POLYCYSTIC OVARY
SYNDROME
– HOMOEOPATHY IS
AT RESCUE
Dr. S. R. Ameerkhan Babu., M.D. (Hom)
Polycystic
ovary syndrome (PCOS) is
one of the most common female endocrine disorders.
PCOS is a complex, heterogeneous disorder of uncertain etiology, but there is strong evidence that it can to a large
degree be classified as a genetic disease. PCOS produces symptoms in approximately 5% to
10% of women of reproductive age (12–45 years old). It is thought to be one of
the leading causes of female subfertility and the most frequent
endocrine problem in women of reproductive age.
PREVALENCE
AND INCIDENCE
Polycystic
ovary syndrome (or PCOS) is common, affecting as many as 1 out of 15 women and
is diagnosed in women in their 20s or 30s. Treatment can help control the
symptoms and prevent long-term problems. The symptoms often begin when a girl's
periods start. Women with this disorder often have a mother or sister who has
symptoms similar to those of polycystic ovary syndrome
CAUSES
PCOS is a complex, heterogeneous
disorder of uncertain aetiology. There is strong evidence that it is a genetic
disease. The symptoms of PCOS are caused by changes in hormone
levels. There may be one or more causes for the hormone level changes. PCOS
seems to run in families, so chance of having it is higher if other women in a
family have PCOS, irregular periods, or diabetes. PCOS can be passed down from
either mother's or father's side. The clinical severity of PCOS symptoms
appears to be largely determined by factors such as obesity.
WHAT ARE HORMONES, AND WHAT HAPPENS
IN PCOS?
Hormones are chemical messengers that trigger many different
processes, including growth and energy production. Often, the job of one
hormone is to signal the release of another hormone.
For reasons that are not well understood, in PCOS the
hormones get out of balance. One hormone change triggers another, which changes
another. For example:
·
The sex hormones
get out of balance. Normally, the ovaries make a tiny
amount of male sex hormones (androgens).
In PCOS, they start making slightly more androgens. This may cause to stop ovulating, get acne,
and grow extra facial and body hair.
·
The body may have a
problem using insulin,
called insulin
resistance. When the body doesn't use insulin well, blood sugar
levels go up. Over time, this increases chance of getting diabetes.
CLINICAL
PRESENTATION
Symptoms tend to be mild at first. Women may have only a few
symptoms or a lot of them. The most common symptoms are:
·
Acne.
·
Weight gain and
trouble losing weight.
·
Extra hair on the face
and body. Often women get thicker and darker facial hair and more hair on the
chest, belly, and back.
·
Thinning hair on the
scalp.
·
Irregular periods.
Often women with PCOS have fewer than nine periods a year. Some women have no
periods. Others have very heavy bleeding.
·
Fertility problems.
Many women who have PCOS have trouble getting pregnant (infertility).
·
Depression.
Most women with PCOS grow many small cysts on their
ovaries. That is why it is called polycystic ovary syndrome.
The cysts are not harmful but lead to hormone imbalances.
DIAGNOSIS
Not all women with PCOS have
polycystic ovaries (PCO), nor do all women with ovarian cysts have PCOS;
although a pelvic
ultrasound is a major
diagnostic tool, it is not the only one.
Standard
diagnostic assessments includes
·
History-taking,
specifically for menstrual pattern, obesity, hirsutism, and the absence of
breast development. A clinical prediction rule found that these four questions can diagnose PCOS
·
Gynecologic ultrasonography, specifically
looking for small ovarian
follicles. These are believed to be the result of disturbed ovarian
function with failed ovulation, reflected by the infrequent or absent
menstruation that is typical of the condition.
·
Serum (blood) levels of androgens (male
hormones), including androstenedione and testosterone may be elevated. Dehydroepiandrosterone sulfate levels above 700-800mcg/dL are highly suggestive of
adrenal dysfunction because DHEA-S is made exclusively by the adrenal glands.
The free testosterone level is thought to be the best measure.
·
Some other blood tests
are suggestive but not diagnostic. The ratio of LH (Luteinizing hormone) to FSH (Follicle stimulating hormone), when
measured in international units, is greater than 1:1
(sometimes more than 3:1), as tested on Day 3 of the menstrual cycle.
Common
assessments for associated conditions or risks are
·
Fasting biochemical
screen and lipid profile
·
2-hour oral glucose tolerance test (GTT) in patients with risk factors (obesity, family
history, history of gestational diabetes) may indicate impaired glucose
tolerance (insulin resistance) in 15–33% of women with PCOS. Insulin resistance
can be observed in both normal weight and overweight patients, 50–80% of PCOS
patients may have insulin resistance at some level.
·
Fasting insulin level
or GTT with insulin levels (also called IGTT). Elevated insulin levels have
been helpful to predict response to medication
·
Glucose tolerance testing (GTT) instead of fasting glucose can increase
diagnosis of increased glucose tolerance and frank diabetes among patients with
PCOS according to a prospective controlled trial.
·
Pregnancy
test (serum HCG)
TREATMENT
General
·
Patients should be
reassured and taught not to be panic
·
Regular exercise,
healthy foods, and weight control are key treatments for PCOS. Medicines to
balance hormones may also be used. Getting treatment can reduce unpleasant
symptoms and help prevent long-term health problems.
The
first step in managing PCOS is to get regular exercise and eat heart-healthy foods. This
can help lower blood pressure and cholesterol and
reduce the risk of diabetes and heart disease. It can also help to lose weight
if need to.
·
Try to fit in moderate
activity and/or vigorous
activity on a regular basis. Walking is a great exercise that
most people can do.
·
Eat a heart-healthy
diet. In general, this diet has lots of vegetables, fruits, nuts, beans, and
whole grains. It also limits foods that are high in saturated fat, such as
meats, cheeses, and fried foods. If have blood sugar problems, try to eat about
the same amount of carbohydrate at
each meal. A registered
dietitian can help to make a meal plan.
·
Most women who have
PCOS can benefit from losing weight. Even losing 4.5 kg may help get
hormones in balance and regulate menstrual cycle. PCOS can make it hard to lose
weight, so work with family doctor to make a plan that can help to succeed.
·
If have habit of smoking, consider quitting. Women who smoke
have higher androgen levels that may contribute to PCOS symptoms.1Smoking also
increases the risk for heart disease.
HOMOEOPATHIC TREATMENT
·
Management of PCOD
primarily involves prescribing a constitutional Homeopathic remedy capable of
working on the ovaries and the entire endocrinal system. This approach
usually helps in correcting the pathology associated with PCOD.
·
There are numerous
remedies capable of influencing this condition. The remedy prescribed is chosen
after carefully understanding your entire constitution, which includes:
o
Presence of any genetic
predisposition
o
Physical makeup
(obesity)
o
Peculiarities of
menstrual cycle
o
entire physical and
personality characteristics
·
Homeopathy for PCOS or
PCOD should be continued for a significant duration of time as the appearance
and normalization of the menstrual cycle as well as decrease or absence of cyst
formation are the only means by which improvement can be monitored
Some Homoeopathic remedies for PCOD
·
Lachesis- Pain in ovaries, especially left sided relieved by
discharges from uterus,Labour like pain in uterus,Os feels open
·
Sepia - Irritability is marked in the patient. Cannot
tolerate the sight of children. Periods are early and profuse. Backache more on
washing.
·
Graphites - Very useful to correct the menstrual irregularities
and to cure pre-menstrual related problems. Patient has induration of ovaries
with aversion to opposite sex. During periods severe nausea and constipation.
Good medicine for obesity also
·
Caulophyllum, useful to women with a history of irregular periods,
discomfort during periods and pain in the pelvic region
·
Lycodium, which may relieve sweet cravings, insatiable appetites,
extended periods, bloating, indigestion, constipation, insomnia and anxiety.
·
Nat. Mur, which may reduce inflammatory skin conditions
such as eczema and vertigo, and may alleviate PMS.
·
Calc-carb - Periods too early, profuse and long lasting. Least
amount of excitement brings the flow. Before periods mammary tenderness,
sweating on forehead and external genitalia.
·
Silicea - Chilly and desirous of warmth, has milky white
leucorrhea, increased flow of menses with icy coldness of body. Nipples sore
and are drawn in, vaginal and ovarian cysts with hard lumps in breasts.
·
Myristica - A very good antiseptic. It hastens suppuration hence
can be used when the condition is highly inflammatory.
·
Platina - With severe gastric irritation and increased sexual
urge; patient will be always with delusion of grandeur.
·
Oophorinum - Usually helpful in climateric states. Ovarian cysts
in young girls.
·
Medorrhinum - Should be used as a Miasmatic remedy. Has offensive
flow with difficulty in washing. May or may not be associated with warts on
genitalia. Left ovary more painful, breast tenderness with dysmenorrhoea.
·
Apis - Thin walled multi locular ovarian cyst with
tenderness in lower abdomen. Menorrhagia after a long gap of amenorrhoea.
Aggravation by heat and touch and > cold.
·
Ova tosta - Ovarian cyst especially of left side, bearing down
sensation, Backache and pain in left hip, Cannot tolerate tight bands on waist.
References
- http://en.wikipedia.org/wiki/Polycystic_ovary_syndrome
- Notes
On Gynaecology by R
K Sachdeva
- Gynaecology By Ten Teachers by
Ash
Monga
- http://women.webmd.com/tc/polycystic-ovary-syndrome-pcos-topic-overview
- Homeopathic Materia Medica by
Boericke
- http://www.homoeotimes.com/aug07/html/pcod_nahida.htm
- Lilienthal S., Homoeopathic
Therapeutics
- Dewey W. A., Practical
Homeopathic Therapeutics
- http://www.homeopathyworldcommunity.com/profiles/blogs/polycystic-ovary-syndrome-and
- http://www.homeoconsult.com/pcos.php
- Principles of
Prescribing, Dr. K.N.Mathur.
Dr. S. R. AMEERKHAN
BABU., M.D. (Hom) (Prac.
of Med).,MBA
Reader, Dept. of
Practice of Medicine
Vinayaka Mission’s
Homoeopathic Medical College & Hospital,
Salem, Tamilnadu.
No comments:
Post a Comment