Management of PCOS through Homoeopathy-A case report

PCOS is the acronym for Polycystic Ovarian Syndrome. It
is the most common endocrine disorder of women in their
reproductive period manifested by irregular menstrual cycles
and polycystic ovaries, excess unwanted hair, and baldness,
although not all patients have all these features. The term
‘polycystic’ means ‘many cysts’, and PCOS gets its name
because of the clusters of small, pearl‑size cysts in ovaries.
These cysts are fluid‑filled bubbles (called follicles) that
contain eggs that have not yet been released because of the
hormonal imbalance.[1] Many women with PCOS demonstrate
challenges to feminine identity and body image due to
obesity, acne, and excess of unwanted hair; also, infertility and
long‑term health‑related concerns that compromise the quality
of life and adversely affect mood and psychological well‑being.
Some authors have shown that women who have PCOS are
more prone to depression, anxiety, low self‑esteem, negative
body image and psychosexual dysfunction.[2] PCOS is a heterogeneous endocrine disorder that affects about
1 in 15 women worldwide.[3] The prevalence of PCOS in the
Indian subcontinent Asian women were 52%.[4] However, recent
findings from countries such as China and India, which are
undergoing rapid nutritional transitions due to Westernised
diets and lifestyles, indicate similar prevalence rates of PCOS.[5] The prevalence of PCOS in Indian adolescents is 9.13%. This draws
attention to the issue of early diagnosis in adolescent girls.[6] Polycystic morphology is seen on ultrasound in approximately
22% of women.[7] Lack of awareness and lifestyle changes are considered to be
the major factor leading to this phenomenon. PCOS has now
become a common health problem that affects teenage girls
and young women. In India, nearly 40% of women are affected
by PCOS. But among them, only 60% report to hospitals for
treatment, when they recognize that they have got infertility.[8] Up to 40% of women with PCOS develop either impaired
glucose tolerance or type 2 diabetes by age 40 as reported
in the British Journal of Obstetrics and Gynecology in 2000.
Large amounts of testosterone is secreted in PCOS which
possibly prevent ovaries from releasing an egg each month,
thus causing infertility, which may be the result of high levels
of insulin that stimulate ovaries to produce excess testosterone.
High testosterone levels can also cause excessive hair growth,
simulating male pattern baldness and acne. In patients with
PCOS, insulin resistance causes fat deposition and excessive
production of testosterone.
There is a parallel increase in the prevalence of PCOS and
type 2 diabetes mellitus world over. Use of different diagnostic
Polycystic ovarian syndrome (PCOS) is an endocrine disorder that affects approximately 5% of all women which are very commonly found
in day‑to‑day (routine) practice. However, these cases present with many complications and it is difficult to cure in contemporary system and
treatment is also very costly. A case of 22 years female suffering from PCOS reported here was treated successfully within 1.5 years by a
single individualised homeopathic medicine Calcarea canonical 30‑1M with repetition as per requirement, The improvement is evident from
regularity of the menstrual cycle and also from the ultrasonography (USG) reports. The case was observed for further 3 years without recurrence
which suggests that permanent cure is achievable through individualized homeopathic treatment.
Keywords: Hirsutism, Homoeopathy, hyperandrogenism, polycystic ovaries, Polycystic ovarian syndrome
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*Address for correspondence: Dr. Padmalaya Rath,
Dr. D. P. Rastogi Central Research Institute of Homoeopathy, A1/1,
Sector‑24, Noida, Uttar Pradesh, India.
Received: 04.11.2015; Accepted: 27.03.2018
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How to cite this article: Rath P. Management of PCOS through
Homoeopathy-A case report. Indian J Res Homoeopathy 2018;12:95-100.
Management of PCOS through Homoeopathy-A case report
Padmalaya Rath*
Dr. D. P. Rastogi Central Research Institute of Homoeopathy, Noida, Uttar Pradesh, India
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96 Indian Journal of Research in Homoeopathy ¦ Volume 12 ¦ Issue 2 ¦ April-June 2018
criteria may partly account for it, as has recently been
shown (18%) in the first community‑based prevalence study
based on the current Rotterdam diagnostic criteria.[9] Education,
awareness and self‑control are the only way to control it from
rising further and affecting more women.
The cause of PCOS is unknown, but studies suggest a strong
genetic component that is affected by gestational environment,
lifestyle factors or both. Women who have PCOS are at
an increased risk for cardiovascular disease, diabetes and
pre‑diabetes, endometrial cancer, heart attack, hypertension,
high levels of low‑density lipoprotein and low levels of
high‑density lipoprotein.
As per Rotterdam criteria, PCOS is defined as the presence of
any two of the three features: (1) Oligo/amenorrhoea: absence
of menstruation for 45 days or more and/or ≤8 menses/year.
(2) Clinical hyperandrogenism: Modified Ferriman and
Gallwey Score of 6 or higher. (3) Polycystic ovaries: presence
of >10 cysts, 2–8 mm in diameter, usually combined with
increased ovarian volume of >10 cm3
, and an echo‑dense
stroma in pelvic ultrasound scan.[10] (Acne Global Severity
Scale score 1 and above)[11] Following is a case of PCOS in reproductive age group treated
successfully with Homoeopathy. Her informed consent was
Case Report
A 22‑year‑old unmarried female of height 162 cm and
weight 70 kg with a clinical history of irregular menses for
2 years reported to the Outpatient Department (OPD) of
DDPRCRI (H), Noida, on 24th April, 2010. Her duration
of cycle was 45–60 days. She was also having complaints of
soreness of breast before and during menses for 1 year which
was relieved after menses. She also complained of abnormal
hair growth on her face and abdomen and acne on face for
1 year. Apart from all these complaints, she was having thin,
milky white leucorrhoea for 1 year and she was suffering from
cold for 10 days with enlarged tonsils.
The patient was overweight at a young age and gained about
8 kg since the last year. The patient was pursuing engineering
curriculum. She was conscious about her weight and had low
self‑esteem. She took allopathic medicines for 3 months to
regularise periods but without improvement. Subsequently,
the patient was brought to the Central Research Institute (H),
Noida, for homoeopathic treatment.
On examination, she was obese, with a body mass index of
=26.67 kg/m2 Waist circumference was increased
at 95 cm. She had hyperandrogenism with hirsutism (Ferriman
Gallwey score of 9), with Acne Global Severity scale of 2.
Investigations revealed normal fasting glucose, thyroid‑stimulating
hormone, prolactin and 17 hydroxyprogesterone levels. Apelvic
ultrasound revealed polycystic ovarian disease (PCOD) and
pelvic inflammatory disease (PID).[Figure 1]. Investigations for
testosterone, follicle‑ stimulating hormone, luteinising hormone
and  dehydroepiandrosterone‑sulfate were not done.
It was recognised that her psychosocial features were likely to
have negative impact on her quality of life and on her ability
to self‑manage this chronic disease as well as her ability to set
and achieve lifestyle goals. This was addressed as a priority.
Past history – History of jaundice in 2007
Family history
Family history revealed diabetes in her paternal grandparents
and her father, hypertension in her father and osteoarthritis
and irritable bowel syndrome in her maternal grandmother.
Physical generals
The patient was tall and fat. She was non‑vegetarian, her
thermal reaction was chilly and had a tendency to catch
cold (throat infection from childhood). Her appetite was good
and had desire for sweets, non‑vegetarian food (chicken, egg),
cold drinks and fast food. She had thirst for large quantity at
a time. She also reported profuse sweat from hand, scalp and
axilla. Bowel movements were irregular, passed every alternate
day even during menses. Further, she was found to be cheerful,
easy‑going, lethargic and expressive on irritation.
Investigations revealed pelvic sonography done on 27th March,
2010; PCOD [Figure 1]; last menstrual period – 22nd March,
2010; previous period was on 1st January, 2010 (before that
taking allopathic medicine for 3 months to regularise menses,
then left and found the same irregularities of period).
First prescription: (24th April, 2010)
Calcarea carb 30, tds – 3 days + placebo for 1month and advised
for regular exercise for 30–35 min/per day with avoidance of
junk/fast food and high‑calorie diet. This case is followed up to
7th July, 2011, as per the follow‑up table [Table 1].
Basis of prescription
Repertorisation was done of the following symptoms.
Chilly patient, tendency to catch cold, tonsil involvement
since childhood, desire for egg, constipation, soreness of
Figure 1: Before treatment
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Indian Journal of Research in Homoeopathy ¦ Volume 12 ¦ Issue 2 ¦ April-June 2018 97
breast before and during menses and amelioration after menses
(synthesis rep), leucorrhoea thin milky white (Boericke’s
Materia Medica pg. no. 146, reprint edn 2007) and tendency
to gain weight. After repertorisation, Calcarea carb scored the
highest rank [Figure 2].
PCOS, however, seems to be related to an imbalance in a
girl’s hormones; is the most common hormonal reproductive
problem in women of childbearing age. The most important
Figure 2: Repertorisation chart provided in image form
Table 1: Timeline including follow up of the case
Follow-up date Symptoms Weight Medicine, potency and doses
12/06/10 LMP‑11.5.10 Bright red, no clots, painful but less than
before soreness of breast decreased coryza and enlarged
tonsils relieved in 3 days after taking medicine
70 kg Cal.carb30C; T.D.S × 3 days
Placebo for 30 days
23/08/2010 LMP‑19.6.10,15.7.10, Bright red , no clots, no pain
Leucorrhoea decreased soreness of breast decreased
68 kg Placebo for 30 days
24/09/10 LMP‑28/8/10,18/9/10
Bright red , no clots, no pain
Leucorrhoea decreased
soreness of breast decreased
65 kg Placebo for 30 days
26/10/10 Period not come 65 kg Cal.carb200C; O.D × 3 days
Placebo for 30 days
20/1/11 LMP‑28/12/10, 22/11/10,29/10/10
No soreness of breast in last period, Mild leucorrhoea
Advice for USG pelvis
63 kg Placebo for 15 days
25/2/11 LMP‑23.2.11,18.1.11
Mild leucorrhoea more before menses
Mild pain in lower abdomen
USG‑no PCO only fluid in POD i.e., P.I.D [Figure 2] Cycle is of 20‑37 days
61 kg Calcarea carb 200C; O.D × 3 days
Placebo for 30 days
23.03.11 LMP‑21.3.11
Leucorrhoea same as before
Mild pain in lower abdomen some times more
61 kg Cal.carb 1M; O.D × 2 days
Placebo for 30 days
15.5.11 LMP‑19.4.11
Mild leucorrhoea some times more
Sometimes mild pain in lower abdomen
Advised for USG Pelvis
61 kg Placebo for 30 days
07.07.11 LMP‑ 22.6.11,20.5.11
Mild leucorrhoea .No pain in lower abdomen
USG report suggest normal study (fig‑3)
60 kg Placebo for 30 days
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98 Indian Journal of Research in Homoeopathy ¦ Volume 12 ¦ Issue 2 ¦ April-June 2018
step is to diagnose the condition in time and provide proper
treatment for PCOS so that it will help to reduce a girl’s
or young woman’s chances of having serious side effects
later on.
The conventional medical management of PCOS is
symptomatic treatment and lifestyle modification with
weight reduction. Metformin, oral contraceptives,
anti‑androgens, clomiphene citrate and thiazolidinediones
are used for the management of different presentations of
PCOS. Metformin is commonly used either alone or in
combination with other medicines for the treatment of most
of the clinical manifestations of PCOS. [1] Moghetti et al.
concluded after a study that metformin treatment reduced
hyperinsulinaemia and hyperandrogenaemia, independently
of changes in body weight. In a large number of patients,
these changes were associated with striking, sustained
improvements in menstrual abnormalities and resumption
of ovulation.[12] The most common side effects of Metformin are nausea,
vomiting or diarrhoea. Lactic acidosis is a dangerous condition
that can be caused by Metformin. Also, the cost of Metformin
is approximately $75.00/month.[13] Oral contraceptive pills (OCPs) reduce hyperandrogenism
as oestrogen suppresses androgen and adrenal production.
Glucocorticoid such as dexamethasone 0.5 mg or prednisolone
5 mg at bed time also reduces androgen production.
Cyproterone acetate has been effective in the treatment of
hirsutism (prevents recurrence of hirsutism).[14,15] Homoeopathic treatment has no side effects and holistically
treats individuals. Homoeopathic medicines can modify
general tendencies, thus causing cure of conditions.
Homoeopathic literature mentions many medicines for
the conditions, of which a similimum can help a patient
for keeping the disease at far away for a longer period
as evidenced in this case. Homoeopathic medicine gives
safe and gentle treatment in a cost‑effective way, whereas
in vitro fertiliszation and surgical resection and metformin
cost a lot. Cinar et al. concluded after a study, mentioned in
CCRH protocol for PCOS, that depression and anxiety are
more common in patients with PCOS as compared with
healthy women. Depression in PCOS might be associated
with obesity and metabolic abnormalities including insulin
resistance and dyslipidaemia.[16,17] In another study, the
author concluded that overall, depression, anxiety mean
scores and depression rates did not show a significant
change in cases of PCOS after treatment with OCPs.[16] Homoeopathic treatment is based on the holistic approach;
therefore, all such aspects are taken into account for
prescription. Besides, many studies found homoeopathic
medicines to be effective.
In a double‑blind randomiszed controlled trial study by
Sanchez‑Resendiz and Guzman‑Gomez (1997), 36 women
suffering from PCOS, and fitting the mental picture of the
homoeopathic remedy Pulsatilla, were given Pulsatilla
6C, 4 h throughout the day for 2 weeks after the end of
menstruation, and this was repeated for 4 consecutive cycles.
At the end of the trial, 30 of the 36 women had no symptoms
of PCOS and they had normal ovulating follicles and 4 of the
36 women became asymptomatic.[18] In this case, the diagnosis of PCOS was confirmed, with the
presence of hyperandrogenism and irregular menstrual cycles
as well as polycystic ovaries on ultrasound. The symptoms of
PCOS are the major source of psychological morbidity and
can negatively affect the quality of life of adolescents or young
women.[19] In this case also the patient was worried about her
weight and personality. Calcarea carb ultimately proved to
be the indicated medicine as the first prescription, going by
the result of repertorization. The potency 30 was selected in
the beginning followed by 200 potency. The potencies 30 and
200 were able to regularise the menses. Then the potency
was increased to 1M when free fluid was found in pouch of
Douglas (POD) and pain in lower abdomen and leucorrhoea
was persisting indicating PID. 1M potency was given with
required result i.e., to remove pain in the lower abdomen
and the free fluid in POD. Ultrasonography (USG) showed
normal study [Figure 3]. This case was successfully treated
as the patient was regularly followed‑up. Again when the
patient came to OPD for fever and pain abdomen, she was
advised to do USG pelvis which showed normal follicular
pattern [Figure 4].
As PCOS is among the most common diseases during
adolescence, there is always a need to investigate all new
relevant data. Early recognition and prompt treatment of
PCOS in adolescents is important to prevent long‑term
Homoeopathy can take care of chronic hormonal syndrome
in an individual, where allopathic hormone‑related
treatment or surgery is otherwise advised. Non‑recurrence
of complaint in the past 3 years suggests that PCOS can be
treated successfully through individualised homoeopathic
medicine with lifestyle management. However, a
well‑planned study with large sample size is required
to establish the efficacy of Homoeopathy in PCOS.
Now, the Central Council for Research in Homoeopathy
is conducting ‘A randomized controlled pilot study
on Management of polycystic ovarian syndrome with
homoeopathic intervention versus placebo’.
Declaration of patient consent
The authors certify that they have obtained appropriate
patient consent form. In the form, the patient has given
her consent for her images and other clinical information
to be reported in the journal. The patient understand that
her name and initials will not be published and due efforts
will be made to conceal her identity, but anonymity cannot
be guaranteed.
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Indian Journal of Research in Homoeopathy ¦ Volume 12 ¦ Issue 2 ¦ April-June 2018 99
Financial support and sponsorship
Conflicts of interest
None declared.
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