Polycystic ovarian syndrome & Homoeopathy
Polycystic ovarian syndrome, or PCOS, is a condition in which a womanâ€™s levels of the sex hormones estrogen and progesterone are out of balance. This leads to the growth of ovarian cysts (benign masses on the ovaries). PCOS can cause problems with a womenâ€™s menstrual cycle, fertility, cardiac function, and appearance. If it isn't treated, over time it can lead to serious health problems, such as diabetes and heart disease.
Polycystic ovarian syndrome (PCOS) is universally recognised as the commonest endocrinopathy of women. The definition and the aetiological hypotheses of PCOS are continuously evolving to accommodate expanding knowledge on the syndrome, which is now known to be more complex than purely a reproductive disorder. Increased androgen synthesis, disrupted folliculogenesis and insulin resistance lie at the pathophysiological core of PCOS.
What causes PCOS?
The exact cause of PCOS is unclear. It's common for sisters or a mother and daughter to have PCOS, but a definite genetic link hasn't been found.
PCOS results from a combination of several related factors. Many women with PCOS have insulin resistance, in which the body can't use insulin efficiently. This leads to high circulating blood levels of insulin, called hyperinsulinemia. It's believed that hyperinsulinemia is related to increased androgen levels, as well as obesity and type 2 diabetes. In turn, obesity can increase insulin levels, causing worsening of PCOS.
Risk factors and pathogenesis:
Genetics: PCOS is believed to be a complex disorder, with genetic as well as environmental factors contributing to development of the disease. 20-40% of female first-degree relatives of women with PCOS also have the syndrome, suggesting that the disease is partially heritable and clusters in families. Prevalence and severity of presentation vary with ethnicity, with South Asians at a higher risk of disease. Some candidate genes have been identified as contributing to risk of the disease, including 7Î²-hydroxysteroid-dehydrogenase type 6 (HSD17B6).
Intrauterine exposures: exposures to testosterone in utero may predispose to the later development of PCOS.
Environment/lifestyle: Sedentary lifestyle is associated with increased metabolic dysfunction, and weight gain is associated with oligoanovulation and hyperandrogenism. BPA and other environmental androgen-disrupting chemicals may accumulate to a greater extent in individuals with PCOS because of decreased hepatic clearance; these also induce androgen production and insulin resistance.
Obesity: although obesity is not believed to cause PCOS, it is known to exacerbate the symptoms of the disease.
Patho-physiology of PCOS:
Abnormality in Neuroendocrine
Women with PCOS have an increase in the frequency of GnRH pulses; shorter pulses preferentially promote the production of luteinizing hormone (LH) and result in a decrease in the production of follicle stimulating hormone (FSH)
Patients with PCOS often exhibit an increase in the LH:FSH ratio, which may contribute to the ovarian excess of androgens relative to estrogens
It is unclear if patients with PCOS have an intrinsically faster GnRH pulsation mechanism which initiates hyperandrogenism in the ovaries, or if oligoanovulation itself promotes more rapid pulsations in GnRH via a reduction in circulating progesterone
Normally, progesterone is released from the corpus luteum following ovulation
Progesterone acts to slow GnRH pulsation
In PCOS, a decrease in ovulatory events may cause a decrease in circulating progesterone
Exposure to androgens in utero or prepubertally may decrease the inhibitory effects of estrogen and progesterone on the hypothalamus and contribute to increased pulsatility
The â€œcystsâ€ in polycystic ovaries are not true cysts, but rather antral follicles which have arrested in development
This is thought to occur because of hormonal abnormalities:
Hyperandrogenism: arrest occurs when the granulosa cells of the ovaries normally begin to produce estrogen by aromatizing androstenedione produced by the theca cells; excess 5a-reduced androgens in the ovaries are thought to inhibit the action of aromatase and therefore reduce estradiol synthesis, which is required for further maturation.
Hyperinsulinemia: exacerbates ovarian hyperandrogenism by :
(1) increasing 17a-hydroxylase activity in theca cells and promoting androstenedione and testosterone production;
(2) promoting LH- and IGF1-stimulated androgen production; and
(3) elevating free testosterone by decreasing the production of sex hormone binding globulin (SHBG)
How does PCOS affect ovulation?
Ovulation is a process in which a mature egg cell (also called an ovum), ready for fertilization by a sperm cell, is released from one of the ovaries (two female reproductive organs located in the pelvis). If the egg doesn't become fertilized as it travels down the fallopian tube on its way to the uterus, the endometrium (lining of the uterus) is shed and passes through the vagina (the passageway through which fluid passes out of the body during menstrual periods; also called the birth canal), in a process called menstruation.
With an ovulatory problem, the woman's reproductive system doesn't produce the proper amounts of hormones necessary to develop, mature, and release a healthy egg.
When the ovaries don't produce the hormones needed for ovulation and proper function of the menstrual cycle, the ovaries become enlarged and develop many small cysts which produce androgens.
Increased levels of androgens can also interfere with ovulation and normal menstrual cycles. Still, some women with polycystic ovaries have normal menstrual cycles.
What are the symptoms of PCOS?
The signs and symptoms of PCOS are related to hormonal imbalance, lack of ovulation, and insulin resistance and may include:
Â·Irregular, infrequent, or absent menstrual periods
Â·Hirsutism (excessive growth of body and facial hair, including the chest, stomach, and back)
Â·Acne or oily skin
Â·Enlarged and/or polycystic ovaries
Â·Infertility (the inability to produce children)
Â·Overweight or obesity, especially around the waist (central obesity) and abdomen
Â·Male-pattern baldness or thinning hair
Â·Skin tags (small pieces of skin on the neck or armpits)
Â·Acanthosis nigricans (darkened skin areas on the back of the neck, in the armpits, and under the breasts)
In addition, women with PCOS may be at increased risk for developing certain health problems. These may include:
Â·Metabolic syndrome, a condition with several components, including:
Â·Type 2 diabetes or insulin resistance
Â·Elevated cholesterol levels
Â·High blood pressure
Â·Excess body weight, especially around the waist and abdomen
Â·Elevated levels of C-reactive protein (a marker of inflammation)
Â·Elevated blood clotting factors
Â·Heavy or irregular bleeding and endometrial cancer. Lack of ovulation for an extended period of time may cause excessive thickening of the endometrium (the lining of the uterus).
The following health conditions are common in women with PCOS:
Â·High blood pressure
Â·Weight gain and obesity
How is PCOS diagnosed?
In addition to a complete medical history and physical examination, diagnostic procedures for PCOS may include:
Â·Pelvic examination: This involves a physical examination of both the external and internal female reproductive organs.
Â·Ultrasound: Ultrasound is a diagnostic imaging technique which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels. Ultrasound can determine if a woman's ovaries are enlarged or if cysts are present, and to evaluate the thickness of the endometrium. A vaginal ultrasound, in which an ultrasound transducer is inserted into the vagina, is sometimes used to view the endometrium.
Â·Blood tests. These tests are used to detect increased levels of androgens and other hormones.
Other tests may be used to identify problems related to PCOS and may include:
Â·Male hormone (testosterone) level
Other blood tests that may be done include:
Â·Fasting glucose (blood sugar) and other tests for glucose intolerance and insulin resistance
Â·Thyroid function tests
Women with PCOS are more likely to develop:
Â·Breast cancer (slightly increased risk)
What is the treatment for PCOS?
Specific treatment for PCOS will be determined by your doctor based on:
Â·Your age, overall health, and medical history
Â·Extent of the disorder
Â·Cause of the disorder
Â·Your signs and symptoms
Homeopathic remedies for Polycystic Ovarian Syndrome or PCOS
Most women dread the thought of menses or periods, but irregularities and unusual changes in the menstrual cycle can be a nightmare. Delayed or irregular menses, absent menses for various months, prolonged menses" all these are indications of an endocrine disorder known in medical terms as Polycystic Ovarian Syndrome (PCOS). The other symptoms of PCOS are excess hair growth on the face or other unusual parts of the body and acne. A few women also suffer from hairfall. Ultrasound studies show the presence of cysts (fluid-filled structure) in ovaries with the enlargement of ovaries. The tendency to gain weight and obesityare common with PCOS too. It is a syndrome that affects women in the reproductive age group and is one of the leading causes of female infertility. Hypertension and Diabetes Mellitus are also associated with PCOS. Homeopathic remedies for polycystic ovarian syndrome are made of natural substances with zero side effects and has the cure for Polycystic Ovarian Syndrome.
Homeopathic treatment for Polycystic Ovarian Syndrome
Polycystic Ovarian Syndrome is curable with the Homeopathic mode of treatment.Homeopathic treatment for polycystic ovarian syndrome is very safe and free from any side effect.Which Homeopathic medicine is required to extract the disease from its roots varies from case to case. Both the physical and mental spheres of the patient are thoroughly investigated while prescribing the Homeopathic medicine. The complete cure of PCOS is a time-consuming process and it cannot be expected in a few days. It requires complete observation regarding the change of symptoms in the patient and frequent clinical follow-ups.
Top Homeopathic remedies for Polycystic Ovarian Syndrome
Apis Mellifica - One of the best Homeopathic medicines for the treatment of PCOS with stinging pains
Pulsatilla - One of the best Homeopathic medicines for PCOD with scanty and late menses
Sepia - One of the best Homeopathic remedies for PCOS with bearing down pains
Lachesis - One of the best Homeopathic remedies for PCOD with aversion to tight clothes
Graphites - One of the best Homeopathic medicines for PCOS with constipation
Sepia: Best Homeopathic remedy for cure of PCOS
Sepia occupies the top position among the Homeopathic medicines for treatment for Polycystic Ovarian Syndrome. The menstrual symptom for Homeopathic remedy Sepia is late and scanty menses. In most of the cases, this is accompanied by bearing down sensations in the pelvic region. The ovaries remain enlarged with fluid-filled cysts in them. Homeopathic medicine Sepia acts very efficiently to regulate the menstrual cycle to appear at the proper expected time. Sepia can also be considered to treat infertility cases due to PCOS. Abnormal hair growth on the face, especially on upper lips, can also be well controlled with Homeopathic medicine Sepia. Other general symptoms to look for before taking Sepia are sensitivity to cold air, mental irritability, and indifferent behaviour towards loved ones.
Pulsatilla: Homeopathic medicine for suppressed menses for long duration
Pulsatila is a natural Homeopathic medicine for treating PCOS. It is especially beneficial for treating PCOS cases in females who suffer from suppressed periods for a long duration. In women requiring Pulsatilla, the periods when they appear remain very scanty and extremely painful. Homeopathic medicine Pulsatilla removes the obstacles that cause the periods to be suppressed and the periods start to flow normally. Homeopathic remedy Pulsatilla increases the bodyâ€™s power and directs its path towards removing the obstacle, thus re-establishing the menstrual flow. Pulsatilla is of great help for young girls at puberty who suffer from PCOS with irregular periods. The physical general symptoms to consider for using Pulsatilla include the total absence of thirst and a desire for cool open air. Open air overall seems to provide relief to the patient. And in the mental sphere, the significant features to take note of are mild, sensitive nature with weeping tendencies. Such a woman weeps at the slightest instance and feels somewhat better when given consolation.
Calcarea Carb: Homeopathic medicine for prolonged and profuse periods
Calcarea Carb, a natural Homeopathic medicine, is of great help in the treatment of PCOS and is particularly suited when a woman with PCOS suffers from profuse periods that are prolonged more than the usual duration. The women with PCOS facing the problem of weight gain and obesity are also the candidates requiring Calcarea Carb. Homeopathic medicine Calcarea Carb helps such women in reducing the excessive weight gain very efficiently. There are a few physical general symptoms to look out for while choosing to take Calcarea Carb. The first is excessive sweating on the head. The second is extreme sensitivity to cold air. And the last is a peculiar craving in eating habits like a desire for boiled eggs and in a few cases, strange things like chalk and lime.
Natrum Mur: Homeopathic cure for PCOS with irregular and suppressed menstrual cycles
Natrum Mur is a very beneficial Homeopathic medicine to treat women with PCOS who have irregular and suppressed menstrual cycles. Natrum Mur benefits most women by regularising their menstrual cycles. Homeopathic medicine Natrum Mur should also be considered for women with difficulty in conception due to PCOS. The important symptoms to look out for while using Natrum Mur are excessively hot sensation, aversion to heat of sun and craving for extra salt in the diet. The mental picture that needs to be considered includes reserved nature of patient, weeping spells especially when alone and worsening of symptoms when sympathy is offered.
Thuja Occidentalis: Homeopathic treatment for retarded menstrual flow
Thuja is a Homeopathic medicine that is considered of great help in PCOS treatment. Thuja is a very efficient Homeopathic medicine and its use is called for when a woman suffers from retarded menstrual flow with multiple cysts in ovaries. Thuja has the innate ability to dissolve abnormal growth or accumulation anywhere in the body. Thus, it has the supreme power to dissolve cysts also. Most women requiring Thuja have cystic growths more pronounced in the left-side ovary. Thuja is also of great help in treatment of extreme hair growth on unusual parts in women due to hormonal imbalance.
Pulsatilla, Kali Carb and Senecio: Homeopathic medicines for suppressed or absent menses
Homeopathic medicines Pulsatilla, Kali Carb and Senecio worksuccessfully in re-establishing the menses that have been absent. Pulsatilla is the top Homeopathic medicine for most cases of suppressed menses and proves successful in bringing back the menstrual period. Homeopathic remedy Kali Carb is a very beneficial medicine when the menses are suppressed altogether for several months. Senecio is the ideal Homeopathic medicine when the menses are suppressed but the woman feels that menses are about to come. In such cases, the complaints related to menses are present like heaviness or pain in pelvis region and nausea, but the menstrual flow is absent.
Homeopathic treatment for scanty and short duration of periods in PCOS
The problem of scanty menses can be treated with Homeopathic medicines Pulsatilla, Sepia and Senecio. The short duration of periods may vary from a few hours to one or two days. Several natural Homeopathic medicines are present to tackle this condition. For menses remaining only for a few hours, Homeopathic medicines Euphrasia, Coccus Cacti and Psorinum are of great help. Homeopathic medicines Sepia and Pulsatilla can help for periods of one-day duration.
Homeopathic medicines for cysts in PCOS
The isolated presence of cysts in the ovaries in no way means that the woman is suffering from PCOS unless the other significant symptoms are experienced. The symptoms are mainly menstrual irregularities and abnormal hair growth, acne, obesity and difficulty in conceiving. The Homeopathic remedy is chosen not on the basis of cysts but rather on each patientâ€™s symptoms, though the cysts may provide help in making the choice of medicine. To take an example, the presence of cysts predominantly in the right ovary suggests the use of Homeopathic medicines Lycopodium, Belladona and Apis Mellifica. And if the cysts occupy the left ovary,Homeopathic medicines Thuja Occidentalis and Lachesis are of great help.
Homeopathic medicines Sulphur and Silicea for treating acne or pimples in PCOS
Both Sulphur and Silicea are equally helpful Homeopathic medicines for treating acne in women with PCOS.
Sulphur brings about excellent results in most cases of acne.
The acne may be painful or may itch in persons requiring medicine Sulphur.
when the acne contains pus and they are deep-rooted Silicea is to be considered.
Homeopathic medicines for dealing with obesity in women due to PCOS
The best Homeopathic medicines for treating obesity are Calcarea Carb, Graphites and Ammonium Carb.
Which of these medicines to take is chosen as per the case demands.
Homeopathic treatment for polycystic ovarian syndrome for reducing excessive hair growth in women with PCOS
Homeopathic medicines can be very useful to decrease abnormal hair growth in women suffering from PCOS. The remedies used in Homeopathy are all natural medicines that are given internally without any external application. Homeopathic medicine Sepia is preferred if there is hair growth on upper lips. For hair growth on chin, Homeopathic medicine Oleum Jecoris Aselli is of great help. Thuja is a Homeopathic cure of great help for excessive hair growth anywhere on the body,be it the face or arms and legs.
Dr. Atul Rajgurav, M.D. (Hom.)
Department of Homoeopathic Pharmacy
Dr. D.Y. Patil Homoeopathic Medical College, Pune