Guide: Dr Srinath Rao

Presenter:Dr Sr Soumya
(Materia medica MD Part-1)
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PCOS

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 DEFINITION ????
• Polycystic ovary syndrome (PCOS) is a condition characterized by the
accumulation of numerous cysts (fluid-filled sacs) on the ovaries
associated with high male hormone levels, chronic anovulation (abse
nt ovulation), and other metabolic disturbances. Classic symptoms
include excess facial and body hair, acne, obesity, irregular menstrual
cycles, and infertility.

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 INCIDENCE
• Start in the early
teens, after the first
menstrual period.
• Symptoms may be
especially noticeable
after a weight gain.

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 RISK FACTOR
•Family history of PCOS.
•Family history of diabetes.
•Long-term use of the seizure
medicine valproate

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 Insulin
resistance?

PCOS Liver
Hypothyroid?
Causes dysfunction?

Stress?
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CAUSES
1. Excess insulin
2. Low-grade inflammation.
3. Heredity

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SIGNS AND SYMPTOMS:
1. Hirsutism - excessive hair growth, usually on the buttocks, back,
chest or face

2. Hair loss (from the head).

3. Acne and oily skin.

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4. No menstrual periods, or heavy, irregular bleeding.

5. Infertility - this could be because there is no ovulation, or it is

irregular or repeat miscarriages.

6. Pelvic pain.

7. Depression or mood swings.

8. Breathing problems while sleeping (obstructive sleep apnea).

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9. Acanthosis nigricans- patches of dark skin at the back of the
neck, inner thighs and axilla. This is caused by too much insulin-
which can cause things like upper body obesity and skin tags.

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Medical history
• Changes in weight, skin, hair, and menstrual
cycle.
• About problems with getting pregnant.
• Treatment history.
• Eating and exercise habits.
• Family history of hormone problems,
including diabetes.

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DIAGNOSTIC CRITERIA:
To be diagnosed, looks for at least two of the following:
1. Irregular periods. Examples include menstrual intervals longer than 35
days; fewer than eight menstrual cycles a year; failure to menstruate for
four months or longer; and prolonged periods that may be scanty or
heavy.
2. Excess androgen. Elevated levels of androgens may result, excess facial
and body hair (hirsutism), adult acne and male-pattern baldness
(androgenic alopecia).
3. Polycystic ovaries. Polycystic ovaries become enlarged and contain
numerous small fluid-filled sacs which surround the eggs.
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Tests and diagnosis
• Physical exam: Height, weight, blood pressure, thyroid gland, skin.

• Pelvic exam. visually and manually inspects reproductive organs for

signs of masses, growths or other abnormalities.

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ULTRASOUND
• On an ultrasound image (inset), shows many follicles. Each dark circle
on the ultrasound image represents a fluid-filled follicle in the ovary.
May suspect PCOS if there are 20 or more follicles in each ovary.

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LAB TESTS
Blood test:
• Human chorionic gonadotropin (hCG), to find out pregnancy.

• Androgens at high levels can block ovulation

• Prolactin, which can play a part in a lack of menstrual cycles or infertility.

• Cholesterol and triglycerides, which can be at unhealthy levels with PCOS.

• Thyroid-stimulating hormone (TSH) to check for an overactive or underactive thyroid.

• Adrenal gland hormones, such as DHEA-S or 17-hydroxyprogesterone. An adrenal problem can

cause symptoms much like PCOS.

• Glucose tolerance and insulin levels, which can show insulin resistance

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 Complications
• Type 2 diabetes

• High blood pressure.

• Elevated triglycerides or low high-density lipoprotein (HDL).

cholesterol, the "good" cholesterol.

• Metabolic syndrome —Increased risk of cardiovascular disease.

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• Nonalcoholic steatohepatitis — a severe liver inflammation caused by fat
accumulation in the liver
• Infertility
• Sleep apnea
• Depression and anxiety
• Abnormal uterine bleeding
• Cancer of the uterine lining (endometrial cancer), caused by exposure to
continuous high levels of estrogen.
• Gestational diabetes or pregnancy-induced high blood pressure.
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 Differential diagnosis

1. Hypothyroidism.
2. Congenital adrenal hyperplasia (21-hydroxylase deficiency).
3. Cushing's syndrome
4. Hyperprolactinemia
5. Androgen secreting neoplasms

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GENERAL MANAGEMENT
• Weight loss of 5-10% if overweight or obese in 3 months.
• Decreased caloric intake if weight loss is desired.
• Decreased intake of enriched carbohydrates.
• Increased fiber intake including fruits, vegetables, and beans.
• Decreased fat intake, particularly saturated fat.
• Smaller, more frequent meals (every 3-4 hours) to help control blood
glucose levels.
• Balanced meals including carbohydrates, protein, and fat.
• At least 150 minutes of moderate or vigorous activity per week for
diabetes prevention.

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• High-fiber carbohydrates include whole-grain breads and cereals,
whole-wheat pasta, bulgur wheat, barley, brown rice, and beans.

• Limit less healthy, simple carbohydrates such as soda, excess fruit

juice, cake, candy, ice cream, pies, cookies and doughnuts.

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MIASM

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SYNTHESIS

FEMALE GENITALIA/SEX - TUMORS - Ovaries - cysts

• Apis arg-met. Aur-m-n. bell. Bov. brom. Bufo canth. carb-an.
carc. Coloc. foll. Iod. kali-bi. Kali-br. Lach. lyc. merc. murx. naja
ov. Pall. Phos. Plat. podo. prun. rhod. Rhus-t. syc. syph. thuj.
Right side: Apis Bell. lyc. pall. podo.
Left side: kali-bi. lach. naja pall. phos. plat. thuj.

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 MURPHY
Female - CYSTS, genitalia - cysts, ovarian
• APIS apoc. arn. ars. aur. Aur-i. aur-m-n. bell. Bov. bry. Bufo
canth. carb-an. chin. Colch. Coloc. con. ferr-i. form. graph. Iod.
Kali-br. kali-fcy. Lach. lil-t. Lyc. med. merc. murx. Ov. Plat. prun.
rhod. Rhus-t. sabin. sep. syc. syph. ter. THUJ. zinc.
Left: apis coloc. Kali-bi. LACH. Podo. Sil. THUJ.
Right: APIS fl-ac. Iod. LYC. Podo. Sil.

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BOGER
GENITALIA - Female organs - ovaries
• Acon. agar. agn. Ambr. Ant-c. arn. Ars. ASAF. AUR. BELL. calc.
CANTH. CARB-AN. Carb-v. caust. Chel. CHIN. clem. CON. dros.
DULC. Graph. hyos. Ign. KALI-C. kali-n. LACH. laur. LIL-T. LYC.
MERC. Mez. nat-c. Nit-ac. Nux-v. pall. PLAT. plb. puls. RAN-B. Ran-
s. ruta SABIN. sars. SEC. SEP. STAPH. Sulph. THUJ. ZINC.

GENITALIA - Female organs - cysts

• APIS Aur.

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 Kali Brom

• Pruritus.
• Ovarian neuralgia with great nervous uneasiness.
• Exaggerated sexual desire.
• Cystic tumors of ovaries.

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Apis mellifica

• Ovaritis, stinging in ovaries after sexual intercourse.

• Burning, stinging, as after a sting of a bee; sharp, stinging, periodic pains in ovaries.

• Ovaritis with amenorrhoea; numbness and dulness beginning in right ovarian region,
extending to hip and ribs and down the whole thigh, amel. when lying upon it.

• Strained pain in left ovarian region, aggr. when walking evenings, followed by bearing-
down pain on right side and lame feeling in shoulder-blades, when walking she is
compelled to bend forward.

• ovary enlarged, swollen and indurated; ovarian tumors.

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LACHESIS MUTUS
• Induration and enlargement (Iod.),
• worse from moral emotions or great exertions (right).
• Pains, boring or burning, increased more and more, until relieved by a
discharge of blood from the vagina Shooting pains extending from the left to
the right ovarian region (Lil.).
• Neuralgic pains (left) with tenderness to pressure of the clothing. Stitching,
pressing, tensive pain with swelling of the left ovary.
• Pain in the right ovary extending towards the uterus or upward to the liver
and chest.

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 Lycopodium clavatum
• Burning, stitching pains in ovaries; relieved by urinating; sharp,
shooting pains, extending from right to left ovarian region (Lach.
and Lil., the opposite).

• borborygmi, particularly in left hypochondrium.

• pain in back before urinating, with relief when urine flows;

dropsy.

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 Bovista lycoperdon
• Ovarian cyst; soreness between labia and thighs.

• Every few days a show between menses; after midnight painful urging
towards genitals, with great heaviness in small of back.

• Amel. next morning by a bloody discharge.

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Colocynth
• Ovarian neuralgia; cramplike pain in left ovarian region, as if the parts were
squeezed in a vise.
• Intense boring or tensive pain in ovary, causing her to draw up double, with great
restlessness.
• Bilious vomiting during the paroxysms; extreme weakness and lassitude with
trembling of legs, aggr. from exercise and open air.
• Ovaritis, supervening on abortion, stitches in ovaries.
• Ovarian cysts with pain in abdomen upon straightening up; walks bent with
hands pressed upon painful side Ovarian tumor.

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Iodium
• ovarian cysts and dropsy, with great bearing-down pain.

• Induration and swelling, with tendency to cancerous degeneration.

• Pain commencing in right ovary, passing down the broad ligaments to

uterus (Ham.).

• Pressing, dull, wedgelike pain from right ovary to uterus and through
sexual organs (with or without menses).

• Pain in ovaries and back during menses; great sensitiveness of right

ovarian region during or after menses; atrophy with sterility (Con.).
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Palladium metallicum
• Induration and swelling of the right ovary, with soreness and shooting
pains from the navel to the pelvis.

• Heaviness and weight in the pelvis, worse from exertion or while

standing, better when lying on the left side; drawing down and
forward in the right ovary, relieved by rubbing.

• swelling and tenderness to touch of the right ovary, with bearing-

down pain; pain in the right ovary, aggravated from mental agitation,
from being in society, from music, conversation or motion,

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MEDORRHINUM
Intense pruritus.
Menses offensive, profuse, dark, clotted; stains difficult to wash out,
urinates frequently at that time.
Sensitive spot near os uteri.
Leucorrhoea thin, acrid., excoriating, fishy odor.
Sycotic warts on genitals.
Ovarian pain, worse left side, or from ovary to ovary.
Sterility.
Metrorrhagia.
Intense menstrual colic.
Breasts cold, sore, and sensitive.

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 THUJA
Vagina very sensitive. [Berb.; Kreos.; Lyssin.]
Warty excrescences on vulva and perineum.
Profuse leucorrhoea; thick, greenish.
Severe pain in left ovary and left inguinal region.
Menses scanty, retarded.
Polypi; fleshy excrescences.
Ovaritis; worse left side, at every menstrual period. [Lach.]
Profuse perspiration before menses.

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• Enormous induration of ovary, cystic enlargement of ovary, sterility
from ovarian disease.
• Has more power over uterine tumors than any other remedy
(Burnett)
Aurum mur
natronatum

• Pain in ovaries before menstrual flow, amenorrhoea, menorrhagia,

metrorrhagia, cystic ovaries,.
• Headache caused by suppressed menses.
Janosia Asoca
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• It has been suggested as a chief remedy in ovarian cysts.
• Suffering follows excision of ovaries.
Oophorinum
 Soreness and tenderness of right ovary.
 Menses delayed scanty with severe cramp-like pain from beginning to
end of period.
Thea

• Valuable remedy in affections of left ovary with pain & tenderness of

ovarian region and frequent micturition.
• Menses preceded by mental depression & constipation. Vespa
Vulgaris
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• Pain in left ovary, shooting down to knee.

• Ovarian cysts, uterine tumours provides favorable ground for the

action of this drug.
Aurum iod

• Tickling, itching in region of ovaries not ameliorated by scratching or

rubbing.
• Metrorrhagia of thin, pale blood becoming very watery the longer it
lasts.
Prunus
Spinosa
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• Cutting, burning pain in ovaries, ovaritis.
• Menses too early, too profuse, blood black or scanty.
• Nymphomania.
• Expels moles, dead foetus and placenta.
CANTHARIS
• Useful in scrofulous constitutions.
• Right ovary seems like a heavy ball. Valuable remedy for ovarian cysts.

Carbo
animalis

• Inflammation of ovaries with vaginal discharge.

Cobaltum
mur
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 According to the Sides
RIGHT LEFT
*Lycopodium *Lachesis
*Carbo animalis *Kali Brom
*Phos *Iodum
*Thuja *Graphites
*Lac can *Eup perf
*Bell *Actea racemosa
*Apis *Ammonium brom
*Platina
*Thea

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REFERNCES
• Text Book of Gynecology D. C. Dutta.
• BOERICKE W., Pocket Manual of Homeopathic Materia Medica.
• BOGER C. M., A Synoptic Key of the Materia Medica.
• FARRINGTON E. A., Clinical Materia Medica.
• LILIENTHAL S., Homoeopathic Therapeutics.
• MURPHY R., Homeopathic Medical Repertory.
• VERMEULEN F., Synoptic Materia Medica.
• wikipedia.org/wiki/Polycystic_ovary_syndromee

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