Department for Health, Community

& Wellbeing

ASSIGNMENT TITLE PAGE

TEACHER: Carrie Walters

PROGRAM: Advanced Diploma of Naturopathy

COURSE: Naturopathy Clinic 2

STUDENT NAME: Luke Clews

STUDENT NUMBER: CIT 066213

ASSIGNMENT TITLE: Case Study Assignment

DATE DUE: 1/6/2011

DATE SUBMITTED: 1/6/2011

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 Case Study Assignment

1. What are the main complaints and their underlying causes?

Complaints: PMS, dysmenhorrhea

Specifically she mentions emotional upsets (weepiness, sensitivity, irritability, mood lability),
tiredness, breast tenderness, acne, fluid retention, lower back pain and sugar cravings.

During her period she suffers from debilitating lower abdominal pain and cramping with heavy
menstrual flow for the first 1-2 days.

An increase in acne formation has been noted

Causes (PMS): We would look for hormone imbalances, specifically a relative oestrogen
excess / progesterone deficiency but other causes could be magnesium deficiency (Mg is
associated with oestrogen clearance), sluggish liver (leading to poor hormone metabolism),
vitamin B6 deficiency or simply stress.

She has a combination of PMS A,C,H & P

Causes (dysmenorrhoea): As dysmenorrhoea is a spasmodic condition we would look to a

prostaglandin imbalance, hormonal imbalance or poor circulation to the reproductive organs.

2. What other information might you want to obtain and how?

Water? Sleep patterns? Family history of female health issues? Any alleviating factors? GIT
symptoms (bloating, flatulence etc.)? Work/personal stress? Phyto/xenoestrogen intake?
OCP (or other contraception)?

Libido? Discharge? Spotting? Clotting? Any other reproductive organ issues (PCOS,
endometriosis etc.)?

Do her emotional upsets include feelings of depression? Does she have body image issues?

3. Discuss your Naturopathic understanding of this case – causal chain and mechanism
of action.

Her symptoms point towards a relative oestrogen excess – the PMS A and the heavy
bleeding are indicators and if she were to mention spotting or clotting we could be relatively
certain that this is the case.

4. Outline a treatment action plan, including possible long-term treatments.

Her lifestyle, diet and exercise-wise, seems to be healthy although I would make sure that she
has sufficient protein and iron in her diet. I assume that she has a degree of stress in her life
and this could be affecting her hormone balance. If I found evidence of liver sluggishness I
might suggest some dietary modifications (lower saturated fats etc.) to improve liver function
to improve hormone metabolism.

She would benefit from the addition (or an increase in intake) of legumes and green, leafy
vegetables for magnesium as well as parsley, celery and dandelion leaf for their diuretic
properties. Including ginger in her diet would help with the symptoms of dysmenorrhoea (by
lowering blood levels of prostaglandins). Ginger is also warming and will help to address any
blood sugar imbalances.

I would suggest that when she is suffering from the cramping and lower abdominal pain that
an Epsom salts bath may be useful, as it would provide heat as well as magnesium. Both are
agents which should contribute to a lessening of spasms.

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 I might also suggest she get her iron levels checked.

5. What Naturopathic and natural therapy treatments would you suggest for this case?

The primary nutrient will be magnesium; a deficiency is associated with PMS A,C & P while it
has been shown to be more effective than placebo for pain relief in dysmenorrhoea. Calcium
supplementation has also been shown to significantly improve symptoms of PMS (water
retention, food cravings and pain).

Other treatments would include a hormone balancing herb (Vitex, Peony), a liver clearance
herb (Globe artichoke, St Mary’s thistle), chromium (for sugar cravings), a diuretic (Dandelion
leaf), a uterine tonic/antispasmodic (Wild yam, Dong quai – although this herb may be
oestrogenergic)1. Alternatively, chamomile can be used as an antispasmodic and as an
anxiolytic.

EFAs are a must for their anti-inflammatory effects.

1
Dong quai also has anxiolytic and antianaemic effects

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