CAULOPHYLLUM patients are apt to be thitsty, chilly, and sensitive to the cold, with a marked intolerance of coffee. Moreover, women needing the remedy often appear rather delicate and nervous, with rapid changes of mood. But the mental and emotional symptoms of CAULOPHYLLUM are rarely as vivid or distinctive as those of IGNATIA or PULSATILLA. The flavor is simply what would be expected in someone exhausted and overwrought from a tremendous effort upon which she has staked too much, and for which she finds herself insufficiently prepared.
CAULOPHYLLUM should at least be considered and will often be useful in typical or early cases of uterine dysfunction in which the predominant flavor is one of muscular weakness and nervous excitement, and there are no other more specific indications pointing to other remedies. This syndrome may be encountered during labor, including premature or false labor; after labor, around expulsion of the placenta and the immediate post-partum period (after-pains); during and after miscarriage or abortion; and in difficult menstruation and dysmenorrhea, from the teen years through menopause.
The remedy corresponds to the whole range of conditions in which general weakness and excitability of the female reproductive system loom as major predisposing factors in chronic infertility, repeated miscarriages, and a tendency to premature or dysfunctional labors, or to postpartum complications secondary to uterine atony (retained placenta, postpartum bleeding, subinvolution, etc.).
For women with a history of this kind, CAULOPHYLLUM should be considered preventively. CAULOPHYLLUM 6 or 12 may be given daily for the last 2-4 weeks of pregnancy, and will often help to facilitate a speedier and more efficient labor, if the typical features are present (or have been in the past). A similar regimen may be used to reduce the risk of dysmenorrhea, miscarriage, or premature labor, where these conditions have occurred repeatedly in the past, or are threatening or imminent. The remedy may be given in a single dose daily for weeks at a time, or more often if need be; as always, the dosage must be adapted to the particular situation.
The proven effectiveness of CAULOPHYLLUM in such situations has led some to advocate giving it routinely in the last month of pregnancy, especially to primigravidas, for whom the excitement of giving birth for the first time might itself conceivably be regarded as a risk factor. Many reputable observers claim that such a regimen does in fact shorten the average length of labor and reduces both the level of discomfort and the risk of complications. On the other hand, using remedies routinely without definite indications and over a long period of time must carry a higher probability of adverse reactions than would taking no remedies at all. This is the sort of dilemma that must ultimately be resolved by the patient herself.
CAULOPHYLLUM is also effective in the treatment of established uterine dysfunction during or after labor, miscarriage, or menstruation, if the typical symptom-picture is present. In such cases, the fundus feels relatively flabby even during the contraction, and the usual signs of generalized muscular weakness and nervous excitement are also present. But it tends to work best in the early stages; in more advanced cases, other more distinctive symptoms will often point to another remedy, such as GELSEMIUM.