A Case of Empty Follicular Syndrome

PCOS Polycystic ovary syndrome

Dr. Piyu Mohanani presents a case of Empty Follicular Syndrome resolved with a sarcode.

Date:  3/02/15

Name:  Mrs. P.M.,

Age: 23 yrs /Female

Occupation:  Housewife

Chief Complaints:

  1. Patient had PCOD since menarche.

After 2 ½ yrs of marriage, she was unable to conceive, so she started treatment with allopathic medicine, but it was in vain.

She subsequently consulted me for her problems:

She had irregular menses since her menarche which was at age 13.

Irregular interval of 45 days. Flow Scanty for 2-3 days. Bright Red with clots

Pain in both breasts before menses

As after marriage it was difficult to conceive so she started allopathic treatment. Their diagnosis was : Bilateral Ovarian Cysts.

She was on tab. Primolute N, to get her menses every month.

Tab. CC 100 mg, Tab.Ovygym for ovulation.

Inspite of taking the medicines, no rupture of follicle, no ovulation.

The drugs were repeated again & again.

  1. Her second complaint was colds ,coryza on and off since childhood.

Nasal discharge sticky, yellowish.  <change of weather

Past History:

History of Mumps in childhood

History of bilateral renal calculi before 3-4 years, treated with Ayurveda

Family History:

History of Obesity on paternal side

History of RA to PGM

History of Recurrent Stye to (mother)

History of DM to maternal aunt.

Personal History:

Diet: Veggie

Desire: Sour+++, Sweets+

Aversion: Not specific

Thirst: 2-3 glasses per day. [Noticed Less Thirst]

Eliminations:

Stool: Constipated  < Fatty food

Urine: Occ. Burning Micturation

Perspiration: Scanty, Axilla, back.  Non-staining

Thermally: Towards hot

Sleep: Sound, Refreshing

Position: On abdomen

Dreams: Routine

Mind:

Married before 2 ½ years in joint family of 15 members. Strict family and difficult to adjust in beginning, but later on adjusted. Weeping at slight things, without cause. Present Scenario in family was, patient is younger, so her elder sister in law dominates her, demanding she do domestic work.  Patient’s reaction is weeping and helpless feeling.  She says her husband is too domineering and fastidious. Patient says: “ I am calm and silent. I don’t react to anyone’s domination. Everyone in the family dominates on me, which troubles me.” Reaction: Weeping during conversation.

O/E: Per-abdominal Examination: Tenderness on right side of Abdomen.

Investigations Done:

Follicular Assay

Hormonal Assay

AMH Test

Working up the case:

Being dominated is the theme presently as per scenario. I picked up the following rubrics:

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Final Prescription:

Pulsatilla: As patient is Hot, Thirstless, has affinity for female reproductive system.

I stopped all the allopathic medicine and prescribed Pulsatilla.

Pulsatilla 200 two doses. SL 6 BID for 15 days.

Follow Up:

16/2/15: Menses appeared before 5 days from LMP. Pain noticed in both breasts before menses.

Flow was for 4 days. Constipation noticed. Mood : Felt refreshed

I repeated Pulsatilla 200, two doses again, as being her constitutional medicine. SLx1month

18/3/15: Menses appeared 2-3 days before LMP. Pain was slight in both breasts before menses.

Flow for 3-4 days. Stool: Satisfactory. Mood: Felt refreshed. No weeping this time.

I gave SL this time and I thought to go for her Ovulation Assay, which can give idea of her Ovulation. After few days patient came with Ovulation report, but in vain. No follicular growth present.

Which is indeed named Empty Follicular Syndrome.

Case was studied again.

Patient gave more history.  “I am helpless at this state. My husband wants child, my In-laws are asking me again and again….. Don’t know why I am not conceiving yet.” She said at home she must perform whatever work she is given. My husband is dominating, my In-Laws also are dominating. She said, “I feel I have lost somewhere, as I don’t get time to think, exactly what I want. I live for others, that is for my family. I feel sometimes, I have lost my will. I live for expectations of others…and I feel sad..”

So here was the history…

Theme of the case:

Being Dominated for a long time.

Loss of will,that is Loss of Individuality.

Feeling of helplessness.

I repertorized the case with the recent rubrics:

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Mind: Helplessness feeling of

Mind: Ailments from Domination.

The remedy was Folliculinum.  I studied Vermeulen Materia Medica and decided to prescribe Folliculinum.

Folliculinum 200 three doses.

23/4/15:  Menses regular. Slight pain in both breasts before menses. Stool: Normal.

I referred her for Ovulation assay which is done from 11th Day of LMP.

This time her reports showed follicular growth, but yet no ovulation.

I repeated Folliculinum 200 three doses.

21/5/15: Patient was active, good energy level, menses reglular, generals better.

I advised her to get ovulation assay. This time follicular growth was present. Also, Ovum was seen in ovulation assay, which was a positive point.

24/6/15: Patient was active, good energy level, menses regular. generals better.

Advised  ovulation assay. Follicular growth present, also ovum was seen in ovulation assay, which was a positive point.

Sl x 10 days

10/7/15:LMP: 8/7/15….. All  Generals better

SLx15 days. Advice: Follicular Assay from 11th day of LMP til 21st day

25/7/15: Ovulation seen in reports. All generals better.   SLx 15 days.

12/7/15: Patient was positive for pregnancy.

Conclusion:  Here Folliculinum was used as an intercurrent.  It stimulates the continuing natural production of oestrogen by the ovaries and by the other organs which also make small amounts of oestrogen, including the adrenal glands, liver and kidneys. So in some cases we need intercurrent medicines to reach our final result. I learned about intercurrent medicines in this case and also how Folliculinum’s sphere of action helped us to go in the right path.

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About the author

Piyu Mohanani

Piyu Mohanani

Piyu Mohanani M.D. has had her own private homeopathic clinic for the last four years. She had her PG training from Dr. J.J. Magdum Homeopathic Medical College, and completed her MD in Organon of Medicine. Her thesis was, “Anger: It’s Interpretation & Its Importance In Homoeopathic Prescription.” She is the author of a Materia Medica book titled“Portrait of Materia Medica”. Dr. Mohanani uses homeopathy in routine practice, where common people can take advantage of it.

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