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Case Study

Ovarian Cyst Presented as Premenstrual Tension
Dr Bansal V P

35 yrs old lady came with the following complaints:

·         Headache before menses

·         Hot flushes before menses

·         Heaviness in the breast before menses

·         Increase in weight before menses

·         Insomnia before menses

·         Irritability before menses

·         No desire to work before menses

·         Unable to take decisions before menses

·         Heaviness in pelvis

·         Pain in lower abdomen during menses

·         Sensation of swelling in pelvis

·         Swelling on right side of face and abdomen at night

·         Heaviness in abdomen after eating any food

·         Constipation

·         Scanty menses: for 2 days only

·         Palpitation on exertion

Her desire and aversion were very peculiar. She likes milk daily but craves alcohol before menses. She was thirstless with scanty urine.

There was tenderness in pelvic region. Perspiration mainly before menses. Her pulse, blood pressure and respiratory rate were on higher side of normal.

She takes cold bath even in winter. She quarrels with her husband as she wants fan with open widows even in winter.

Husband disclosed that she was very talkative and was very jealous of her sister-in-law and of a suspicious nature.

Past history :
In childhood she had Grand Mal Epilepsy which manifested during sleep only. She was treated by Gardinal. After marriage she used to get nocturnal asthmatic attacks, which disappeared after last pregnancy.

Family history :
Mother was a patient of Pulmonary Tuberculosis. Father was a diabetic.

After Repertorisation main remedies were Lachesis, Apis, Carbo-veg, Merc-sol etc.

Looking at modalities of most of the PMS symptoms, aggravation before menses with loquacity and jealousy, Lachesis 1M one dose was prescribed on 5th day of menses.

In the subsequent cycle, patient felt better both in general as well as mental symptoms. After each cycle, on the 5th day, Lachesis was repeated with increasing potency. At the end of 6 months most of symptoms of Pre menstrual aggravation disappeared but few symptoms became more prominent. She started complaining of severe pain and tenderness on Rt. side of pelvis. Appendicitis was suspected but ultra sonography revealed a cyst in right ovary about 5 cms in diameter.

Taking into account thirstlessness, scanty menses, agg warm, Jealousy with right ovarian cyst, Apis 10M one dose was prescribed on 5th day of menstrual cycle.

After 15 days she developed Leucorrhoea and within 2 months she became symptom-free. Sonography revealed decrease in size of the ovarian cyst [2 cms] Patient was treated with increasing potency of Apis with intercurrent Medorrhinum in 10M potency for about 6 months and ultimately cyst disappeared.

Conclusion :
This simple looking case of Pre menstrual tension turned out to have an ovarian cyst, diagnosed by ultra sonography, therefore I refer each and every case of premenstrual tension for sonography.