Clinical Cases

PCOS in a Woman of 24

Written by Sonal Sinha

Dr. Sonal Sinha presents a case of polycystic ovarian syndrome. Ovarian cyst on the right side, burning urine, thirstless, eruption on face, absent minded were among the symptoms that led to the simillimum.

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy that affects women. PCOS is also a leading cause of infertility. This disorder is characterized by excessive androgen production by the ovaries that interferes with the reproductive, endocrine and metabolic function.

Most women with PCOS grow a number of small cysts, small fluid-filled sacs that develop on the ovaries. The cysts are not harmful, but they can lead to an imbalance in hormone levels. Women who can conceive with PCOS have an increased risk of miscarriage, gestational diabetes, pregnancy- induced high blood pressure, pre-eclampsia, and premature delivery.

CLINICAL FEATURES:   

                          SYMPTOMS                          FREQUENCY (%)

Oligomenorrhea                                    50- 90

Amenorrhea                                           25-50

Infertility                                                55-75

Obesity                                                   50-60

Hirsutism                                                60-90

Acne                                                       25-30

Acanthisis nigricans                               05-33

Male pattern baldness/ alopecia             65-70

A 24 year old female visited my clinic on Feb 17, 2018. She was Hindu by religion, unmarried, educated as a B.A.  She was a resident of Jaipur, with the chief complaint of irregular periods with severe pain in abdomen the last six months.. She complained of pimples in both cheeks with spots. She suffered from burning in urine the last 6 months. She was diagnosed with right ovarian cyst and was under allopathic treatment for more than 4 months for acne and irregular menses. She had severe abdominal pain during menses. There was a history of irregular menses. 3-4/40-45 days, more profuse and painful bleeding.

1 st usg found right ovarian cyst                                                   

Physical Generals:

Appetite – Normal

Desire – Spicy, Sweets

Aversion –N/S

Bowel – Constipation occasionally

Urine – Burning

Perspiration –Profuse on face,

Sleep – Sound sleep

Thermal –Hot

Thirst –Thirstless

Mental general-     Absent minded

Fearful to be bad news

Memory weak and forgetful

Past history – Typhoid- 4 years ago

Chicken pox -8 years ago

Family history – father –healthy/alive

Mother –suffered from arthritis since the last 2 years.

Physical Examination: B.P.- 124/82

Pulse- 76/min

Temperature- 98.60 f

R.R – 16/min

Pallor – present

Case analysis: The following rubrics were taken on the basis of the above

Absent minded

Fear to see bad news

Pain in abdomen during menses

Right ovarian cyst

Menses irregular

Thirstless

Burning in urine

Eruption on face

Repertorisaton –

Management plan:

Apis is the leading remedy and covered most of the rubrics in repertorisation.

Patient was hot. The remedy selected for the 1st prescription was Apis. Apis was selected after analysis based on the totality of symptoms.

Rx:  Apis 30 single dose on 17/2/18, followed by PL 30 TDS X 7 days

According to homoeopathic principles, the minimum dose was prescribed and observed, until the medicinal action was noticed.

23/2/18 – symptoms –  Menses appears 21/2/18.

Treatment – PL 30 TDS X 7 days

3/3/18 –  symptoms – Decrease in frequency of eruption on face.

Treatment – Apis 200 1 dose stat, PL30 TDS X 15 days

19/3/18 – symptoms – Menses appear 18/3/18 . no abdominal pain.

Treatment – PL 30 TDS X 10days

31/3/18 – symptoms – Improvement in eruption on face

Treatment – PL 30 TDS X 15days

17/3/18 – symptoms – Menses appear at morning. Normal flow & no abdominal pain.

Treatment –  Apis 200 1 dose stat ,PL 30 TDS X 15days

10/5/18 – symptoms – No symptoms.

I suggested USG of lower abdomen.

14/5/18 – USG- normal

2 nd normal report

About the author

Sonal Sinha

Dr. Sonal Sinha - BHMS, PGNAHI, (Nagpur) MD (PGR), Repertory from Swasthya Kalyan Homoeopathic Medical College, Jaipur Rajasthan, India. CGO, CCH (Maharastra). Dr. Sinha is a member of LMHI.

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