Individualized homeopathy for primary dysmenorrhea: a new study

Homeopathy is sometimes claimed to be effective for primary dysmenorrhoea (PD), but the claim is not supported by sound evidence. This study was undertaken to examine the efficacy of individualized homeopathic medicines (IH) against placebo in the treatment of PD.

A double-blind, randomized, placebo-controlled trial was conducted at the gynecology outpatient department of Mahesh Bhattacharyya Homoeopathic Medical College and Hospital, West Bengal, India. Patients were randomized to receive either IH (n=64) or identical-looking placebo (n=64). Primary and secondary outcome measures were 0-10 numeric rating scales (NRS) measuring the intensity of pain of dysmenorrhea and verbal multidimensional scoring system (VMSS) respectively, all measured at baseline, and every month, up to 3 months.

The two groups were comparable at baseline. The attrition rate was 10.9% (IH: 7, placebo: 7). Differences between groups in both pain NRS and VMSS favored IH over placebo at all time points with medium to large effect sizes. Natrum muriaticum and Pulsatilla nigricans were the most frequently prescribed medicines. No harms, serious adverse events, or intercurrent illnesses were recorded in either group.

The authors concluded that homeopathic medicines acted significantly better than placebo in the treatment of PD. Independent replication is warranted.

A previously published RCT could not show any significant effect of homeopathy on primary dysmenorrhea in comparison with placebo. The authors of the new study claim that the discrepant findings might be due to the fact that IH requires great skill. In other words, negative studies are according to this explanation negative not because homeopathy does not work but because the prescribers are not up to it. Such notions have often been voiced on this blog and elsewhere and are used as a veritable ‘get-out clause’ for homeopathy: ONLY THE POSITIVE RESULTS ARE VALID! Consequently, systematic reviews of the evidence must only consider positive trials. And this, of course, means that the findings are invariable positive.

I find this more than a little naive and would much prefer to wait for an independent replication where ‘independent’ means that the trial is run by experts who are not advocates of homeopathy (as in the present trial).