Ayurvedic Management of Polycystic Ovary Disease or PCOD
By Dr. Sajimon George BAMS. AAA. ATMS
Polycystic Ovary Syndrome – PCOS or Polycystic Ovary Disease – PCOD is a disease characterized by two to five times bigger ovaries and multiple cysts or numerous small sacs filled with fluid. Such ovaries are bigger than normal ovaries, and they have a white, thick, tough outer covering.
PCOS usually affects a woman’s menstruation cycle, fertility, hormonal balance, insulin production and usage, heart, blood vessels and physical appearance. About 5 -10 percent of women of childbearing age have PCOS. Women are usually diagnosed when they are in their 20s or 30s. This can also lead to infertility.
Symptoms of PCOD
- Acne, its aggravation
- Enlarged ovaries with multiple small cysts
- Irregular menstrual periods – no menstrual periods or irregular bleeding
- Decreased breast size
- Anovulation (lack of ovulation and therefore infertility)
- Dysfunctional uterine bleeding (abnormal bleeding patterns at mid cycles)
- Hirsutism (excess hair growth, usually in a male pattern)
- Facial hair
- Thinning of the scalp hair
- Change of voice may be present
- Insulin resistance (problems with blood sugar regulation)
- Male-pattern hair loss and fat deposition
- Weight gain, difficulties losing weight, central obesity
Cause is yet not known. May be hereditary – often transmitted from mother. Obesity may be a cause – fat tissues may produce estrogens which disrupts ovulation.
PCOS may be due to: High levels of insulin in the blood.
- There is no single test to diagnose PCOS. But, physical examination including an ultrasound, hormone level tests and blood sugar levels can help in diagnosis. During a pelvic examination, the ovaries may be enlarged or swollen by the increased number of small cysts.
Ayurvedic Management of PCOD
The treatment principle is to clear obstruction of Vatha humor in the pelvis, normalize metabolism and regulate the menstrual system (arthava dhatu).
Ayurveda classifies PCOS as a kapha disorder. The organs responsible for reproduction in the female body are called artava dhatu. The subtle channels that supplies, nourish and enable the functional action of carrying the ovum to the uterus is called artava vaha srota.
All three humors play important and distinctive roles in the processes involved in the female reproduction which includes the ovarian cycle and the menstrual cycle.
Vatha is responsible for movement of the follicle during the ovarian cycle, the rupture of the ovary wall releasing the matured ovum, the movement of the fimbriae (the finger like projections that guide the ovum into the fallopian tubes and the movement of the ovum towards the uterus). These actions are due to Apana vatha (Subdivision vatha). Apana vatha is also responsible for the movement of menses during menstruation and the energy behind the downward movement of a baby through the birth canal during labour etc.
The actions of the hormones express the function of pitha, the energy responsible for transformation. All stages of the female reproductive process such as different stages of the ovarian and menstrual cycles are a result of the interplay of hormones and are controlled by pitha.
Kapha nourishes the development of the tissues that form and support the reproductive system including the nurturing energy supporting growth of the follicle during the ovarian cycle. It is responsible for the mucosa layer of the fallopian tubes and endometrial uterus that protects the tissues from the drying effect of omnipresent vatha.
PCOS is due to kapha blocking vatha and pitha, hence movement is obstructed and the transformation process is suppressed.
Vitiated Kapha first affects the digestive fire – agni and starts to affect the transformation of the seven tissues. In the case of PCOS the dhatus that are affected are rasa dhatu – lymph and plasma, medo dhatu – fat tissue and artava dhatu – the female reproductive system.
Increased rasa dhatu circulating the body via the circulatory system mixed with increased ama or partially digested dhatus begins to coat the cells of the body, this begins to affect subtle channels or srothas. Due to the increased sticky and heavy qualities of rasa dhatu, kapha and ama, the cell membrane of the tissues are coated and affects cellular intelligence causing insulin receptors on the cell to not recognize chemical structures that normally engage them.
Insulin unable to engage cellular receptors begins to build up in the blood stream moving towards artava dhatu where it comes across free receptors that engage its molecular structure.
Aggravated kapha and ama having affected rasa dhatu moves through the channels to medo dhatu. Meda dhatu is often one of the first dhatus along with rasa dhatu to reflect a kapha aggravation resulting in obesity.
As medo dhatu is increased, along with kapha and ama it starts to block the channels of the body. Artava dhatu thus affected by the heavy and sticky qualities of kapha and ama causes improper functioning of subtle channels of female reproductive organs or artavavaha srotas.
Apana vatha in artava vaha srotas is blocked, affects the normal functioning of Vatha in the ovarian cycle. Free androgens moving throughout the body are processed at the level of medo dhatu and it is also affected.
Since Vatha is blocked, Pitha fails in functions involving movement or otherwise it is also blocked. As Pitha is blocked the hormones that carry the energy of transformation are unable to initiate their action. The accumulated Kapha humor is manifested as the formation of the cyst in the ovary.
Menstrual problems manifest due to the aggravation of all three doshas but the basic cause is Apana Vatha.
“Without the aggravation of Vatha, the females does not get disorders, hence it should be treated before Pitha and Kapha” This principle given by Achaarya Vaghbhata successfully lead us throughout the treatment of PCOS.
Ayurvedic line of treatment of PCOS
Holistic system of medicine considers body and mind as a single unit depending on each other. The Ayurvedic system is an age old holistic system of medicine, so treatment corrects hormonal functions of insulin, sex hormones etc altogether. Every treatment procedure or medicine will be prescribed only after considering each complaint presented by the patient such as diabetes, obesity etc.
The initial step is weight reduction through food control and modification of lifestyle.
The next step includes Panchakarma techniques such as Vamana, Virechana, Vasthi, Uthara Vasthi, and Nasya. Prior to all these panchkarma procedures oral administration of medicated oil and steaming is mandatory.
Oral administration of medicated oils
It has fat burning properties, which is performed using herbal decoction and powder of suitable herbs. This is useful in dissolving fat blocking subtle channels all along the body.
Steaming and other heating procedures: Oils are never used. It is useful in removal of blockage of subtle channels or srothas.
Vamana or Medicated vomiting
Suitable medicines are given orally to induce vomiting.
Virechana or Medicated purgation
It is a cleansing method, performed by giving some herbal purgatives in oil form which help to eliminate blockage of pathways of Vatha humor.
Vasthi or Enema like procedure
Designed to clean the lower alimentary canal and most effective in Ayurvedic treatment bringing cleansing of subtle channels or srothas spread all over the body. This is very effective in aggravated Vatha through removal of blockage in pathways of vatha humor thus enable us to calm Vatha aggravation. This include anal administration of medicated oil alone called Anuvasana Vasthi followed by Nirooha Vasthi where medicated oil, suitable herbal decoction, rock salt, honey and paste of herbal powder are mixed together and administered together.
This is different from common vasthi in the way of administration, quantity and in ingredients. Medicine is applied to uterus through vaginal route. This is very useful in Poly Cystic Ovarian Disease.
Nasal administration of medicines. After the above mentioned procedures suitable medicine is administered through nostrils. Suitable medicated oils or herbal juices are administered through each nostril in a specific dosage.
In this clinical condition since pituitary gland is involved, nasya is found to be very effective.
Ayurvedic diet and activities for PCOS or PCOD
A strict diet regime has to be followed during the entire treatment period since many physiological systems are impaired in this condition.
1) Regular exercise is recommended – Evening or morning walk.
2) Consumption of vegetables preferred – bitter guard and drumsticks.
3) Do check fasting and post lunch blood glucose at least once a week.
4) Strictly follow doctor’s drug regimen and diet.
5) Drink at least 8 – 10 glasses of water daily.
Therapeutic Yoga and Meditation
Ayurveda emphasizes on the effect of stress in PCOD.
Psychological state of mental well being can positively influence higher mental functions and thus pituitary. Practice of Yoga and meditation are useful.
A proper yoga program after medical opinion can improve accumulated fat, insulin resistance.
1) Reduce alcohol consumption and smoking. Black gram, sour items, chillies and salted things have to be avoided.
2) It is better to avoid refrigerated/chilled foods.
3) Avoid caffeine and alcohol
4) Avoid day sleep which will worsen total situation of a PCOD patient.
5) Avoid freshly harvested grains and sesame seeds in particular.
6) Avoid milk and milk products, particularly yogurt and buttermilk.
7) Avoid fish and jaggery.