“To be feminine not masculine” – Psychological aspects of polycystic ovarian syndrome and a case report
Dr Aswathi K V
ABSTRACT
Polycystic ovarian syndrome is one of the most common gynecological disorders affecting the females at their fertile age. The somatic symptoms of the disorder can be associated with g great number of psychological symptoms like body image dissatisfaction, feeling of masculinity, feeling less sexually attractive, low self – esteem, and reduced sexual libido . Homoeopathy as a holistic system of medicine gives importance to the somatic as well as the psychological symptoms of the patient. Here an attempt is done to correlate the somatic and psychological symptoms of PCOS and to search the related mental rubrics from the repertory.
A case report of PCOS is also presented, to demonstrate the positive results of individualized homoeopathic medicine in the treatment of PCOS.
INTRODUCTION
Polycystic ovarian syndrome (PCOS) is one of the most common disorders interrupting the homeostasis of the female endocrine system affecting between 6.5 to 8 percent of women. Several studies have linked specific features of PCOS, such as infertility, hirsutism and acne, to decreased mental well-being. Hyperandrogenism associated with PCOS causes intensified body hair growth (hirsutism), problematic greasy skin, acne and masculine type hair loss (alopecia of androgen origin). As a result of insulin resistance, overweight or obesity is also common in PCOS. As these symptoms causes changes that are visible to other people and interfere with the norms of femininity, this disorder often has a negative impact on individual’s mental health and well being.
Psychosocial Concerns related to PCOS and related rubrics
| Somatic symptoms | Psychological concerns related to the somatic symptom | Related rubrics |
| Obesity | Body dissatisfaction, body image disturbances.
Low self esteem |
|
| Hirsutism | Sexual identity
Feeling of masculinity in women Failure of their femininity
|
Confusion of mind, identity, as to his, sexual identity.
Mannish behavior, women in Mannish, girls; mannish looking Generals, hair distribution in women; masculine |
| Infertility and negative effect on sexual functioning | Lower sexual satisfaction
Feeling less sexually attractive Reduced sexual libido |
Sexual desire, diminished |
CASE: A 27 year old women from a middle socio economic status family reported to the outpatient department of Government homoeopathic medical college, Bengaluru on 21st February 2021 with the complaint of weight gain and scanty menses since 2 years. Gradually she started with facial hair growth and blackish discoloration in the nape of the neck, armpit and in the groins. Her menstrual cycles are regular, duration of menses is 3days and the flow is scanty. Last menstrual period was on 24/01/2021.
PAST HISTORY: Nothing significant
FAMILY HISTORY: Family history revealed uterine fibroid in Mother& Hypertension and Diabetes mellitus in Father.
PHYSICAL GENERAL
- Appetite: Can’t tolerate hunger
- Thirst: 2-3 liters/day
- Desire: fish2+
- Bowel habits: once/day, no difficulties
- Bladder habits: 4 times/day, no difficulties
- Perspiration: More on face2+, palms2+ and soles2+, not offensive, no staining.
- Sleep: good, refreshing
- Thermals: Can’t tolerate extremes, more towards hot
MENTAL GENERALS
- Longing for good opinion of others
- Social position concerned about
- High self esteem
- Throwing things, anger during
INVESTIGATION REVEALED: Ultrasonography of abdomen and pelvis as on 22/02/2021
Impression
- Polycystic appearing ovaries
- Hepatomegaly with fatty infiltration
- Reducible umbilical hernia
RUBRICS AND REPERTORISATION
- Mind – Longing for- good opinion of others
- Mind – Social position concerned about
- Mind – Self esteem-high
- Mind- Anger, throwing things around
- Generals – Hunger aggravation
- Female genitalia – Tumors-ovaries-cysts
FIRST PRESCRIPTION ON 22/02/2021
Staphysagria 200 one dose and placebo for 15 days was given.
Patient was advised to do regular exercise and to include more vegetables in the diet and to reduce intake of carbohydrate rich food and meat.
FOLLOW UP OF THE CASE IS GIVEN IN BELOW TABLE.
| Follow up date | Symptom | Medicine, potency and doses |
| 10/03/2021 |
|
Placebo/TID for 15days. |
| 28/03/2021 |
|
Staphysagria 1M/1dose
Placebo for 1month. |
| 30/04/2021 |
|
Placebo/TID for 1 month. |
| 29/05/2021 |
|
Staphysagria1M/1dose
Placebo/TID for 1 month. |
| 27/06/2021 |
|
Placebo/TID for 1 month. |
| 29/07/2021 |
|
Placebo/TID for 1 month. |
| 29/08/2021 |
|
Staphysagria1M/1dose
Placebo/TID for 1 month. |
| 09/09/2021 |
|
Colocynth 200/BD/3 days
Placebo for 1 week. |
| 28/09/2021 |
|
Placebo/TID for 1 month. |
After treatment: USG of abdomen and pelvis as on 11/09/2021
Impression : Pelvic scan shows normal uterus and ovaries
CONCLUSION:
This case shows the importance of holistic approach and positive role of homoeopathy in the treatment of Polycystic ovarian syndrome along with life style modifications.
REFERENCES:
- Sayyah-Melli M, Alizadeh M, Pourafkary N, et al. Psychosocial Factors Associated with Polycystic Ovary Syndrome: a Case Control Study. J Caring Sci. 2015;4(3):225-231. Published 2015 Sep 1. doi:10.15171/jcs.2015.023.
- Farkas J, Rigó A, Demetrovics Z. Psychological aspects of the polycystic ovary syndrome. Gynecol Endocrinol. 2014 Feb;30(2):95-9.
- Radar software: Frederik Schroyens Synthesis Repertory, Version 9.1
Dr Aswathi K V
MD Part II – PG Department of Materia medica,
Government Homoeopathic Medical College & Hospital, Bengaluru
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