Known among medical practitioners as just PCOS, Polycystic Ovarian Syndrome is a major ailment of women of the reproductive age, with strong links to modern lifestyle. Streeroga expert Dr. Jeena Aravind tells us why some women have ovaries that function peculiarly and in abnormal ways resulting in PCOS, and how Ayurveda can help deal with this condition.
It is one of the most common multi-system involved disorder as well as a panicky reproductive health issue with puzzling patho-physiology.It is complex and works like a jigsaw puzzle with various causes that determines the heterogeneity in its presentations. It can have many manifestations in the metabolic, endocrine and reproductive systems. It is the reason for a majority of menstrual disturbances and anovulatory infertility that we see today. Polycystic Ovarian Syndrome or PCOS is a major cause of worry among women.
Normal menstruation, ovulation and fertility are part of the well-being of women. Different entities of physiology such as metabolic, endocrine, cognitive and reproductive systems are present well in a healthy person. These are often inter-connected too. Hormonal co-ordination and the resultant regular ovulation presents itself in the normal female reproductive physiology.
In the Ayurvedic perspective, the entire edifice of physiology rests on the disciplined state of dosha, dhatu and mala. When the functioning of any of these elements is disrupted, the interplay of hormones and ovulation becomes disorderly. This results in a disturbed hypothalamo-pituitary-ovarian axis that is often multi-factorial.
Drilling down further into the ayurvedic perspective, we can say that agni and vayu have a leading role in the menstrual physiology. Agni is the tool of all subtle and major transformations of the body. Any malfunctioning of the agni can have an impact on every element of the body. Vayu is the other controller and co-ordinator of all bodily functions. This when disturbed, can tilt the physiological balance of the body. Sometimes the functioning of vayu is impaired by stress and strain. It is vitiated when its pathways are obstructed by ill-formed elements, which does not happen suddenly.
Generally, the mental well-being helps reproductive physiology to maintain its normalcy. It can be seen that psychological stress is often associated with menstrual disturbances. Genetic factors also favour the changes from normal ovaries to polycystic ones with a strong support from the erratic physiology. The specificity in the causes and/or the deranged pathways of transforming bodily elements may determine the pathogenesis and clinical presentations of the spectrum. When this erratic physiology forms a spectrum of events that is manifested as hyper-androgenic environment with PCO changes and/or infrequent ovulation, the condition may be termed as PCOS.
Key villain: food habits
Of late, frequent snacking, less or excess food intake, frequent dining out, skipping of breakfast, and intake of junks, processed, fast food and sweetened food stuffs have become increasingly prevalent among females of reproductive age. This can have unhealthy outcomes in the long run resulting in metabolic issues. Such eating habits, coupled with a sedentary lifestyle, can lead to occurrences of PCOS. Favourable genetic background maybe a hidden risk factor that triggers the journey to an altered H-P-O axis, ovarian dysfunction and aberrant follicular micro environment in the presence of etiologies. Thus, health problems may escalate with the cumulative effect of all these entities.
Majority of PCOS women are obese/overweight in nature. Menstrual abnormalities comprise of oligomenorrhea, amenorrhea, hypomenorrhea or episodic menometrorrhagia. Features of hyper-androgenism are hirsutism, acne and crown pattern baldness. Infrequent ovulation is a common feature in those affected with PCOS. This can also be a major reason for infertility too. Acanthosisnigricans is seen in many PCOS affected women. The PCOS state, if left untreated, can lead to dyslipidemia and Type-2 diabetes mellitus. Gestational diabetes is a common pregnancy complication among those affected with PCOS.
Ayurvedic management of PCOS aims at reversing the disturbed internal environment back to a healthy state. Here, the factors behind the cause of PCOS in a particular subject is explored. Measures are taken to erase this picture using the basic principles of Ayurveda. Such an individualised approach, considering the severity and specificity of causes and manifestations, can result in successful outcomes.
Lifestyle intervention is always the mainstay of PCOS management. There is no such formula in Ayurveda connecting the PCOS with certain medicines alone. A wide range of medicinal combinations seem to have promising results in this condition. Appropriate ones can be selected after individual evaluation. Those with adverse reproductive profile and obstetric outcomes can be better managed with vasti as a part of the pre-conception care. Psychological well-being is quite essential here. Co-morbidities can also be well managed with medicines along with regular physical activity with diet modification.
Department of Prasooti- Streeroga
Astamgam Ayurveda Chikitsalayam & Vidyapeedham