AYUSHDHARA ISSN: 2393-9583 (P)/ 2393-9591 (O)

An International Journal of Research in AYUSH and Allied Systems

Case Study

HOMOEOPATHIC MANAGEMENT OF OVARIAN CYST – A CASE REPORT

Arunava Nath1*, Deb Kumar Palit2, Nivedita Kundu3
*1Assistant Professor, Dept. of Forensic Medicine & Toxicology, 2Assistant Professor, Dept. of Community
Medicine, 3Assistant Professor, Dept. of Organon of Medicine & Homoeopathic Philosophy, Pratap Chandra
Memorial Homoeopathic Hospital & College, Kolkata, West Bengal, India.

KEYWORDS: Ovarian cyst, ABSTRACT

CA-125, totality of symptoms, Ovarian enlargements, cystic or solid, may occur at any age. Functional
Lycopodium clavatum. and inflammatory enlargements of the ovary develop almost exclusively
during the childbearing years. They may be asymptomatic or produce
local discomfort, menstrual disturbances, infertility, or in rare cases
cause acute symptoms due to complications like haemorrhage, rupture or
torsion. A case on dysmenorrhoea along with right ovarian cyst
measuring about 52x45 mm has been presented which was treated with
*Address for correspondence constitutional homoeopathic medicine Lycopodium clavatum. Literature
Dr Arunava Nath, review suggested spontaneous regression of cysts within 3 months with
64A, Christopher Road, P.O. oral combined pills but in the presented case the subject had been
Gobinda Khatick Road, P.S. suffering for last one year and was under hormonal treatment with no
Topsia, Taruvilla Apartment, 1st favourable results. In the case of simple cysts more than 5 cm in diameter
Floor, Kolkata, West Bengal,
and complex cysts, surgical removal of the mass is most often
India. Pin – 700 046
Email: recommended in an attempt to preserve viable ovarian tissue. With
[email protected] homoeopathic approach the treatment lasted for nearly one year with
Mob No. +91 9339444585 gradual reduction in pain intensity and sonographically no detectable
abnormality was noted after treatment.

INTRODUCTION
The ovaries are anatomically paired syndrome, endometrial cysts (chocolate cysts).
primary sex organs of human female. Anatomically Except the last one, all are functional cysts of the
they are located in the posterior leaf of the broad ovary and loosely called cystic ovary.[3] Dermoid
ligament in close proximity to the fallopian tubes on cysts are classified under germ cell tumours and
either sides of the uterus.[1,2] The ovary is complex comprise of 5-10% of all cystic tumours of ovary.[4]
in its embryology, histology, steroidogenesis, and Hemorrhagic ovarian cyst (HOC) is an adnexal mass
has the potential to develop malignancy. Ovarian formed because of occurrence of bleeding into a
enlargement is classified under non neoplastic and follicular or corpus luteum cyst.[5] Paraovarian cysts
neoplastic growths. Ovarian neoplasms exhibit a represent 5-20% of all adnexal masses in
wide variation in structure and biological pathologically verified series. Histopathologically,
behaviour. Unlike the cervix and uterus, the ovaries they are classified into one of three categories:
are not clinically accessible, and therefore, easy paramesonephric, mesonephric, or mesothelial.
screening methods for detecting ovarian neoplasms These are often misdiagnosed as ovarian cyst and
are not available. The ovary, after the uterus, is the need accuracy for correct diagnosis.[6] The
second most common site for development of development of functional cyst depends on
gynaecological malignancy, and the prognosis ahormonally stimulated ovary, the incidence should
remains poor.[3,4] The non neoplastic enlargement of be higher in menstruating patients, when the
the ovary is usually due to accumulation of fluid pituitary-gonadal axis is cyclically functioning, and
inside the functional unit of the ovary. The causes lower in postmenopausal women. Regardless of the
include follicular cysts, corpus luteum cysts, theca patient’s age and the ultrasonographic features of
lutein and granulose lutein cysts, polycystic ovarian the cystic contents, the size of the cyst and the rate

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 AYUSHDHARA, 2019;6(5):2393-2399
of regression are directly correlated. The frequency Family history: Father died of cerebrovascular
of spontaneous regression is 82.6% for cysts 4cm or accident two years ago. Mother alive, suffering from
smaller; 63.4% for cysts 4 to 6cm; and 28.6% for (?) osteoarthritis. Elder sister was suffering from
cysts 6 to 8cm. The period of complete regression primary infertility with polycystic ovarian
can be as long as 3 months for cysts that are 6 to syndrome.
8cm.[7] Personal history: Patient was a school teacher and
The patients with ovarian cysts generally was married for one year, had no issues. She lived in
manifest some typical symptoms like-feeling of a well-ventilated house. Her diet was regular and
congestion in the abdomen with right- or left-sided she was a non-vegetarian.
soreness in the inguinal region; have a feeling of Physical generals
stinging, burning and sore sensation. Along with Appetite: very good+++
these, sometimes, they report complaint of Thirst: profuse+++
tightness of the chest with an urge to urinate, Desire: for sweets+++, warm foods++, meat+
occasionally with burning sensation in urine, Aversion: Sour, pungent
bearing down sensation as if menses were to Sweat: profuse+++, stains white, offensive++
appear, sensitive and tenderness over abdomen. Stool: constipated during menses
Patients experience amelioration of these Urine: clear
symptoms by cold water application and warmth Thermal reaction: Hot patient++
often aggravates.[8] Women carrying homozygous Menstrual history
inactivating LHCGR mutations have hyper- Menarche: At the age of 13 years.
gonadotropic hypogonadism with primary LMP: 13.07.2016
amenorrhea or oligomenorrhea, cystic ovaries, and Cycle: Menses used to last for 3-4 days, clotted,
infertility.[9] Mutations in the FSHR gene are extremely painful and usually delayed by 7-8days.
associated with ovarian hyper stimulation Other associated features: Leucorrhoea appeared
syndrome that includes the presence of multiple only before menses.
serous and hemorrhagic follicular cysts.[10]
Mental symptoms: She had a calm and quiet
Transvaginal ultrasonography (TVS) is the most
disposition. She was an intellectual person
commonly employed imaging modality for the
(teaching profession). She loved company.
assessment a gap between: of adnexal masses. The
risk of malignancy index (RMI) combines General survey: The patient was mentally alert,
ultrasound features, serum CA125 levels and the conscious, without any features of anaemia,
menopausal status of the patient and is used to cyanosis, jaundice or clubbing. Blood Pressure:
characterize ovarian pathology.[11] 122/80 mm of Hg, pulse: 70/min, weight: 58 kg.
Case Report Respiratory rate: 16/ min.
Patient information: A married lady aged 27 years Temperature: afebrile
visited the outpatient department of National Physical examination: Tenderness in right iliac
Institute of Homoeopathy, Kolkata on 20th June, fossa on superficial palpation. On deep palpation a
2016 with the complaints of pre-diagnosed features round lump can be felt in the right iliac fossa.
of ovarian cyst. Rovsing sign negative.
Presenting complaint: Patient presented with pain Laboratory investigation: Ultrasonography (USG)
in right side of lower abdomen since one year which of lower abdomen done on 09.06.2016, impression:
aggravated before and during menstruation, and right ovarian cyst measuring about 52x45 mm.
was relieved by rest and warm application. Diagnosis: International Classification of Diseases
History of present complaint: The onset of the classify ovarian cyst under 2020 ICD-10-CM
symptoms was insidious. There was heaviness and Diagnosis Code N83.201-Unspecified ovarian cyst,
uneasiness in the lower abdomen during each right side.[12]
menstrual nisus. The intensity of pain was gradually Analysis and evaluation
increasing and she had been taking hormonal 1. She was an intellectual person
supplements since 6 months without any relief. 2. Calm and quiet disposition
When she came for the homoeopathic treatment, it 3. She loved company
was unbearable. 4. Hot thermal reaction
Past history: Patient suffered twice from jaundice 5. Desire for sweets and warm food
in childhood. (? Hepatitis A or E) 6. Pain in right side of lower abdomen before and
during menses

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 Arunava Nath et al. Homoeopathic Management of Ovarian Cyst
7. Pain in right side of abdomen repertorization software [RADAR®, version
8. Constipation during menses 10.0.028 (ck), Archibel 2007, Belgium] taking
9. Profuse and offensive perspiration Repertorium Homeopathicum Syntheticum (Edition
10. Right sided ovarian cyst 9.1) as the case presented with characteristic
Case analysis mental picture and prominent physical symptoms.
The case had characteristic mental and Remedial analysis
physical generals. Based on this individualised Lycopodium clavatum (26/12), Sulphur
clinical picture, totality of symptoms was framed (23/11), Phosphorus (21/11), Silicea terra (20/11)
and the individualized homoeopathic medicine and Sepia officinalis (23/10), were the medicines in
Lycopodium clavatum 30c was prescribed based on the top gradation. Lycopodium clavatum covered the
the susceptibility of the patient.[13] For analysis and maximum number of symptoms, i.e. 12 out of 13
evaluation of the case Kent’s philosophy was symptoms with the highest gradation.
consulted. Repertorization was done with
Table 1: Repertorial sheet

The analysis contains 679

remedies and 13 symptoms

Remedy selection and administration/ Prescription: Lycopodium clavatum 30c, one dose in saccharum
lactis (sac. lac.) for one day, followed by Rubrum once daily for one month.
Advice: To maintain local hygiene; avoidance of meat, dairy products; increase intake of fibre rich food;
blood for serum CA 125.
Follow up:
Table 2: Follow up sheet
Date Change in symptomatology Prescriptions
Pain abdomen reduced by nearly 50%, during menses stool
remained constipated. Last menstrual period (LMP) on
Rubrum once daily for one
18.08.2016.
31.08.2016 month.
O/E: tenderness over right lower abdomen on deep
Advice: serum CA 125
palpation but not on superficial palpation, though lump can
be felt. Generals nothing striking.
Lycopodium clavatum 200c,
Pain abdomen same as earlier cycle, stool constipated. Last
one dose in sac. lac. once daily
menstrual period (LMP) on 22.09.2016.
28.09.2016 for one day, followed by
O/E: tenderness over right lower abdomen remains. Lump
Rubrum once daily for one
over right lower abdomen palpable.
month.
Pain abdomen reduced by nearly 80%. Bowel movement Rubrum once daily for one
02.11.2016 regular during last menstrual cycle. Last menstrual period month.
(LMP) on 26.10.2016.

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 AYUSHDHARA, 2019;6(5):2393-2399
O/E: tenderness over right lower abdomen reduced by
nearly 70%. Lump over right lower abdomen was difficult
to elicit.
Patient was better, so did not visit in the last month. Pain
Rubrum once daily for one
abdomen was absent. Menstrual cycles for two consecutive
18.01.2017 month.
months were on 30.11.2016 and 05.01.2017 respectively.
O/E: lump over right lower abdomen not felt.
Lycopodiumclavatum1M, one
Pain abdomen slightly aggravated during last menses. Stool dose in sac. lac. once daily for
01.03.2017 consistency hard. LMP on 09.02.2017. O/E: lump over right one day, followed by Rubrum
lower abdomen was not felt. once daily for one month.
Advice: serum CA 125
Pain abdomen almost absent. Bowel habits become regular. Rubrum once daily for one
19.04.2017 LMP on 10.03.2017 and 12.04.2017 respectively. O/E: No month.
tenderness over right lower abdomen. Advice: USG of lower abdomen.
Overall better, menses were regular, stool regular. No pain Rubrum once daily for one
07.06.2017
or tenderness. LMP on 13.05.2017 month.
Rubrum once daily for one
Overall better. LMP on 13.06.2017 and 14.07.2017
19.07.2017 month.
respectively.
Advice: USG of lower abdomen.
Overall better. USG of lower abdomen done on 25.07.2017 To continue with Rubrum once
02.08.2017
suggests no detectable abnormality. daily for one month.
DISCUSSION
The case presented here was selected on the inflammatory conditions.[17] Dr S K Banerjea has
basis of totality of symptoms in consultation with classified ovarian tumours and polycystic
Repertorium Homeopathicum Syntheticum and conditions under sycotic miasm.[18] Homoeopathic
Lotus Materia Medica and was treated with repertories were consulted and following
individualized homoeopathic medicine Lycopodium repertorial rubrics were obtained:
clavatum in different potencies. The general Female Genitalia/Sex - Tumors - Ovaries – cysts
wellbeing of the patient was improved and pre-post Apis.arg-met.Aur-m-n.bell.Bov.brom.Bufo.canth.carb-
treatment result was sonographically favourable. an.carc.Coloc.foll.Iod.kali-bi.Kali-
The patient said she would do blood for CA 125 as br.Lach.lyc.merc.murx.naja.ov.
per financial availability but could not manage. Pall.Phos.Plat.podo.prun.rhod.Rhus-t.syc.syph.thuj.[19]
The simple, multiple and proliferous cysts Female - CYSTS, genitalia - cysts, ovarian
constitute in a very large majority of instances the APIS. apoc. arn. ars. aur. Aur-i. aur-m-n. bell. Bov. bry.
disease known as ovarian dropsy and for which Bufo canth. carb-an. chin. Colch. Coloc. con. ferr-i.
operative measures are chiefly demanded.[14] Dr form. graph. Iod. Kali-br. kali-fcy. Lach. lil-t. Lyc. med.
Samuel Hahnemann in §80 of Organon of Medicine merc. murx. Ov. Plat. prun. rhod. Rhus-t. sabin. sep.
has mentioned dropsy as secondary manifestation syc. syph. ter. THUJ. zinc.[20]
of Psora.[15] Dr Guernsey extended the favourable Homoeopathy is based on individualization
prognosis to all kinds of ovarian enlargements. He where totality of symptoms can determine the most
had further said that all such growths are of appropriate remedy. It is indeed the only thing the
dynamic origin and that the pertinent use of a physician has to take note of in every case of
remedy homoeopathic to the particular case in disease and to remove by means of his art.[15]
question will certainly contract the diseased Therapeutically few medicines which are indicative
condition. [16] In the secondary stage of Sycosis the in ovarian cysts include:
most frequently met sycotic inflammations are to be
Apis mellifica
found in the pelvic diseases of women. Cystic
degeneration of the ovaries, cervix and uterus are Ovary enlarged, swollen and indurated; ovarian
some of the more severe changes due to these tumors; cysto-ovarium size of head; ovarian dropsy

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 Arunava Nath et al. Homoeopathic Management of Ovarian Cyst
with an unusually white and transparent skin, pains Medical Journal for 1868, in which, after a single
aggravation from touch and heat amelioration by tapping, the continuous use of the Potassium
lying on right side; ovarian dropsy and anasarca. [21] bromide, in doses of five, ten, and fifteen grains,
Bovista lycoperdon effected a complete cure.[23] A study conducted by
Ovarian cyst; soreness between labia and thighs; Bukhsh et al. on large sized ovarian cysts in three
every few days a show between menses; after patients all having guiding symptoms of Thuja
midnight painful urging towards genitals, with great occidentalis were cured by the use of different
heaviness in small of back, amelioration next potencies of the single remedy. The study
morning by a bloody discharge.[21] concluded that proper selection of the homeopathic
remedy matching the totality of symptoms can
Cantharis vesicatoria
remove cysts from the ovary without any surgical
Cysto-ovarium; much tenderness and burning in intervention although some allopathic drugs are
ovarian region; dysuria, cutting burning in passing also used to ameliorate symptoms.[24] Another study
only a drop or two, which is often bloody, or by Das et al. indicated that proper selection of the
strangury complete; stitches in ovarian region, homeopathic remedy matching the totality of
arresting breathing, or violent pinching pain, with symptoms and in consultation with the Kent’s
bearing down towards genitals; sterility.[21] rubric can remove cysts from the ovary without any
Colocynthis surgical intervention and this can serve as an
Ovarian cysts with pain in abdomen upon alternative option, at least in patients where
straightening up; walks bent with hands pressed surgery also has some risk or undesirable.[8] A
upon painful side.[21] single-blind, randomised, placebo-controlled pilot
Iodium study in polycystic ovary syndrome conducted by
Chronic congestion, usually with leucorrhoea; Central Council for Research in Homeopathy, New
ovarian cysts and dropsy, with great bearing-down Delhi, showed homoeopathic medicine Pulsatilla as
pain, induration and enlargement; induration and the most frequently indicated medicine in such
swelling.[21] condition. Homoeopathic intervention (HI) along
Kalium bromatum with life style modification (LSM) had shown
promising outcome in managing polycystic ovarian
Neuralgia of ovaries; pain, swelling, tenderness of
syndrome and improvement in quality of life (QOL);
left ovary; diminution of sexual desire; ovarian
thus homoeopathic intervention alleviated not only
tumors.[21]
the disease per se but also the patient as a whole.[25]
Lycopodium clavatum A case study by Rath P. also suggested
Delayed menses with undeveloped breasts at homoeopathy can take care of chronic hormonal
puberty. Dysmenorrhoea violent with fainting. syndrome in an individual, where allopathic
Pains in right ovary, from right to left. Ovarian hormone-related treatment or surgery is otherwise
tumours. Ovarian dropsy.[22] advised. Non-recurrence of complaint in the past 3
Thuja occidentalis years suggested that PCOS could be treated
Inflammation, with pain in the left ovary, extending successfully through individualised homoeopathic
through the left iliac region into the groin and medicine with lifestyle management.[26] Dr J C
sometimes into the left leg, frequently worse from Burnett forbade salt, milk and pepper in cases of
walking or riding, so that she has to lie down mammary tumours from ovarian and uterine
(during menses); burning pain in the ovary; ovarian irritation and recommended a partial exclusion of
affections and pains are worse during menses; meat from patient’s dietary regime.[27] Dr. Samuel
affections connected with gonorrhoea or syphilis. Lilienthal advised a strict milk and fruit diet which
Cysto-ovarium. [21] ought to be observed in treating ovarian
Dr. Percy Wilde has recorded two well-marked tumours.[20] A retrospective case-control study
cases of unilocular ovarian cyst, both of which were indicated a positive relationship between the high
rapidly cured by Apis 3x. In one four years, in the levels of dietary protein and the functional ovarian
other two, had elapsed since the recovery, and in cysts. Giving the direct relationship between
neither had there been any re-filling of the cyst. Dr. protein consumption and the functional ovarian
Hallock reports a case in which what seemed a cysts, the decrease in the protein intake may
fibrocystic ovarian growth, consequent on a kick in prevent the occurrence of the functional ovarian
the region, disappeared under Apis 3, though an cysts.[28] Another case-control study suggested
operation had been recommended. [16] Another case dietary fats might affect the ovarian function. Meat
of ovarian cyst was recorded in the Edinburgh and dietary production contain saturated fat that

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 AYUSHDHARA, 2019;6(5):2393-2399
was probably associated with functional ovarian 9. Latronico AC, Anasti J, Arnhold IJP, Rapaport R,
cysts concluded the study.[29] Mendonca BB, et al. Testicular and ovarian
CONCLUSION resistance to luteinizing hormone caused by
Individualized homoeopathy showed inactivating mutations of the luteinizing
favourable results in the management of ovarian hormone receptor gene. New Engl J Med 1994;
cysts. Several other studies also corroborated the 334: 507–12.
same. However multi centric randomized controlled 10. Smits G, Olatunbosun O, Delbaere A, Pierson R,
trials with adequate sample size would further Vassart G, et al. Ovarian hyperstimulation
elucidate on the effectiveness of homoeopathic syndrome due to a mutation in the follicle-
treatment in such conditions. Proper dietary stimulating hormone receptor. New Eng J Med
advices and maintenance of healthy life style should 2003; 349: 760–66.
be advocated to get optimal results. 11. Sayasneh A et al. The characteristic ultrasound
features of specific types of ovarian pathology
ACKNOWLEDGEMENT
(Review). Int J Oncol 2015; 46: 445-58.
The authors acknowledge the Director, 12. ICD-10 code N83.201 for Unspecified ovarian
National Institute of Homoeopathy; departmental cyst, right side is a medical classification as
heads of Organon of Medicine and Practice of listed by WHO under the range - Diseases of the
Medicine, National Institute of Homoeopathy; the genitourinary system.[cited 20 November 2019]
patient’s consent was taken, without which the case Available from URL : https://coder.aapc. com/
study could not have been done. icd-10-codes/N83.201
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Cite this article as:

Arunava Nath, Deb Kumar Palit, Nivedita Kundu. Homoeopathic Management of Ovarian Cyst – A
Case Report. AYUSHDHARA, 2019;6(5): 2393-2399.
Source of support: Nil, Conflict of interest: None Declared

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