POLYCYSTIC OVARIAN SYNDROME

PCOS have abnormalities in metabolism of androgen and estrogen and in the control of androgen production. Diagnosis of PCOS is made when woman has 12 or more follicles in at least one ovary -measuring 2-9 mm in diameter or total ovarian volume greater than 10 cm³.

Signs and symptoms:

Menstrual irregularities, anovulation, and signs of hyperandrogenism.

• Hirsutism
• Infertility
• Obesity and metabolic syndrome
• Diabetes mellitus
• Obstructive sleep apnea

On examination:

• Virilizing signs
• Acanthosis nigricans
• Hypertension
• Enlarged ovaries: may or may not be present

Investigations:

Tests to be done to exclude other disorders which can cause menstrual irregularities and hyperandrogenism like adrenal and ovarian tumors, thyroid dysfunction, congenital adrenal hyperplasia, hyperprolactemia, acromegaly, and Cushing syndrome.

These tests should be done in women suspected to have PCOS:

• Thyroid function test (TSH, free thyroxine)
• Serum prolactin level
• Total and free testosterone
• Serum HCG level
• Free androgen index
• Cosyntropin stimulation test
• Serum 17-hydroxyprogesterone (17-OHPG) level to rule our Congenital adrenal hyperplasia
• Urinary free cortisol and creatinine levels to rule out Cushing syndrome
• Low dexamethasone suppression test to rule out Cushing syndrome
• Serum insulin-like growth factor (IGF-1) level to rule out acromegaly

Other tests:

• Androstenedione level
• FSH and LH levels (In PCOS LH to FSH ratio is usually greater than 3)
• GnRH stimulation testing
• Glucose level
• Insulin level
• Lipid level

Imaging tests:

• Pelvic ultrasonography preferably transvaginal approach
• Pelvic CT scan or MRI to visualize adrenals and ovaries

Endometrial biopsy may be needed to evaluate for endometrial disease, such as malignancy.

Management:

Lifestyle modification is the first line of treatment for PCOS:

• Diet
• Exercise
• Weight loss

Homoeopathic treatment for PCOS:

While treating patients with homoeopathy, homoeopath prescribes constitutional remedy considering symptoms of mind and disposition along with physical symptoms of patients. Medicines given this way helps to treat women with PCOS in complete and permanent manner.

Some remedies which are frequently indicated for PCOS includes:

1. Apis mellifica: It mainly affects the right ovary with burning, stinging pains. Numbness in region of ovaries extending down the thighs.

2. Graphities: Swelling and induration of left ovary; also pain in the right ovarian region. Delayed and scanty menses.

3. Argentum metallicum: Bruised pain in left ovary. Sensation as if ovaries were growing large.

4. Iodium: Congestion or dropsy of right ovary. Dull, pressing wedge like pain, extending to right ovary to uterus like a plug, worse during menstruation. Dwindling of the mammae.

5. Lachesis muta: pain in left ovary better by menses. Cannot bear anything heavy or touch in ovarian region.

6. Thuja: left sided ovarian affection. Grumbling pains in ovarian region with irritability.

Other remedies which are constitutionally indicated in PCOS are Calcarea carb, Sepia, Pulsatilla, Ignatia, Natrum mur, Phosphorus, Platina, Sulphur and many more.

Anyone of these remedies or some other may be indicated depending on the symptoms of the patient, in homeopathy we do not believe in specifics and so it is advisable to get treated at hands of homeopathic doctors.

Dr. Zubin S Dehmeri, MD(Hom.)

Email: drzubin123dehmeri@gmail.com

Mob: +91-9819219042.