PCOS and PCOD Ayurvedic Treatment

These are a group of disorders in women of reproductive age (those having menstruation) due to hormonal dysfunction. The main feature is irregularities in menstrual period. In people with PCOS, male hormone (androgen) will be abnormally high. There will be multiple fluid filled sacs (ie cyst) in ovary/ ovaries (polycystic ovary) in those women. In fact, these sacs/ cysts are immature ovarian follicles. As a result, there may not be normal ovulation (release of mature follicle called ovum from either ovary during alternate menstrual periods), but some have normal ovulation. The exact cause of PCOS is unknown, but the possible reasons are insulin resistance, heredity, excess levels of androgen in blood and low-grade inflammation. Early diagnosis and treatment comprising weight reduction, and dietary as well as lifestyle modification can prevent complications like infertility, diabetes etc. 

Signs and symptoms

 The signs and symptoms of PCOS often varies from person to person. They may appear from first menstrual period or even later. Usually, PCOS is diagnosed by the presence of at least 2 of the following symptoms/ signs: 

    • Irregular menstrual periods– late periods, missed periods, bleeding lasts for long, bleeding in between periods, scanty/ profuse bleeding, absence of menstruation for long time etc. 
    • Hirsutism (abnormal hair growth over face, breast etc) due to excess androgen. 
  • Polycystic ovaries

Other symptoms include obesity, dark pigmentation over nape of neck/ inner thighs etc, hair fall, severe pain during menstruation, abdominal bloating etc. 

Ayurvedic analysis

 A number of conditions having similar signs and symptoms with PCOS are mentioned in Ayurveda such as- 

Arthava kshaya- scanty menstruation or anovulation

Arthava dushti- irregular menstruation

Pushpaghni- absence of menstruation, abnormal fat deposition etc

Vandhyata- infertility

Yonivyapat- disorders of female reproductive system

Arthavavaha srotodushti- blockage in channels of Arthava (menstrual blood) etc. 

 The dosha predominance and signs & symptoms of these condition are different. Management is based on the assessment of symptoms, dosha vitiation, associated disorders etc. The main dosha involved are pitta and rakta though other dosha are also involved in the manifestation of the problem. Common symptoms described in Ayurveda are irregular menstruation, overweight, excess facial hair growth, painful menstruation, abdominal bloating, constipation, infertility etc. 

Causative factors (Ayurveda)

 The causative factors of vitiation of yonivyapat are Mithyahara (unhealthy food habit) and mithyavihara (faulty lifestyle). Abnormalities of Arthava is caused by vitiation of pitta and rakta by excess anger/ stress/ depression etc, excess intake of sweet/ heavy/ oily food items, day sleep, indigestion, disturbed sleep, increased exposure to heat etc. also there will be vitiation of Rasavaha, Medovaha and Arthavavaha srotas. 

Possible complications

 The major complication of PCOS is infertility. Others are miscarriage, pre-mature birth, metabolic syndrome (condition with high blood sugar, high blood pressure and high cholesterol level), gestational diabetes (diabetes during pregnancy), hypertension during pregnancy, pre-diabetes or diabetes mellitus, liver inflammation caused by fat deposition (non-alcoholic steatohepatitis), endometrial cancer, psychological problems (like depression, anxiety) etc. Some people who were lean before may become obese due to long term PCOS. 

Other systemic diseases and precautions to be taken

 Consider other issues such as obesity, diabetes, inflammatory conditions, infertility etc before planning treatment. 

Management

 The management of PCOS is focused on weight reduction and correcting hormonal imbalance. Normalization of pitta and rakta in body along with removal of ama, agnimandya, srotorodha

Internal medications are enough in uncomplicated or acute cases. Otherwise, hospitalization is needed to perform procedures like rukshana (removal of ama– eg: takrapana/ consumption of buttermilk, udwarthana/ powder massage, valuka sweda etc), snehana (external/ internal administration of medicated ghee/ oil), swedana (sudation with steam bath, kizhi, sirodhara etc), nasya (nasal administration of drugs for correcting the hormonal imbalance), vamana (emetic therapy) or virechana (purgation), vasthi (enema with suitable drugs) etc. In chronic cases of PCOS and those suffering from psychological distress, psychotherapy helps a lot. 

Diet

 The diet of women/ girls with PCOS must contain whole grains, millets, green vegetables (especially those having bitter taste, creepers, and with lot of water content- eg: snake gourd, ash gourd, ridge gourd, ivy gourd etc), fruits having less amount of sugar and more of sour taste (eg: grapes, orange, guava etc), nuts, dates, small fishes, egg, white meat/ meat soup, horse gram, sesame seeds and oil etc. Reduce the intake of heavy and oily food items, curd, sweets, junk and processed food having artificial sweeteners and colours, refined grains, fermented food, carbonated drinks, alcohol, red meat, food items that cause bloating, coffee/ tea etc. Drink plenty of water. 

Exercise

 Exercise is very much important in PCOS as it can regulate the hormones. Moderate exercises that provide massage effect on the abdominal and pelvic organs (like uterus, ovaries, liver) and reduce inflammation are recommended to perform at least for 30 minutes. Yoga (therapeutic yoga for PCOS), pranayama and meditation are also very effective. Follow the guidelines of physician for a better exercise schedule. 

Preventive aspects

 Limit the consumption of heavy to digest/ oily/ sweet food, junk food, fermented food, processed food, fried items etc. Ensure adequate hydration and enough sleep. Women in reproductive age group must include whole grains, millets, green vegetables, citrus fruits, buttermilk, horse gram, sesame, jaggery, ginger, garlic, fenugreek, vinegar, dates, small fishes etc in diet. Exercise regularly and maintain healthy body weight. Avoid stress, excess anger, sadness etc. 

Importance of diet

 Strict dietary restriction is needed to regulate menstruation and hormones. Slight changes in the food pattern may worsen the condition. Select the right food as per physician’s guidance. 

Lifestyle 

 Maintain healthy weight. Follow the dietary regulations and drink plenty of water. Ensure adequate sleep and avoid day sleep. Exercise regularly. Avoid stress, anger, depression etc. Apply suitable oil all over the body and scalp before bath.

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