E-ISSN:2456-3110

Case Report

Polycystic Ovarian

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 7 JULY
Publisherwww.maharshicharaka.in

An Ayurvedic management of Polycystic Ovarian Disease: A Case Report

Nema S1*, Kapil S2
DOI:10.21760/jaims.9.7.57

1* Sanskrati Nema, Post Graduate Scholar, Department of Prasuti Tantra Evum Stree Roga, RGGPG Ayurvedic College and Hospital, Paprola, Himachal Pradesh, India.

2 Soni Kapil, Professor, Department of Prasuti Tantra Evum Stree Roga, RGGPG Ayurvedic College and Hospital, Paprola, Himachal Pradesh, India.

Polycystic ovarian Disease (PCOD) is a prevalent endocrine disorder characterized by irregular menstrual cycles, excess androgens, and multiple small ovarian cysts. Its incidence, currently ranging from 5-15%, is on the rise due to modern lifestyle changes, impacting reproductive health and causing issues like irregular periods, infertility, weight gain, hair loss, and insulin resistance. According to Ayurveda, PCOD involves imbalances in the three Doshas, primarily Kapha and Vata. Vitiated Kapha causes Strotoavrodha, leading to Vata Vaigunyata. These Doshas also affect Rasa, Rakta, and Medas Dhatu, which in turn affect channels such as Rasa, Rakta, and Artava Vaha, resulting in symptoms like Artavkshya, absent menstruation, infertility, abnormal bleeding, and anovulation. A 24-year-old female patient presented at the PTSR OPD in RGGPG Ayurvedic Hospital, Paprola, with a history of irregular menstruation for the past four years. Her hormonal profile showed raised FSH and LH levels, and ultrasound examination revealed a bilateral PCOD pattern.

Aim and Objectives: The study aimed to evaluate the efficacy of Shodhan Chikitsa along with Yog Basti (Saindhvadi Tail Anuvasan Basti & Lekhan Aasthapan Basti) and Artav Janan Chikitsa in the management of PCOD.

Results: After undergoing Ayurvedic treatment the patient's menstrual cycle became regular, hormonal levels normalized, and ultrasound showed a disappearance of the PCOD pattern.

Conclusion: Ayurveda offers a promising approach to managing PCOD by restoring balance to the body and addressing the underlying imbalances that contribute to the disorder. The success of Ayurvedic management in PCOD lies in its holistic approach, which focuses on addressing the root cause of the disorder rather than just managing symptoms.

Keywords: PCOD, Lekhan Basti, Shaman Chikitsa, Artav Janan Yog

Corresponding Author How to Cite this Article To Browse
Sanskrati Nema, Post Graduate Scholar, Department of Prasuti Tantra Evum Stree Roga, RGGPG Ayurvedic College and Hospital, Paprola, Himachal Pradesh, India.
Email: 		Nema S, Kapil S, An Ayurvedic management of Polycystic Ovarian Disease: A Case Report. J Ayu Int Med Sci. 2024;9(7):360-365.
Available From
https://jaims.in/jaims/article/view/3357

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-05-12 2024-05-24 2024-06-04 2024-06-14 2024-06-24
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 13.65

© 2024by Nema S, Kapil Sand 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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Sanskrati N et al. An Ayurvedic management of Polycystic Ovarian Disease

Introduction

The female reproductive system's intricate balance, including the hypothalamo-pituitary-ovarian axis and uterine-adnexa, is crucial for bodily functions. Disruptions, like Polycystic Ovarian Disease (PCOD), characterized by irregular menstrual cycles, excess androgens, and ovarian cysts, are on the rise (5-15%) due to modern lifestyle changes. According to Ayurveda, PCOD involves imbalances in the three Doshas, primarily Kapha and Vata. Vitiated Kapha causes Strotoavrodha, leading to Vata Vaigunyata. These Doshas also affect Rasa, Rakta, and Medas Dhatu, which in turn affect channels such as Rasa, Rakta, and Artava Vaha, resulting in symptoms like Artavkshya, absent menstruation, infertility, abnormal bleeding, and anovulation.

Case Report

A 24-year-old female patient presented with complaints of irregular menstruation for the past year. She had a history of amenorrhea for six months, following which she underwent three months of hormonal therapy for withdrawal bleeding. However, she discontinued hormonal treatment as she was not willing to continue. Afterward, she experienced another two months of amenorrhea. Seeking a solution, she came in PTSR OPD at RGGPG Ayurvedic Hospital, Paprola to restore her normal menstrual cycle through Ayurvedic management. Her Hormonal profile revealed elevated FSH and LH ratio and ultrasound examination showed a bilateral PCOD pattern.

History of Past illness

No History of HTN, DM Type2, Thyroid Dysfunction, TB, Epilepsy, Jaundice, or any other medical illness.

History of Surgery

No history of any surgical intervention

Allergy:No any drug or food allergy

Family History: Nothing Significant

Previous menstrual history

Interval: 60-70 days
Duration: 2-3days
Amount: Moderate (2-3 pad per day)
Pain: Mild pain was present in lower abdomen
Clot: Not present
Smell: Not present

Age of menarche: 14 years

LMP: 16/11/2024

Marital Status: Married

Clinical Examination

Pulse78/min
BP120/80 mm of hg
Temp.98.4° F
RR20/min
Height5’2”
Weight56kg

No Icterus, Pallor, Edema, Lymphadenopathy.

Dashvidha Pariksha

PrakratiVata-Kapha
Vikrati Lakshan Nimittaj
Saar Madhyam
SamhananMadhyam
Praman Madhyam (5’2’’)
Satva Madhyam
Satamya Sarvaras Satmya
Aahar ShaktiAbhayaran Shakti - Madhyam
Jaran Shakti - Madhyam
Vyayam ShaktiMadhyam
VayaYuvavastha

Ashtavidha Pariksha

NadiNiyamit, Dosha- VataKapha, Gati -78/min.
Mala Samanya, Vega- 1-2 times/day, Varna- Peet
MutraSamanya, Vega- 4-5 times/day, Varna- Peet
ShabdaSpashta
SparshaSamsitoshna
Drika Samanya
JivhaAnavratt
AakritiSamanya

Per Abdominal Examination: Soft, Nontender.

P/S Examination: Mild tenderness was present over B/L fornices.

Investigation

Blood GroupB+ve
Bleeding time1 min.
Clotting time5 min 30 sec.
Hb11.4 g /ml
Platelet count173
ESR47 mm fall in 1st hr
FBS 92 mg/dl
Urine (routine & microscopic)EPC -2-3/hpf
HIVNR
VDRLNR

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Sanskrati N et al. An Ayurvedic management of Polycystic Ovarian Disease

Thyroid profile

T30.96 ng/ml
T46.27 ug/dl
TSH2.80 UIU/ml

Hormonal Profile

FSH4-8mg/dl
LH10-20mg/dl
AMH71 pmol/l
Prolactin11.54 ng/ml

Lipid Profile

Serum Cholesterol134mg/dl
Triglyserides140mg/dl
HDL39mg/dl
LDL67mg/dl
VLDL28mg/dl

Whole abdomen Ultrasound

Uterus: AV, Normal in shape & size.

Ovaries: Both the ovaries are enlarged in size & reveal the presence of small peripherally located follicles each measuring <10.0 mm Both the ovaries contain > 20 such follicles.

No fluid is seen in the POD.

Rt Ovary: 4.5x2.4x2.3 cm (Vol.12.92 cc)

Lt Ovary: 4.2x2.1x2.6 cm (Vol.11.92cc)

Impression: Sonological features are suggestive of Bilateral Polycystic Ovaries.
jaims_3357_00.JPG

Samprapti Ghatak

  • Dosha:Kapha-Vataj
  • Dushya:Meda, Mansa, Rakta
  • Srotas:Aartav Vaha Strotas
  • Srotodushti:Sanga
  • Adhishtthan:Garbhashaya
  • Sadhya-Asadhyta:Sadhya

Treatment planned for patient

Sanshodhan was planned for the correction of underlying pathology. Vamana Karma followed by Virechana Karma was done. Along with 1cycle of Yog Basti Basti was given.

Table 1: Shodhan Chikitsa (Vamana Karma) Started on 2/02/2024

1-3 DaysDeepan-PachanShunthi Churna given with lukewarm water.
for 5 DaysAbhyantara SnehpanaShuddha Goghrita given in Arohi Krama started with 30 ml given upto 200ml
6th Day of SnehpanSarvang Abhyang & Swedan§ After observed Samyak Snigdha Lakshan on 6th day, Sarwang Abhyanga and Swedan was done.
§ Kaphavardhak Ahara like milk products curd, kheer etc. was given.
7th DayKsheerpan and Vamakyog for Vamana K  arma§ Madanphala Sheet Kashaya (made of Madanphla Churna and Madhuyashti Kashaya).
§ Lavnodak was given for processing of Vamana Karma.
After Madhyam Shuddhi, Pittant Vaman was observed.
For 7 DaysSansarjan Karma

Table 2: ShodhanChikitsa (VirechanKarma) Started on 4/03/2024-

For 3 DaysAbhyantara SnehpanaShuddha Goghrita given in Arohi Krama started with 80 ml given upto 200ml
Subsequent 3 DaysSarvang Abhyang & SwedanAfter observed Samyak Snigdha Lakshan on 3rd day, Sarwang Abhyanga and Swedan was done.
On 7th DayVirechan KarmaVirechan Yog made by Triphala, Haritiki and Trivrit.

After Sanshodhan Karma, 1 cycle of Yog Basti with Saindhvadi Tail Anuvasan Basti & Lekhan Aasthapan Basti was given.

which was made by Makshik, Lavan, Sneh (Saindhvadi Tail), Kalka (Putoyavani Kalka), Kashaya(Triphla), Prakshep Dravya (Hingu,Shilajeet,Yavkshar).


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The order of the Basti

Table 3: YogBastiChikitsa Started on 29/03/2024

Day12345678
Types of BastiALALALAA

Along With Lekhan Basti, Artavjanan Chikitsa given to the Patient for 3 Months.

Table 4: Ayurvedic Medication (ArtavjananChikitsa) For 3 Months.

SNDrugComponentDoses
1.Vijaysar ChurnaVijaysar (Pterocarpus marsupium)3gm BD
2.Gorakhmundi ChurnaGorakhmundi (Sphaeranthus indicus)3gm BD
3.KumaryasavaKumari Ras, Makshika, Loha Bhasma, Panchakol, Chaturjataka, Triphala, Hapusha, Dhanyaka, Kramuka, Kutki, Rasna, Devdaru, Haridra, Bala, Atibala, Kapikacchu, Makshik Bhasma, Daruharidra, Punarnava, Dhataki, Pushkarmoola, Hingu, Gukshura, Danti, Yashtimadhu, Lavanga Marich.20ml BD
4.DashmoolarishtaBilva, Agnimantha, Kashmari, Shyonaka, Patala, Sarivan, Kantakari, Shalaparni, Prishniparni & Gokshur.20ml BD

Observation and Results

Improvement in menstrual cycle after the treatment

SNSymptomsBefore TreatmentAfter Vaman KarmaAfter Virechan KarmaAfter Lekhan Basti along with oral Ayurvedic medicine
1.LMP16/11/202413/02/202420/03/202414/04/2024
2.Interval between 2 cycles60-70 daysMenses start from 13/02/202428-30 days28-30 days
3.Duration of menses2-3 days3-4 days3-4 days3-4 days
4.Amount of Bleedingscantymoderatemoderatemoderate
5.Pain during menstruation+---

Investigation results before and after treatment

InvestigationsBefore TreatmentAfter Treatment
LH10-20mg/dl10.85mIU/ml
FSH4-8mg/dl7.44 mIU/ml
AMH71 pmol/l24pmol/l
Prolactin12ng/ml11.54 ng/ml

USG findings before and after treatment

InvestigationsRight OvaryLeft Ovary
Before TreatmentAfter TreatmentBefore TreatmentAfter Treatment
Number of NDF>20->20-
Diameter of NDF<10.0mm-<10.0mm-
Number of DFNot SeenNot seenNot seenNot seen
Ovarian Size4.5x2.4x2.3 cm3x2.5x1.5cm4.2x2.1x2.6 cm3x2.4x1.8cm
Ovarian VolumeVol.12.92 ccVol.3-6ccVol.11.92ccVol.4-6cc
Ovarian StromaEchogenicEchogenicEchogenicEchogenic

Discussion

PCOD, an endocrinological metabolic disorder, is often caused by lifestyle factors and stress. Ayurvedic treatments like Sanshodhan and Lekhan Basti effectively manage PCOD by addressing its root cause. Vijaysar with its Rasayana and Deepan-Pachan properties, Vijaysar aids in toxin elimination and metabolism improvement by reducing Kapha or Ama. It regulates blood sugar levels, which is beneficial for managing PCOD symptoms like insulin resistance and irregular menstrual cycles. Gorakhmundi has anti-androgenic properties that reduce testosterone levels, restoring the balance between FSH and LH. Additionally, it balances Kapha-Pitta Doshas in the body. Kumaryasava helps reduce the symptoms of PCOS due to its Vata-Kapha balancing properties. Dashmoola consists of Laghupanchmoola and Brihat Panchmoola, which have Vata-Pitta Shamak and Deepan-Pachan properties. It also contains Gokshura, which improves ovarian function, and Bilva, known for its antioxidative properties that may help reduce oxidative stress often present in women with PCOS.

Conclusion

PCOD is mainly caused by the imbalance of Vata and Kapha. Therefore, Ayurvedic treatment focuses on restoring balance to the body by normalizing Vata and Kapha, reducing Pitta aggravation, elimination of toxins (Amapachana), and promoting regular menstruation (Artav Janana). This holistic approach, addresses the root cause of the disorder rather than just managing symptoms, offering promising results for managing PCOD.


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Sanskrati N et al. An Ayurvedic management of Polycystic Ovarian Disease

References

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2. Shastri KN Pandey, Vidyotini Hindi Commentary on Charak Samhita of Charak (Vol 2) Siddhi Sthana: Chapter4, Verse 16. Varanasi: Chaukhamba Bharti Academy; 2020,16 p.925

3. Kashinath Shastri, Vidyotini Hindi Commentary on Charak Samhita of Charak (Vol 2) Kalpa Sthana: Chapter1, Verse 13. Varanasi: Chaukhamba Bharti Academy; 2017,16 p.896

4. Kaviraj Govind Das Sen Bhaisajya Ratnavali, edited by Mishra S, Vajikaranadhikara: Chapter74, Verse 354. Varanasi: Chaukhamba Surbharti Prakashan, 2024, p.1154

5. Dutta Text Book of Gynaecology Secondary Amenorrhea,7th edition. New Delhi, London, Philadelphia, Panama; JAYPEE Health Science Publisher; 2016.page no.378


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