ABSTRACT
The female reproductive system relies on the intact uterine adnexa and the hypothalamic-pituitary-ovarian axis. An imbalance can lead to pathogenesis. PCOS is characterized by ovarian cysts, hyperandrogenism, and irregular ovulation. Over time, it can lead to symptoms such as changes in menstruation, obesity, infertility, depression, and increased risk of diabetes, cardiovascular disease, and endometrial cancer. In Ayurveda, PCOS is a condition affecting Rasa, Rakta, and Medas, the three Dhatus. Rakta, Rasa, and Artavavaha are the Srotas that are implicated in this illness. Symptoms that may appear include Anartava (amenorrhea), Vandhyatwa, Pushpagni, and Abeeja Rutuchakra (an ovular hemorrhage). A 23-year-old woman presented at the outpatient department with complaints of irregular menstruation and rapid weight gain. An ultrasound revealed left-sided polycystic ovary syndrome (PCOS). Palliative treatments such as Kaklarakshak Yog, Trikatu, and Triphala Churna were administered for 2 months. The patient experienced a significant reduction in symptoms and a return to a normal menstrual cycle within two months.
KEYWORDS: Artava, PCOS, Raktadhatu, Rasadhatu, Rutumaticharya
INTRODUCTION
The occurrence of oligo-or anovulation, polycystic ovaries, and clinical and/or biochemical hyperandrogenism constitutes the Rotterdam criteria of 2003 for polycystic ovarian syndrome. If a patient meets at least two of these requirements, they are diagnosed with PCOS.[1] It affects 5-15% of people and is increasing due to modern lifestyles. It can develop during adolescence or soon after puberty and is a common diagnosis in 15-20% of infertile women. Additionally, 50-70% of individuals with PCOS are obese, and the exact cause remains unknown.[2]
Higher DHEAS (dehydroepiandrosterone sulfate) levels in females may be linked to genes causing early balding and insulin resistance. Lifestyle, genetic, familial, and environmental factors contribute to this condition. Obesity often leads to increased adipose tissue, disrupting insulin signaling and causing insulin resistance. PCOS can begin in early adolescence or even earlier, with the early onset of menarche and pubertal hair growth. Oligomenorrhea occurs in 87% of PCOS patients, with 26% experiencing amenorrhea later. Infertility is common due to anovulatory cycles, and if a woman with PCOS conceives, she may develop carbohydrate intolerance, diabetes, and hypertension. Hyperandrogenism is marked by hirsutism, abnormal facial hair, and acne. Other symptoms include baldness, thyroid enlargement, increased BMI, and high blood pressure. Treatment may involve hormonal therapy, surgical procedures like laparoscopic ovarian drilling, and ovarian wedge resection.[3] Ayurveda emphasizes maintaining healthy ovaries for fertility. Neglecting Rutucharya (seasonal regimens), Rutumaticharya (regimens during Menstruation), and Dinacharya (daily regimens) can lead to stress, unhealthy eating, and hindrance to the body’s balance. This can cause hormonal imbalance, obesity, and amenorrhea. The uniqueness of this case lies in the fact that the patient achieved complete relief from PCOS symptoms within just two months of Ayurvedic treatment.
Patient information
A 23-year-old unmarried woman, a student by occupation, presented at the Kayachikitsa OPD of Mahatma Gandhi Ayurveda College Hospital and research center Salod (H) with complaints of gradual weight gain, and irregular menstrual cycles, for the past 3 months.
Family and Past History: Not relevant
Menstrual History:
Age of Menarche-12
Cycle-Irregular
Bleeding Days-1-2 days
No. of Pads-1
Pain++
Clots-Nil
Personal History
Diet-Veg
Exercise-No
Habit-Tea
Sleep-Disturbed
Clinical findings
The patient was in good condition, with a weight of 63 kg and a height of 157 cm. All vital signs and systemic examinations were normal.
Investigation
The ultrasound (USG) report indicated left side PCOS. Blood tests showed hemoglobin at 11.5 g/dl, FBS at 90 mg%, PPBS at 110 mg%, and an abnormal thyroid profile.
Diagnostic assessment
Polycystic Ovaries on USG
Oligomenorrhea
Diagnosis-PCOS
Therapeutic intervention
Palliative treatment was given for 2 months as outlined in Table 1, including the following Do’s and Don’ts:
Table 1.
Palliative treatment
| Drug Name | Dose and Time | Anupan | Duration |
|---|---|---|---|
| Trikatu Churna | 3 gm BD before a meal | Lukewarm water | 7 days |
| Triphala churna | 5 gm HS | Lukewarm water | 15 days |
| Kaklarakshak Yog | 1 Tab BD empty stomach 6 am-6 pm | Lukewarm water | 2 months |
- Avoid junk food like dairy products, pizza, fried food, and daytime napping
- Fix a scheduled time for meals each day (2 meals and 1 breakfast)
- 30-minute brisk walk daily.
Follow-up and outcome
Follow-up was taken on the 8th, 30th and, 60th days to monitor patient progress and address any unexpected symptoms.
The patient showed improvement after 2 months of treatment, with regular menstrual cycles, improved insulin sensitivity, and weight reduction. The USG report on the 60th day showed a normal left ovary, and the thyroid profile was within normal limits [Table 2].
Table 2.
Outcome of treatment
| Parameters | Before | After |
|---|---|---|
| Weight | 63 Kg | 60 Kg |
| BMI | 25.6 Kg/m2 | 24.39 Kg/m2 |
| USG | Left ovary- s/o PCOD | Left Overy-Normal |
| T3 | 1.70 | 1.52 |
| T4 | 11.9 | 10.9 |
| TSH | 1.65 | 1.44 |
DISCUSSION
To effectively treat PCOS, it’s important to identify and eliminate its root cause. Junk foods like pizza and burgers are the primary cause, so it’s necessary to avoid them. Incorporating yoga, exercise, and avoiding unhealthy habits can help with weight loss and hormonal balance. According to Ayurveda, PCOS may lead to inflammation and weight gain due to metabolic toxins. To restore normalcy, drugs with Agni Deepana (carminative), Pachana (digestive), Vatanulomana (proper functioning of Vāyu), Lekhana (Scrapping), and Artavajanana (ovulation induction) properties should be used.
Lekhana, Deepana, and Pachana properties of Trikatu aid in disrupting the disease process. Piperine increases digestive juice secretion and enzyme functioning in the small intestine, leading to increased metabolism and decreased obesity.[4]
Kakalarakshak Yog contains Kanchanar (Bauhinia variegate), Ashwagandha (Withania somnifera), Guduchi (Tinospora cordifolia), Chitrak (Plumbago zeylanica), Katuka (Picrorhiza kurroa), Guggul (Commiphora mukul. The main ingredient in this medicine, Kanchanara, has anti-inflammatory and anti-diabetic properties that help reduce insulin resistance[5] associated with PCOS. Ashwagandha helps regulate hormones, reduce levels of testosterone, LH, and FSH, enhance endocrine function, increase insulin sensitivity, and lower cholesterol levels.[6] Guduchi lowers insulin resistance and revitalizes body tissues. The berberine alkaloid found in Guduchi can enhance glucose tolerance, reduce fasting plasma glucose, and improve insulin sensitivity.[7]
Plumbagin in Chitrak roots have anti-inflammatory, antioxidant, anticancer, and antibacterial effects and helps reduce ovarian pathology and polycystic changes.[8]
Kutaki helps in reducing Pitta and purifying the blood. This ultimately leads to the purification of the reproductive system.[9]
Guggul has anti-inflammatory and antioxidant properties due to the active compound Z-guggulsterone. It offers health benefits such as being a blood purifier, liver stimulant, pain reliever, aiding digestion, and reducing cholesterol absorption. It can treat conditions like edema, dysmenorrhea, and glandular enlargement, and is considered a good Rasayna for rejuvenating body tissues. Triphala is a natural antioxidant abundant in vitamin C that helps cleanse and detoxify the body while reducing body fat and insulin resistance.[10]
Due to the above properties, vitiated Doshas and Jatharagni (digestive fire) get corrected, and Srothoshodana leads to the expulsion of Doshas from the body. The Lekhana property of drugs reduces Kapha and Medas. The Rasayana and Artavajanaka properties restore normalcy to the female reproductive system.
CONCLUSION
Ayurvedic medicine can effectively treat PCOS and related conditions like thyroid imbalances. It helps reduce symptoms and body weight, supports ovulation, and lowers insulin resistance. Research studies with large sample sizes are recommended to demonstrate its effectiveness.
Conflicts of interest
There are no conflicts of interest.
Acknowledgements
We declare that the manuscript is original, has not been published before, and is not currently being considered for publication elsewhere.
Funding Statement
Nil.
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