Homoeopathy a system of holistic healing as an alternative treatment for PCOS: a review

Polycystic ovarian syndrome (PCOS) is a complex hormonal and metabolic disorder characterized by oligomenorrhea or amenorrhea, hyperandrogenism and infertility. Global prevalence of PCOS is estimated to be between 06% and 26%. Homoeopathy, being a system of holistic healing can be accepted as one of the alternative treatments for PCOS. Aim & Objective: The aim of the study is to review clinical data, where the intervention was aimed to treat PCOS through Homoeopathy. The objective of the study is to identify the therapeutic approach, assessment criteria, treatment outcomes through an alternative therapy i.e., Homoeopathy in cases of PCOS. Methods: A systematic literature search was conducted in the month of June2021 following International/National search databases for all clinical studies published in the period from 2000 to 2021. This search was aimed to target the entire literature of randomized trials or controlled trials, observational studies case studies/reports on PCOS in homoeopathy. Result:28 articles related to Homoeopathy on PCOS were identified. Out of these 28studies, 22 studies (01 RCT, 02 NRCT,06 observational studies,04 case series and 09 case reports) were included in this review. All studies were published in peer reviewed journals.Conclusions:To establish the evidence-based efficacy of the homoeopathic treatment in cases of RCT more pragmatic studies need to be planned in the future based on proper diagnostic criteria.

Role of anti-mullerian hormone as a diagnostic tool for polycystic ovary syndrome

Background: PCOS has been recognized as the most frequent endocrinopathy among reproductive aged women. This study has been done to determine whether the measurement of serum AMH can be used to diagnose PCOS and as a tool to predict the prognosis of PCOS.Methods: This was a prospective case control study on a woman attending gynae OPD of LLRM Medical College, Meerut, from May 2018 to June 2019. Study comprised of 50 women diagnosed with PCOS using Rotterdam criteria and 50 controls. Clinical data were collected including history, oligomenorrhea, hirsutism, examination included BMI, FG score and blood investigations including serum FSH, LH, TSH, prolactin, estradiol and serum AMH level. USG was done for all women.Results: Both PCOS cases and controls were matched for age and BMI. Mean level of AMH in PCOS cases and controls was 7.1096 and 2.423 respectively, AMH was two to three times higher in women with PCOS than controls which was statistically significant (p<0.05). Most frequent phenotype of PCOS in this study was phenotype A (48%). Highest mean level of AMH was also found in phenotype A (OA+HA+PCOM), thus reflecting the severity of PCOS. Maximum diagnostic potential for PCOS was at cut off 4.22 ng/ml with sensitivity of 92.5% and specificity of 100%.Conclusions: AMH level can be used as diagnostic and prognostic modalities in PCOS. AMH value rises when hyperandrogenism is present therefore serum AMH levels also reflect the phenotype of PCOS and severity of PCOS.

Study of prevalence of insulin resistance and other metabolic abnormalities in various phenotypes of polycystic ovary syndrome in central India

Background: Till recent times, defining symptoms of PCOS remained a debatable topic. In 2012, National Institute of health consensus panel proposed diagnostic criteria based on phenotypes. Evidence showed higher incidence of diabetes mellitus, insulin resistance and compensatory hyperinsulinemia among women with PCOS. So, the present study was undertaken to compare the clinical, metabolic and hormonal profile among various phenotypes in women with PCOS and to find out the prevalence of insulin resistance among the PCOS phenotypes.Methods: The prospective, observational study was done on 292 women with PCOS-related infertility. These women were divided into 4 phenotypes. Ferriman-Gallwey score, HOMA-IR, OGTT, lipid parameters, hormonal parameters, mean ovarian volume and mean antral follicle counts were compared among the 4 phenotypic groups. One-way ANOVA followed by post-hoc Tukey was applied.Results: Mean weight, BMI, waist circumference, SBP, DBP and Ferriman-Gallwey score, fasting glucose, fasting insulin, OGTT (1 hour) and HOMA-IR was highest in phenotype A, while fasting glucose / insulin ratio was lowest in phenotype A. Total triglycerides, total cholesterol, LDL were higher and HDL was lowest, testosterone, mean ovarian volume and mean antral follicle count were highest and vitamin D was lowest in Phenotype A.Conclusions: Phenotype A is the group with all features of PCOS syndrome, while phenotype D is associated with milder metabolic profile. Women with phenotype A and B are at a higher risk for metabolic syndrome. Identifying various phenotypes will assist in providing appropriate treatment and prognosticating the patients with PCOS-related infertility.

Is there any association between vitamin D levels and polycystic ovary syndrome (PCOS) phenotypes?

ABSTRACT Objective The aim of this study was to assess the serum vitamin D level in a retrospective study in women with polycystic ovary syndrome (PCOS), according to the different phenotypes of the disease. Subjects and methods In this retrospective study, the records of 351 infertile women who were diagnosed with PCOS were examined, and 200 of them were enrolled in the study randomly in 4 PCOS phenotypes. Fifty normal ovulatory women with the history of male factor were selected as the control group. Parameters, including age, infertility duration, body mass index (BMI), hormone profile, as well as the serum vitamin D level were compared among the 4 phenotypes, with the P-value ≤ 0.05 considered statistically significant. Results The findings showed a higher serum vitamin D level in the control group than in PCOS patients, which was statistically significant (P < 0.001). In addition, there was no significant difference in the serum vitamin D level among the four phenotypes of PCOS. Conclusions No significant difference was found in the serum vitamin D level of the different phenotypes of PCOS. Further studies with larger sample sizes are recommended to be done to establish the role of the serum vitamin D level in PCOS patients.

Polycystic ovary syndrome and its association with immune reproductive disorders: A reproductive study

@#<p style="text-align: justify;"><strong>BACKGOUND:</strong> Polycystic ovary syndrome (PCOS) is usually present with reproductive dysfunction. Ovarian function of women with polycystic ovary syndrome might be disturbed, with resultant abnormal folliculogenesis and steroidogenesis. Although it is difficult to define the exact pathogenesis of anovulation, multiple other possible abnormalities have been postulated as contributory factors in the reproductive failure.</p><p style="text-align: justify;"><strong>OBJECTIVE:</strong> The study aimed to determine the association of polycystic ovary syndrome with immune reproductive disorder.</p><p style="text-align: justify;"><strong>MATERIALS AND METHODS:</strong> The study was carried out in a private institution from October 2017 to November 2017. A total of 192 patients were included in the study with ages ranging from 19-40 years old. Review of clinical charts and laboratory results were the primary mode of data gathering. The primary outcome of the study was the presence of immune reproductive disorders among women with and without polycystic ovary syndrome. The Rotterdam criteria were used for the diagnosis of polycystic ovary syndrome and positive results of immunoassays for the five categories were used for the basis for diagnosis of the immune reproductive disorder.</p><p style="text-align: justify;"><strong>RESULTS:</strong> A total of 102 patients were included in the first group and 90 were included in the second group. Out of 102 in Group A, 66 (64.71%) tested positive for immune reproductive disorder. On the other hand, out of 90 patients in Group B, 59 (65.56%) tested positive for immune reproductive disorder. The computed relative risk is almost 1, which means that there is no difference in the risk of having immune reproductive disorder for patients with or without polycystic ovary syndrome.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> Current evidence does not support a central role of autoimmunity in the pathogenesis of PCOS.</p>

The prevalence of polyocystic ovary syndrome in nurses of reproductive age / 中华内分泌代谢杂志

Objective To explore the prevalence of polycystic ovary syndrome (PCOS) in nurse of reproductive age and compare the characteristics of four phenotypic subgroups.Methods A cross-sectional survey was carried out in nurses aged 18-45 years in Renji Hospital in 2011.Questionnaire and anthropometric and biochemical assessments were made.Pelvic ultrasound evaluations were made and blood androgen levels were determined.Diagnosis of PCOS was based on Rotterdam 2003 criteria,consisting of anovulation/oligo-ovulation (ANOVU),clinical and/or biochemical hyperandrogenism (HA) and polycystic ovaries (PCO).Results There were 520 participants and finally 486 individuals finished questionnaire and androgen level determination.283 subjects were totally normal,48 suffered from PCO,129 HA,and 89 ANOVU.54 out of 486 women were diagnosed as PCOS,a prevalence of 11.1％.A significant difference exited only in age among four phenotypic subgroups (P＜0.05).There was no statistic difference in other parameters.Conclusion Establishing an explicit definition of each condition in PCOS criteria has important investigational implications and increase the comparability of published researches.Application of Rotterdam criteria is feasible for earlier diagnosis and timely intervention in order to prevent serious complications.