A Multidimensional Integrated approach towards PCOS - Need of the Hour

REVIEW ARTICLE October 2024 Journal of Ayurveda and Integrated Medical Sciences | October 2024 | Vol. 9 | Issue 10 218 A Multidimensional Integrated approach towards PCOS - Need of the Hour Vidhya Sarode 1 , Aishwarya Bongane 2 1 HOD, Dept. of Streerog and Prasuti Tantra, Ashvin Rural Ayurved College, Manchi Hills, Sangamner, Ahmednagar, Maharashtra, India. 2 Post Graduate Scholar, Dept. of Streerog and Prasuti Tantra, Ashvin Rural Ayurved College, Manchi Hills, Sangamner, Ahmednagar, Maharashtra, India. I NTRODUCTION PCOS is a common endocrinopathy typified by oligo ovulation or anovulation, signs of androgen excess and multiple small ovarian cysts. These signs vary widely between women and within individuals over time. Definition of PCOS - Rotterdam Criteria (2003) [2] 2 of the 3 should be included 1) Clinical/Bioclinical Hyperandrogenism 2) Oligo or Anovulation 3) PCO Signs and Symptoms -1) menstrual dysfunctionamenorrhoea /oligo/menometrorrhagia Address for correspondence: Dr. Aishwarya Bongane Post Graduate Scholar, Dept. of Streerog and Prasuti Tantra, Ashvin Rural Ayurved College, Manchi Hills, Sangamner, Ahmednagar, Maharashtra, India. E-mail: bonganeaishwarya 20@gmail.com Submission Date: 13/09/2024 Accepted Date: 24/10/2024 Access this article online Quick Response Code Website: www.jaims.in DOI: 10.21760/jaims.9.10.36 2) Hyperandrogenism-Hirsutism, acne, androgenic alopecia. 3) Insulin resistance - Acanthosis nigricans, obesity, impaired GTT 4) obstructive sleep apnea 5) metabolic syndrome and cardio vascular diseases.6) Endometrial neoplasia 7) Infertility 8) pregnancy loss 9) Psychologic health. M ATERIALS AND M ETHODS Materials Only literary material i.e., Ayurvedic classical text along with research journals and magazines are viewed to collect the data during work. Also websites like PubMed, google scholar and Wikipedia are used. Methods Literary data collected was analyzed and clinical approach was made in accordance to modern science A IMS AND O BJECTIVES 1 To review PCOS from different books, research articles and websites. 2 To find out various solutions and treatment approaches towards the presenting complaints. 3 To find relevant data described in Ayurveda i.e. Aahara and Vihara modifications along with internal medications. A B S T R A C T Due to the rapidly changing lifestyles, habits and environmental conditions a veraciously growing picture of PCOS is emerging. The estimated prevalence in India is ranged from 3.7% to 22.5% [1] PCOS is a common hormonal condition that affects women of reproductive age. It usually starts during adolescence but symptoms may fluctuate over time. It has varying symptoms ranging from irregular menses to chronic conditions like endometrial CA, heart diseases, etc. This article primarily deals with the various approaches which can be applied to treat PCOS dependin g upon patient’s condition and interest. Key words: Anovulation, Hyperandrogenism, Insulin Resistance.

Vidhya Sarode et al. A Multidimensional Integrated approach towards PCOS ISSN: 2456-3110 REVIEW ARTICLE October 2024 Journal of Ayurveda and Integrated Medical Sciences | October 2024 | Vol. 9 | Issue 10 219 Various approach according to need 1) Women with PCOS not willing to conceive 2) Women with PCOS keen on conception 3) Patients which can be managed by just dietery and lifestyle modifications. 4) Patients requiring internal medications. 5) Patients with severe complications. 1) Women with PCOS not willing to conceive ▪ Weight reductionexercise, walking, running ▪ Hirsutismde-epilatory aids ▪ Insulin sensitizing agentsmetformin [3] ▪ Acnetopical retinoids 2) Women with PCOS keen on conception ▪ Weight reduction - Kanchanara Guggulu [3] Lekhan Karma Vaat Kapha Shamak Guna ▪ Insulin sensitizing agents with ovulation induction drugs ▪ Ashwaghandha ( Withania somnifera ) - reduces stress, decreases oxidative stress. ▪ Shatavari ( Asparagus racemosus ) - brings balance and strengthens menstrual system ▪ Basti - women having amenorrhoea / oligomenorrhoea / repeated abortions should be prescribed Anuvasana Basti [4] ▪ Yaapana Basti - perform both actions i.e., cleansing and oleation which is useful in infertility. Samprapti of PCOS include Agnimandhya, Apana Vayu Sanga, Vata Dushti, Dhatu Kshaya Overall effect of Basti - Agnee Pradipan, Vatanuloman, Tridosh Shamak, Balya, Bruhan, Yogavahi Giving Basti through Guda Marga (anus) spreads all over body expels accumulated vitiated Doshas, Malas and expel them out of body normalizes Vata, Beeja Nirmana and regulates Raja Pravrutti. 3) Patients which can be managed by dietary and lifestyle modifications A) Diet ( Aahara ) ▪ Balanced diet ▪ protein rich ▪ non starchy vegetables ▪ whole grains ▪ fruits ▪ fiber rich food B) Lifestyle ( Vihara ) ▪ Dinacharya, Rutucharya, Ratricharya [5] ▪ balanced sleep cycle ▪ regular exercise ▪ fresh air ▪ Yoga [6] a) Sarvangasana - improves blood circulation and digestion b) M atsyasan - stimulates glands that stimulate hormones c) Pashimottanasana - stimulates ovaries and uterus and regulates menses d) Suryanamaskar [7] regulates cycles, reduces stress, improves sleep e) Ushtrasana - decreases menstrual discomfort and improves digestion. 4) Patients requiring internal medications. ▪ Kapha reducing, insulin enhancing, hormone rebalancing, obstruction clearing herbs like Jambu, Guduchi, Amalaki, Haridra ▪ Kanchanara Guggulu - Lekhan Karma, decreases weight ▪ Methi ( Trigonella foenum graecum ) - balances BSL ▪ Ashwaghanda, Shatavari, Maricha ▪ Inositols -D-chiro and myo act as insulinomimetics activating/sensitizing effect of insulin-induces ovulation, decreases obesity.

Vidhya Sarode et al. A Multidimensional Integrated approach towards PCOS ISSN: 2456-3110 REVIEW ARTICLE October 2024 Journal of Ayurveda and Integrated Medical Sciences | October 2024 | Vol. 9 | Issue 10 220 ▪ Creates healthy intra ovarian milieu, corrects hyperandrogenism, improves menstrual irregularities and promotes ovulation and fertility ▪ OC PILLS - decreases androgen production, regulates oestrogen 5) Patients with severe complications. ▪ Treated according to the disease ▪ Ovarian Wedge Resection ▪ Ovarian Drilling DISCUSSION PCOS is highly complex endocrine disorder. It is the leading cause of infertility, menstrual disturbance and is associated with obesity, hirsutism and chronic and anovulation. It can be co-related with Asamavastha metabolic toxins in Ayurveda. Apathya Aahara Vihara causes formation of Ama in Rasadhatu which in turn causes Aarthava Upadhatu Dushti this vitiated condition leads to improper selection and maturation of ovum. The Ama thus produced disturbs the normal functioning of body and affect various Dhatu, Upadhatu, Strotas causes excessive weight gain and hair loss. hair loss occur due to Asthi Dhatu Dushti, Kapha and Medo Dushti happen due to excessive intake of Mamsahara Avyayma and Divaswapna. To normalize this condition drugs and life style which make Amapachana, Agni Deepana, Pachana, Vatanulomana and which could restore the normalcy in female reproductive system should be used. CONCLUSION Thus, from the above-mentioned aspects PCOS can be managed by variety of methods according to the need of the patient as every patient is different with different expectations. Ayurveda has a wide range of modalities to offer in treatment part and can be integrated with modern medicine. REFERENCES 1 www.ncbi.nlm.nih.gov-national institute of health. 2 Hoffman, schorge, williams gynecology third edition pcos and hyperandrogenism pg.387. 3 Tomer p, dey YN, Sharma D Wanjari MM-Cytotoxic and antiproliferative activity of kanchanara guggulu and ayurvedic formulation. J Integr med 2018 Nov; 16(6):411-417. 4 Kashyap Samhita siddhi sathana 1/39-41. 5 Charak Samhita Dr. Brahmananda Tripathi published by Chaukhamba Surbharati Varanasi sutra sthan 30/26 6 Yoga- Sampurna Swasthavrautta vidnayan Dr. Vijay Patrikar Asan 22 pg 225 7 Suryanamaskar Rugved Mandal 7 Anuvak 54 Subhra 1 ******************************* How to cite this article: Vidhya Sarode, Aishwarya Bongane. A Multidimensional Integrated approach towards PCOS - Need of the Hour. J Ayurveda Integr Med Sci 2024;10:218-220. http://dx.doi.org/10.21760/jaims.9.10.36 Source of Support: Nil, Conflict of Interest: None declared. Copyright © 2024 The Author(s); Published by Maharshi Charaka Ayurveda Organization, Vijayapur (Regd). This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc-sa/4.0), which permits unrestricted use, distribution, and perform the work and make derivative works based on it only for non-commercial purposes, provided the original work is properly cited