It is a major abnormality in the patient with the failure of regular, predictable ovulation and the patients are at risk or the development of dysfunctional bleeding and endometrial hyperplasia associated with unopposed estrogen exposure in PCOS the following two or all three criteria should be fulfilled which are as follows:-
1. Oligomenorrhoea or anovulation
2. Hyperandrogenism
3. Polycystic ovaries
ETIOLOGY:-
● The most common problem in the 4th & 5th decade of life.
● It is considered a part of metabolic syndrome.
● Genetic factors
● Environmental factors
● Inflammation ( overweight )
Signs and Symptoms:-
1. The foremost and important divical feature of PCOS is menstrual dysfunction i.e
oligomenorrhea, amenorrhoea, etc.
2. In teenagers, acne or oily skin is the most common feature which is found.
3. Obesity is found in around 50% of the patients the body fat is usually deposited centrally i.e. hip or waist and the patient can be at risk of diabetes mellitus and cardiovascular diseases in later life.
4. There can be an increased incidence of hypertension, atherosclerosis, cardiovascular disease myocardial infarction in 40% of perimenopausal women.
5. Women may develop acanthosis nigricans (a velvety hyperpigmented change of the crease area of skin ) and it usually occurs on the axilla, neck, etc.
6. HIRSUTISM i.e. excessive hair growth which is the main problem suffered by patients with PCOS. It can be treated with bleaching, shaving plucking, etc but
ultimately leads to scarring, folliculitis, etc, and usually occurs on the face, chest, back, or buttocks.
7. The other problems faced by the patient are alopecia, infertility, and weight loss
obese women are encouraged to lose weight.
8. Women with PCOS have difficulty in conceiving and a higher risk of miscarriage.
9. Diabetes mellitus Lead to endometrial carcinoma.
10. Hormonal imbalance, nutritional, psychological, and hematological factors play a contributory role.
Some other health-related risk factors are :
● Cholesterol
● Liver disease
● Hypertension
● Non-alcoholic fatty liver
● Depression & anxiety
● Abnormal uterine bleeding
● Type-2 diabetes mellitus
MANAGEMENT:-
1. In obese women, weight loss should be the first line of treatment.
2. The patient should avoid bleaching, shaving, plucking, and laser as it can lead to scarring, folliculitis, hyperpigmentation, etc.
3. Patients with alopecia should be given psychological support and with the help of homeopathic remedies, we can cure a greater number of cases in a very safest way as it is the most refined method of treating the patients.
4. Unnecessary use of different types of drugs should be avoided.
5. Insulin lipid profile should be maintained as it can cause cardiovascular diseases in women.
6. Diabetes & blood pressure should be regularly monitored and maintained.
INVESTIGATION:-
1. The first and the foremost investigation is ultrasonography generally, ovarian size is increased.
2. 70% of patients with PCOS usually contains intermediate and atretic follicle measuring 2- 8cm in diameters, resulting in a “polycystic appearance” at an ultrasound.
3. Collected immature oocytes from PCOS patients being researched diagnostics.
TREATMENT:-
1. Pulsatilla – best homeopathic remedy with scanty and late menses.
2. Sepia – bearing down pains from the back and abdomen. It is one of the best homeopathic medicine for PCOS.
3. Lachesis – best remedy when there is an aversion to tight clothes or intolerance to anything worn a little tight, it is the left-sided remedy. The menses are too short
and the flow is feeble.
4. Graphites –best medicine for PCOS with constipation along with other symptoms. The menses are too late, pale, and scanty.
5. Apis – stinging pain with tenderness over the abdomen & uterine region, it affects the right side more.