A critical analysis of Dosha Prakopa Nidana in the Samprapti of Artava Dushti w.s.r. to Polycystic Ovarian Syndrome - A Review

G Akshaya; Ajantha; Nandesh Mohan P

A critical analysis of Dosha Prakopa Nidana in the Samprapti of Artava Dushti w.s.r. to Polycystic Ovarian Syndrome - A Review

Akshaya G.^1*, Ajantha.², Mohan P N.³

DOI:

^1* G Akshaya, Post Graduate Scholar, Department of Roga Nidana & Vikriti Vijnana, SDM College of Ayurveda and Hospital, Hassan, Karnataka, India.

² Ajantha, Professor, Department of Roga Nidana & Vikriti Vijnana, Yenepoya Ayurveda Medical College & Hospital, Mangalore, Karnataka, India.

³ Nandesh Mohan P, Associate Professor & Head, Department of Roga Nidana & Vikriti Vijnana, SDM college of Ayurveda & hospital, Hassan, Karnataka, India.

Manifestation of disease is impossible without Dosha Prakopa & Sammurchana with Dushya. Dosha Vaishamya, mainly Dosha Prakopa is an essential step in manifesting the Samprapti & understood by assessing the Nidana with that the Dosha involved in the Samprapti can be done helps in Samprapti Vighatana & to avoid disease manifestation. Artava Dushti refer to the vitiation of Artava that is seen as complexity of symptoms with reference to polycystic ovarian syndrome (PCOS). Dosha Prakopa occurs due to the Gunataha Vrddhi after the Nidana Sevana and thus lead to the manifestation of the disease. PCOS is defined as hyperandrogenic state, the presence of clinical and / or biochemical features of hyperandrogenism along with other features of PCOS that is the revised Rotterdam criteria (2013) having several symptoms and correlated to several Vikara in Ayurveda.

Keywords: Dosha Prakopa, PCOS, Polycystic Ovarian Syndrome, Artava, Samprapti, Guna

Corresponding Author	How to Cite this Article	To Browse
G Akshaya, Post Graduate Scholar, Department of Roga Nidana & Vikriti Vijnana, SDM College of Ayurveda and Hospital, Hassan, Karnataka, India. Email:	G Akshaya, Ajantha, Nandesh Mohan P, A critical analysis of Dosha Prakopa Nidana in the Samprapti of Artava Dushti w.s.r. to Polycystic Ovarian Syndrome - A Review. J Ayu Int Med Sci. 2022;7(10):211-214. Available From https://www.jaims.in/jaims/article/view/2135

Introduction

Polycystic ovarian syndrome is an endocrinopathy having several organ involvements leading to multiple signs and symptoms hence, renamed as syndrome from disease. In Ayurveda this disorder is correlated to several Artava Roga like Pushpaghni Jataharini,^[1] Udavartini^[2]and Vandhya^[3]Yonivyapat, Ashta Artava Dushti,^[4] Lohitakshaya,^[5] Artava Kshaya^[6] based on the signs and symptoms observed in this syndrome. Without the Dosha Dushti and Dosha Dushya Sammurchana Vyadhi will not develop hence the knowledge of Dosha and Dushya based on Nidana Sevana is sufficient to diagnose all diseases even if it is not mentioned in our treatises.^[7]. Artava Dushti refer to the vitiation of Artava Dhatu due to the Dosha Prakopa and are of eight types and amongst them the Granthi Bhuta and Ksheena Artava Dushti can be understood with PCOS. The Granthi Bhuta Artava Dushti is having Dushti of Kapha and Vata Dosha whereas Ksheena Artava Dushti have Dushti of Vata and Pitta Doshas. On the whole Vata Pradhana Tridosha Dushti is seen in the pathophysiology of PCOS.

Materials and Methods

References are taken from Nighantus, Samhitas, reference articles, previous research works on Dosha Prakopa Nidana, Artava Dushti with mention to PCOS.

Discussion

In the Samprapti of Artava Dushti all the Tridoshas are involved but Vata Dosha is predominant due to its Yogavahi and Sukshma Guna with ability to control the other Dosha and Dhatu of the Shareera. The Lakshanas of Ksheena and Granthibhuta Artava Dushti are correlating to the clinical and sonological findings of the PCOS. The Lakshanas of Ksheena^[8] Artava Dushti due to the Dushti of Pitta and Vata Dosha as delayed and scanty menstrual cycles, black or brown coloured with pain in the vagina. The Lakshanas of Granthi^[9] Bhuta Artava Dushti due to Kapha and Vata Dushti as appearance of cysts over the ovaries hence named so. The Ashta Artava Dushti are Vataja, Pittaja, Kaphaja, Kunapa, Granthi, Putipuya, Ksheena, Mutrapurishagandhi. In most of the PCOS cases appearance of cysts over the ovaries causing anovulatory irregular cycles with

scanty menstruation such Lakshanas are seen due to vitiation of Tridosha hence. PCOS is considered as spectrum of various Vikara explained in Ayurvedic classics amongst which Artava Dushti is one such disease. For each Dosha separate Nidana are enlisted in treatises as Dosha Prakopa Nidana^[10] in the perspective of Ahara, Vihara, Manasika and Panchakarma Apacharaja, etc. but analysing each Dosha Prakopa due to the Guna of affliction paves way for better understanding.

Vata Dushti in PCOS: Among the Vimshati Gurvadi ^[11] Guna, Vata Dosha possess Rooksha, Laghu, Sheeta, Khara, Sukshma, Cala Guna. In the Samprapti of PCOS based on the Lakshana, Vata Dosha Dushti can be interpreted as Aniyamita and Kashtartava, Artava Kshaya. Dushta Artava Lakshana of Ksheena and Granthi Bhuta Artava are observed. Among the Pancha Vata, Vyana and Apana Vata Dushti are observed as such Karmas get hampered. There will be rise in the Rooksha and Sheeta Guna due to which Vata Dushti is occurring. There will be reduction in the Artava Pravrutti due to the increased Rookshana causing Shoshana of the Artava. The Sheeta Guna possess the Stambhana and Srotorodhana due to which there will be Srotorodha occurring due to increased Vata Dosha. Among the Panchavata the Vyana and Apana Vata Dushti are afflicted predominantly. Apana Vata Dushti Lakshanas are Klaibya, Artava Dushti, Klaibya is defined as Maithuna Asaamarthya as per Charaka. Madhavakara, Sushruta, Vagbhatta also described similar explanation. Artava Dushti is due to vitiated Vata moving through Artava Vaha Srotas (Rajavaha Srotas) vitiates Artava along with other two Doshas, so Ashta Artava Dushti is manifested which is diagnosed by clinical features and characteristics of Artava. Vyana Vata Dushti Lakshana are Rasa Srava is due to Vyana Vata helps in circulation of Rasa and Rakta throughout the body. But when it is obstructed or gets Prakopa it vitiates Rasa and Rakta resulting in improper formation of Dhatus. Shukra Pratipadana is due to Vyana Vata produces or circulate Shukra, when it is deranged then Beeja Dushti is seen. Dhatu Santarpayati is due to Vyana Vata, Vyana Vata helps in nourishment of all the Dhatus, when it deranged the Dhatu nourishment will be deranged. In PCOS Chronic Oestrogen exposure unopposed by progesterone produces constant stimulation of the endometrium, thickened endometrium result in an unpredictable bleeding pattern.

Androgen may counteract oestrogen to produce an Atrophic endometrium.

Pitta Dosha in PCOS: Pitta Dosha possess Sneha, Teekshna, Ushna, Laghu, Visra, Sara, Drava Guna. In the Samprapti the changes in the skin that is Prabha Hani (discoloration) Agnimandya, hormonal dysfunction can be considered as Pitta Dushti Lakshanas due to the rise of Teekshna, Ushna, Drava Gunas as Ushna cause excess Paka of the Dhatus due to Bhrajaka Pitta Dushti. Drava Guna Kopa cause increase of Kledana. Teekshna Guna cause Daha and Paka seen as Vyanga on the skin. Abeejata as anovulatory cycles is due to the dysregulation of the HPO axis that can be explained as the Dhatwagni Mandyata due to Pitta Dosha Dushti.

Kapha Dosha Dushti in PCOS: Kapha Dosha possess Snigdha, Sheeta, Guru, Manda, Slakshna, Mritsna, Sthira Guna. In the Samprapti the Guru, Manda, Sheeta, Snigdha Gunas cause the Kapha Dushti seen as polycystic appearance, Sthoulya, Agnimandya, Artava Dushti as these Gunas cause Sroto Upalepa leading to Srotorodha. Sheeta is Stambhaka in nature, Guru Guna cause Upalepa, Sada, Tarpana, Dhatumala Vardhaka.^[12]

Samprapti Ghataka	Particulars
Dosha	Vata Pradhana Tridosha Vyana, Apana Vata; Bhrajaka Pitta; Kledaka,
Dhatu	Rasa, Rakta, Mamsa, Meda
Upadhatu	Twacha
Mala	Kapha, Kesha, Loma
Srotas	Rasavaha, Raktavaha, Mamsavaha, Medavaha, Artava Vaha
Srotodushti	Sanga, Vimarga Gamana
Agni	Jatharagni, Dhatwagni
Ama	Jatharagni Janya and Dhatwagni Janya Ama
Adhisthana	Shareera
Udbhava Sthana	Amashaya
Sanchara Sthana	Yoni
Vyakta Sthana	Garbhashaya
Roga Marga	Abhyantara
Vyadhi Avastha	Ama
Vyadhi Swabhava	Chirakari
Sadhyaasadhyata	Kruchra Saadhya
Purva Rupa	Aniyamita Artava, Sthoulya
Roopa	Aniyamita Artava, Kashtaartava, Anartava, Stoulya, Alasya, Tandra, Klama, Gurugatrata, Vyanga, Pidaka, Khalitya, Lomasha Ganda
Roga Nirnaya	Vandhya due to Artava Dushti, Pushpaghni Jataharini
Upadrava	Vandhyatwa, Prameha

Conclusion

PCOS is an encompass of signs and symptoms due to endocrine dysfunction becoming cause for infertility due to the sedentary life style. But according to Ayurveda it is due to the Tridosha Dushti that can be understood due to the Gunataha Vriddhi causing the Dosha Prakopa interpreted through the symptoms manifested. Hence, in this article an attempt is made to analyse the Dosha Prakopa due to the variation of the Guna respectively that cause the Prakopa of Doshas in the manifestation of the disease. Even understanding the PCOS disease in Ayurveda perspectives with Artava Dushti finds way for better understanding.

Reference

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Manuscript Received	Review Round 1	Review Round 2	Review Round 3	Accepted
2022-09-26	2022-09-28	2022-10-05	2022-10-12	2022-10-19
Conflict of Interest	Funding	Ethical Approval	Plagiarism X-checker	Note
Nil	Nil	Yes	19%

Review Article

Polycystic Ovarian Syndrome

Journal of Ayurveda and Integrated Medical Sciences