Case study Poly Cystic ovarian syndrome (PCOS)
History: 28 years old unmarried girl history of delayed menses, additional hair growth in the face, weight gain, mental irritability since 2 years
Personal History
Diet Vegetarian
Appetite Good, Able to take little quantity, often feels hungry
Bowels Normal
Urine Normal
Sleep Normal
Prakruti Pitta and Kapha
Desired taste Spicy, salty, warm foods and drinks
Patient details
Registration date 22.01.2010
Family history No relevant family history (One girl child)
Disorder history Diagnosed with PCOD with USG
Medication history Ovaral –G (Combination of estrogen and Progesterone) – one tablet daily for 21 days with a gap of 7 days for six months. Menses were normal in this period but general health conditions were not improved.
Menstrual history Menarche at the age of 12 years.
Past MC – 4-5/ 28-30 day cycle; Moderate flow and mild pain
Since last six month menstrual cycle – 2-3/ 40-45 days, scanty flow and sometimes pain
Last menstrual cycle: 29.11.2009
Physical examination
General examination Build & Nutritional status: satisfactory
Pallor: Mild
No evidence of thyroid enlargement
BP 120/80 mm/Hg / Pulse 72 per minute
Height: 156 cm
Weight: 69 Kg
Respiration rate 19 per minute
Systemic examination Cardio Vascular system
Heart sounds (S1, S2) – Normal, No added sound, HR-62 per minute
Respiratory system
Clear, equal air entry, no added sound
Per abdomen
Soft, No palpable mass and no organomegaly, No abnormality detected
Investigations Hemoglobin – 12.6 mg/dl (11 – 14 gm/dl)
TLC, DLC and ESR, within normal range
Hormone profile
Prolactin – 18.12 ng/ml (3.24-29.15 ng/dl)
L H – 3.09 mIU/ml (1.00-18.00 mIU/ml in follicular phase)
PSH – 6.34 mIU/ml (4.00 mIU/ml/ml in follicular phase)
Thyroid profile
TSH – 3.2 mU/ ml (0.49-4.67 mIU/ml)
Thyroxin – 0.87 ng/dl (0.71-1.85 mg/dl)
Tridothyrixine – 2.36 pg/ml (1.45-3.48 pg/dl)
Insulin – fasting – 4.9qU/ml (0-9 qU/ml)
Radiology USG – 20.12.2009 – Enlarged ovaries with multiple small follicles in peripheral distribution with increased stromal echogenecity suggestive of poly cystic ovaries
Follicular study 29.11.2009 – Anovulatory cycle
X Ray – PA view – No abnormality detected
Clinical evaluation of the patient on clinical and biochemical basis on frequent follow ups
Clinical findings On registration date
(22.01.2010) 2 nd follow up
(07.03.2010) 5 th follow up
(01.11.2010)
Lethargy ++++ ++ Nil – Fresh and Energetic
Pallor ++ Nil Nil
Irregular periods Last menses on 29.11.2009 (3 days, scanty and painful) On 40 th day (01.03.2010), 3-4 days Every 30 th day, regular for 4-5 days
Amount of menses Scanty normal normal
Weight 62 Kg 59.2 Kg 50 Kg (Unchanged since 4 months)
Investigations 07.03.2010 18.05.2010 25.10.2010
Hb gm% 11.6 gm/dl 12.1 gm/dl 14.6 gm/dl
Prolactin 16.12 ng/dl 18.11 ng/dl 15.46 ng/dl
LH Normal Normal Normal
PSH Normal Normal Normal
Free Testosterone Normal Normal Normal
Thyroid profile Normal Normal Normal
Ultra sound scan Enlarged in volume, Increased number of cyst (Peripherally ) Ovaries enlarged with fair amount of cysts with mild stromal thickening Ovaries normal, no visible cyst mass, No stromal thickening, Normal study
Follicular study Anovulatory cycle Anovulatory cycle Ovalatory cycle, Ovulation occurs at Day 16
Diagnosis
Anemia and thyroid disorder are ruled out. Hormonal studies and USG exhibits Poly cystic ovarian syndrome (PCOS)
Management Done
Food – Green gram, Red rice, wheat, Green, fresh vegetables, Milk etc
Avoid – spicy, salty, fermented foods and drinks, canned foods and drinks, curd
Exercises- 30 minutes walk every day with Pranayama and meditation for 10-15 minutes
Medicines advised
1. Saptasaram Kashayam Tablets
3 tablets – with warm water 30 minutes before breakfast and Dinner
2. Kalyanaka Kshara (21)
250 mg after food with curd water thrice daily after food
3. Satavari gulam
5 gm at bed time followed by 200 ml of warm milk
Conclusion
In PCOS is a condition caused by abnormalities of hypothalamic – pituitary axis and ovarian or adrenal steroidogenic pathway.
Ayurveda names this condition as ‘Arthava Dushti’ – means abnormalities in the functions elements of the menstrual cycle. This condition is termed under easily treatable disorders section.
At rVita we combine best of the ancient Indian systems like Ayurveda and Yoga with modern diet and nutrition plans with a unique personalization based on the bio energy or Prakriti analysis. This helps the person to attain the self healing in due course of time and the disease is cured permanently.
rVita currently enrolling patients for PCOD program (Women health) with unique Online patient Management system which enables to upload all the medical records and monitor health etc online.
For more details about the Online PCOD program (Women health) please feel free to call 1800 425 4325 (India Only) / 00 91 9500123412 / visit www.rvita.com and click the ‘rVita personalized consultation’ tab
Alternatively, please visit our flag ship rVita health center at No.2, Krishnamacharya Avenue, Adayar, Chennai 600020, (Opposite to Adayar Ananda Bhavan Sweets), and India. For appointments please call 044 42187226 / 1800 425 4325 (India Only) / 9500123412 / gowthaman@rvita.com
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