Endometriotic cyst and fibrocystic disease of the breast treated with individualised homoeopathy – A case report

Abstract

Abstract Introduction: Endometriosis is one of the benign gynaecological disorders in childbearing women, characterised by the presence of functioning endometrial tissue outside the uterine mucosa. Fibrocystic disease of the breast is the most common and benign lesion among women of reproductive age group seeking medical advice for breast problems during a lifetime. It is characterised by hyperproliferation of connective tissue or fibrosis, which is followed by facultative epithelial proliferation in the breast tissues. Case Summary: A case of a left endometriotic ovarian cyst with multiple cystic lesions in the right breast in a 36-year-old patient successfully treated with individualised homoeopathic medicine is reported. She had severe cyclic lower abdominal pain for more than 7 years, and conventional analgesics and even surgical procedures could not afford relief. Homoeopathic treatment was started with Silicea based on the totality of symptoms and repertorisation and later switched to Conium maculatum as an anti-miasmatic remedy, which showed disappearance of the left endometriotic cyst and reduction in the size of cystic lesion in the right breast with general improvement. The Modified Naranjo Criteria were used to assess causal attribution to the prescribed medicine in this case. Assessment of pain was done using a visual analogue scale. This evidence-based case reported according to the HOM-CASE guidelines suggested that individualised homoeopathic medicines can be used as a useful, safe and non-invasive mode of treatment for ovarian endometriotic cyst, associated with fibrocystic disease of the breast. Abstract Endometriosis is an estrogen-dependent chronic inflammatory condition of women seen in the reproductive period, identified by the presence of endometrial glandular epithelium and stroma outside the uterine cavity. [1] The risk of endometriosis seems to increase in women aged 25–35 years. [2] It affects 20% of infertile women and 15% of women with chronic pelvic pain. [3] Ultrasonograph y is a readily available, user-dependent and inexpensive tool for the diagnosis of endometriotic lesions. [4] Management depends on location, size and extent of the lesion, age of the patient, desire for fertility and results of previous therapy. Conventional therapy comprises medical, surgical and a combination of both depending on the severity and response of medical treatment. [5] Symptoms of endometriosis are alleviated in the conventional medicine system by hormonal medications and gonadotropin-releasing hormone agonists or antagonists, whereas surgical treatment mostly amounts to laparoscopy, be it diagnostic or therapeutic. Ovarian reserve, follicular density and fecundity rate may be affected by surgical excision of the cyst. Moreover, various research works suggest that the efficacy of the surgical intervention is controversial. [6] For endometriomas, more than 4 cm size laparoscopic cystectomy is recommended. Recurrence of the cyst is possible following invasive surgery. A few published articles report the effectiveness of homoeopathic medicines in the treatment of endometriotic cyst. [7-9] irregular and and Introduction: tissue outside the uterine mucosa. Fibrocystic disease of the breast is the most common and benign lesion among women of reproductive age group seeking medical advice for breast problems during a lifetime. It is characterised by hyperproliferation of connective tissue or fibrosis, which is followed by facultative epithelial proliferation in the breast tissues. Case Summary: A case of a left endometriotic ovarian cyst with multiple cystic lesions in the right breast in a 36-year-old patient successfully treated with individualised homoeopathic medicine is reported. She had severe cyclic lower abdominal pain for more than 7 years, and conventional analgesics and even surgical procedures could not afford relief. Homoeopathic treatment was started with Silicea based on the totality of symptoms and repertorisation and later switched to Conium maculatum as an anti-miasmatic remedy, which showed disappearance of the left endometriotic cyst and reduction in the size of cystic lesion in the right breast with general improvement. The Modified Naranjo Criteria were used to assess causal attribution to the prescribed medicine in this case. Assessment of pain was done using a visual analogue scale. This evidence-based case reported according to the HOM-CASE guidelines suggested that individualised homoeopathic medicines can be used as a useful, safe and non-invasive mode of treatment for ovarian endometriotic cyst, associated with fibrocystic disease of the breast. Sie hatte mehr als sieben Jahre lang starke zyklische Schmerzen im Unterbauch, und herkömmliche Analgetika und selbst chirurgische Eingriffe konnten keine Linderung bringen. Die homöopathische Behandlung wurde mit Silicea auf der Grundlage der Gesamtheit der Symptome und der Repertorisierung begonnen und später auf Conium maculatum als antimiasmatisches Mittel umgestellt, das ein Verschwinden der linken endometriotischen Zyste und eine Verringerung der Größe der zystischen Läsion in der rechten Brust mit allgemeiner Besserung zeigte . Die modifizierten Naranjo-Kriterien wurden verwendet, um in diesem Fall die kausale Zuordnung zum verschriebenen Medikament zu beurteilen. Die Schmerzbeurteilung erfolgte mit einer visuellen Analogskala (VAS). Dieser evidenzbasierte Fall, der gemäß den HOM-CASE-Richtlinien berichtet wurde, legte nahe, dass individualisierte homöopathische Arzneimittel als nützliche, sichere und nicht-invasive Behandlungsmethode für endometriotische Ovarialzysten in Verbindung mit fibrozystischer Erkrankung der Brust verwendet werden können.