Polycystic ovarian syndrome: Ayurvedic Treatment, Remedies, Diet

Polycystic ovarian syndrome, also known as Polycystic ovarian disease or PCOD is a very
common female health complaint. The word Syndrome is used to describe the PCOD
because, it is a complex manifestation involving many factors and organs such as
obesity, insulin resistance, irregular menstrual bleeding (in most cases, excessive menstrual
bleeding), abnormal menstrual periods & cycle, lack of ovum production (anovulation) etc.

PCOS is a common female endocrine disorder affecting approximately 5- 12% of women.It

causes worry as it is commonly found in reproductive age ; also it is thought to be one of the
leading cause of female infertility.

Organs involved in Polycystic Ovary disease

1. Ovary the female gonad organ, present at the either sides of the uterus.
2. adrenal glands The glands which are placed just above the both the kidneys.
3. Pancreas Gland that produces insulin in our body.
4. Pituitary gland the gland just below the brain, which is responsible for all the hormonal
control.
What happens in PCOD?
There is increased production of Androgen (a hormone) by the ovaries, which suppresses
the maturation of ovarian follicles (ovarian follicles lead to ovum). So, ovum does not get
properly formed and released (anouvlation). Remember that ovum meets with the sperm
during intercourse leading to conception. So, in a case of PCOD, the lady usually will be
having problem with conception.
How frequent is the problem of PCOD?
The incidence varies between 0.5 4 per cent, more common amongst infertile women. It is
prevalent in young reproductive period.

what happens inside the body?

Typically, the ovaries are enlarged two to five times the normal size (PCOS Ovarian cysts).
Stroma is increased. The capsule is thickened and pearly white in color. Ovary which is
normally oval in shape, will have many cysts within it.

Hystologically there is thickening of tunica albugenia. The cysts are follicles at varying
stages of maturation and atresia. There is theca cell hypertrophy (stromal hyperthecosis).
Patient may present with features of diabetes mellitus (insulin resistance).

Careful survey concludes that the biggest lifestyle contributor to PCOS is poor diet. Young
women with PCOS tend to eat far too much sugar or carbonized drinks and highly refined
carbohydrates which causes unhealthy raise in insulin levels. According to world fame
Jerilyn Prior, insulin stimulates androgen receptors outside of ovary, causing typical PCOS
symptoms which also play a role in blocking release of ovum from follicle. This type of diet
will cause obesity and thus aggravating PCOS.

Also, in stressful women, as they eat more food that are high in fat, sugar and carbohydrate
in response to stress, the more fat they store, thus, contributing in the development of
obesity- linked PCOS.Thus we can deduce that the modern stressful lifestyle and food-
habits are linked and contribute or accelerate many diseases, PCOS being one among
them.

The signs and symptoms

Clinically PCOS often manifest itself at menarche with some form of menstrual irregularity,
but not essentially.The principle signs and symptoms of PCOS are related to menstrual
disturbance and elevated levels of male hormones (androgens).

Also patient approach the physicians with the features like menstrual irregularities,
androgenic features such as hirsutism, acne, alopecia etc ,obesity and infertility caused by
improper ovulation etc.

Patient complains of increasing obesity, menstrual abnormalities in the form of less

menstrual bleeding, absence of menstruation, or abnormally high and irregular bleeding and
infertility. There may be abnormal growth of hair at different places of the body. The patient
may not always be obese.

In some patients, due to insulin resistance, a dark coloured band like skin lesion may be
developed at the back of the neck, inner thighs and axilla, called as Acanthosis nigricans.

Internal examination reveals bilateral enlarged cystic ovaries which however may not be
revealed due to obesity.

Diagnosis: laboratory investigations:

The assessment and based diagnosis of PCOS is mainly based upon clinical presentation
together with
USG Ultra Sonography findings and hormonal profile appropriate to mode of presentation.

OVERALL VIEW OF PCOD

1. Hypothalamic pituitary compartment abnormality:

Stimulation of GnRH leads to increased LH. (leutinizing Harmone). Leading to increased

secretion of LH and decrease of FSH (Follicle stimulating Hormone) This way, Hormonal
imbalance is triggered in PCOD.
2. Androgen excess in some patients the excessive production of Androgen by ovaries
and adrenal glands. Excessive androgen production is partially influenced by excessive LH.
Increased insulin levels also results in androgen excess.

3. Anovulation (absence of ovum production)

Because of low levels of Follicle stimulating hormone, follicle growth inside the ovary is
arrested leading to absence of ovum production (anovulation ) further leading to infertility.

4. Relationship between obesity, insulin production and PCOD

Obesity is recognized as an important contributory factor. It also induces insulin resistance
and increased levels of insulin in blood, which in turn increases the androgen production.

Insulin resistance means that the body cells will not respond to the effect of insulin. So,
though the body is trying to compensate by producing more and more insulin, leading to high
levels of insulin, but thus produced insulin will be inefficient to metabolize the glucose in the
body. So, the body becomes resistant to insulin, means the body will not respond to insulin.

Long term consequences in a patient suffering from PCOD

Excess androgens (predominantly androstenedione) leads to thickening (hyperplasia) of the
inner layer of the uterus (endometrium).
Risk of developing diabetes mellitus due to insulin resistance.
Risk of hypertension and abnormally high lipid profile.

Treatment
treatment of PCOD needs individualistic approach because, not all the symptoms might be
seen in all the patients.
It depends on the presenting symptoms, like menstrual abnormalities, infertility, obesity,
hirsutism or combined symptoms.

Biochemical abnormalities to be corrected

Hyper- androgenism,
Hyper secretion of LH (correction of hormonal balance), .
High levels of insulin &
Low Follicle stimulating hormone (again related to hormone imbalance management.)
Weight reduction in obese patients is the first line of treatment. Body mass index (BMI)< 25
improves the menstrual abnormalities, hirsutism and infertility.

Ayurvedic herbal remedy for PCOD

Ayurvedic treatment is by applying a multi-pronged approach towards
correcting the hormonal imbalance,
treatment to obesity and avoiding high cholesterol levels,
treatment to insulin resistance.

1. Correcting hormonal imbalance:

there are many herbs useful in correcting the hormonal imbalance. Ashoka (saraca asoca),
Dashamoola (a group of ten herbal roots) a group of herbs useful in preparation of
Sukumara Kashaya like Ashwagandha, Eranda, Shatavari etc. are useful in correcting the
hormonal imbalance.

2. Treatment to obesity:
Treatment to obesity and specifically against cholesterol can be achieved by using Ayurvedic
herbal remedy plus diet and lifestyle changes.

3. Treatment insulin resistance:

Treatment for insulin resistance involves a time-consuming approach with effective
Ayurvedic treatment and diet and lifestyle changes including exercise.
Note:
The PCOD or PCOS is a common complaint in women, which can be effectively managed
using Ayurvedic herbal remedies and herbal medicines.
A multi pronged approach taking care of different organs and glands is necessary.
Not all the symptoms are manifested in all the cases of PCOD. but irregular periods is seen
in common in many.

Ayurvedic explanation:
In Ayurveda this condition is not explained as a single disease entity; but it can be
considered under the heading of Yoni Vyapat(utero vaginal disorders). Also, Pushpaghni
Rewati ,mentioned by Acharya Kashyapa bears some similarity with the symptoms of PCOS.

Ayurvedic perspective of PCOS:

In Ayurveda, the balance state of doshas is mainly responsible for health and any
derangement to this will lead to disease.
This dosha-vaishamya is directly connected to symptoms and the relation
between doshas and lakshanas are permanent.
By the outlook of the symptoms of PCOS as per modern description, it becomes clear that
even though they are not compiled as a syndrome in Ayurveda most of them have been
described as features of separate diseases or conditions.

The symptoms commonly found in these conditions can be summarized as below-

1. Menstrual irregularities have been described under artava

vyapadsor Yonirogas(uterine disorders).
2. Anovulation is included under Vandhya(infertility).
3. Obesity is the condition described as Sthoulya, a santanpanajanya vikara.
4. Acne and Baldness have been described as Mukhadooshika and Khalitya,
two independent pathogenesis.
5. Hyperinsulinemia leads to type 2 Diabetes mellitus, and is described under prameha.
It is also manifested as a complication of sthoulya.
6. Since menstrual irregularities including anovulation and obesity are the commonly
seen symptoms these two has to be taken care with due attention.

Pathology or origin of diseased condition:

When the deranged vata etc. vitiates the mamsa, shonita and meda mixed up
with Kapha; thus they produce circular, raised and knotted inflammatory swelling called
Granthi. This type of glandular swelling has been compared with the modern terminology
cyst which means an abnormal closed epithelium- lined cavity in the body, containing liquid
or semisolid material.

In PCOS, development of follicles has been arrested at one or any level and remained as it
is. The cysts are follicles at varying stages of maturation and atresia. So, these cysts are not
destined to ovum. Thus, this pathology is compared with granthibhuta artava dushti i.e. cyst,
as in PCOS, the follicles becomes cysts instead of developing up to mature ovum.

Line of treatment of PCOS:

As PCOS is primarily concerned with Rajah and Stri beeja formation and to some
extent medodhatu much attention should be given to these while treating the conditions.

Treatment modalities mainly aim at providing comprehensive care by correcting the ama
dosha, achieving koshta shuddhi and regularizing tridoshas.
The management approach to PCOS should concentrate on:

1. Treating agnimandya at jataragni and dhatwagni level (Deepana-carminatives and

Pachana-digestives)
2. Alleviating sroto avarodha-Samshodhana9purificatory therapies based upon the
grade of doshic vitiation and site of affliction) followed with(free radical scavenging
agents-rasayana drugs)
3. Regularization of apana vata(vatakaphahara madicaments)
d.Nidan parivarjana:Avoidance of kaphkara ahara and vihara.

1. Yogas Asanas Lifestyle:

2. Pranayama, Kapalabhati etc
3. Shavasana, Sarvangasana, Matyasna etc
iii. Compatible and timely intake of balanced diet, regular physical exercises and healthy
lifestyle will build up therapeutic measures to curb PCOS.

Single herbs useful in PCOS:

(Click on the herb names to know more about them)

1. Varuna- Crataeva nurvala helps to clear the channels and reduces the size of the
cyst.
2. Hareetaki- Terminalia chebula Due to laxative effect it reduces the body morbidity
and contributes significantly.
3. Pippali- Long pepper-Piper longum Being a potent rejuvenator,carminative and
free radical scavenging agent curbs the pathology in a significant manner.
4. Bilva- Aegle marmelos-Reduces the size of the growth by its potent digestive effect.
5. Agnimantha- Premna integrifolia- like Bilva it acts as digestive.
6. Guduchi- Tinospora indica-Due to rejuvinative effect and bitter principles it imparts its
benefits in breaking the patho-physiology.
7. Punarnava- Boerrhavia diffusa-diuretic benefits and smoothening effect reduces the
size of the growths.
8. Chitraka- Plumbago zeylanica- potent digestive and carminative.
9. Shunthi- Ginger quick penetrative and digestive.
10. Anjani- Memycylon indicum-proven afficacy inreducing the cysts and breaking the
pathology.
Ayurvedic medicines for PCOS management:
(Click on the medicine names to know more about them)

1. Chitrakadi vati used in Ayurvedic treatment of anorexia and indigestion. It improves

digestion power. It is one of the widely used Ayurvedic tablet.
2. Varunadi kwatha Useful in reducing the size of cyst and obesity management
3. Panchakola choorna
4. Arogyavardhini vati
5. Triphala guggulu
6. Varunadi louha
7. Phalatrikadi kashaya
8. Punarnavadi kashaya
9. Navayasa louha
10. Navakarshika guggulu etc
Last drop
Essentially PCOS should be taken care in its beginning itself. But most of the time it is
diagnosed only in later period or else it is neglected that it is a minor health complaint or
simple menstrual irregularity. Early detection and immediate attention will help to curb the
disease as well as to avoid the complications like infertility.
Article by Dr MS Krishnamurthy and Dr Hebbar