Hormonal Disharmony—A Rare Case of Catamenial Cyclical Vomiting Syndrome

Cyclic vomiting syndrome (CVS) is a rare and enfeebling neuroendocrine disorder mostly seen in children. It is characterized by recurrent episodes of nausea and vomiting with interepisodic normal periods. There are various triggers for an episode among which menstruation is one critical trigger. A m...

Full description

Saved in:
Bibliographic Details
Main Authors: Souganya Vijayan, Barath Ramanathan, Arun Selvaraj, Ponmani Elangovan
Format: Article
Language:English
Published: SAGE Publishing 2025-04-01
Series:Journal of Psychosexual Health
Online Access:https://doi.org/10.1177/26318318251322047
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849433700995956736
author Souganya Vijayan
Barath Ramanathan
Arun Selvaraj
Ponmani Elangovan
author_facet Souganya Vijayan
Barath Ramanathan
Arun Selvaraj
Ponmani Elangovan
author_sort Souganya Vijayan
collection DOAJ
description Cyclic vomiting syndrome (CVS) is a rare and enfeebling neuroendocrine disorder mostly seen in children. It is characterized by recurrent episodes of nausea and vomiting with interepisodic normal periods. There are various triggers for an episode among which menstruation is one critical trigger. A majority of childhood-onset CVS attain remission by teenage or before puberty. There is neurophysiological evidence to associate cyclical vomiting with migraine. It is also supported clinically by the presence of aura and photophobia. The fluctuation in estrogen and progesterone levels during the menstrual cycle is proposed to be the pathophysiological basis of catamenial CVS, which is shared by catamenial migraine. The diagnosis of cyclical vomiting is essentially clinical. Management comprises of acute stage followed by chronic stage. The acute management is targeted to abort the current episode and correct the fluid and electrolyte imbalance. Sumatriptan is found to be effective in the termination of an acute episode. Intravenous fluid and electrolyte replacement are critical. The second step is planning a prophylactic treatment strategy to prevent further episodes. Tricyclic antidepressants are extensively used and are found to be effective. Considering the background of hormonal fluctuation in catamenial cyclical vomiting, hormone replacement therapy with oral and transdermal patches has been attempted with positive results. Any chronic vomiting with inconclusive findings in investigations must raise suspicion regarding CVS. Early identification and treatment considerably improve the quality of life.
format Article
id doaj-art-949bb63d3d674ee7b5b183c2f5745462
institution Kabale University
issn 2631-8318
2631-8326
language English
publishDate 2025-04-01
publisher SAGE Publishing
record_format Article
series Journal of Psychosexual Health
spelling doaj-art-949bb63d3d674ee7b5b183c2f57454622025-08-20T03:26:56ZengSAGE PublishingJournal of Psychosexual Health2631-83182631-83262025-04-01710.1177/26318318251322047Hormonal Disharmony—A Rare Case of Catamenial Cyclical Vomiting SyndromeSouganya Vijayan0Barath Ramanathan1Arun Selvaraj2Ponmani Elangovan3 Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India Department of Psychiatry, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, IndiaCyclic vomiting syndrome (CVS) is a rare and enfeebling neuroendocrine disorder mostly seen in children. It is characterized by recurrent episodes of nausea and vomiting with interepisodic normal periods. There are various triggers for an episode among which menstruation is one critical trigger. A majority of childhood-onset CVS attain remission by teenage or before puberty. There is neurophysiological evidence to associate cyclical vomiting with migraine. It is also supported clinically by the presence of aura and photophobia. The fluctuation in estrogen and progesterone levels during the menstrual cycle is proposed to be the pathophysiological basis of catamenial CVS, which is shared by catamenial migraine. The diagnosis of cyclical vomiting is essentially clinical. Management comprises of acute stage followed by chronic stage. The acute management is targeted to abort the current episode and correct the fluid and electrolyte imbalance. Sumatriptan is found to be effective in the termination of an acute episode. Intravenous fluid and electrolyte replacement are critical. The second step is planning a prophylactic treatment strategy to prevent further episodes. Tricyclic antidepressants are extensively used and are found to be effective. Considering the background of hormonal fluctuation in catamenial cyclical vomiting, hormone replacement therapy with oral and transdermal patches has been attempted with positive results. Any chronic vomiting with inconclusive findings in investigations must raise suspicion regarding CVS. Early identification and treatment considerably improve the quality of life.https://doi.org/10.1177/26318318251322047
spellingShingle Souganya Vijayan
Barath Ramanathan
Arun Selvaraj
Ponmani Elangovan
Hormonal Disharmony—A Rare Case of Catamenial Cyclical Vomiting Syndrome
Journal of Psychosexual Health
title Hormonal Disharmony—A Rare Case of Catamenial Cyclical Vomiting Syndrome
title_full Hormonal Disharmony—A Rare Case of Catamenial Cyclical Vomiting Syndrome
title_fullStr Hormonal Disharmony—A Rare Case of Catamenial Cyclical Vomiting Syndrome
title_full_unstemmed Hormonal Disharmony—A Rare Case of Catamenial Cyclical Vomiting Syndrome
title_short Hormonal Disharmony—A Rare Case of Catamenial Cyclical Vomiting Syndrome
title_sort hormonal disharmony a rare case of catamenial cyclical vomiting syndrome
url https://doi.org/10.1177/26318318251322047
work_keys_str_mv AT souganyavijayan hormonaldisharmonyararecaseofcatamenialcyclicalvomitingsyndrome
AT barathramanathan hormonaldisharmonyararecaseofcatamenialcyclicalvomitingsyndrome
AT arunselvaraj hormonaldisharmonyararecaseofcatamenialcyclicalvomitingsyndrome
AT ponmanielangovan hormonaldisharmonyararecaseofcatamenialcyclicalvomitingsyndrome