Polycystic Ovarian Syndrome in a Woman of 18

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
Rotterdam (2003)	2 of 3 criteria
AE-PCOS Society (2009)	Yes	Yes	Yes
AE-PCOS Society (2009)	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:

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.
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.

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.

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

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:

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 9^th Sep 2017]
Androgen Excess and PCOS Society. Polycystic Ovary Syndrome. Available from: http://www.ae-society.org/ [Accessed 9^th Sep 2017]

Address for correspondence

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

Email: [email protected]