Polycystic Ovary Syndrome (PCOS): An Integrative Ayurvedic and Modern Medical Perspective

Abstract

Polycystic Ovary Syndrome (PCOS) is a multifactorial endocrinological and metabolic disorder commonly affecting women of reproductive age. It is characterized by chronic anovulation, hyperandrogenism, and polycystic ovarian morphology, often associated with obesity, insulin resistance, and infertility. Objective: To provide a comprehensive overview of PCOS through an integrative lens combining modern diagnostic and clinical understanding with Ayurvedic principles, pathogenesis, and therapeutic interventions. Methodology: This review synthesizes classical Ayurvedic texts, modern diagnostic criteria (Rotterdam), and evidence from published clinical trials on Ayurvedic formulations and purification therapies (Shodhana). Key Ayurvedic concepts such as Kapha-Vata vitiation, Rasavaha and Medovaha Srotodusti, and Agnimandya were explored in relation to PCOS pathophysiology. Results: Ayurvedic management, including lifestyle correction (Nidana Parivarjana), Shodhana (Vamana, Virechana, Basti, Nasya, Uttar Basti), and Shamana therapies (Deepana, Pachana, Lekhana, Artavajanana), has demonstrated promising results in restoring menstrual regularity, reducing cyst size, and improving metabolic markers. Evidence-based interventions using Shatapushpa, Kanchanara Guggulu, and yoga practices further support integrative management. Conclusion: Ayurveda offers a holistic and individualized approach to PCOS management by targeting root causes and balancing doshas. Further clinical research is warranted to validate traditional practices using modern tools and outcome measures.

Introduction

PCOS Overview:
PCOS is a prevalent endocrine disorder in women of reproductive age, marked by chronic anovulation, hyperandrogenism, and polycystic ovaries. It affects 2–21% of women globally, depending on diagnostic criteria. Common complications include menstrual irregularities, infertility, insulin resistance, obesity, T2DM, and cardiovascular risks.

Clinical Features

• Obesity (especially abdominal) – ~50%

• Menstrual issues – oligomenorrhea, amenorrhea (~70%)

• Infertility, hirsutism, acne, acanthosis nigricans

• Diagnostic tools include Ferriman-Gallwey score (>8 = hirsutism) and Rotterdam Criteria (2003):
  Requires 2 of 3:

  1. Oligo/anovulation

  2. Hyperandrogenism

  3. Polycystic ovaries on ultrasound

Ayurvedic Perspective

Pathophysiology (Samprapti)

• Kapha impairs follicle growth

• Vata (esp. Apana Vayu) disrupts ovulation

• Pitta imbalance leads to hormonal dysfunction

• Causes include poor diet/lifestyle (Mithya Ahara/Vihara), genetic factors, and hormonal imbalances

Affected Systems

• Doshas: Kapha ↑, Vata deranged

• Dhatus: Rasa, Rakta, Mamsa, Meda

• Srotas: Rasavaha, Raktavaha, Mamsavaha, Medovaha, Artavavaha

• Agni disruption leads to Ama and disease progression

Clinical Correlations (Ayurveda–Modern)

• Anartava/Vandhya = Amenorrhea/Infertility

• Sthoulya = Obesity

• Mukhadooshika = Acne

• Prameha = Insulin resistance/Diabetes

• Atiloma = Hirsutism

Ayurvedic Management

A. Nidana Parivarjana – Eliminating root causes through:

• Balanced diet, daily routine, exercise, stress reduction, and sleep

B. Shodhana Chikitsa – Detoxification:

• Vamana (emesis) – clears Kapha & Ama

• Virechana (purgation) – purifies Pitta-Kapha

• Basti (enema) – regulates Vata

• Nasya & Uttar Basti – stimulate hormones, improve ovulation

C. Shamana Chikitsa – Pacification therapy:

• Herbs and formulations: Trikatu, Shatavari, Kumaryasava, Kanchanara Guggulu, etc.

D. Yoga & Pranayama – Improve endocrine function:

• Asanas: Sarvangasana, Paschimottanasana, Surya Namaskara

• Pranayama: Bhastrika, Ujjayi

Scientific Evidence

Clinical trials show that Ayurvedic therapies (e.g., Shodhana, herbal formulations) significantly improve menstrual cycles, hormonal levels, BMI, and reduce ovarian cysts (p < 0.0001).

Conclusion

Despite advancements in understanding PCOS, ambiguities remain regarding its exact pathophysiology and treatment. Integrating Ayurveda into PCOS management provides a holistic approach aimed at restoring doshic balance and reproductive health. Further clinical research grounded in Ayurvedic principles is essential to validate and refine these therapeutic approaches.

References

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Copyright

Copyright © 2025 Dr. Khushboo Sharma, Dr. Harsh Sharma, Dr. Rajouri Joshi. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.