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Introduction

Polycystic ovarian syndrome is the most common endocrine disorder in a woman of reproductive age. This heterogeneous disorder is characterized by excessive androgen production by the ovaries mainly. PCOS is a multifactorial and polygenic condition.As per the Rotterdam Criteria, PCOS is defined as the presence of any two of the three features:

1. Oligo/amenorrhoea: Absence of menstruation for 45 days or more and/or 28 menses/year.

2. Clinical hyperandrogenism: Modified Ferriman and Gallwey Score of 6 or higher.

3. Polycystic ovaries in the pelvic ultrasound scan.1

In PCOS hormonal imbalance affects follicular growth during the ovarian cycle causing the affected follicles to remain in the ovary. The retained follicle forms into a cyst, with each ovarian cycle a new cyst is formed leading to multiple ovarian cysts, ultrasonic morphologic evidence of ≥ 12 follicles measuring 2.9mm diameter in single plane during quiescent phase of ovary i.e., 27 days of cycle associated with obesity, oligomenorrhea, anovulation, hyper-androgenism, hyper-insulinemia Increased level of insulin in the blood is due to sensitivity of cells to insulin, androgen secretion by the ovarian stroma, and reduces serum sex hormone binding globin (SHBG) causing increased levels of free testosterone. Due to the presence of increased androgen in the ovary, the follicle undergoing maturation in the ovarian cycle is affected causing anovulation of particular follicle.2 PCOS mainly caused by Stress & strain, Perennial tension, Modern faulty lifestyle, Anxiety, depression.

Signs and Symptoms: are Amenorrhoea, Irregular menstrual cycle, DUB, Ovarian cyst, Infertility, Acne and blemishes Hair loss, Baldness similar to male, Dandruff, Acanthosis nigricans, Abdominal bloating, Frequent mood swings, Irritability, HAIR-AN syndrome, Hair growth on the face and rest of the body, obesity and insulin resistance.2 The features of PCOS may be correlated with "Puspaghnee Jataharinee described in Ayurvedic classics (Kashyapa Samhita, Kalpasthana) having the clinical features, viz. Vrutha Pushpa (may be correlated with amenorrhea anovulatory cycle), Sthulalomasha Ganda, i.e., obese cheeks with hairs be correlated with hirsutism hyperandrogenism).3 Another specific condition "Nashtarthava" told by Susrutha4 can also be considered as PCOS. Major etiological factors are Atisnigdha, Atimadhura (high calorie food), Abhishyandi Ahara (Junk food), Alpa Vyayama (reduced bodily activities), Divaswapna (day sleep), Ruksha Ahar Vihar, Stress, Jagarana are causes vitiation of Tridosha.PCOS is a disorder involving Vata,Pitta, Kapha, Medas, Ambhuvaha Srotas and Artava Dhatu. All three Doshas play important and distinctive role in the production, development, maturation and release of ovum, therefore the ovarian cycle and menstrual cycle is under control of three Doshas.On analysing the signs and symptoms of PCOS based upon Ayurvedic principles, it can be inferred that the Kapha, Vata vitiation is the main cause of this disease along with Rasa, Rakta and Medho Dhatu Dushti.5 The Agneyatwa of the Pitta is reduced in this condition. Kapha Vata Shamana and Pitta Vardhana is the basic treatment principle in Arthavarodha. So, a better intervention is that which improves Agni and clear Strotorodha.3 Yoga therapy and Ayurveda offer holistic alternatives for PCOS management. Yoga helps relieve stress one of the major contributors to PCOS – through postures like Asanas, relaxation exercises, pranayama, and meditation, all of which balance hormonal function and soothe the mind. Specific Ayurvedic formulations, such as Rajahpravartini Vati, Dashamularishta, Kuberaksh Vati,Shatavari Churna and Kanchanar Guggulu, are traditionally used to regulate hormonal balance and promote reproductive health. A structured daily practice of Yoga for 30 minutes, including Pranayama, meditation, and Shavasana, aids weight management and stress reduction, ultimately stabilizing hypothalamo-pituitary-ovarian function. This paper highlights the integrated approach of Ayurveda and Yoga in addressing PCOS, emphasizing their efficacy in restoring hormonal balance and improving overall reproductive health.

Incidence:

In worldwide an estimated 6-13% of reproductive age women. In India, the prevalence of PCOS is highly variable, ranging from 2.2% to 26%.6 The risk factors of PCOD are as follow: Heart attack, Diabetes, Strokes, Anxiety disorder, Depression and Uterine cancer are the consequences of PCOS.7

Aim: - To study the case of polycystic ovarian syndrome through a holistic approach by Ayurveda and Yoga therapy.

Objective: -

1.To design and implement a holistic treatment plan combining Ayurveda and yoga for a case of PCOS.

2.To evaluate the effectiveness of yoga practices and lifestyle modification in balancing hormones, reducing stress and improving metabolic health.

Materials and Methods:

Patient information- A diagnosed case of 21 years old unmarried female came in OPD with following complaints;

Chief complaints- Patient with irregular menstruation for 2 years. Her duration of cycle was 45-60 days. She also complained of pimples, acne on her upper back, weight gain, feeling of heaviness over her abdomen and breast, facial hair growth, mood swings, insomnia and constipation. She has gained 5 kg weight in last 1 year. She was preparing for medical exams and had a lot of exams stress,irrgeluar sleep cycle. Her USG s/o PCOS and the clinical symptoms of hyperandrogenism. So as per the Rotterdam criteria,She was a case of PCOS.

History of Past illness- Not Significant

Family History-Not Significant

Menstrual History-

Age of Menarche-13 years

Cycle- Irregular

Bleeding days- 1-2 days

No.of Pads- 1-2 per cycle

Pain- moderate relieved by painkiller

Clots-Nil

Personal History-

Diet-veg/non veg

Exercise- No

Habit- Tea

Sleep- Disturbed (Khandit)

Appetite-Normal

Micturation-Normal Frequency

Vital Examinations-

Pulse Rate-80 bpm

BP-110/70mmHg

RR-18breaths/min

Weight-60 kg

Height-154cm

BMI- 25.29

Systematic Examination-Normal

Diagnosis: Diagnosis was done clinically by following symptoms as per Rotterdam criteria

• Scanty menstrual bleeding
• Abnormal menstrual cycle
• Weight gain
• Polycystic ovary morphology on USG

According to Ayurveda Samprapti Ghatakas are as follows;

Hetu- Ruksh Ahar Vihar,Diwaswap, Jagran,Avyayam,Stress

Dosh- Kapha,Vata

Dushya- Rasa,Meda

Strotas- Rasavaha, Medovaha,Artavvaha

Strotodushti-Strotasgaman,Vimarg-Gaman

Pratyatma Lakshan-Artavkshaya,Sthualya

Investigation-Both Ovaries are marginally bulky in sizeand show multiple small follicles with central echogenic stroma.

Asthavidha Pariksha-

Nadi- 72/min

Mootra- Prakrit

Mala-Niram

Jihwa-Kinchit saam

Shabda-Spashta

Sparsha-Samsheetoshna,dryness

Drik-Vikrit, Dark circles

Akriti-Sthool

Treatment

1)Nidan Parivarjana

Pathya- Ghrut, Godhuma, Sthali, Mudga, Garlic, Black Sesame, daily yoga practice for 30 mins.

Apathya- Burger, Pizza, Dairy Products, Processed food, Sedentary Lifestyle

2) Ayurveda treatment

3) Yogic Practices- for 30-45 mins daily includes

Surya Namaskar

Asanas like Bhujangasana, Naukasan, Bhadrasana, Trikoasana,Shalbhasan,Chakki chalanasan,Shavasan Pranayama like Bhramari pranayam, Naadi shodhan

4) Lifestyle Modification

Results and Findings: -

After three months of an integrative treatment approach combining Ayurvedic therapies, Yoga Practices, Lifestyle modifications and dietary changes the patient demonstatred significant improvements across multiple clinical, hormonal and metabolic parameters. Menstrual cycle regularization was one of the notable improvements. Initially, the patient experienced irregular cycles occuring every 45-60 days, often accompanied by scanty menses and dysmenorrhea. By the end of the treatment, her menstrual cycles had become more regular, averaging 28-30 days, with improved flow and reduced discomfort.

Improvement before and after the treatment:

Discussion

Kanchanara Guggulu has Vata Kaphashamans, Lekhana (scrapping) and Shotha-Hara (anti-inflammatory) properties. Kanchanara Guggulu exhibits cytotoxic effect by inhibiting cell division. Guggulu being warm pacify the Vata. It is Medohara because of being Ruksha and Vishada and due to Tikshna and Ushna Guna, it pacifies the Kapha. It has anti-inflammatory action along with Rasayana and Artavajanaka properties. Anti-inflammatory, anti-diabetic properties of Kanchanara (Bauhinia variegate) helps in the reducing insulin resistance often associated with PCOS.8 Dashmularishta is a classical polyherbal Ayurvedic formulation prepared by natural fermentation process of the decoction. It contains more than 50 herbs along with the group of ten herb roots known as Dashamulo. Therapeutic uses of which is noted in Vatashaman According to Ayurveda, Vata plays important role in vitiation of any female related disorders. So, for the suppression of Vata. Dashamularishta plays a major role. In Sharangadhar Samhita, it has been indicated in infertility.8 Kuberaksha Vati is used for various purposes. Effective against polycystic ovarian syndrome (PCOS), Helps get rid of ovarian lumps problems, Effective against colic pain, stomach pain, and indigestion used in the treatment of uterine pains and disorders. Raja Pravartini Vati is likely to stimulate the ovulation and corrects the ovarian functions. It also promotes the menstrual discharge due to its emmenagogue action by its Ushna Guna of its content. It is helpful in the treatment of amenorrhea, oligomenorrhea, dysmenorrhea associated with light menstruation or scanty periods and backache during menstruation.9

Shatavari Churn improve ovulation, follicular growth and maintain hormonal balance by soothing mind, relieving stress. Surya Namaskar (Sun Salutation) The twelve Yoga posen in the Sun Salutation is good to enhance flexibility in the body as well as effective in controlling hormonal imbalance Surya Namaskar is also helpful in controlling of weight, Sun Salutation helps to de-toxify and de-stress the entire system. It balances the whole endocrinal system by direct massaging of glands and increasing blood flow to organ thus regularizes the menstrual cycle [to]. Calms anxiety and improves memory. It also strengthens the abdominal muscles.10 Bhujangasana (Cobra pose) Cobra pose exerts pressure on the stomach and helps to stimulate ovarian function. It improves menstrual irregularities, elevate mood, reduces fat helps to improve blood circulation and maintain hormonal balance. It has many advantages like improves digestion, bust stress, good for chest, lungs, and shoulder.10 Shalabhasana (Superman Pose) enhances blood flow to reproductive organs, tones the abdomen and lower back, strengthens the chest, arms, shoulders, and legs. Opens the chest and supports core stability, beneficial for infertility and abdominal health.11 Trikonasana (Triangle Pose) strengthens legs, stretches hips, groin, and hamstrings. Improves pelvic blood circulation, digestion, and flexibility. Engages core muscles, aiding hormonal balance.11

Bhadrasana (Butterfly Pose) deeply stretches the groin and pelvic region, enhancing circulation and flexibility in reproductive organs. Stimulates kidneys, bladder, ovaries, and digestive organs. Relieves varicose veins, sciatica, and menstrual discomfort.11

Naukasana (Boat Pose) strengthens the abdominal region, enhances blood flow to reproductive organs, improves ovarian function, and supports weight loss.11

Chakki Chalanasana (Grinding Wheel Pose) stimulates endocrine glands, enhances hormonal secretion, and massages liver, kidneys, pancreas, uterus, and reproductive organs.11

Pranayama techniques

Nadi Shodhana (Alternate Nostril Breathing / Anulom Vilom) balances the nervous system, reduces anxiety, promotes relaxation, and supports natural healing of PCOS.

Bhramari Pranayama (Bee Breath) controls stress, anxiety, and mood swings. Regulates hormonal balance by improving FSH production and normalizing the FSH/LH ratio, promoting timely ovulation and regular periods.12

Meditation & Relaxation Techniques:

Meditation acts as a mood stabilizer, calms the mind, and harmonizes body, mind, and emotions to help manage PCOS naturally. Shavasana (Corpse Pose) a key closing posture in yoga practice that deeply relaxes the body and mind, relieving stress and tension — crucial for PCOS management.12

Conclusion

Polycystic ovarian syndrome is a complex disorder with multiple etiologies for which multiple treatment approaches are required, depending the reason a patient seeks treatment. For this one need controlled and balanced diet and exercise for weight reduction along with medication and lifestyle management. This case study highlights the effectiveness of an integrative approach combining Ayurvedic formulation and Yogic Practices for the management of polycystic ovarian syndrome (PCOS). The patient demonstrated significant improvements in menstrual cycle regulation, hormonal balance, metabolic health, weight management, and overall well-being after three months of treatment. Ayurvedic interventions, including herbal formulations (Kanchanar Guggulu, Dashamukarishta, Rajpravartini vati, Kuberaksh Vati, Shatavari), Yogic Practices and lifestyle modifications played a key role in detoxifying the body, improving insulin sensitivity, balancing Doshas, and enhancing reproductive health. Yoga facilitates relaxation and pelvic stretches, while Pranayama and meditation aid to quiet the mind. The benefits of Yoga practice for women with PCOS to aid in their recovery are discussed in this paper. Thus, adopting a holistic treatment mentioned in Ayurveda, good life style with appropriate diet, Yoga, Pranayama and stress-free living synergistically can prove to be effective in the management of PCOS.

Limitations Of the Study: -

Further investigations after treatment are not available. To draw the conclusion more no. of patients of PCOS should be study with holistic approach.

Source Of Support: - None

Conflict Of Interest: -NIL