PCOS is a common endocrine disorder in reproductive age females. In this the ovary have various cysts which impairs the ovarian function. It is a syndrome thus a combination of various symptoms like amenorrhea (artava kshaya), irregular menstrual bleeding (yonivyapad- uterine disorders), and sub-fertility (Vandhyata), Obesity (stholya). Persistent acne, hair loss, unwanted facial hair and dark pigmentation of skin especially around the neck i.e. acanthosis nigricans as well. Underlying hormone resistance, high level of male hormone testosterone i.e. Hyperandrogenism; imbalance of LH- Luteinizing hormone and FSH- follicle stimulating hormone, make PCOS a very complex metabolic disorder.
PCOS in Ayurveda is correlated to Granthibhuta aartava dushti which has symptoms like artavakshaya, vandhyta, sthaulya, kashtartava etc.
As per Ayurveda the cause is – When the deranged vata (esp Apana 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. It is also due to jathragnia and dhatvagni dysfunction.
To summarize the pathology in PCOS is an obstruction in the pelvic cavity (Apana Kshetra) causing disorders in the flow of Vata. This in turn leads to an accumulation of Kapha and Pitta.
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.
The main aim of Ayurvedic therapy in women with PCOS are:
- Detoxification of body
- Strengthening and revitalizing the female reproductive system and regularizing menstrual cycles.
Rectifying hormonal imbalance
- Ayurvedic therapies also help in gradual and wholesome weight loss, reduce hair, facial hair growth and reduces acne.
Thus the treatment principle is to clear obstruction in the pelvis, normalize metabolism and regulate the menstrual system (Aartava Dhatu). Kapha reducing, insulin enhancing and hormone rebalancing drugs help to the relieve symptoms of Poly Cystic Ovarian Syndrome.
Few Herbs and their action
Triphala Kwatha, Chandraprabha Vati and manibhadra churna help to clear obstruction and normalize the srotas. Especially Triphala and Guggulu are very useful for reducing excess weight.
Powder of Asparagus racemosus brings balance and strength to the menstrual system and it helps to regulate Aartva Dhatu. Sehachara removes unwanted follicles.
Powder of Guduchchadiya enhances the overall immunity
Powder of Atibala has properties of Prajasthapana, Garbhasya Daurbaly, Ahara, Balya, Brunhana and Ojo Vardhana. Therefore it helps to get conceived and avoid miscarriage.
Uttara Vasti with 5ml of oil of Shatapushpa two consecutive days per month from the day which is completely cessation of the menstrual flow in between 4th to 10th day of the cycle is the most effective treatment in gynaecological disorders. It helps to purify and clear the Aartava Vaha Srotas, pacifies vitiated Apana Vata and improve follicular maturity.
Diet and lifestyle for PCOS
PCOS being lifestyle disorder is caused due to unhealthy diets, smoking, lack of exercise and stress. Such habits result in Obesity which is responsible for faulty ovulation in females due to PCOS which in turn causes infertility. It can happen in non-obese females too but incidences are higher in obese females. It can be controlled and prevented if PCOS patient follows certain diet and lifestyle changes as per Ayurveda.
- Avoid excessive sleep in the afternoon and sedentary lifestyle. Increased physical activity by exercising, yoga- suryanamaskara, and pranayama. For this at least 30minutes of exercise per day is important like brisk walk etc.
- Avoid stress, anxiety. Take adequate sleep at night.
- Avoid fried fatty food, alcohol, and smoking.
- Avoid cold and raw food, white bread, pasta, white rice, sugary food and drinks, fast food, processed & canned food, frozen food, overuse of corn-flakes and breakfast cereals etc.
- Fruits to be eaten are- oranges, lemon, sweet lime, pineapple, papaya, apple, blueberries and strawberries, red grapes, pear.
- Grains- Oats, millets, barley.
- Vegetables- Green leafy- spinach, kale, seasonal veggies. Avoid potato, corn and peas too much.
- Nuts- Almonds, walnuts
- Dairy- Buttermilk, ghee.
- Spices- Cumin, cardamom, cinnamon, nutmeg, coriander, fennel, fenugreek.
- Sweetener- Honey is best. Reduce intake of sugar products, which increases the Kapha in the body.
- Beans are recommended. Nuts should be avoided.
- Sleep at regular time and go to bed 2-3 hrs after dinner.
- Take next food only when the previous food has been digested or 4-5 hrs after the previous food. Avoid eating without hunger.
- Drink warm water with lemon in the morning. Drink warm water all through the day.
- Don’t take large amount of food at once as it exerts a pressure on liver. Divide them into 5-6 smaller meals through the day.
- Low-fat milk is recommended. Boil milk before drinking. Drink it warm. This makes it easier to digest. Do not take milk with a full meal or with sour or salty foods. Add a pinch of turmeric or ginger to the milk before boiling it. This helps to reduce the kapha increasing qualities of the milk.
- Negative feelings like stress and tension should be avoided. Do not undertake physical or mental work beyond your capacity.
- Limit the use of contraceptives
- Follow an active lifestyle, yet the exercises should be according to one’s capacity. Both, excessive fasting and overeating are harmful.
- Smoking, drinking alcohol and using narcotics aggravates menstrual disorders.