Introduction
PCOS is a problem with hormones that affects women during their childbearing years. Many women have PCOS but don’t know it. Polycystic ovary syndrome (PCOS) is a condition that affects a woman’s hormone levels. Women with PCOS produce high amounts of male hormones than normal. This hormonal imbalance causes them to skip menstrual periods and makes it harder for them to get pregnant.
Although it is a disease primarily affecting the reproductive system, it has effects on the whole body. It produces signs and symptoms in areas other than the uterus & ovary. These include hair growth on the face and body and baldness. And it can contribute to long-term health problems like diabetes and heart disease.
In many cases, birth control pills and diabetes drugs can help fix the hormone imbalance and improve symptoms with necessary changes in diet & lifestyle.
Signs & symptoms
PCOS is mostly diagnosed as a part of treatment for infertility. Some women with recent excessive weight gain and missed periods when tested, get the same diagnosis.
The most common PCOS symptoms are:
- Irregular or missed or late periods with heavy bleeding and other discomforts.
- Extra hair growth – hair on their face and body — including on their back, belly, and chest. It is called hirsutism.
- Acne – Male hormones can make the skin oilier than usual and cause breakouts on areas like the face, chest, and upper back.
- Recent weight gain leading to obesity
- Baldness like in males – Hair on the scalp gets thinner and falls out.
- Black discoloration of the skin – Dark patches of skin can form in body creases like those on the neck, in the groin, and under the breasts.
- Headache
Causes
The exact cause is still not known.
Genes, insulin resistance, and a high level of inflammation in the body are considered to be related to excess androgen production.
Pathophysiology
PCOS affects a woman’s ovaries, the reproductive organs that produce estrogen, and progesterone — hormones that regulate the menstrual cycle. The ovaries also produce a small number of male hormones called androgens. The ovaries release eggs to be fertilized by a man’s sperm. The release of an egg each month is called ovulation. Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) control ovulation. FSH stimulates the ovary to produce a follicle — a sac that contains an egg — and then LH triggers the ovary to release a mature egg.
PCOS is a “syndrome,” or group of symptoms that affects the ovaries and ovulation. In PCOS, many small, fluid-filled sacs grow inside the ovaries. The word “polycystic” means “many cysts.” These sacs are follicles, each one containing an immature egg. The eggs never mature enough to trigger ovulation. The lack of ovulation alters levels of estrogen, progesterone, FSH, and LH. Estrogen and progesterone levels are Low Progesterone than usual, while androgen levels are higher than usual. Excess male hormones disturb the menstrual cycle, so women with PCOS get fewer periods than usual.
Diagnosis
- Case history
- Physical examination
- Pelvic examination
- Blood tests to check the levels of male hormones.
- Ultrasound scan
- PCOS is diagnosed when a woman has at least two of these three symptoms
- high androgen levels
- irregular menstrual periods
- cysts in the ovaries
Treatments
Lifestyle interventions are the first treatments doctors recommend for PCOS, and they often work well. Weight loss can treat PCOS symptoms and improve the odds of getting pregnant. Diet and aerobic exercise are two effective ways to lose weight.
Medicines are an option if lifestyle changes don’t work. Birth control pills, Clomiphene, and metformin can both restore normal menstrual cycles and relieve PCOS symptoms. Hair removal creams and treatments are done in needed cases. Surgery is also an option where other therapies fail.
Prognosis
PCOS is a life-long condition that can be managed but a permanent cure is not possible. Without treatment, women with PCOS are at increased risk of several complications.
Complications
- Infertility
- Gestational diabetes or pregnancy-induced high blood pressure
- Miscarriage or premature birth
- Non-alcoholic steatohepatitis — a severe liver inflammation caused by fat accumulation in the liver
- Metabolic syndrome — a cluster of conditions including high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that significantly increase your risk of cardiovascular disease
- Type 2 diabetes or prediabetes
- Sleep apnoea
- Depression, anxiety, and eating disorders
- Abnormal uterine bleeding
- Cancer of the uterine lining (endometrial cancer)
- Obesity is associated with PCOS and can worsen complications of the disorder.
Disease & Ayurveda
In Ayurveda, cysts are considered as granthi which are unwanted and abnormal growths that can develop wherever possible in the body. Ayurveda explains that the vitiated doshas travel from their sites throughout the body and get lodged where there are abnormalities or damage in the circulatory channels(srotas). When the doshas cause granthi in aartavavahasrotas (reproductive channels) it is called granthiartava.
Nidana
- Causative factors for the vitiation of Kapha and Vaata
- Unwholesome diet and lifestyle during menstruation
Purvaaroopa
Not mentioned
Samprapti
When vitiated Kapha and Vaata in women reach the reproductive organs and get lodged in andasaya, artava production is affected and the development of it is delayed & arrested in andasaya. Due to the kapha and vaata doshas, it forms a cyst-like growth which leads to granthiartava
Lakshana
- Irregular menstrual bleeding with clots
- Lower abdominal pain
Divisions
Not mentioned
Prognosis
- Saadhya in new cases in healthy women with no complications.
- Yaapya in chronic cases
Chikithsa
The aim of Ayurvedic medicine treatment in granthiartava is to remove and expel the kapha dosha blocking the normal functioning of Vaata. This will help the reproductive system functioning in the normal way. To eliminate kapha, vamanam and nasyam are done if the patient is suitable. After clearing the obstruction in channels, treatment is given to enhance artava formation and development in a normal way. Nasya has a specific effect on ovulation, about stimulation of Hypothalamo-Pituitary-Ovarian axis. Along with kaphahara treatment, Vaata should also consider as Ovary in Pakwasaya is the seat of Vaata and the process ovulation is controlled by Vaatadosha too.
Samana
- Aamapaachana
- Agnideepana
- Internal medicines and diet with ushna-teekshna (hot, pungent & penetrating) properties
- Krishna Tila, kulattha
Sodhana
- Sneha-sweda
- Vamana
- Virechana
- Kashayavasti
- Snehavasti
- Uttaravasti
Commonly used medicines
- Varanadi kashayam
- Sapthasaram Kashayam
- Kanasathahwadi Kashayam
- Sathavareechinnaruhadi Kashayam
- Thila Qwath
- Pathadi kashayam
- Sukumaram kashayam
- Kallyanagulam
- Nirgundyadi kashayam
- Chiruvilwadi kashayam
- Kumaryasavam
- Asokarishtam
Patented Medicines
- M 2 Tone Tablets
- Hyponidd Tablets
- Eranada Sukumaram Capsules
- Sahacharadi 21 Capsules
Brands available
- AVS Kottakal
- AVP Coimbatore
- SNA oushadhasala
- Vaidyaratnam oushadhasala
Home remedies
No home remedies can completely cure ovarian cysts. But a healthy diet and lifestyle can help manage the discomforts.
Diet
1.To be avoided
- Heavy meals and difficult to digest foods – cause indigestion.
- Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
- Carbonated drinks – makes the stomach more acidic and disturbed digestion
- Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
- Milk and milk products – increase kapha, obstruct channels, and obesity
- Curd – causes vidaaha and thereby many other diseases
2.To be added
- Light meals and easily digestible foods
- Green gram, soups, sesame oil
- Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain, etc
Behavior:
- Protect yourself from an extremely hot climate.
- Better to avoid exposure to excessive sunlight wind rain or dust.
- Maintain a regular food and sleep schedule.
- Avoid holding or forcing the urges like urine, faeces, cough, sneeze, etc.
- Avoid a sedentary lifestyle. Be active
Yoga
As granthiartava develops due to stagnant Kaphadosha due to a sedentary lifestyle, regular exercising is advised unless severe pain present. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana for apaanavayu correction is recommended.
Regular exercise helps improve the bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
