A CASE STUDYOF PCOS TREATED WITH HOLISTIC APPROACH

INTRODUCTION

Homoeopathy, a holistic system of medicine deals rationally with many multisystem endocrinopathies and their psychosomatic bases. Amongst them polycystic ovarian syndrome can be well managed without synthetic hormonal therapy and even sequel of PCOS like anaemia, obesity, infertility etc, and even helpful in regaining hereditary traits of the disease with well selected homoeopathic similimum on the bases of principles of homoeopathy.

PCOS is a heterogenous, multisystem endocrinopathy with features of oligomenorrhoea, non-ovulation, obesity, hirsutism and infertility. Itoriginates from insulin resistance; hyperinsulinemia and obesity are linked.¹

PCOS is a multifactorial. Causes include 1. Genetic, 2. Lifestyle, diet, stress. 3. Hypothalamo pituitary axis dysfunction, 4. Idiopathic i.e. drug induced.²

The case selected for this study is having multisystem endocrinopathies, overactive ovaries resulting in delayed menstrual cycle and sequel of disease in form of anaemia, infertility etc. and some psychological corelation with the disease. Selected case is showing efficiency of homoeopathic remedy selected on the bases of holistic approach.⁴

Case is having constitutional symptoms and Homoeopathic constitutional treatment helps to balance hyperactivity of glands, regulate hormonal balance, dissolve the cysts and enhance normal functioning of ovaries thereby eliminating the need for hormone therapies and surgery.⁵

CASE HISTORY:

A married female of age 25years old came on 24^th sept 2023 with the complain of irregular menses since menarche.

Age of menarche – 15^th year of age.

Cycle – irregular, Menses delayed since the age of puberty, delayed for 1 to 2 months.

Duration – 6 to 7 days, every time flow is variable in character.

Flow – for first 2 days it is more in amount, then scanty and variable in character.

Investigations – 2014- USG shows left ovarian cyst.

P/H/O Stomatitis frequently.

Gastric headache – off an on due to outside food or heavy food, and indigestion.

27/01/2022 – USG shows – Early changes of PCOD, Hb – 9 mg/dl.

LMP: 11^th sept 2022.

Menses – Delayed every time, delayed for 10-15 days to 1-2 months. No much symptoms before menses she feels, dull and paleness of face. Only on first day – severe lower abdominal pain, thighs sprain, irritability increased. Pt has to take painkillers. Feels slight relief in pain with warm compression. Leucorrhoea yellowish greenish – present sometimes after menses.

Patient has taken few homoeopathic remedies too, like Silicea, Natrium muriaticum, Lachesis, Folliculinum etc. but no improvement.

Location	Sensation	Modalities	Concomitants
Female genitalia	Menstrual cycle – Irregular, mostly delayed up to 1 to 2 months		Increased irritability
	LMP: 11th Sept 23. Flow is variable in character, first 2 days more flow. With severe lower abdominal pain, thighs sprain	Pain > by painkillers, warm compression.	Leucorrhoea – mild, yellowish greenishafter menses.
Head	Pain, after outsidefood or heavy food which causes indigestion. Left sided pain, A/F – Hunger	>by eating
GIT	Loose motions, watery, semisolid stool. A/F – outside food, heavy food.		Headache

PAST HISTORY:

In childhood – measles 3-4 times.

H/o Once 3 years back – greenish diarrhoea.

Motion sickness, feels giddiness and nausea while travelling through car or bus.

Aphthae – many times

FAMILY HISTORY:

Father: Alive and healthy.

Mother: Alive and healthy.

Paternal Grandfather: Natural death, had no major Illness.

Paternal Grandmother: Alive and having Osteoarthritis.

Maternal Grandfather: Alive and having Hypertension.

Maternal Grandmother: Alive and Healthy.

PHYSICAL GENERALS:

• Appetite: In morning hunger leads to headache (left) > eating.
• Thirst: thirst less, with moist tongue
• Desire: Sour, Sweets, Cold water, Cold drinks.
• Aversion: Warm water.
• Thermal: Hot.
• Stool: Diarrhoea (stool – loose in consistency). Heavy or outside food causes once semisolid

stool, cake causes blackish stool.

• Urine: No any complaints.
• Sleep: Sound.
• Perspiration: less.

MENTALS:

Mild and quite by nature in general. Sensitive, slightest things affects her mood profoundly, Irritability is marked. Fear of darkness, (sensitive to said of people to her, negative comments), Dancing is her hobby, she weeps easily, Weeping ameliorates, Mood gets changed.

DIAGNOSIS: PCOS

On the bases of: Clinical findings – irregular, delayed periods.

Ultrasound showing – multiple follicles, enlarged ovaries.

Differential diagnosis – Thyroid disease, Hyperprolactinemia, Congenital adrenal hyperplasia, Cushing’s syndrome.

INVESTIGATION REPORTS:

ANALYSIS AND EVALUATION OF SYMPTOMS:

Changeable mood, Fear of darkness, Sensitive, oversensitive person. Smallest matter or said of people affect her. Feels disturbed and irritable. Sometimes feels better by weeping. Desire- sour, cold food and drinks, Aversion- warm food, Stool – diarrhoea loose in consistency, Thirst less and moist tongue, Irregular, delayed, scanty menses since puberty, Cystic growth esp of left ovary, Stomatitis. Gastric Headache > eating.

1. Fear- dark – Mental general
2. Sensitive – oversensitive. – Mental general
3. Reserved – Mental general
4. Desire – sour – Physical general
5. Desire – cold drink – Physical general
6. Desire-cold food – Physical general
7. Aversion – warm food – Physical general
8. Menses late – Physical particular
9. Tumours – ovaries – cysts. – Physical particular
10. Pain – gastric – Head – Physical particular
11. Aphthae – Mouth – Physical particular
12. Thirstlessness – Physical general⁹

REPERTORISATION:

Mild gentle and tearful, yet she is remarkably irritable, not in a sense of pugnacity, but easily irritated, extremely touchy, sensible to every social influence. Many of the complaints are associated with weakness of the stomach and indigestion, or with menstrual disorders. Women with various irregularities of the menstrual flow, the mental symptoms are often associated with the ovarian and uterine difficulties. One sided complaint is peculiar to Pulsatilla. Periodic sick headaches. The abdominal bowel symptoms are associated. The haemorrhoids it cures look like the flowers of the plant, so inflamed, red and bleeding, tender to touch. Menses too late, menstruation has been painful since puberty.⁷

In girls of mild disposition, when puberty is un duly delayed, menstrual function is defectively or irregularly performed. Menstruation, anaemia. Symptoms ever changing.⁸

With above references, on the bases of totality and repertorisationi.e. choosing holistic approach Pulsatilla Pratensis was selected in I M Potency.

PRESCREPTIONN AND RESULT –

24^th sept 2022 – PulsatillaPratensis 1M, single dose, followed by SL two times a day for 15 days.

8^th oct 2022 – LMP -1^st oct 2023, lasted for 5-6 days, flow was normal, on first day mild lower abdominal pain, headache once before a week but better than before. Diarrhoea once after outside food. Pulsatilla 1 M, 1 dose, followed by SL 2 times a day for 15 days.

11^th oct 2022- Pt. had c/o mild Abdominal pain, diarrhoea, with semisolid stool twice, felt better after passing stool. Advised to increase fluid intake and light diet. SL for next 20 days.

8^th Nov 2022 – LMP-4^th oct, flow was normal, dysmenorrhoea mild on first day, flow lasted for 6 days. Strong smell causes nausea and vomiting, diarrhoea not now, sometimes bloating feelings. SL for 20 days was prescribed. 30^th oct – pt complained of stomatitis but mild advised to apply glycerine over ulcers.

5^th Dec 2022 – today first day of flow, spotting only, no pain in lower abdomen. SL prescribed for 20 days. 29^th Dec 2022 – constipated few days back with mild bleeding per anus. H/O same complaints few years back. Puls 1M, one dose, followed by SL for a month.

12^th Feb 2023 – LMP-11^th Jan & 11^th Feb, with 6 days normal flow and no symptoms of PMS or headache, stool – normal, no stomatitis now. SL for a month.

26^th March 2023 – LMP – 20^th march, no any complains now. Repeat USG shows above changes.

CONCLUSION

Homoeopathy is quite effective in PCOS in nature and certainly the best alternative medication by correcting hormonal imbalance and thereby correcting the ovulary cycles as well very proficient in managing symptoms of ovarian cyst.

Homoeopathy treats mental symptoms with beautifully acting drugs.⁴ (§.210).Homoeopathic constitutional treatment helps to balance hyperactivity of glands, regulate hormonal balance, dissolve the cysts and enhance normal functioning of ovaries thereby eliminating the need for hormone therapies and surgery.⁵

BIBLIOGRAPHY

1. HOWKINS AND BOURNE SHAW’S TEXTBOOK of gynaecology,18^th edition by VG Padubidri and SN daftary.
2. DC DUTTA’S textbook of gynaecology, 8^th edition by Hiralal Konar.
3. DR. SUBRATA BANERJEA, Miasmatic prescribing, Second extended edition.
4. DR. SAMUEL HAHNEMANN’s ORGANON OF MEDICINE, 6th edition translated by R. E. DUDGEON, with an introduction and commentary on the text by B.K SARKAR.
5. H. A ROBERTS, The principle and art of cure by homoeopathy, 2^nd Edition.
6. J.T. KENT, Lectures on homoeopathic Materia Medica by Kent JamesTyler, 2^nd edition
7. Repertory of the Homoeopathic Materia Medica, 6^th Edition by Ehrhart and Karl
8. HENRY C ALLEN, Allen’s keynotes – rearranged and classified with leading remedies of the Homoeopathic Materia Medica and Bowel Nosodes, 10^th edition.
9. ZOMEO Homeopathic software – bjainrx

ABOUT THE AUTHOR

Written by RUKAIYA SABHAI, 4^TH BHMS, BHMCH, Vadodara, Gujarat.

Guided by DR. FALGUNI PATEL (MD. HOMOEOPATH, CR),Clinician and HOD, Dept of practice of medicine, Baroda homoeopathic medical college and hospital, Vadodara, Gujarat.