Homoeopathic management of a hemorrhagic ovarian cyst with periumbilical hernia: a case report

Dr J Jesiah Anto Poovendan

ABSTRACT
This case report documents the successful homoeopathic management of a left-sided complex hemorrhagic ovarian cyst in a 36-year-old female, confirmed through ultrasonographic evaluation. The patient presented with lower abdominal pain, premenstrual mastalgia, emotional disturbances, and an associated periumbilical hernia.

Individualized homoeopathic treatment with Sepia and Hamamelis was prescribed based on the totality of symptoms. Over a follow-up period of four months, the patient showed marked clinical improvement, accompanied by complete radiological resolution of the hemorrhagic ovarian cyst. Comparative analysis of ultrasound scans dated 19.08.2025 and 07.12.2025 substantiated the therapeutic outcome.

KEYWORDS : Hemorrhagic ovarian cyst,pelvic pain , individualization ,complex cyst

A 36-year-old female patient presented to the outpatient department on 27 August 2025 with multiple gynaecological, gastrointestinal, and psychosomatic complaints.

PRESENTING COMPLAINTS
The patient complained of lower abdominal pain predominantly on the left side, radiating to the lower back, of several months duration. The pain was more pronounced in the premenstrual period and was associated with the passage of menstrual clots during the previous cycle. She also reported premenstrual mastalgia, which subsided after the onset of menses.

Additionally, the patient noticed a ball-like protrusion near the umbilicus, which became prominent while walking, sitting, coughing, or straining, suggestive of a periumbilical hernia. She experienced pain in the hernial region while lying on either side, which caused discomfort during sleep.

Other associated complaints included palpitations during emotional stress, disturbed sleep due to mental tension, and constipation occurring intermittently.

MENSTRUAL HISTORY
The patient had a regular menstrual cycle of 28 days, with 4–5 days of moderate flow. She reported mild dysmenorrhoea, with increased pain and clot formation noted in the last menstrual cycle.

MENTAL AND EMOTIONAL STATE
The patient exhibited marked emotional sensitivity, particularly toward criticism from her husband, which she perceived as insulting. She described a tendency to suppress her emotions, especially sadness and anger. Although tears would come to her eyes, she often restrained herself from crying; however, weeping provided significant emotional relief.

She expressed a strong unfulfilled desire to become a teacher, but was currently pursuing law studies due to family pressure, leading to internal conflict, stress, and emotional burden.

PAST AND PERSONAL HISTORY
No significant past medical or surgical history was reported. Appetite was normal, thirst was moderate, and bowel habits were irregular with episodes of constipation. Sleep was disturbed mainly due to mental stress.

Diagnostic Imaging (Prior to Treatment)

An ultrasonography (USG) examination dated 19 August 2025 revealed:

• A well-defined thin-walled complex cystic lesion measuring 4.4 × 3.3 cm in the left ovary, showing lace-like reticular echoes, consistent with a hemorrhagic ovarian cyst
• Minimal free fluid in the pouch of Douglas
• Periumbilical hernia with omental herniation

Repertorial totality -using synthesis repertory¹

1. Mind – Ailments from – domination;
2. Mind – Sensitive – criticism, to
3. Mind – Silent grief / suppressed emotions
4. Mind –Dancing -amel

Physical Generals

1. Sleep – Disturbed – from mental exertion / emotional tension
2. Particular / Local Symptoms
3. Female genitalia-tumor- ovaries -cyst
4. Female genitalia – pain-Bearing down – sensation –
5. Female genitalia – Pain – before menses-agg
6. Female genitalia – Breasts – pain – before menses
7. Abdomen – Hernia – umbilical –

POSOLOGY AND REGIMEN

• Sepia officinalis was administered in a 30c potency, selected according to the patient’s sensitivity, constitution, and symptom intensity. The dose and repetition were individualized as per homoeopathic principles³.
• Hamamelis virginiana was prescribed in mother tincture (Q) / in therapeutic doses, targeting the hemorrhagic aspect of the ovarian cyst.
• The patient was reviewed at regular follow-up intervals of 4–6 weeks, with clinical assessment and ultrasonographic evaluation to monitor therapeutic response.

DISCUSSION
The present case demonstrates both subjective clinical improvement and objective radiological resolution following individualized homoeopathic management. The therapeutic approach was based on a comprehensive evaluation of the patient’s mental, emotional, and physical symptom totality⁶.

Sepia officinalis was selected as the constitutional remedy to address the hormonal imbalance, premenstrual symptomatology, and suppressed emotional state, all of which were prominent features in this case. The patient exhibited significant improvement in pelvic pain, premenstrual mastalgia, menstrual regularity, and emotional well-being, indicating a favorable constitutional response.

Hamamelis virginiana was prescribed as an intercurrent remedy to target the venous congestion and hemorrhagic pathology associated with the ovarian cyst. Its known affinity for the vascular and venous systems likely contributed to the resolution of the hemorrhagic component of the cyst.

Serial ultrasonographic evaluations provided objective evidence of therapeutic response. The ovarian cyst demonstrated a progressive reduction in size from 4.4 × 3.3 cm on 19 August 2025 to a collapsed resolving lesion measuring 3.1 × 1.9 cm on 07 December 2025, thereby confirming anatomical and pathological resolution.

CONCLUSION
This evidence-based case demonstrates that individualized homoeopathic treatment, specifically with Sepia officinalis and Hamamelis virginiana, was associated with the clinical and radiological resolution of a hemorrhagic ovarian cyst, as confirmed by comparative pre- and post-treatment ultrasonographic imaging.

Homoeopathy may offer a non-invasive and safe complementary option for managing ovarian cysts in selected patients, particularly when conservative management is preferred over immediate surgery..

REFERENCES

1. 1.Schroyens F, editor. Augmented Clinical Synthesis 9.1. New Delhi: B. Jain Publishers; 2023.
2. Boericke W. Pocket Manual of Homoeopathic Materia Medica and Repertory. 9th ed. New Delhi: B. Jain Publishers; 2008.
3. Dutta DC. Textbook of Obstetrics. 8th ed. New Delhi: Jaypee Brothers; 2015
4. Shaw RW, Luesley D, Narakorn C. Shaw’s Textbook of Gynaecology. 17th ed. Delhi: Elsevier; 2018.
5. Kent JT. Lectures on homoeopathic materia medica. New Delhi: B. Jain Publishers; 1993.
6. Moorthi K, Tharshini KS. Uterine fibroid and haemorrhagic ovarian cyst treated with homoeopathic medicine Sepia officinalis in LM potency: An evidence-based case report. Indian J Res Homoeopathy 2025;19:207-13. doi: 10.53945/2320-7094.2081
7. Burt WH. Physiological materia medica: Containing all that is known of the physiological action of homeopathic remedies. Chicago: Gross & Delbridge; 1873.
8. Chicago: Hahnemann, Samuel. 1921. Organon of Medicine. 6th ed. Translated by William Boericke. New Delhi: B. Jain Publishers.

Dr.J.Jesiah Anto Poovendan M.D.(Hom).,
Medical Director, Santham Homoeopathy Hospital & Research Centre , Chennai
Email : santhamhomoeopathy@gmail.com

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