PCOD in a Woman of 25

A 25 year old tall, slender, fair looking young unmarried girl, came with

C/O of irregular menses since menarche. On OC pills since 2yrs with h/o severe dysmenorrhoea graying of hair since 1year maybe 10-12 strands of hair on chin since 3-4yrs when dysmenorrhoea started.

H/C/O:

1. Dysmenorrhea -on OC pills since 2yrs with h/o severe dysmenorrhoea.

So much so that used to faint due to pain after 2yrs of menarche. Spasm – a lot of pain and will vomit and have diarrhea. Pain intolerant of. “I would rather take a medicine.”

Rx, hormonal treatment – T. Krimson 35 for 21 days, since 2 years till 5 days ago.

On T. Mefftal spas for 5 years.

2. Greying of hair , since 1year but < since 3-4 months . Hairfall , since 3-4 months.   Hair growth on chin , since 3-4 yrs. Hair growth on body is also there ( thick black) Every 20 days she does waxing .
3. I have a lot of gas problem <chocolates. I generally take chocolates less. Headache – gas if hungry.
4. Bloated sensation. Heavy and painful feeling retrosternally < walking.
5. “Usually my problems are with physical appearance – main gandi lag rahi hu , pimple , hairfall, white hair – that’s the reason I am here.

PAST HISTORY :  She has taken homoeopathy for tonsillitis. She has tonsillitis since childhood-very big, every month.B/L  rt < lt .

Family history : nothing specific.

Thermals –  CHILLY

MIND : The patient says that whatever diseases she has show up on skin and hair. It is peculiar that she is concerned more about her looks than menstrual issues. Physical features are very important for her. If skin is bad or hair fall is there, then she will panic. She is an introvert and sometimes she doesn’t  want people around her and stays alone in peace.

“I feel peaceful when I am not around people.” If some problems are there, she gets reserved, “I go into my shell (hand gesture). I feel more comfortable when I am in my shell. Protection in my shell”. Patient has no concern regarding irregular periods that can cause problems in fertility. Rather she doesn’t want to give birth to a child in the future. The patient got agitated on this topic and expressed her high level of disinterest in getting pregnant –it’s  too much responsibility for her .At least 4-5 times she stated that she does not want a baby. Te reason behind it was “I am a very career oriented person, I want to become a big person. If suddenly a baby is conceived then I won’t be able to continue with it .  Very much organized  and control oriented. For her,everything should be planned.  She likes new people , wants to see new places, dancing ,experience more and do new things. Family oriented. I never hide anything. I like to be myself. She feels comfortable when with her family.

She has different types of friends and easily changes types. She doesn’t like to stick to one group.Decisions are difficult for her. That is why plans help her.

DREAMS : 1) uncle was trying to arrange a marriage for her (she doesn’t want to get married )

• Horse riding. She used to fall from a horse. After sometime that horse changed to a bike (thrill).These things gave her an outlet = fast , spontaneous . non- rigid. Flying and riding – theme is common in all dreams.
• I was having ice cream with Hritik Roshan–Very Colourful dreams – fluorescent pink coloured ice cream and fluorescent green-bright vision.

In school she used to sit on the last bench alone and then write down her anger or sadness. If anyone asks her any question regarding the subject and if she doesn’t know the answer then she will go to bathroom and cry. She said she is very competitive and egoistic- that ego should not get hurt. She is very rigid, not flexible, non-spontaneous. She explained Rigid -Which is very solid ,you can depend on that person.

Sensitive to rejection. Not being chosen. Not getting what you want and somebody else getting it.

Fears: I am not doing well enough. Fears she won’t be able to complete things.

Likes to get away from everybody, get in touch with inner conscious and inner person .. (hand gesture) like going into a a cave . Silence and being alone into my shell .Its cold and windy, silent. I like morning time because of this-cold and windy, silent .I don’t feel suffocated (here we didn’t ask patient about suffocation – it came spontaneously

I lost my energy. I lost my personality. Here two polarities can be seen – one is to flow as much as she can – change , and the other –stay in comfort zone, not venture out too much ) I am stuck. Opposite-I am free , myself , its open and its (hand gesture) Trapped for air, can’t breathe. Very important for me always is  open windows.

She is so much competitive that she always wants to be the first person to do things and then people copy her. Hindrance – responsibilities which she is not ready to take. She wants to travel and be free and not tied down with relatives. I dont want to settle in one place. Just roam(feeling behind responsibilities).I take decisions in family. They come to me for decisions.

MENSTRUAL HISTORY :-

Very irregular no clots

She takes oc pills for menses *21 days and on 22^nd day menses comes .

Cycle :- 40-50 days.

RUBRICS WITH THE USE OF RADAR APPLICATION :-

1. GENERALS – FOOD and DRINKS – fish – desire: (84)-synthesis
2. MIND – FEAR – pregnant; of getting: (1) –kent
3. MIND – COMPANY, – aversion to – avoids the sight of people: (10)
4. MIND – DELUSIONS, – visions: (36) -kent
5. MIND – INDIFFERENCE,apathy,etc. – relations,to – her children: (5) -kent
6. MIND – AMBITION – increased: (72) -synthesis
7. MIND – AVERSION – children, to: (20). -synthesis
8. MIND – CHANGE – desire for: (23) -synthesis
9. MIND – AILMENTS FROM – rejected; from being: (13) -synthesis

Let’s have a look at sensation words:-

1. Inside my shell
2. Withdraw from it
3. Venture out
4. Flow
5. Absorb
6. Adaptable
7. Flexible, suiting to the surrounding ,being appropriate for the environment
8. Change
9. Hindrance
10. Open and close
11. Suffocation
12. Stuck
13. Free
14. Fast, spontaneous, non rigid
15. Stick to it.
16. Streamline
17. Silence and aloneness in my shell
18. Going inside a cave
19. Cut off from the outside

These words along with the whole case represent the animal kingdom and the Mollusc family.  Sepia is cephalopoda. The shells vary in this class, they may be external as in nautilus, internal as in cuttlefish or even absent as in octopus.

Rx, Sepia 1M 1dose

D.D :- Octopus.

1^st FOLLOW UP AFTER A MONTH :

P: I am  much better. Feeling very enthusiastic. Feeling fresh. Not stuck.

1. With the start of remedy – loose motions- old complaint . But didn’t take any medicines – it became normal on its own.
2. Skin- became very rough. Now it is fine. Hair is looking good.Scalp has become oily –since childhood this was there .
3. Underarms-smelly- if I don’t take bath – mom scolds. My sweat – sour smell.
4. A lot of gas since 2-3 days < sweets , lower abdomen tight
5. After eating cold – tonsils pain is there. This used to be my old complaint.

Generals :

sleep- sound

thirst- ok

stool- satisfactory

urine- n

MENSTRUAL HISTORY :- L.M.P- 16.04.2017  ( no hormonal pills were taken .)

FIRST DAY IT WAS NOTHING-

2^ND DAY HOT FLOW-

3^rd– very less

4^th day – spots

back heaviness –only on 2^nd day.this is new- I felt like lying down.

FOLLOW UP AFTER SIX MONTHS :-

The patient has been on SL up till now and the Sepia 1M dose was repeated only twice .The extra growth of hair over chin and chest has not gone completely but no new growth of hair. The hair was thick and dark – it has reduced in density.

Menses has been regular of 28-30 days cycle, every month .Her skin is glowing and looking good.  Her mother said she used to be very irritable on the topic of the marriage but nowadays she is at least listening to us.The patient is still under treatment.

Lessons learned from this case:

The use of repertory as well as knowledge of the different advanced methods of case taking help in such a miraculous way. The patient started talking and within no time hand gestures were there with particular words that were noted and kept in mind.