Polycystic ovarian disorder is a multifaceted disease that affects the reproductive endocrine and metabolic system. The condition is confined in the reproductive age of women and mainly causes infertility in them. The two doctors described this disease in 1935 by the name Stein-Leventhal. According to Rotterdam, the disease was defined in 2003 as the occurrence of two incidences out of the three fundamental problems oligo ovulation and anovulation, hyperandrogenism, and polycystic ovaries (PCO). 4-12% of reproductive women (12-45 years) due to PCOD suffer from menstrual irregularities. The statistics claim 6-7% of women face PCOD worldwide. The percentage varies among countries as per their diversities, but India is on a great hike, nearly 35% of women are undergoing from the symptoms of PCOD.
The primary criteria for the diagnosis of PCOD are infertility, ovarian dysfunction, hyperandrogenism, insulin resistance, chronic anovulation, and metabolic dysfunction such as obesity, type 2 diabetes, and cardiovascular disorders. Significant symptoms include infrequent periods within 3-4 years, heavy or light blood flow during periods, abdominal discomfort during periods, weight gain, bone pain (arthralgia), hair loss (alopecia), excessive hair growth on the face, neck, chest, and lower abdomen (skin tags), constipation and indigestion.
Different medicinal systems provide different rates of treatment for PCOD. The allopathy can manage and control the condition but generally do cure the disease.
Homeopathy and Ayurvedic have proved the cure of illness in several cases. Also, the latter two approaches deal with minimal side effects. The primary focus of all the treatments is always infertility, acne, or obesity.
Ayurvedic Treatment of PCOD
PCOD is a disease in which cysts get formed on the ovaries, which destroys the normal functioning of the ovary. Ayurveda describes the disease by involving the Dosha, Dhatu (Vata, Pitta & Kapha), and Upadhatu. The system does not define the condition in a single term but a combination of different relatable terminologies such as
- Anartava: amenorrhoea
- Yonivyapad: anatomical & physiological disorder of the reproductive system
- Arajaska: oligomenorrhea due to vitiation of Vata dosha
- Lohitaksha: oligomenorrhea due to vitiation of Vata-pitta dosha
- Vandhya: infertility
- Abhijata: anovulation
- Rajo Dushti and Ash Artava Dushti: menstrual flow disorder due to vitiation of dosha
- Shandhi Yonivyapad: vitiation of Vata due to genetic factors resulting in menstrual irregularities and sometimes anovulation
- Vishama and vihara (improper diet and activities), which cause digestive and metabolic problems can lead to the formation of immature rasa and Vata Prakopa. The immature rasa vitiates the menstrual blood, which leads to an increase in media Dhatu, and Kapha obstructing the body channels, and Vata Prakopa causes obesity and amenorrhea.
Hormonal imbalance and incomplete metabolism occur due to the abnormal enzymatic reactions caused by the formation of ama (undigested food). The latter is responsible due to the Vata & Kapha and Vishama Aahar & Vihara. The hormonal imbalance leads to hyperinsulinemia and hyperandrogenism, ultimately causing anovulation, amenorrhea/oligomenorrhea, and polycystic ovaries.
The treatment principle of Ayurveda is to clear the obstruction in the pelvic cavity (Apana Kshetra), which is responsible for the flow of Vata and accumulation of Kapha and Pitta. It will normalize the metabolism and regulate the menstrual system (Artava Dhatu). Polycystic ovarian disorder associated symptoms is treated with Kapha reducing, increasing insulin release, and hormone rebalancing medicines.
Triphala Kwatha, Chandraprabha Vati, and Manibhadra Churna: It helps in clearing the obstruction and normalizing the Srotas. Triphala and Guggul are highly beneficial in reducing weight.
A. racemosus powder: It brings the balance and strength to the menstrual system and helps in regulating the Artava Dhatu.
P. graveolens seeds powder, Krishna Jeeraka oil, and Sahachara oil: It helps in destroying polycystic ovaries and stimulating follicular maturity.
- Guduchi Chadiya powder: It increases the overall immunity
- Atibala powder: It helps in conceiving and preventing miscarriage.
- Uttara Vasti: One of the most effective drugs of Ayurveda for gynecological disorders. It helps in purification and clearing of Artava Vaha Srotas, pacifying vitiated Apana Vayu, and ultimately improves follicular maturity.
Allopathic Treatment for PCOD
The principal behind the allopathy treatment is treating the hormonal imbalance by HRT (Hormone Replacement Therapy). There is a misconception that malfunctioning of the insulin hormone causes PCOD and diabetic drugs like metformin was prescribed in those cases as an insulin sensitizer. When medicinal therapy does not work, practitioners approach to surgery. In this, the ovary is pierced or perforated, or cystic tissue is destroyed for better hormone gain. Sometimes surgery is preferred over hormonal therapy as the administration of artificial hormones in the body depletes the natural endocrine system and makes the body lazy. The chemicals which were once released by the body naturally cannot be compensated by artificial means. Therefore, HRT, despite its significant therapeutic effects, cannot be used in the long run.
The two major drugs used along with HRT in the treatment of PCOD are
- Metformin: It lowers the TSH levels of the body.
- Clomiphene combined with low doses of Dexamethasone: PCOD has a strong association with preeclampsia, premature birth, and gestational diabetes. The prescribed dose suppresses androgen production from adrenal glands.
The failure of allopathy in a higher percentage of people is due to the unwanted side effects attached to the therapy, such as bloating, pelvic pain, night sweats or vasomotor symptoms, blurred vision, yellowing of eyes & skin, malnutrition, substantial menstrual period or bleeding.
Homeopathic Treatment for PCOD
This mode of treatment is considered very safe and free from side effects. Homeopathy focuses on dissolving or solubilizing the cyst to eliminate the need for hormonal therapy or surgery. Hence, the treatment works on the root cause of the problem. Homeopathic doctors recommend exercises such as at least 30 minutes walking, aerobics, swimming, etc. along with the medicines. The list of homeopathic medicines used for PCOD includes Apis, Pulsatilla, Sepia, Lachesis, and Graphites. Out of these, Sepia is considered the best cure for PCOD, while Pulsatilla is used for suppressing menses. Also, Thujaoccidentalis is used in slow menstrual flow. The same drugs are beneficial in the treatment of extreme hair growth on the unnecessary part of the woman’s body. Another drug Lycopodium (LYCO) is used for vomiting, indigestion, bloating, constipation, anxiety and insomnia. Lachesis is used in PCOD women for blood poisoning, menopause, tonsillitis, and uterine problems.
Clinical Efficacy Of Ayurveda Treatment Regimen On Infertility Associated With Polycystic Ovarian Disorder
PCOD patients undergoing infertility relates to the elevated hormone, insulin levels, which can interfere with the implantation or development of an embryo. Chances of conception reduce, and misconception increases with the increase in the level of luteinizing hormone in the woman’s body. The additional disturbed insulin level can decrease the quality of the egg and ultimately causing miscarriage. Osuki Ayurveda Centre conducted a study to determine the cure of infertility associated with PCOD.
Patients: Forty patients (25-40 years aged) of infertility with PCOD were recruited from the Osuki Ayurveda Centre, Rajagiriya, Sri Lanka, for the study. After their selection, they were clinically examined for FSH, LH levels & its ratio, Testosterone, FBS, Lipid profile, Liver function test, and USG.
Criteria for Diagnosis
The prevalence of any of the three incidences was set as the criteria for the diagnosis of PCOD:
- Polycystic ovaries on ultrasound sonography
- Oligomenorrhea or anovulation
- Elevated LH
- LH: FSH ratio >3
Patients suffering from diabetes mellitus, hypertension, thyroid disorder, hyperprolactinemia, heart diseases, renal disorders, congenital adrenal hyperplasia, or any other gynecological disorders were not made part of the study. Also, the male partners of selected candidates were checked for any abnormalities in Seminal Fluid Analysis, which can cause subfertility.
Method: The treatment regimen consisted of three stages to be completed in six months.
Stage 1 (Day 1 to 14): 30 ml of Triphala Kwatha, two pills of Chandraprabha, and five grams of powder of Manibhadra twice a day in the morning and evening was set as the dosage schedule for the subjects. The medicines were selected to purify the body of patients, and also, these drugs are beneficial for the functioning of female genital organs.
Stage 2 (Day 15 to 4th month): Five grams of each powder of Shatavari (increase follicular maturity), Shatapushpa (increase follicular maturity & reduces pain & menstrual irregularities), and Guduchi (enhance immunity) twice a day in the morning and evening was administered in this duration. Also, the subjects were given Krishna Jeeraka (20ml) twice a day in the morning and evening.
Stage 3 (4th to 6th month): Five grams of each powder of Atibala (improves hormonal imbalance and reduces miscarriage) and Shatapushpa and four pills (each 125 mg) of Rasayana Kalpa (Terminalia chebula, T. bellerica, Embelica officinalae, T. cordifolia, Naredostachys jatamansi, Herpestis monnieria) was administered twice a day in the morning and evening at 6PM. Also, the candidates were prescribed 20ml of oil of Sahachara (remove unwanted follicles) twice a day in the morning and evening at 8 PM. Patients in their cessation of blood flow from 4th to 10th day of the periods were treated with Uttara Vasti with five ml oil of Shatapushpa for two consecutive days every month.
Outcome measures: The efficacy of the therapy was measured in terms of symptomatic relief, Ultrasonography results (changes in the ovaries and follicles due to the treatment), and LH/FSH hormones (balanced hormones levels after the procedure). hCG test confirmed the pregnancy in cured women.
Statistical analysis: The selected subjects were four to six years of married housewives suffering from primary subfertility. Before the treatment, for six months, 80% of them were not using any contraceptive methods, while 10% used oral contraceptives, and 5% used a condom and other natural processes. None of the patients took any medicine within one year for PCOD or infertility before the study.
Selected candidates complained about menstrual irregularities, less blood flow during periods that too for only three days or less, excessive hair growth on face & chest, skin discoloration, and obesity. The evaluation of therapy was done based on improvement in these cardinal symptoms. The symptoms were analyzed and compared with baseline by using the student’s paired ‘t’ test.
Results: USG reports signified reduction of polycystic ovaries and improved follicular maturity. LH/FSH ratio came to normal levels. At the end of treatment, 85% of the women were successfully cured of the polycystic ovarian disorder, while 75% of them reported being pregnant. Irregularity could be observed in only 25% of the patients. 75% of them were relieved from dysmenorrhea, and 70% had an average quantity of menstrual blood. Regarding skin coloration, 87.5% of women reported a complete absence of the symptom. Despite these fantastic results, excessive hair growth on unnecessary body parts did not show significant improvement.
Discussion: Infertility due to PolyCystic Ovarian Disorder can be cured for a lifetime by using Ayurveda described above treatment regimen.
Polycystic ovarian disorder is a gynecological disorder that occurs due to the hormonal changes and mainly characterized by menstrual irregularities, amenorrhea, dysmenorrhea, weight gain, excessive hair growth on face, neck & chest, and most importantly infertility. A considerable percentage of women suffer from this disorder worldwide, but the significance varies country wise. India is on the top list of the statistics due to several reasons, among which Aahar vihar (diet) is the sole reason. The reproductive women opt for different medicinal therapies for the treatment, such as Ayurveda, Allopathy, and Homeopathy.
Allopathy works by the administration of artificial hormones in the body and does not focus on the root cause of the problem. Hence, allopathy cannot cure the disease. Ayurveda and Homeopathy promise to cure the disease. An Osuki Ayurveda Centre in Srilanka submitted a report on curing of infertility associated with PCOD in 20 to 45 years aged women, and a significant ladies were found pregnant at the end of the study. Only excessive hair growth on the face, chest & neck did not improve significantly. Otherwise, all cardinal symptoms, i.e., irregular menstruation, heavy or less blood flow, amenorrhea, dysmenorrhea, and skin discoloration, got treated very well. Hence, Ayurveda has proved in the medicinal region for the cure of polycystic disorder with negligible side effects of the therapy.
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