this menopausal time without the remedies. I will carry this experience with me as I am fully aware of the help that alternative therapies can give."

Homoeopathy as a Supplementary Form of Treatment
In reality, many women may opt for a working compromise between conventional medical help and an alternative approach, especially in the early days of homoeopathic treatment. They are likely to monitor their general state of health through regular checks and screening procedures that are available through their GP surgery. However, if general unhappiness arises about protracted drug use, or the unacceptable side-effects that can be associated with conventional medicines, they are increasingly likely to opt for non-orthodox systems of treatment such as homoeopathy, herbal medicine or acupuncture to treat any problems that emerge further down the line.

Even if HRT is prescribed, the use of homoeopathic remedies may still be of value in providing effective substitutes for extra conventional medicines that may be used in addition to HRT. These orthodox treatment options may include the prescription of sleeping tablets for insomnia, or anti-depressants for emotional problems. When homoeopathy is used successfully within this context, undesirable side-effects can be avoided, as well as the build up of toxic overload in the system from the complex interaction of a number of drugs.

By beginning in this way, an opportunity is given for the patient to slowly and gently build confidence in their homoeopathic treatment as symptoms such as sleeplessness improve. Once a patient experiences these first hand benefits they often seek more ambitious homoeopathic help on what homoeopaths call a constitutional level.

Homoeopathic Constitutional Prescribing
When a patient's constitutional homoeopathic remedy is selected, it is done on the basis of an analysis of the detailed information that is given by the patient to their practitioner. This includes striking features of the patients constitutional make up such as their build (whether they are slender or chunky), metabolic rate (this could be fast or slow leading to a tendency to lose or gain weight easily), characteristic emotional features (such as tendencies to be irritable, anxious, depressed, or euphoric), body temperature (whether they are habitually chilly or warm-blooded), and patterns of energy and stamina (such as tendencies to short bursts of fluctuating energy interspersed with bouts of fatigue, or steady levels of stamina). This complex jig-saw of information is assembled by the experienced homoeopathic practitioner into a picture of the patient's constitutional type.

It is then the task of the homoeopath to find the closest match possible between the picture presented by the patient and the most appropriate homoeopathic constitutional remedy. When this occurs, and the remedy is given, the strengths in the patient's constitutional make-up are enhanced while weaknesses are compensated for, and in some cases, eliminated.

For example, the patient who fits the Calc carb constitutional type will have a slow metabolism with a tendency to rapid weight gain and cold, clammy perspiration and easy flushing on making the least effort, poor stamina with frequent sense of exhaustion, easy fractures as a result of poor bone density, and a tendency to slow mental processes with a general sense of insecurity and anxiety. Any physical or mental effort causes aggravation of symptoms, since the Calc carb constitutional type does not respond well to stimulation from stress of any kind. Keynotes of the Calc carb picture include sluggishness (on a digestive level leading to indigestion and constipation, and on a circulatory level to chilliness and sudden flushes of heat), obstinacy, and a generally slow, plodding nature. If we think of the fable of the tortoise and the hare, someone with a Calc carb constitution would be likely to identify with the tortoise.

However, if we came across a patient who revealed Nux vomica constitutional characteristics, they would show a craving for stimulation on all levels (mentally through high-pressured jobs, physically through a dependence on coffee, alcohol, and highly-spiced foods, and emotionally through the need for extremely intense relationships). Chilliness predominates, with a craving for the soothing effect of warmth. Energy levels are characteristically high, with a profound capacity for creativity if enough motivation is provided. Because of this passionate nature, there is a tendency to do everything to extremes, with the result that the risk of burn out is always lurking just around the corner. This can be due to a combination of workaholism, over-indulgence in alcohol, cigarettes, prescription drugs, rich food, and a social life that involves burning the candle at both ends. Not surprisingly, those who respond well to Nux vomica have a history of digestive disorders (such as stomach ulcers, irritable bowel syndrome, or chronic constipation), migraines, insomnia, and periods of extreme physical exhaustion. Irritability and lack of tolerance of those who can't keep the pace are strong Nux vomica characteristics, as well as emotional turmoil that springs from a period of enforced inactivity such as redundancy, or approaching a major transitional phase in life such as the menopause. All in all, this is clearly a 'hare' type if we continue the analogy used above.

Each constitutional type has its unique defining characteristics that affect each system of the body such as the nervous system, urinary tract, reproductive, digestive and endocrine systems. When the appropriate constitutional remedy is prescribed, we would expect to see an all round improvement including enhanced energy levels, increased sense of well-being, improved digestive function, smoother circulatory performance greater emotional balance and equilibrium, and a generally more resilient system. In other words, a well-prescribed constitutional remedy will not transform someone into a different person, but it will enable them to fulfil their potential for optimum health by strengthening possible areas of weakness.

If we consider that the menopause is a phase of life when our areas of vulnerability can be thrown into sharp relief, homoeopathic constitutional prescribing can be invaluable in the years leading up to it. This can have the beneficial effect of strengthening constitutional weakness that have a nasty habit of coming to the fore during the general emotional and mental upheaval of the change of life. These areas of vulnerability may take the form of bouts of anxiety, general lack of energy, insomnia, hot flushes, or flagging libido. While these may still arise during constitutional treatment, the symptoms are likely to be less severe, and of shorter duration than they would be without homoeopathic treatment.

While it is ideal to have the chance to prescribe at this preventative level as early as possible, it is not too late to use effective constitutional prescribing after menopausal symptoms have become well established. However, we can appreciate that this form of prescribing does not fall into the self-help category that has become popular since homoeopathic remedies have become readily available through high street chemists. This is largely because the newcomer to homoeopathic prescribing is not going to have a comprehensive knowledge of homoeopathic remedies and their main spheres of action, nor are they going to have the psychological distance that a practitioner must have in assessing their constitutional characteristics.

With this in mind, we may well ask whether there is any point in using homoeopathic self-help manuals for relief of menopausal problems. The sensible answer is a qualified yes, since it is possible to use well-chosen homoeopathic prescriptions within a strictly limited context to provide short-term relief for troublesome menopausal symptoms. However, we must be aware of the boundaries and limitations we need to work within for this approach to be of positive help. In other words, once we become conscious of what we can and cannot treat, and have a clear awareness of indications that suggest we are getting out of our depth, we are able to use homoeopathic remedies within this context with confidence and security.

Homoeopathic Acute Prescribing
A well-prescribed, acute homoeopathic remedy can go a long way towards easing problems with menopausal symptoms. However, if the appropriate remedy needs to be taken on a regular basis in order to maintain a state of improvement, or if it ceases to have a beneficial effect, it is important to consult a homoeopathic practitioner in order to obtain professional help.

However, if symptoms are mild in nature, and appear to be greatly relieved by an occasional dose of an acute homoeopathic remedy, this may be all the support that is needed in the short-term. If we consider the distressing and very common menopausal symptom of hot flushes and briefly examine the range of acute homoeopathic remedies that can relieve this problem, we shall quickly become aware of how we each acute remedy is different from another.

For example, if hot flushes are at their worst during the night or on waking, with a tendency for pressure around the neck to be unendurable (for example from a polo necked jumper or a scarf), and if mood swings have begun to appear in someone who is calm and equable as a rule, we may benefit from the homoeopathic remedy Lachesis. On the other hand, flushes and night sweats that move in an upward direction from the lower part of the body to the neck, face and head, with burning hot skin that does not change colour may do well with Sepia provided the choice is confirmed by the presence of the remedy's characteristic emotional picture of weariness, indifference and exhaustion.

Violence and abruptness of appearance of hot flushes without warning, leaving the feet icy cold while the head is burning hot, points to a choice of Belladonna. This would be confirmed if skin looks bright red, and feels hot and extremely dry without breaking out into a sweat. Alternatively, hot flushes and drenching sweats that are extremely changeable in nature, moving from one part of the body to another may respond to Pulsatilla. Selection of this remedy would be appropriate if the leading characteristics of extreme sensitivity to badly-ventilated rooms, faintness, palpitations and extreme weepiness with a craving for sympathy are present.

From this brief review of remedies we can see that we need to select the most appropriate homoeopathic medicine on the basis of differentiating characteristics. In other words, we must be aware of the individualising features that mark one person's experience of a problem from another, before we are in a position to select the most appropriate remedy.

Once we appreciate this fundamental fact, we have grasped the essence of homoeopathy. The strength of this powerful and fascinating system of medicine lies in the way that it is designed to treat each patient as an individual who experiences ill health in their own unique way. Homoeopathic medicine does not hold all of the answers, nor should it be practised in a dogmatic way to the exclusion of other therapeutic possibilities. However, it is a system of healing that seeks to help each patient reach a state of emotional and physical balance, stability and self-knowledge.


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About Beth MacEoin

Beth MacEoin BA, MNCHM, RSHom is a professional homoeopath. She is the author of Practical Homoeopathy, Homoeopathy and the Menopause and Homoeopathy for Women. She can be contacted on Tel: 0191 281 6667. Beth will be a key speaker at the Positive Health Menopause Symposium in April 1998.

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