E-ISSN:2456-3110

Case Report

Poly Cystic Ovarian Syndrome

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 6 June
Publisherwww.maharshicharaka.in

Ayurvedic management of Poly Cystic Ovarian Syndrome (Aarthava Kshaya)

Pawar J.1*, Bhalgat M.2
DOI: http://dx.doi.org/10.21760/jaims.8.6.40

1* Jyoti Pawar, Post Graduate Scholar, Department of Stree Roga and Prasuti Tantra, S.V.N.H Ayurved Mahavidyalaya Rahuri, Ahmednagar, Maharashtra, India.

2 Madhuri Bhalgat, HOD & Professor, Department of Stree Roga and Prasuti Tantra, S.V.N.H Ayurved Mahavidyalaya Rahuri, Ahmednagar, Maharashtra, India.

Poly Cystic Ovarian Syndrome (PCOS) is the most common endocrinopathy in women of reproductive age, resulting from insulin resistance and the compensatory hyperinsulinemia. This results in adverse effect on multiple organ systems and may result in alteration in serum lipids, anovulation, abnormal uterine bleeding and infertility. According to Ayurvedic view PCOS can be correlated with Aarthava Kshaya. It was revealed that most of subfertility patients who were presented in Osuki Ayurveda Centre suffered from the PCOS. Here is a case report of 28 year old women who presented with irregular menstruation, rapid weight gain and hair loss. On USG she was detected to have bilateral PCO pattern. Based on the clinical features, treated with ayurvedic management.

Keywords: Poly Cystic Ovarian Syndrome, Aarthava Kshaya

Corresponding Author How to Cite this Article To Browse
Jyoti Pawar, Post Graduate Scholar, Department of Stree Roga and Prasuti Tantra, S.V.N.H Ayurved Mahavidyalaya Rahuri, Ahmednagar, Maharashtra, India.
Email: 		Jyoti Pawar, Madhuri Bhalgat, Ayurvedic management of Poly Cystic Ovarian Syndrome (Aarthava Kshaya). J Ayu Int Med Sci. 2023;8(6):254-257.
Available From
https://jaims.in/jaims/article/view/2551

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-04-25 2023-04-27 2023-05-04 2023-05-11 2023-05-18
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 18%

© 2023by Jyoti Pawar, Madhuri Bhalgatand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Pawar J et al: Ayurvedic management of Poly Cystic Ovarian Syndrome (Aarthava Kshaya)

Introduction

The definition of Polycystic Ovarian Syndrome as per Rotterdam criteria 2003 is based on features such as clinical and/or biochemical hyperandrogenism, oligo-/anovulation and polycystic ovary. Among these if two of the three criteria is present in a patient it’s diagnosed as PCOS.[1] Current incidence of PCOS is 5-15% and is increasing due to current lifestyle changes. It’s so common now a days from adolescent period itself, developing soon after puberty. 15-20% of infertile women are diagnosed with PCOS. About 50-70% of PCOS patients are obese.[2]

Aartava-Kshaya, which can be correlated with PCOS has been described as deficiency or loss of Artava, Artava does not appears in time or is delayed, is scanty and does not last for three days. Pain in vagina also can be seen. According to Ayurveda, Aartava-Kshaya is a disorder involving Pitta and Kapha Doshas, Medas, Ambu/Rasa, Shukra/Artava Dhatu and Rasa, Rakta, Artava Vaha Srotas.[3] Therefore Poly Cystic Ovarian Syndrome can also be described with same involvement of Dosha, Dhatu and Upadhatu Kapha predominance manifests as increased weight, subfertility, hirsutium, diabetic tendencies and coldness. Pitta predominance manifests as hair loss, acne, painful menses, clots and heart problems. Vata predominance manifests with painful menses, scanty or less menstrual blood and severe menstrual irregularity.[4,5]

Aim and Objectives

To study the effect of given Ayurveda treatment regime of Nastartava or Anartava.

Materials and Methods

All available References have been collected from literatures, Ayurvedic Samhitas, Ayurvedic textbooks and modern text books, different websites, published articles and critically analysed.

Case Report

A female patient, 28 years old, came to Prasuti Tantra and Stri Roga OPD of our Ayurveda College, on 05 March 2022 with chief complaint of Irregular Menses, Scanty Menses, wight gain, wants to conceive, Backache, Hair fall and Constipation in the last 2 Years.

Menstrual History

Age Of Menarche - 13year

LMP - 13-06-2021

Interval - 30 Days

Duration - 2days

Pain - Mild

Clots - Nil

History of past illness - NIL

Obstetric History - G2P1L1A1

Personal History

Diet - Vegetarian

Appetite - Normal

Bowel Habits - Constipated

Bladder - Normal

Sleep - Normal

Clinical findings

General examinations

Built - Normal

Weight - 48 kg

Height - 159 cm

Pulse rate - 70/min

B.P. - 110/70 mm of hg

Respiration rate - 18/min

Temp. - 98.6°F

O/E

P/S - Cervix - thick white discharge, Nabothian cyst on both cervical lips, Cervix slightly eroded and inflamed

P/V - Not done

Investigations

Uterus - Anteverted, Anteflexed in size measuring 71×36×45 mm with homogenous echotexture endometrial thickness - 9.9mm

Ovaries - Both Ovaries are normal in size and show peripheral arranged multiple small sized follicles. Right Ovary vol. 8.8cc, Left Ovary vol. 8.2cc,


Journal of Ayurveda and Integrated Medical Sciences 2023;8(6)255
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A dominant follicle measuring 23 × 18 mm is seen in the right ovary. The impression is of the normal size of bilateral ovaries with a polycystic component.

Serum prolactin is normal

Serum LH - 9.69 mIU/ml

Serum FSH - 7.91 mU/ml

Serum TSH - 4.27 μm/ml

A Pap smear shows an acute inflammatory smear.

Physical examination

Ashtavidha Pariksha

Nadi (pulse) - VK

Mutra (urine) - Samyakmutrapravriti

Mala (stool) - Sama

Jihwa (tongue) - Sama

Shabda - Samyak

Sparsha (touch) - Ushna

Drika (eye) - Samanya

Aakriti (physical appearance) - Samanya

Dashvidha Pariksha

Prakriti (nature) - Vatakaphaja

Sara (Purest body tissue) - Madhyam (medium)

Samhanana (Body compact) - Madhyam (medium),

Pramana (Body proportion) - Madhyam (medium)

Satmya (homologation) - Madhyam (medium)

Satva (mental strength) - Madhyam (medium)

Vaya (age) - 31years

Criteria for diagnosis

  • Polycystic Ovaries on USG
  • Oligomenorrhea or anovulation
  • Clinical or bio-chemical evidence of Hyperandrogenism
  • Elevated LH

Treatment plan

1. Triphala Guggulu - 1 tab BD with Lukewarm Water after a meal

2. Dashmool Kwath - 30ml BD Empty Stomach

3. Nasya with Anutaila - 4 drops BD

4. Uttar Basti with Phala Ghrita

Aahar and Vihar Balanced diet is essential for normal health. Because dietetic abnormality vitiates Doshas which cause various gynaecological disease may result infertility. It also produces loss of Dhatu which influences hormones causes menstrual irregularity. Abnormal diet hamper nourishment of fertilized egg and implantation of zygote.

Weight reduction by Pathya / Apathya Aahar and Vihar - Mode of life as suggested in the Ritucharya and Dincharya should be followed properly.

Following are some Yoga techniques helpful for weight reduction and to decrease blood sugar level as well. Like: Anuloma Viloma, Kapalbhati and Mandukasan. Vyayam (exercise) enhances tissue sensitivity to insulin (80% of the body’s insulin mediated glucose uptake occurs in muscles).

Discussion

Dashmool Kwath contains Brihat Panchmoola and Laghu Panchmoola. The combination of these ten roots is used widely in Ayurveda which acts on Vata Dosha, it has Vata Kaphashaman, and Medonashaka properties. Its anti-inflammatory and analgesic property is all potent, it also reduced back pain.[6]

Triphala Guggulu[7] - helps to heal wounds, reduction in pain associated with wounds, anti-inflammatory action, relieve constipation, reduce weight it also have to reduce cyst of ovary. By its Medohara, Lekhana, Katuvipaka, Tikshna, Ushna, Granthihara, Shophara properties. Some healthy habits like regular exercise and Yoga, Avoid processed foods, junk foods and high-calorie foods, Avoid all forms of refined sugar, Salt restriction is another major aspect, Use of natural salt like Saindhav (Himalayan Crystal Salt) gives more benefit, Avoid sleeping after lunch or during daytime, Avoid late night exposure to artificial lights, Green leafy vegetables such as spinach, cabbage, broccoli, Low glycaemic index foods, Barley, cauliflower, tomatoes, onions, peaches, apples, and grapefruit are effective to prevention Polycystic ovarian syndrome.

Uttara Basti: It is highly beneficial in gynaecological disorders as it clears the Artavavaha


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Srotas and pacifies vitiated Apana Vayu and promotes follicular maturity. Uttara Vasti is the most effective treatment in gynaecological disorders. It helps to purification and clears the Aartava Vaha Srotas, pacifies vitiated Apana Vayu[8] and improve follicular maturity.

Nasya: It may stimulate olfactory nerves and limbic system, which in turn stimulates hypothalamus leading to stimulation of Gonadotropin Releasing Hormone (GnRH) neurons, regularizing GnRH pulsatile secretion and maintaining the HPO axis, helps in regular and normal menstrual cycle.

Conclusion

PCOS is mainly due to Avarana of Vata and Kapha, so Vatanulomak, Kapha Shaman, and Pitta Vardhan, Aamapachana, Artava Janana Chikitsa, are effective. Therefore, we are giving this treatment regime for polycystic ovarian syndrome. All these drugs have properties which helps easily reduce weight and also the symptoms of PCOS. It helps to lower insulin resistance more efficiently thereby favouring ovulation which is one of the prime factors for the maintenance of fertility.

Reference

1. Hoffman, Schorge, Williams Gynecology, Third edition, United States of America, Mc Graw Hill Education, 2016, p.387.

2. Sunesh Kumar, Hokin’s and Bourne Shaw’s Textbook of Gynaecology, Seventeenth Edition, New Delhi, Elsevier, 2018, p.314.

3. Tewari P.V. Ayurveda Prasuti Tantra Evam Stri Roga, Stri Roga, Chaukambha Orientale. Varanasi: 1996. p. 169. (192). Part-II.

4. Sharma P.V. Charaka Samhita (English Translation) Chaukambha Orientalia. Varanasi: 1981.

5. Shastri K, Charaka Samhita II, Comm. Published By Chaukhamba Bharti Academy, Varanasi, 2009.Pp-91.

6. Tiwari P, Rastantrasara Evam Siddhaprayog Sangrah Pratham Khand, Published By Krishnagopal Ayurved Bhavan Ajmer, 2012.Pp-349.

7. Shastri P, Shanrngdhar Samahita Madhya Khand, Published By Chaukhamba Subharti Prakashan, Varanasi, 2009.pp-204.

8. Srikantha Mruthi K.R. Sushruta Samhita (English Translation) Chaukambha Orientale. Varanasi: 2001. pp. 170–173


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