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
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).6>
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
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
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
Desire- Cold food , desire spicy food.
Aversions/ intolerance- NS.
Urine- 5/6 times/day. No special. Characteristics.
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
* 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 :
* Anxiety about health
Desire for open air
* Desire for cold Food , desire spicy food
* Menses late
* 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.
* 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 .
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
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