Definition
PCOD is a hormonal disorder of reproductive-age women, characterized by multiple immature ovarian follicles that fail to mature and ovulate, leading to cyst formation, irregular menstruation, infertility, and signs of androgen excess.
Etiology
• Genetic predisposition.
• Hormonal imbalance: ↑ LH, ↓ FSH, ↑ Androgens.
• Insulin resistance, obesity, sedentary lifestyle.
• Secondary causes: thyroid dysfunction, Cushing’s syndrome, hyperprolactinemia.
Pathology
• Enlarged ovaries with thickened capsule.
• Multiple peripheral cysts (2–9 mm).
• Increased ovarian stroma and theca cell hyperplasia.
Pathophysiology
• Hypothalamic–pituitary axis dysfunction → ↑ LH, low/normal FSH.
• Increased ovarian/adrenal androgen production.
• Insulin resistance with hyperinsulinemia worsens androgen excess.
• Arrested follicular development → anovulation.
Clinical Features
• Menstrual irregularities (oligomenorrhea, amenorrhea, dysfunctional uterine bleeding). • Central obesity.
• Hirsutism, acne, scalp hair thinning.
• Acanthosis nigricans, skin tags.
• Infertility, recurrent miscarriage.
Investigations
• Ultrasound: Enlarged ovaries with ≥12 follicles.
• Blood tests: ↑ LH/FSH ratio (>3:1), ↑ androgens, ↓ SHBG, ↑ insulin. • Rule out thyroid disorders, CAH, hyperprolactinemia.
Diagnosis
Diagnosis is based on Rotterdam Criteria (any 2 of 3):
1. Oligo/anovulation.
2. Clinical/biochemical hyperandrogenism.
3. Polycystic ovaries on ultrasound.
Management
Lifestyle: Weight reduction, exercise, balanced diet.
Drugs:
– COCs: regulate cycle, reduce androgen.
– Metformin: improves insulin sensitivity.
– Ovulation induction: Clomiphene, Letrozole.
– Anti-androgens: Spironolactone, Cyproterone.
Surgery: Laparoscopic ovarian drilling in resistant cases.
Homoeopathic Perspective
According to Hahnemann, there is no purely local disease—ovarian cysts and menstrual disturbances reflect a deeper constitutional disturbance. PCOD often indicates synoptic miasma due to its chronic, cystic, proliferative nature.
Homoeopathy treats both the acute symptoms and the constitutional tendency behind the disease, addressing hormonal imbalance, emotional state, and susceptibility. Treatment involves selecting remedies based on totality of symptoms, mental state, and miasmatic background.
Homoeopathic Therapeutics
Sepia – Scanty, irregular menses, bearing-down pains in pelvis, indifference to loved ones, better from vigorous exercise.
Pulsatilla – Delayed/suppressed menses, mild and weepy temperament, thirstless, better in open air.
Lachesis – Left-sided ovarian pain, worse after sleep, talkative, jealous, hot patient.
Natrum mur – Profuse/irregular menses, oily skin, acne, hair loss, reserved personality, worse from sun/heat.
Calcarea carb – Early, profuse menses, obesity, cold intolerance, easy fatigue, anxiety about health.
Thuja – Cystic growths, late scanty menses, left ovarian pain, sycotic constitution.
Apis mellifica – Suppressed menses, stinging ovarian pain, ovarian tenderness.
Folliculinum – Estrogen imbalance, irregular ovulation, premenstrual migraines.
Oophorinum – Regulates ovarian function, infertility.Â
Lycopodium – Right-sided ovarian cysts, bloating, digestive complaints, craving sweets.
Sulphur – Irregular menses, itching eruptions, heat aggravates.
Medorrhinum – Chronic PCOD with strong sycotic background, craving sweets/sour, extremes of behavior.
Other remedies: Bovista, Aurum mur, Belladonna (specific presentations).
References
1. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group (2004). Revised consensus on diagnostic criteria and long-term health risks related to PCOS. 2. IADVL Textbook of Dermatology, 4th Ed.
3. Cleveland Clinic: Polycystic Ovary Syndrome.
4. Das AK, Treatise on Organon of Medicine (Homeopathic reference).
5. Boericke W., Pocket Manual of Homoeopathic Materia Medica.
6. Clarke J.H., Dictionary of Practical Materia Medica.
