An Approach to a Case of PCOS/PCOD through

Homoeopathic Medicine Thyroidinum

Dr. Malaya Kumar Ray
Medical officer, D.G.D. Raghubir nagar, Dte. Of AYUSH

Abstract

Polycystic ovary syndrome (PCOS) also called as polycystic ovarian disease (PCOD) is a
common heterogeneous endocrine disorder characterized by irregular menses,
hyperandrogenism, and polycystic ovaries. It is the most common endocrine disorder among
women between the ages of 18 and 44 years & one of the leading causes of poor fertility
worldwide. However treatment & control of it remains a major challenge. In Homoeopathy
effective cure is possible due to its holistic approach of treatment.

An unmarried girl patient consulted for PCOD in OPD (OPD no.2384) of Delhi Govt. Dispensary
Raghubir nagar. She was treated with Thyroidinum. It took 1 year to cure the case. i.e from 01-
04-14 to 30-04-15. Besides Thyroidnum inter current medicines had given:-Sabina-30 with
Trillium pendulum-Q /Ficus religiosa-Q (to control hemorrhage) , Palladium-6 &
Oophorinum-3x (empirically given for ovarian cyst for few periods). USG done at 4 months
interval. At the end of 1 year USG revealed a normal study along with normal menstrual
cycle.

Key words
Poly cystic ovarian syndrome; Poly cystic ovarian disease Thyroidinum; Sabina; Trillium
pendulum; Ficus Relligiosa; Palladium; Oophorinum; Homoeopathy.

Introduction
Polycystic ovary syndrome (PCOS) also called as polycystic ovarian disease (PCOD) is a
common heterogeneous endocrine disorder characterized by irregular menses,
hyperandrogenism, and polycystic ovaries. However, there is considerable inter individual
variation in presentation.

Polycystic ovary syndrome (PCOS) was first reported in modern medical literature by Stein and
Leventhal who, in 1935, described seven women suffering from amenorrhea, hirsutism, and
enlarged ovaries with multiple cysts. It is now recognized as a common, heterogeneous,
heritable disorder affecting women throughout their lifetime. PCOS adversely affects endocrine,
metabolic, and cardiovascular health.11

While the exact cause of PCOS is unknown, doctors believe that PCOS is due to a combination
of genetic and environmental factors. Risk factors include Diabetes & obesity, not enough
physical exercise, and a family history of someone with the condition. Women are more likely
to develop PCOS if their mother or sister also has the condition.

Overproduction of the hormone androgen may be another contributing factor. Androgen is a

male sex hormone that womens bodies also produce. Women with PCOS often produce
higher-than-normal levels of androgen. This can affect the development and release of eggs
during ovulation. Excess insulin (a hormone that helps convert sugars and starches into energy)
may cause high androgen levels.2

The clinical presentation of PCOS varies widely. Women with PCOS often seek care for
menstrual disturbances, clinical manifestations of hyperandrogenism, and infertility.

Menstrual disturbances:- include oligomenorrhea, amenorrhea, and prolonged erratic

menstrual bleeding.6 However, 30% of women with PCOS will have normal
menses.3 Approximately 85%90% of women with oligomenorrhea have PCOS while 30%
40% of women with amenorrhea will have PCOS.8

Hyperandrogenesim:-More than 80% of women presenting with symptoms of androgen

excess have PCOS.2 Hirsutism is a common clinical presentation of hyperandrogenism
occurring in up to 70% of women with PCOS. Over 90% of normally menstruating women with
hirsutism are identified through ultrasound to have polycystic ovaries.1, 10 Acne can also be a
marker of hyperandrogenism but is less prevalent in PCOS and less specific than hirsutism.
Approximately 15%30% of adult women with PCOS present with acne.2, 9. Of those women
presenting with severe acne, over 40% were diagnosed with PCOS. Some experts recommend
that women presenting with acne be asked about their menstrual history and be evaluated for
other signs of hyperandrogenism.9

Infertility:- It affects 40% of women with PCOS. PCOS is the most common cause of
anovulatory infertility. Approximately 90%95% of anovulatory women presenting to infertility
clinics have PCOS. 12

Psychological symptoms:- Depression, Anxiety, Anorexia nervosa.

Metabolic disorder:- Diabetes, Hypertension, High cholesterol, obesity.

Most long term Complications are: Diabetes, Hypertension,Cardiovascular disease, sleep
apnoea, depression,endometrial cancer &breast cancer.12

Diagnosis is based on purely medical history, clinical features, hormonal assays &USG. Two of
the following three findings: no ovulation, high androgen levels, and ovarian cysts usually
confirm diagnosis.16 Hormonal tests are:-

Serum FSH, L.H., Prolactine level

Serum total & free Testosteron level

Serum DHEA,

Serum T.S.H., Insulin,

Lipid profile.

In Modern medicine PCOS has no cure. 13 Treatment may involve lifestyle changes such as
weight loss and exercise. Birth control pills may help with improving the regularity of periods,
excess hair, and acne. Metformin and anti-androgens may also help. Other typical acne
treatments and hair removal techniques may be used. 14 Efforts to improve fertility include
weight loss, clomiphene, or metformin. In vitro fertilization is used by some in whom other
measures are not effective. Surgery sometimes recommended for some women with PCOS.
Ovarian drilling is a procedure in which doctor punctures ovary with a small needle that carries
an electric current, in order to destroy part of the ovary. This is a short-term solution that can
promote ovulation and reduce male hormone levels.15

Homoeopathy & PCOD

In Homoeopthy every case of PCOD is individual. Due to holistic and individualistic
approach we treat the case not the disease. Our principle is to select constitutional medicine
covering the totality of symptoms of the patients. We are to take care of the fundamental cause
and not the ultimate of the disease. The environmental causes must at the same time be taken
proper care of.

A proper case taking is done as per the instructions laid down in Organon of Medicine in
aphorisms 83 to 104. The maintaining cause in the particular case should be assessed and
conveyed to the patient so that he can avoid it. A remedy should be prescribed as per the
totality of symptoms and miasmatic state. Regular follow up is done to assess the improvement
of the patient.

Case Details

An unmarried girl patient of age 26 years with fair complexion and heavy body built consulted to
my OPD (OPD no.-2384) on 01/04/14 having complaints of:-

Mennorhagia since 8 months with early (twice a month), too profuse, long lasting
menses nearly about 2 weeks,
Flow partly fluid partly clotted with gushing type.
Gaining weight

Physical generalities: -

Thermal Reaction: Highly chilly patient with great tendency to take cold.

Appetite: Increased appetite.

Desire: Sweet, Cold things.

Stool: Irregular & Unsatisfactory.

Perspiration: normal.

Sleep: Sound sleep.

Past history- Nothing specific.

Family history- Father- Bronchial asthma, G.F. (paternal)-Eczema, Diabetes.

Investigation done- Thyroid profile for gaining weight which was normal.

Medicines prescribed: - Sabina-30, TDS* 3 DAYS & Trillium Pendulum-Q, 10 DROPS BD* 10
DAYS.

Investigation advised: - USG whole abdomen, C.B.C. Advised: - Regular exercise for weight
loss.

MAJOR FOLLOW UPS:-

Date Complaints Investigation Prescription

19/04/14 Bleeding better USG showed Thyroidinum-
P.C.O.D. 200/4d, bd*2
days.S.L-30/od*
10 days,
Oophorinum-3X,
tds* 2 months.
15/05/14 Flow normal lasts - Repeat all
for 5 days medicines.
05/07/14 M.C. normal. Lasts Advise for again Repeat only
for 5 days. Last USG whole Thyroidinum & S.L.
L.M.P.S are-10th abdomen in same potency
may, 15th june. and same doses.
Oophorinum
stopped.
31/07/14 M.C. regular USG done Repeat above
on30/07/14 medicine.
showed multiple
small follicles with
no significant
increase in
ecogenicity.
Impression of
P.C.O.D.
13/09/14 Last menses last - Repeat above
only for 2 days medicine.
14/10/14 Menes not yet Palladium-6,
come Q.I.D.* 10 days &
S.L. for 10 days.
10/11/14 M.C. regular lasts Advised for USG Thyroidinum-
for 4-5 days. whole abdomen 200/4d, bd*2
days.S.L-30/od*
10 days
26/12/14 Profuse menses Sabina-30, tds*3
since 1 months days & Trillium-Q
10 drops tds* 1
week
12/01/15 Complaints Repeat
persisting Thyroidinum-200
/4 doses,bd * 2
days along with
Trillium-Q
22/01/15 Normal flow S.L for 10 days
14/03/15 M.C. regular & Advised for USG Repeat
normal flows.i.e. whole abdomen Thyroidinum
4-5 days. as patient didnt again.
do last USG.
30/03/15 No further USG done on S.L.-30
bleeding 30/03/15 showed
normal uterus &
ovaries. No
P.C.O.D.
08/05/15 M.C. regular & USG whole S.L-30
flows normal. abdomen done
 on30/04/15
(another USG to
re confirm)
showed normal
study.
Now it is near about 2 years running. Patient is on and off visits dispensary for other complaints
but never complains regarding her menstrual problems. Her cycle continued to be normal and
having normal flow. She is absolutely fine.

Case Analysis, Discussion & Conclusion

Basis of prescription of Thyroidinum:-

Patient is highly chilly patient

Desire for cold food, sweet, increased appetite.
Family history of allergic manifestation.
Great medicine for any abnormalities of menstrual & functional or organic troubles
accompanying the menstrual cycle.

Dr. S.P. Dey in his book Clinical experience with some nosodes clearly stated that the trio
of guidelines for Thyroidinum use may be summarized as follows:

History of Allergy in any form in the patient in the past or in his/her family (both paternal
& maternal sides)
History of metabolic disturbances in the family e.g. gout, diabetes etc. Indicating
metabolic imbalance.
Disease characterized by vaso motor disturbances e.g. flushing, profuse sweating,
palpitation etc. without any gross organic defect anywhere.5

Out of three 1st two guideline features were found in the patient i.e. her father was asthmatic &
her grandfather was diabetic indicating of family history of allergic & metabolic disturbance
manifestation respectively, which were strong indications of prescribing Thyroidinum.

Besides this Dr. S.K.Ghosh in his book Clinical experience with some Rare Nosodes
under Thyroidinum written: - Thyroidinum has a wide range of action on the abnormalities of
menstrual & functional or organic troubles accompanying the menstrual cycle.7

Here menstrual abnormalities were irregular menses & menorrhagia, Organic troubles was
ovarian cysts which was another strong indication of prescribing Thyroidinum.

Another strong indicating symptom of Thyroidinum was craving for cold things & sweet. (As
mentioned by Dr. Boericke in his pocket manual books.)4

So all these lead to me prescribe Thyroidinum.The reason behind prescribing Thyroidinum in

same 200 potency over the entire year was that I never found patient symptoms became static
for periods after giving 200. Every time I prescribed 200 potency, patient shows signs of
improvement. I would think about 1M only when there was no further improvement after giving
200 in repeated times.

Palladium-6 & Oophorinum-3x which I was prescribed empirically didnt feel that, it
supplementing the action of Thyroidinum. So I stopped on the course of treatment. But yes
Sabina-30 with Trillium pendulum-Q /Ficus religiosa-Q was a great anti hemorrhagic medicine,
one can rely upon it.

At last I can conclude that Thyroidinum may be effective in most of the cases of PCOS as
it covers almost all the symptomatology of PCOS. So future study over its efficacy can
be recommended.

References

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3. Balen A, Conway G, Kaltsas G. Polycystic ovary syndrome: the spectrum of the disorder in 1741
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4. BOERICKE WILLIAM., 2002, Pocket Manual of Homoeopathic Materia medica and Repertory; Low
price edition, B-Jain Publisher Pvt.Ltd. New Delhi.
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6. Farquhar C. Introduction and history of polycystic ovary syndrome. In: Kovacs G, Norman R,
editors.Polycystic Ovary Syndrome. 2nd ed. Cambridge, UK: Cambridge University Press; 2007. pp. 424.
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9. Lowenstein E. Diagnosis and management of the dermatologic manifestations of the polycystic ovary
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10. Souter I, Sanchez L, Perez M, Bartolucci A, Azziz R. The prevalence of androgen excess among
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11. Stein IF, Leventhal ML. Amenorrhea associated with bilateral polycystic ovaries. Am J Obstet
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14. "Treatments to Relieve Symptoms of PCOS". http://www.nichd.nih.gov/. 2014-07-14. Retrieved 13

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Annexure, USG Reports: