Homeopathic Management of Coexisting Adenomyosis and Uterine Fibroid A Case Report

Background: Adenomyosis and uterine fibroids frequently coexist and produce overlapping symptoms that complicate diagnosis and management. Case: A 46-year-old woman presented with long standing heavy menstrual bleeding, pelvic and low back pain, and systemic complaints. Imaging confirmed diffuse adenomyosis with intramural and subserosal fibroid nodules. She received individualized classical homeo pathic treatment with Arsenicum album as the principal constitutional remedy, with periodic follow up and remedy adjustments. Outcome: Over serial follow ups from November 2021 to June 2025 the patient reported reduction in gastrointestinal complaints symptoms, intermittent improvement in bleeding patterns, decreased pelvic pain at several visits, and improved general well being. No serious adverse events were recorded.

This single patient case illustrates the application of individualized homeopathic prescribing in a patient with combined adenomyosis and fibroid uterus. The report documents symptom course, remedy rationale, and longitudinal follow up, and highlights the need for controlled studies to evaluate homeopathy’s role as an adjunct in conservative management of benign ute rine pathology.

Adenomyosis; Uterine fibroid; Homeopathy; Arsenicum album; Case report; Abnormal uterine bleeding

Adenomyosis and uterine fibroids are common benign uterine conditions that often coexist and produce heavy menstrual bleeding, dysmenorrhea, pelvic pain, and fertility concerns. Modern imaging such as transvaginal ultrasound and MRI permits noninvasive diagnosis, but overlapping clinical and sonographic features complicate management decisions. For women seeking conservative, fertility preserving approaches, individualized homeopathic care is sometimes sought as an adjunct to conventional options. This repo rt describes the homeopathic assessment, remedy selection, and longitudinal follow up of a patient with combined adenomyosis and fibroid uterus.1 Case Presentation Patient profile and presenting complaints • Age and sex: 46 years, female. • Date of presentation: March 2025 (history from December 2020 onward). International Journal for Multidisciplinary Research (IJFMR) E-ISSN: 2582-2160 ● Website: www.ijfmr.com ● Email: [email protected] IJFMR260276053 Volume 8, Issue 2, March-April 2026 2 • Chief complaints: Heavy menstrual bleeding with clots lasting 13 –14 days, low back pain, calf cramps, and long standing diagnosis of adenomyosis with fibroid uterus. Associated complaints included , seasonal burning of palms and soles, constipation with hard stools, hemorr hoids, recurrent pharyngitis, and episodic mouth ulcers. Relevant investigations and clinical data • Ultrasound December 2020: Findings consistent with adenomyosis; anterior wall fibroid; subserous fibroid in lower segment measuring 2.4 × 2.1 cm; endometrial thickness 14 mm. • Endometrial sampling: Reported simple endometrium (date unspecified). • Laboratory data September –November 2022: Hemoglobin 11.8 g/dL; Vitamin D3 6.49 ng/mL; LDL 125.8 mg/dL; HbA1c 5.7%. • Prior therapy: Conservative allopathic therapy including progestational agents with side effects; patient sought homeopathic care for symptom control and general health. Menstrual systemic and constitutional pattern • Menstrual history: Menarche at 13 years; cycles previously regular; current menses dark, heavy with clots, premenstrual lumbago and calf pain, occasional nausea and breast tenderness. • Generals: Thirsty; prefers sweets; scanty perspiration; tends toward warmth; disturbed sleep with startling. • Psychological profile: Introverted childhood; conscientious, punctual, fastidious, emotionally sensitive, independent decision maker. Homeopathic Assessment and Prescription Rationale Totality and differential considerations The totality comprised heavy menses with clots, pelvic and low back pain, waterbrash and retrosternal burning, constipation with hard stools and anal pain, scanty perspiration, marked thirst, and a fastidious punctual mental constitution. Differential co nstitutional remedies considered included Nux vomica , Sepia, and Arsenicum album. Rationale for final remedy selection Arsenicum album was selected as the principal constitutional remedy based on concordant mental and emotional features (fastidiousness, need for order, time consciousness, inner restlessness), physical generals (marked thirst, burning sensations, scanty perspiration), and gastrointestinal complaints ( waterbrash, flatulence). The prescribing approach followed classical individualized potencies and schedules with periodic reassessment and symptom-directed adjustments. Prescription summary Initial prescription: Arsenicum album 200C single dose (stat) on 18 November 2021 with constitutional tincture/complex follow up as per clinic protocol. Subsequent targeted remedies: Aesculus hydrophilum 200 for anal pain and burning on stool; Bryonia 200 for constipation with hard stools and pricking pain; repeated courses of Arsenicum album and constitutional tincture as clinically indicated. International Journal for Multidisciplinary Research (IJFMR) E-ISSN: 2582-2160 ● Website: www.ijfmr.com ● Email: [email protected] IJFMR260276053 Volume 8, Issue 2, March-April 2026 3 Table Prescription Timeline and follow up Date Remedy Potency Dose / Schedule Clinical note 18 Nov 2021 Arsenicum album 200C Single stat; CT × 15 days Initial constitutional prescription 18 Dec 2021 Constitutional tincture (CT all) — CT × 15 days Patient reported improvement 05 Jan 2022 Constitutional tincture (CT all) — CT × 31 days Bleeding episode noted; retrosternal burning improved 30 Jun 2022 Arsenicum album 200C 15 doses Recurrence of heavy bleeding; low back pain 04 Nov 2022 Constitutional tincture (CT all) — CT × 31 days Generals good; USG: mildly bulky uterus 27 Apr 2024 Aesculus hydrophilum 200C 3 doses × 7 days For anal pain and burning on stool 14 Jun 2025 Bryonia 200C 3 doses; CT × 15 days For constipation with hard stools and pricking pain Multiple dates Arsenicum album / CT all 200C / — Repeated courses as indicated Symptom-directed adjustments over follow up Abbreviations: CT = constitutional tincture/complex; stat = single dose given immediately. Follow up and Clinical Course Serial follow ups from November 2021 to June 2025 documented a fluctuating but overall improved symptom burden in several domains: • Menstrual bleeding: Intermittent reductions in duration and intensity were reported at multiple visits (December 2021, January 2022, November 2022), though heavy episodes recurred intermittently. No surgical intervention was undertaken during the documented period. • Pelvic and back pain: Frequency and severity of low back and hypogastric pain decreased at several follow ups. • Gastrointestinal symptoms: Patient-reported improvement in GERD symptoms following initial homeopathic courses. • Anal and rectal complaints: Periodic exacerbations of constipation and anal pain were managed with targeted remedies with symptomatic relief. • General health: Improved tolerance of daily activities and better overall well being reported at several visits. Blood pressure remained stable. No serious adverse events or remedy intolerance were recorded. Reperatorisation chart Rubrics (Symptoms) Arsenicum album Sepia Nux vomica Sulphur Aesculus Bryonia Mind – Anxiety about health 2 1 – – – – Mind – Fastidious 3 – 2 – – – International Journal for Multidisciplinary Research (IJFMR) E-ISSN: 2582-2160 ● Website: www.ijfmr.com ● Email: [email protected] IJFMR260276053 Volume 8, Issue 2, March-April 2026 4 Rubrics (Symptoms) Arsenicum album Sepia Nux vomica Sulphur Aesculus Bryonia Generalities – Burning pains 3 – – 2 – – Stomach – Sour eructations 3 – 2 – – – Rectum – Hemorrhoids, painful 2 – – – 3 – Female – Menses, profuse, prolonged 3 2 – – – – Generalities – Thirsty 2 – 1 – – – Generalities – Perspiration scanty 2 – – – – – Interpretation • Arsenicum album scored the highest (18), covering both mental -emotional rubrics (fastidiousness, anxiety about health) and physical generals (burning pains, thirst, scanty perspiration, prolonged heavy menses). • Sepia and Aesculus showed partial relevance, especially for gynecological and hemorrhoidal complaints. • Nux vomica was moderately indicated for gastric symptoms but did not dominate the case.2 • The repertorial analysis strongly supports Arsenicum album as the constitutional remedy, consistent with the clinical prescription timeline

The case illustrates classical homeopathy’s dual focus on constitutional prescribing and symptom directed remedies. Arsenicum album 200 was chosen for a concordant mental and physical picture; subsequent remedies addressed acute local complaints. Limitations include the single -patient design, absence of standardized bleeding quantification such as PBAC scores, and lack of serial objective imaging reported in the record. Natural disease fluctuation, placebo effects, and prior or concurrent conventional thera pies may have influenced outcomes.

• This case report documents longitudinal homeopathic management of a woman with coexisting adenomyosis and uterine fibroid. Individualized constitutional prescribing, principally Arsenicum album, alongside symptom directed remedies was associated with periods of clinical improvement and good tolerability over multi-year follow up. The report underscores the importance of multimodal assessment, individualized care planning, and careful monitoring. Rigorous prospective studies with standardized outcome measures are needed to evaluate the efficacy and role of homeopathy as an adjunct in conservative management of benign uterine pathologservative therapies. • Careful documentation: Record constitutional and local symptom patterns when applying individualized homeopathic prescriptions. • Safety nets: Maintain clear referral pathways for worsening bleeding, anemia, or new red flag symptoms. International Journal for Multidisciplinary Research (IJFMR) E-ISSN: 2582-2160 ● Website: www.ijfmr.com ● Email: [email protected] IJFMR260276053 Volume 8, Issue 2, March-April 2026 5

1. Standard gynecology and imaging texts for adenomyosis and fibroid management. 2. Classical homeopathic materia medica and repertory entries for Arsenicum album, Aesculus, and Bryonia. BEFORE TREATMENT International Journal for Multidisciplinary Research (IJFMR) E-ISSN: 2582-2160 ● Website: www.ijfmr.com ● Email: [email protected] IJFMR260276053 Volume 8, Issue 2, March-April 2026 6 International Journal for Multidisciplinary Research (IJFMR) E-ISSN: 2582-2160 ● Website: www.ijfmr.com ● Email: [email protected] IJFMR260276053 Volume 8, Issue 2, March-April 2026 7 AFTER TREATMENT REPORT International Journal for Multidisciplinary Research (IJFMR) E-ISSN: 2582-2160 ● Website: www.ijfmr.com ● Email: [email protected] IJFMR260276053 Volume 8, Issue 2, March-April 2026 8