Clinical Cases

Polycystic Ovarian Syndrome in a Woman of 18

PCOS in a Woman of 24

Drs. Sandeep Karmakar and Pratibha Shivhare present a case of Polycystic Ovarian Syndrome in a Woman of 18. Fear of cancer, sad events affect her profoundly, aversion to business, timidity and desire for sour food were among the symptoms leading to the simillimum.

Abstract

An 18-year old girl diagnosed with polycystic ovarian syndrome and fibroadenoma of right breast consulted for irregularity of menstruation and lump in right breast on 07/09/15. After Homoeopathic case taking, she was prescribed Calcarea carbonicum in ascending LM potencies. Her menstruation regularized within 16 weeks of treatment. Other symptoms such as anxiety, depression, oiliness of face, abnormal growth of facial hair, and body weight reduced together with disappearance of a lump in her right breast, improving her quality of life. The investigations repeated after 4 months showed complete resolution of ovarian cysts.

Key words

Polycystic Ovarian Syndrome; Calcarea carbonicum

Introduction

PCOS is now recognized as the most common endocrinopathy in reproductive-aged women with key features of menstrual irregularity, elevated androgens, and polycystic-appearing ovaries. Increased production or sensitivity to androgens commonly leads to hirsutism (male-patterned hair growth), acne, or alopecia (thinning or loss of scalp hair). Adolescent patients pose particular diagnostic problems because characteristics of normal puberty often overlap with signs and symptoms of PCOS.

PCOS Diagnostic Criteria for Adolesents

PCOS Definition Clinical Hyperandrogenism

(Ferriman-Gallwey Score ≥ 8) or

Biochemical Hyperandrogenism

(Elevated Total/Free Testosterone)

Oligomenorrhea

(Less than 6-9 Menses per Year) or

Oligo-Ovulation

Polycystic Ovaries on Ultrasound (≥ 12 Antral Follicles in One Ovary or Ovarian Volume ≥ 10 cm3)
NICHD (1990) Yes Yes No
Rotterdam (2003) Yes Yes Yes
2 of 3 criteria
AE-PCOS Society

(2009)

Yes Yes Yes
1 of 2 criteria

This is a case report of Homoeopathic treatment of an 18-year old girl for four months suffering with PCOS and fibroadenoma of right breast.

Case Report

Patient information

Name Age Sex Religion Address Marital status Occupation
T. P 18 years F Hindu Kaliachak, Malda, West Bengal Married Student

Patient was tall, thin, fair complexioned, dark eyed, with acne and abnormal growths of hair on oily face. She consulted me on 07-09-2015 for the following complaints:

  1. Irregularity of menses for 4 years, occurring at an interval of 4 to 5 months; flow was profuse, with occasional clots, and severe pain in lower abdomen.
  2. Lump in the right breast for 3 years.

History of present complaints:

Her complaints started 4 years back. She gradually gained weight. Acne appeared on her face. Her face became oily and regularity of menses was altered. She was regularly taking allopathic medicine from a gynecologist for the last 3 years, before coming to me. She also developed a lump in her right breast 3 years ago, and was advised lumpectomy by a surgeon.

Polycystic Ovarian Syndrome in a Woman of 18 1

Polycystic Ovarian Syndrome in a Woman of 18 2

Past History

Nothing significant

Family History

Nothing significant

Personal History

Married; College going student

General Symptoms

Physical Generals

Appetite Good. But cannot tolerate hunger
Desire Sour, meat, cold food
Aversion Bread
Intolerance Milk and rich food causes indigestion
Thirst Profuse; 4 litres/ day; thirst for large quantities of water
Tongue Clean, moist, flabby, indented
Breath offensive
Salivation salivation off and on
Sleep Sound; sleeps on right or left lateral position
Dreams Lascivious
Sweat Scanty, non-offensive, especially on face and chest; feels better after sweating.
Stool Unsatisfactory; twice a day; hard stool followed by soft stool; offensive; first stool of the day after taking tea or water.
Urine Clear
Menses Irregular; occurring at an interval of 4 to 5 months; profuse flow; with occasional clots and severe pain in lower abdomen.
Thermal Reaction Hot patient; prefers winter season
General Tendency Catches cold easily

Mental Generals

She was also a college going student and her academic performance deteriorated due to depression and anxiety about the future. She could not do her household work for the same reason.

She was mild, timid and slow. She repeatedly emphasized throughout the consultation that she had an incurable disease which may convert into cancer in the future. She used to become uncomfortable if anyone in her surroundings or among relatives or known persons suffering with cancer dies.

Analysis and evaluation of symptoms

Mental generals Fear of Cancer

Fear of impending incurable disease

Sad events affect her profoundly

Aversion to business

Doubtful of recovery

Timidity and bashful

Curious

Mildness

Slowness

Physical generals Desires sour food, meat and cold food

Intolerance of milk

Tongue: indented

Thirst for large quantities of water

Sweat scanty

Stool hard followed by soft stool

Tendency to take cold easily

Hot patient

Particulars Tumour in right breast

Totality of symptoms and conversation of symptoms into rubrics

Symptoms Rubrics
Fear of Cancer Mind: Fear, Cancer of
Fear of impending incurable disease Mind: Fear, disease of impending, incurable, of being
Sad events affect her profoundly Mind: Horrible things, sad stories affect her profoundly
Aversion to business Mind: Business; aversion to
Doubtful of recovery Mind: Doubtful recovery of
Timidity and bashful Mind: Timidity, bashful
Desires sour food, meat and cold food Generals: Food and drinks, sour food, acid, desires
Generals: Food and drinks, meat, desires
Generals: Food and drinks, cold food, desires
Intolerance of milk Generals: Food and drinks, milk agg.
Tongue: indented Mouth: Indented, tongue
Thirst for large quantities of water Stomach: Thirst, large quantities, for
Sweat scanty Perspiration: Scanty, sweat
Stool hard followed by soft stool Stool: Hard, followed by, soft stool

Repertorization of the case

The symptoms of the patients have been analysed as per Kentian method of evaluation into mental generals, physical generals and particular symptoms.

The case has been repertorized using RADAR 10.5.003 Software (Figure: 4) based on Synthesis 9.0 by F. Schroyens, following Kentian method of Repertorisation method and Total addition process.

Polycystic Ovarian Syndrome in a Woman of 18 3

Calcarea carbonicum was finally selected after consulting materia medica.

Intervention

Calcarea carbonicum in 0/1 potency was prescribed in 16 doses to be taken every morning vac ven. and after 16 days, Calcarea carbonicum in 0/2 potency was to taken in same way.

Follow-Up of the case

Date Indications for prescription Medicine
04/10/15 Menses did not appear

Breast lump slightly reduced in size

Acne, oiliness of face, abnormal growth of hair on face were same as before

Anxiety and depression slightly improved

Weight: 64 kg; same as before

Calc. carb. 0/3, 16 doses, OD, vac ven followed by Calc. carb. 0/4, 16 doses, OD, vac ven
01/11/15 Menses appeared on 20/09/15 and was continuing till 01/11/15

Menses profuse; with occasional clots with severe pain in lower abdomen

Breast lump slightly more reduced in size

Anxiety and depression markedly improved

Acne, oiliness of face is slightly reduced

Abnormal growths of hair on face same as before

Weight: 63 kg; slightly reduced

Calc. carb. 0/5, 16 doses, OD, vac ven followed by Calc. carb. 0/6, 16 doses, OD, vac ven
29/11/15 Menses ceased on 06/11/15

Breast lump disappeared

Anxiety and depression markedly improved

Acne, oiliness of face much more reduced

Abnormal growths of hair on face were same as before

Weight: 62 kg

Patient was doing well; no new complaints; So patient was advised for USG lower abdomen and breast mammograph.

Calc. carb. 0/7, 16 doses, OD, vac ven followed by Calc. carb. 0/8, 16 doses, OD, vac ven
27/12/15 Menses appeared on 25/12/16

Menstrual flow was normal; with slight pain in lower abdomen

Breast lump disappeared

Anxiety and depression no more

Acne and oiliness of face no more

Abnormal growth of hairs on face slightly reduced

Weight: 62kg; same as before

Patient came with USG Pelvis dated 21/12/15 showing normal study. She was unwilling to undergo breast mammograph.

Calc. carb. 0/9, 16 doses, OD, vac ven followed by Calc. carb. 0/10, 16 doses, OD, vac ven

Polycystic Ovarian Syndrome in a Woman of 18 4

Conclusion

This is a single case report of PCOS resolved by homoeopathic treatment. The homoeopathic similimum cures the case. More case reports clinical trials and RCTS on PCOS are needed to define the scope of homoeopathy in treatment of PCOS.

Financial support and sponsorship

Nil.

Conflict of interest

None declared.

References:

  1. Roe AH., Dokras A. The diagnosis of polycystic ovary syndrome in adolescents. Rev Obstet Gynecolv.4(2); Summer 2011. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3218544/ [Accessed 9th Sep 2017]
  2. Androgen Excess and PCOS Society. Polycystic Ovary Syndrome. Available from: http://www.ae-society.org/ [Accessed 9th Sep 2017]
  3. Schroyens F. Radar software, version 10.0; © Archibel 2007, Belgium

Address for correspondence

Dr.Sandeep Karmakar, Near Truck Stand, Shakuntala park (Ghorapir); P.O. Rathbari; Dist: Malda-732101, West Bengal

Email: [email protected]

About the author

Sandeep Karmakar

Sandeep Karmakar

Dr. Sandeep Karmakar received his BHMS degree from National Institute of Homoeopathy, Kolkata, India under Calcutta University in 2003. He secured his MD (Homoeopathy) in Organon of Medicine and Homoeopathic Philosophy from the National Institute of Homoeopathy, under the West Bengal University of Health Sciences, Kolkata, in 2017. He has worked as Associate Professor in Maharshi Menhi Homoeopathic Medical College & Hospital, Bihar, India for two and a half years. He has been practicing Homoeopathy in Malda, West Bengal, India since 2003.

About the author

Pratibha Shivhare

Pratibha Shivhare

Dr. Pratibha Shivhare received a BHMS degree from National Homoeopathic Medical College, Lucknow, India under Dr. Bhimrao Ambedkar University, Agra, India in 2013. She got her MD (Homoeopathy) in Organon of Medicine and Homoeopathic Philosophy from the National Institute of Homoeopathy, Kolkata, under The West Bengal University of Health Sciences in 2018. She has been working as Homoeopathic Medical Officer for the Government of Chhatishgarh, India since August 2018. She is owner of the YouTube channel: Mission Homoeopathy.

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