The
journey to fertility - A case of poly cystic ovarian syndrome
Prof
G R Mohan
M D(Hom)., P G Dip(Env Stud)
Principal, Devs Homoeopathic Medical College,
Deva nagar, Ankireddypalli, Kesara mandal, R R
Disrtict, A P
drmohangr@yahoo.co.in
www.drgrmohan.com
Poly cystic ovarian syndrome first described by American gynecologists
Stein and Leventhal in
1935, PCOS is a hormonal disorder affecting 10-15% of women, worldwide,
irrespective of race or color. The World Health Organization estimates that it affects
116 million women worldwide as of 2010 (3.4% of the women). According Dr Rajeev Punjabi India witnesses alarming rise in the
incidence of PCOS , India has witnessed about 30 per cent rise in polycystic ovary syndrome (PCOS) cases in the last
couple of years. Lack of awareness and lifestyle changes are
considered to be the major factor leading to this phenomenon.,1 2
At least 12
follicles develop in the ovaries
(polycystic means 'many cysts'). Cysts are fluid-filled sacs. Increased testosterone
level, raised levels of insulin in the bloodstream is thought to be
the main underlying reason to develop PCOS. A high level of Luteinising hormone is found in about 4 in 10 women with PCOS
this test is suggestive
but not diagnostic.1,3
Symptoms : 80% Menstrual Disorders (absent), Anovulatory Bleeding (<6 nbsp="" span="">Menses per year) Infertility (74%) and Recurrent Miscarriage, Acne Vulgaris oily skin, Hirsutism (69%) Dark
or thick skin markings and creases around the armpits, groin, neck, and breasts
, androgenic alopecia, Clitoris swelling, 49% Central Obesity (apple shaped ) BMI over 27
(65% of PCOS patients) , Mood disturbance (e.g. Major Depression, Anxiety).
|
Ultrasound,
Glucose to Insulin Ratio < 4.5,
A systematically selected homeopathic remedy has the capacity to
correct hormonal imbalance due to poly cystic ovarian syndrome by stimulating the glands to secrete various
hormones in the required manner,
basic pathology, miasmatic nature, individual study, a suitable homeopathic
similimum will bring an excellent change in blood and sonographic
reading. Homeopathic
remedies would help in the regression of ovarian cysts.
Losing
5 percent to 10 percent of weight according to B M I, can help to restart
ovulation, Exercise can help you lose weight. Diet
:
Low glycemic index foods, diet include whole grains, beans, fruit, vegetables and
lean protein , Eating a few small meals rather than three big ones may
help even out blood sugar levels
|
A
case of P CO D : Patient
by name MS S, aged 20 years, unmarried ,
a B Tec student ,
who was dreaming to get married and conceive , came to me on 10-02-2013 who was
medium built, with 64.9 Kg weight, hot
patient, very irritable, known case of hypothyroidism since 4 years presented
the following symptoms
PRESENTING COMPLAINTS:
Menses delayed by 5 months, irregularity
since 3 years
Irritability 2 years
Anxiety about health 1year
Haughty since 8 months
Hair over upper lip, neck. 2
years
PAST HISTORY:
Since 2007 period is late,
was diagnosed as hypothyroidism and kept on allopathic medication, taking
medication for P C O S
FAMILY HISTORY: F/H
hypothyroidism
*
PERSONAL HISTORY
Appetite-
Good
Diet- mixed.
Thirst-
less.
Desire-
Cold food , desire spicy food.
Aversions/ intolerance- NS.
Bowels-
Regular.
Urine-
5/6 times/day. No special. Characteristics.
Sweat- NP
Sleep- refreshing
Habits and addiction : no
*
LIFE SPACE INVESTIGATION.
*
She
belongs to an upper middle class family
of Hyderabad. Her father is a business
person . She is a first child of her parents. Had normal
childhood, 3 years back her mother died due to health problem.
*
General physical examination
*
The patient was short stature 64.9 Kg weight, B M I: 25, no pallor, cyanosis, edema, clubbing or
lymphadenopathy.
*
Systemic examination
*
Examination
of neck : slight swelling of thyroid gland on deglutition.
*
GIT System: abdomen was soft, liver palpable, spleen
not enlarged
*
CNS System: Nothing abnormal detected
*
CVS System: Nothing abnormal detected
*
Respiratory System: Nothing abnormal detected
*
Investigations:
*
U
S Scan : P C O D ( 2009, 2010 & 2012 )
*
Antverted
uterus, Endometrial thickness :
*
F S
H 6. 7.9 ; L H :21.78 ; S Prolactine : 8.8
*
T
S H : 3.78uiu/ml
*
Clinical diagnosis: P C O D
*
Clinical classification :
*
Dynamic chronic fully developed miasmatic disease.
*
Miasmatic diagnosis
*
Psoro -Sycotic and Syphilitic.
*
Susceptibility: moderate
*
Totality of symptoms :
*
Irritability
*
Anxiety about health
*
Haughty
Desire for open air
*
Desire for cold Food , desire spicy food
*
Menses late
*
Thirstless
*
Repertorisation (attached below)
4
*
Phosphorus
and Pulsatilla were the first two remedies emerged on Repertorisation. Reasons for selecting Pulsatilla was due to as it covered all symptoms with maximum score. Boericke says that "it is pre-eminently a female remedy , He says that the disposition and mental state are the chief
guiding symptoms to the selection of Pulsatilla.
Treatment:
*
10/02/2013 before the total case was taken , on the day
one Thuja30C, Five doses were given every 12 the hourly, along with Placebo 5
days .
*
patient
came on 26-2-13 no trace of menses Pulasatilla 200c ,5doses were given with Placebo for 20 days .
*
24-03-13
: patient came with no trace of menses Pulasatilla IM, 3 were
given with Placebo 30 days .
*
21-04-13 :
patient came and said that menses
appeared on 17-04-13, bleeding was more. Placebo 30days .
*
19-05-13 :
patient came and said menstrual bleeding continued for 20 days, extreme weakness China 200C, 5 doses , Placebo 15days Carcinosin 1M , one dose , Placebo 15days was given.
*
16-06-13 :
patient came and said weakness
reduced, Menses was again delayed 12 days, it appeared on 29-05-13, LM P was on 17-04-13, Pulasatilla I0M, one dose was
given with Placebo 30 days . I
have advised her to undergo U S Scan of the abdomen.
*
14-07-13 :
patient came and said menses
appeared on 29-06-13, two days bleeding
was present, weakness reduced, Placebo 30days .
25-08-13
: patient came with the U S Scan report which was showing
Normal study (attached below).
Irritation and other symptoms were normal. Carcinosin 1M , one dose ,
Placebo 15days was given.Ahoka Q, was
given daily .
Discussion :
In the above case all
investigations were done , all investigations were pointing towards Poly cystic ovarian syndrome . since 2009 she is
having problem, took various treatments with any benefit, as age is marriage
age any girl wish to get married and concive, but her periods were very
irregular, many times she was kept on contraceptive pills to regulate periods
and used metformin
without any benefit. with that she gained her weight.2009 to 2013 she has put on 11 kg
weight.developed sever anxity about her health and future.
In the conventional treatment Medical treatment
of PCOS is lowering of
insulin levels , restoration of fertility, treatment of hirsutism or
acne and restoration of regular
menstruation, and prevention of endometrial
hyperplasia and endometrial cancer.
Polycystic ovaries are treated with a
laparoscopic procedure called "ovarian drilling" OR Reducing insulin resistance by
improving insulin sensitivity through medications such as metformin
anti diabetic drug. If fertility is not the primary aim, then menstruation can usually be regulated with a contraceptive pill . 1
Pulasatilla
has given good result in regulating menstruation , it has changed her mood, helped Her to shed weight and
lastly P C O Ds vanished with homeopathic
remedies. In the above case Carcinosin Burnett
was given; as it coved Sycotic, Tubercular,
Syphilitic miasms, it’s a Chronic,
Intercurrent remedy . Thuja
Occidentalis coved Psoric, Sycotic, Syphilitic miasms
It's surprising to note that Pulsatilla which is
selected on the basis of repatriation ,
given to the patient gave success, but following observations were noted.
In Murphy’s repertory
under the rubric female-Tumors,
genitals-ovaries, cysts : 44 remedies are there but Pulsatilla is missing
Synthesis 8.1 V repertory under the rubric female-Tumors, genitals-ovaries, cysts : 32
remedies are there but Pulsatilla is missing
Boericke O, repertory
under the rubric female sexual
system -ovaries, cysts dropsy : 25
remedies are there but Pulsatilla is missing
References
:
1) Ganie M A, Kalra S. Polycystic ovary syndrome - A metabolic malady, the mother of all lifestyle disorders in women - Can Indian health budget tackle it in the future?. Indian J Endocr Metab [serial online] 2011 [cited 2013 Sep 16]; 15:239-41. Available from: http://www.ijem.in/text.asp?2011/15/4/239/85571
4) Hompath Wildfire
11-02-2013
