Vulvar vestibulitis and the Labiata family

A Case of Vulvar Vestibulitis and the Labiata Family

R. Female - age 30

Main complaint:
Vulvar Vestibulitis.
Started 7 years before the first interview.
“It dominates my life. I am at my wit’s end. I don’t know what else to do.”


Presentation:
She seems self-assured, practical and superior. She hardly smiled during the interview. She is habitually late for her appointments.


Background Information:
She was on Birth Control Pills at the time when the vestibulitis started.

She was misdiagnosed and treated for yeast infection and bacterial infection for a year. Once diagnosed as having Vulvar Vestibulitis she was given antidepressants, which did not work. Had Physical Therapy and relaxation techniques, which helped somewhat. She was giving creams to numb the area, but she did not think that worked.

Had some infertility problems and did get pregnant with Intrauterine Insemination. The pregnancy was great, but still had the vestibular pain on contact.

At the time of the first consultation her son was 6 months old.

She has been with the same partner for 8.5 years and married him 6 years before the consultation. The problem developed while they were engaged to be married. It started as a minor pain at the end of intercourse. It progressively got worse coming on sooner and being higher in intensity to the point where intercourse was not possible.


Sensations/Modalities:
“Nothing can be seen, it just feels very sensitive.”
The area is not red, irritated or swollen. It is triggered by foreplay and touching. It is superficial.

It feels like a bad sunburn and any contact, even when mild, feels excessive. It is not an ache, it does not feel muscular at all, it feels superficial on the skin. It is burning and painful.

It feels raw
For me it is superficial and the skin is very sensitive
“Penetration is impossible and my sex drive is zero. The idea of sex is awful. I should be experiencing pleasure and instead it hurts.
Sometimes it is better, but better is relative. Penetration is not possible. Sometimes a slight touch hurts too much. It only hurts with lovemaking.”
Applying a tampon hurts when putting it in but then it is fine.
Not uncomfortable with the period.
The condition got worse after the birth of her son.


Disposition:
Her feelings about her main problem:
“Making love is a problem. I feel sadness, grief, anger and disappointment in myself. My husband and I are fortunate we have gotten through this well, and I am proud of us because of that. We are very close and this problem is the only part of the relationship that is not strong.

I do not deserve to have these things happening to me. I am a good healthy person. I care about others and care about myself. I lead a good life; I have good friends that I love and I love my husband. Why is this happening to me? I know it is a minor thing compared to what happens to people. But this is happening to me and my body cannot take care of it. I feel let down by my body.”


Home body:
I am a “neat freak,” a home body. I feel calm when house neat and organized. The house was hit by lightning and now going through repairs and removing lead paint. It is hard living out of boxes.


Motherhood:
Baby still breastfeeding but he is now starting to take solid food and I feel depressed about the thought of stopping.

Motherhood is mostly wonderful. Lately, whether hormonal or overwhelmed due to the work being done in the house, I feel I don’t get time to myself and get mad at my son: ‘why don’t you let me sit down to my lunch and eat it.’

Frustrated that I cannot exercise in the morning and trying to figure out how to do it. She feels jealous that her husband can play in his band because 'I am home caring for our son.'


Anxiety:
"I am anxious. I worry about my health, about death, that I will forget to pay a bill, that we will not be able to pay the mortgage, terrorism, the house getting hit by lightning again.” She is scheduled for a colonoscopy next week and feeling anxious about it.


Dreams:
Most recent: Drove off a cliff with the baby and landed upside down in the car. Very scary and then woke up.


Relationship with mother/mother’s death:
Mother died of colon cancer when R. was 19. “The way I dealt with it was to try to move on with my life. It could be that I never dealt with the issues. I don’t know, I feel I did, but that is one of the possible factors that I think of when I try to find an explanation.”

At 7 parents divorced and she went to live with her father. Mother was very depressed. Saw her on weekends and holidays. “I did not want to visit her because I was afraid that she was going to kill herself when I was there. My sister did not want to leave mom’s side and I thought my sister was also afraid that mom would commit suicide.

I did not deal with her illness. I thought she was going to be ok. When I realized she was not going to be ok. I moved with her in the last few months and tried to be strong for my sister who was living with her and was a mess. I wanted to be the one that was ok and I handled it ok. A lot of it was a relief.” --meaning her mother’s death.

“Mother was a midwife and my pregnancy and delivery brought all that back out. I would have liked to have her around.

We were not very close. When I see my friend’s relationships with their mothers it makes me sad and I wish we had been closer.” (all this is said as a matter of fact/no emotions).


Giving up her dream:
“Fresh out of college I wanted to do photography and go to far away places. I was excited, I love animals and wanted to photograph the animals of the Serengheti.” She met the man that is now her husband and felt that it was most important to be with him.
”it was not realistic not to be with him.
Now I lost all sense of adventure and want to be home.”


Other Complaints:
-Wart on the left foot. Very active, reddish, with black specks. Size: _” in diameter.
“I cannot get rid of this wart. It infuriates me. This thing is not healthy. It was chemically burnt 3 times, I have been applying over-the-counter treatments for 2.5 years.

-Toes numb for about 3 months. Neurologist thinks it is due to wearing too small shoes during pregnancy when my feet expanded."
The tips of the toes are numb when touching them.


Family History:
Mother died at 46. She was struggling with symptoms for a couple of years.

Parents divorced when R. was 7. She went to live with her dad and her sister stayed living with mother.

“Father married again and had been married before he married my mother.
His type of parenting was ‘hands-off’. He gave us freedom and put a lot of responsibility on us. Though I appreciated it in a way, I also felt that he was not that interested. In college he showed no interest in the courses I was taking. He did not know how to interact with me as an adult either. He was sort of distant."

Paternal Grand Mother: Breast Cancer, Emphysema (from heavy smoking)
Paternal Grand Father: Bone Marrow Cancer, 2 strokes.
Maternal Grand Mother: TB at 50.
Maternal Grand Father: Skin Cancer. Exposed to the sun in WW2. Had it in his ear and lips. “I was a little girl and saw him when they removed his ear. When he died he had no lips and a hole in his head where his ear was eaten away. Other than that very healthy”
(When she mentions this she has no expression in her face)


Prescription:
Originally I prescribed Platinum Muriaticum 200c.

Her demeanor was subtly arrogant.
The extreme sensitivity to the genitals
The numbness of the toes.
Self-centered energy about her, as well as the need to keep things under control by keeping herself away from feeling (Her mother’s illness and death and witnessing the grandfather’s disfiguring by Cancer: no lips and a hole where he ear was)


Response to first prescription:
Her libido returned and though they have not had intercourse they have been closer than usual.
Her wart, which she hated so much and had tried to get rid of it by all means, was gone.
She assessed that the vulvar sensitivity was mildly better.


Hernia operation:
2 months after the first prescription she had to have surgery to repair an umbilical hernia she did not know she had.
After the surgery she called to tell me that the pain was mildly better before the surgery, but now is back with a vengeance.
She repeated the remedy and waited a couple of weeks but she is not better.

She feels disappointed, frustrated. It has been 8 years. “I have spent an unbelievable amount of time and money. What a waste! Acupuncture, PT, and all the specialists did not help. I have seen a dozen of people. It is hard to contemplate doing anything else.
I am glad the wart is gone, I did all kids of things to that thing: burnt it, froze it, cut it and it just went away, like that! ... I do want to continue with homeopathy.”


SECOND CASE EVALUATION:

Superficiality –She repeated several times “it is superficial”
Inability to access her depth.
Self-Centered.
The genitals are the focus of the case and what she experiences is a hyper-sensitivity.

I realized that I am looking at a person that was excited about life and wanted to travel and experience things. (Tubercular) And now what I see is no reaction, a numbness and disinterest. We are looking at the active and passive/primary and secondary reactions of a substance.


The Labiatae family comes to mind:

“Superficial” “Hyper-sensitive”
And I sadly think of the grandfather without lips.


This is the dictionary’s description of the family: Labiatae
noun
A large family of aromatic herbs and shrubs having flowers resembling the lips of a mouth and four-lobed ovaries yielding four one-seeded nutlets and including mint; thyme; sage; rosemary...”

Lou Klein, on this family:
“We see in the Labiatae an alternation between excitability and being numb from the world.
Control, keeping self-control, trying to control others, but it is a kind of ‘silly’ control.
Labia and vagina are the areas of pathology in this family.”

The Tubercular aspect that Lou sees in this family is the passion, intense romantic expectations.

The sensitivity to touch is extreme in this family — In her case, it’s extreme in the genitals and she feels the numbness in the toes only if she touches them.

It is interesting to notice that among the Labiatae:
- Ocinum has Nipples aggravated by touch.
- Menthol and Teucrum have pains aggravated by touch.
- Sankaran classified Agnus Castus as part of the Labiatae family possibly because the sensations are very similar and very much aggravated by touch.

I decided to give her Salvia Officinalis 200c.:

Though possibly this is true of all the Labiatae, Salvia has difficulty penetrating their own depth. And I remember her words “penetration is impossible.”
Isn’t it beautiful how the pathology and the inner state is one and the same and they keep reflecting each other?
Salvia is focused on self.
They feel mistreated by their family.
And curiously enough, Lou mentioned that they are late for things and she was consistently late for her appointments. Not that we will give Salvia to everyone that is late, but it is a nice confirmatory symptom!



Follow-ups:
6 weeks later.
Libido increased but the pain is as intense as it was.
“What changed is that I am not totally repulsed by having sex.
We tried but it was too painful. I am more willing because I am more aroused, but it is very sensitive to touch around the area.”

The toes are the same.

Told her to take one dose of Salvia Of. 200c., and I would mail her a dose of Salvia Of. 1m. To take in a week.


Follow-up 12 weeks after the first dose of Salvia Of. 200c.

The pain is down slightly since 3 weeks ago. She was able to have intercourse twice. It hurt but it was possible. She experienced the same burning-raw feeling, but less.

The toes feel worse, the numbness feels deeper into the tissue.

She has been able to plan her time so she can exercise more, which is good.
She said she was feeling good.


Follow-up 5 months after first dose of Salvia Off.

Up to two weeks ago doing very well. She has had no pain and her libido was great. Had pain free sex 6 times in a week. Now I feel my libido dropped, it might be hormonal.

Got her period for the first time since the pregnancy 4 weeks ago. And has her second period right now.

The numbness of the feet is milder. It has been fluctuating in intensity.


Follow-up 7 months after the first dose of Salvia Of.

Took another dose of the remedy a week after we talked.
There is almost no pain during intercourse. Sometimes it is a little sore, but compared to how it was before, now it is almost non-existent.
The libido fluctuates, but it is good and has been so for over 3 months.

The numbness is about the same. Goes for days without noticing it. The surface layer of the toes is numb.

“I am doing good and I am happy. A big chunk of my sexual life is back and that is wonderful.”


I checked in on the phone a year after the last follow up (or a year and 7 months after the first prescription of Salvia Of.)

Had a baby girl a month ago.
Aside from some scalp itching, which she had before and had gotten better with the remedy, she is doing very well.
“The baby and I are doing well, the birth was under 5 hours.
I have been free of pain for all this time.
Thank you for making me stick with it.”


At the present time it has been 3 years and 7 months since she was given Salvia Off. And she remains free of symptoms.


Matilde Flores, Lic.Ac. CCH. Has been practicing Homeopathy for 26 years.
She serves on the Board of the New England Homeopathic Academy
and has a private practice in Maynard, Massachusetts, USA.

matiflo@verizon.net