Impact of Lean PCOS on Fertility and Benefits of Ayurveda
Journal name: Ayushdhara
Original article title: A Case Report on the Impact of a Lean Poly Cystic Ovarian Syndrome on Fertility and Potential Benefit of Ayurveda Regime
AYUSHDHARA is an international peer-reviewed journal. It focuses on research in Ayurveda, Yoga, Unani, Siddha, Homeopathy, Allopathy, and Pharmaceutical Sciences.
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K. Bharathi
Professor and H.O.D, Prasutitantra and Stree Roga Dept., NIA, DU, Jaipur, Rajasthan, India
Divya Deepak Patil
PG Scholar, Prasutitantra and Stree Roga Dept., NIA, DU, Jaipur, Rajasthan, India
Ayushdhara:
(A peer-reviewed, bi-monthly open-access journal)
Full text available for: A Case Report on the Impact of a Lean Poly Cystic Ovarian Syndrome on Fertility and Potential Benefit of Ayurveda Regime
Year: 2022 | Doi: 10.47070/ayushdhara.v9iSuppl1.1027
Copyright (license): CC BY-NC-SA 4.0
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Summary of article contents:
Introduction
Infertility is a significant health issue affecting approximately 15% of couples globally, with polycystic ovarian syndrome (PCOS) being a leading ovarian factor contributing to female infertility. PCOS can present in various phenotypes, including a rare lean form that complicates treatment. A case report highlights a 32-year-old female with primary infertility, lean phenotypical features, and ultrasound findings indicative of PCOS. After unsuccessful allopathic treatment, including a single cycle of IVF, the patient was evaluated through the lens of Ayurveda, culminating in a diagnosis correlating to Ayurvedic terms denoting infertility and diminished reproductive capacity.
Management through Ayurvedic Approaches
The therapeutic strategy involved two stages: a preliminary three-month Shamana (palliative) therapy followed by Shodhana (cleansing) therapy, including intrauterine instillation (Uttarabasti) and oil therapy (Ksheerabasti). The Ayurvedic treatment aimed at addressing identified issues such as scanty menstruation, hyperandrogenism, and lean body presentation. Dietary modifications were also recommended to enhance overall health. The course of treatment led to a 4 kg weight gain, improved acne symptoms, and a notable enhancement in menstrual duration and flow.
Understanding Lean Polycystic Ovarian Syndrome
Lean PCOS is characterized by hyperandrogenism and multiple cysts on the ovaries, yet patients typically present with a Body Mass Index (BMI) <25 kg/m². This study emphasizes how lean PCOS can continue to be overlooked until individuals experience infertility. In Ayurveda, the condition aligns with concepts like Artavakshaya (reduced menstrual flow) and Karshya (emaciation), both arising from aggravated Vata and Pitta dosha. These Ayurvedic assessments and their associated treatment principles underscore the importance of individualized care in addressing infertility issues stemming from hormonal imbalances.
Conclusion
This case report demonstrates the effectiveness of Ayurvedic interventions structured around a precise diagnosis of lean PCOS-related infertility. The combination of herbal therapies and lifestyle changes facilitated the patient's successful conception within four months of treatment. The positive outcome reinforces the relevance of tailored Ayurvedic practices in managing complex reproductive health issues, paving the way for further exploration of holistic approaches in fertility enhancement. Furthermore, the patient's perspective expressed disbelief and joy upon learning about her pregnancy, underscoring the profound impact of successful treatment on overall well-being.
FAQ section (important questions/answers):
What is lean PCOS and its impact on fertility?
Lean PCOS is a variant affecting women with a BMI under 25. It causes hormonal disturbances, leading to issues like anovulation and infertility, making treatment and conception more challenging.
How was the patient diagnosed with lean PCOS?
The diagnosis was made after evaluating the patient’s symptoms, family history, ultrasound findings indicating polycystic morphology, and menstrual irregularities, aligning with Ayurvedic terms like Anapatya Vandhya and Artavakshaya.
What Ayurvedic treatments were used in this case?
The treatment included Shamana therapy for three months, followed by Shodhana therapy like Uttarabasti, Ksheera Basti, and Nasya Karma. A combination of Ayurvedic medicines targeted hormonal balance and improved menstrual health.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Impact of Lean PCOS on Fertility and Benefits of Ayurveda�. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Ayurveda (Ayus-veda):
Ayurveda is a traditional Indian system of medicine that aims to balance bodily doshas (Vata, Pitta, and Kapha) for overall health. In the context of the case report, Ayurveda provides the diagnostic and therapeutic framework used to treat the patient's lean PCOS and infertility issues.
2) Karshya (Karsya, Kashrya):
Karshya refers to a condition characterized by extreme leanness or emaciation. In the case report, lean PCOS is associated with Karshya, highlighting the patient's thin physique with a BMI less than 25 kg/m², which complicated the therapeutic approach.
3) Taila (Thaila):
Taila refers to oil used in various therapeutic interventions in Ayurveda. For example, Shuddha Bala Taila and Apamarga Kshara Taila were used in Uttarabasti for intrauterine instillation to enhance fertility and normalize ovarian function in the patient.
4) Basti:
Basti is an Ayurvedic procedure involving enemas for detoxification and medicinal purposes. Ksheera Basti, involving medicated milk enema, was used to provide nutrition and balance in the treatment of lean PCOS in the patient.
5) Medicine:
Medicine refers to substances used to treat conditions and diseases. In this case, Ayurvedic medicines like Kumaryasava, Raja Pravartini Vati, and others were utilized to treat the symptoms of lean PCOS and promote fertility.
6) Shuddha (Suddha):
[see source text or glossary: Shuddha]
7) Bala:
Bala is a herb (Sida cordifolia) known for its tonic and regenerative properties. In the therapy, Shuddha Bala Taila was used for its Prajasthapana benefits, aiming at enhancing endometrial receptivity and improving fertility in the patient with lean PCOS.
8) Drug:
Drug refers to any substance used in the diagnosis, treatment, or prevention of diseases. In the case report, various Ayurvedic drugs such as Apamarga Kshara Taila and Shuddha Bala Taila are mentioned for their specific therapeutic actions.
9) Balataila (Bala-taila):
Balataila is an oil prepared from the herb Bala (Sida cordifolia). Shuddha Bala Taila was used in Uttarabasti to promote receptivity and optimize the endometrial environment, improving fertility in the patient suffering from lean PCOS.
10) Vata:
Vata is one of the three doshas in Ayurveda, associated with movement and subtle energy. In the case, vitiation of Vata dosha along with Pitta is linked to Artavakshaya, a condition mimicking PCOS, resulting in hormonal imbalance and infertility.
11) Shodhana (Sodhana):
Shodhana refers to detoxification therapies in Ayurveda used to cleanse the body of accumulated toxins. In the report, Shodhana therapies such as Basti and Nasya Karma were employed to address the patient’s lean PCOS and associated infertility.
12) Samana (Shamana):
Shamana therapy is aimed at pacification of doshas without eliminating toxins. In the case, Shamana therapy included the use of Ayurveda medicines for three months to regulate menstruation and hormonal imbalance in the lean PCOS patient.
13) Uttara:
[see source text or glossary: Uttara]
14) Pitta:
Pitta is another dosha in Ayurveda, associated with heat and metabolism. The patient’s condition involved the vitiation of both Vata and Pitta doshas, contributing to the development of lean PCOS and related symptoms such as scanty menstruation and acne.
15) Nasya (Nashya):
Nasya is the administration of medicinal substances through the nasal passage. Anu Taila Pratimarsha Nasya was used in the case to stimulate the hypothalamus and regulate hormonal imbalance, aiding in the treatment of lean PCOS and infertility.
16) Raja:
[see source text or glossary: Raja]
17) Rasa (Rasha):
Rasa refers to the taste or essence in Ayurveda. It is also one of the seven bodily tissues. Shatapushpa Churna, which has particular Rasayanic (rejuvenating) properties, was used to address the nutritional and hormonal imbalance in the lean PCOS patient.
18) Shatapushpa (Satapuspa, Shata-pushpa):
Shatapushpa (Anethum sowa or dill) is an herb used for its Rasayana (rejuvenating) effects. In the case report, Shatapushpa Churna was administered to the patient to correct Agnimandya, Karhsya, and Artavakshaya, thereby improving general health and fertility.
19) Apamarga:
[see source text or glossary: Apamarga]
20) Rasayana (Rasa-ayana):
Rasayana refers to rejuvenative therapy in Ayurveda aimed at promoting overall health and longevity. Shatapushpa Churna in the report served as a Rasayana to improve the patient’s nutritional status, reproductive health, and address lean PCOS symptoms.
21) Bharathi:
Bharathi is the author of the case report and is likely a scholar or practitioner at the National Institute of Ayurveda (NIA), Jaipur, Rajasthan. Her expertise in Ayurveda contributes to the successful outcome in treating lean PCOS and infertility.
22) Vandhya (Vamdhya):
Vandhya refers to infertility. In the discussed case, the patient was diagnosed with Anapatya Vandhya, which means primary infertility, associated with lean PCOS and managed successfully through an Ayurvedic therapeutic regime.
23) Dravya:
Dravya refers to substances or materials used for therapeutic purposes in Ayurveda. Examples in the report include Kumaryasava, Raja Pravartini Vati, and various medicinal plants like Ashwagandha and Yashtimadhu used to treat the patient’s lean PCOS.
24) Artava:
Artava refers to the menstrual blood and ovum. Artavakshaya is a condition resembling PCOS, characterized by scanty menstrual flow. The therapeutic strategy in the case targeted Artava to normalize menstruation and improve reproductive health.
25) Kshaya (Ksaya):
Kshaya means depletion or deficiency. Artavakshaya is a condition where there is a deficiency in the menstrual flow or ovum. It closely resembles the symptoms of PCOS and was a key focus in the treatment of the patient’s infertility.
26) Divya:
Divya is the co-author of the case report and likely a PG Scholar at the Dept. of Prasutitantra and Stree Roga, NIA, Jaipur. Her research and clinical input were integral to formulating the Ayurvedic treatment plan for the lean PCOS patient.
27) Shoka (Soka):
Shoka in Ayurveda refers to sorrow or psychological stress. It is listed as one of the etiological factors leading to conditions like Karshya, which can further aggravate doshas and contribute to ailments like Artavakshaya and infertility in lean PCOS.
28) Patil:
Patil is the surname of Divya Deepak Patil, one of the co-authors of the case report. She contributed to the research and clinical strategies used in treating the patient with lean PCOS and infertility through Ayurveda.
29) Guna:
Guna means quality or attribute. In the case report, the qualities of drugs (e.g., Agneya, Ushnaguna) and symptoms (e.g., Ruksha) were considered in formulating the Ayurvedic treatment to address the imbalance of doshas and improve fertility.
30) Milk:
Milk, or Ksheera, is used as a base in certain Ayurvedic treatments. In the report, Ksheera Basti with medicated milk involving Vrishya Dravya provided nourishment, aiding in the case’s goal to manage Karshya and enhance overall reproductive health.
31) Pratimarshanasya (Pratimarsanasya, Pratimarsha-nasya):
[see source text or glossary: Pratimarsha-nasya]
32) Ksharataila (Ksarataila, Kshara-taila):
[see source text or glossary: Ksharataila]
33) Yashtimadhu (Yastimadhu, Yashti-madhu):
Yashtimadhu (Glycyrrhiza glabra) is an Ayurvedic herb known for its rejuvenative and anti-inflammatory properties. It was part of the Ksheera Basti formulation used in the patient’s treatment to improve general health and support reproductive functions.
34) Vidarikanda (Vidari-kanda):
Vidarikanda (Pueraria tuberosa) is used in Ayurveda for its nutritional and tonifying properties. It was included in the Ksheera Basti formulation to enhance reproductive health and support the treatment of lean PCOS in the case report.
35) Pittadosha (Pittadosa, Pitta-dosha):
Pitta dosha is one of the three fundamental bio-elements responsible for metabolism and biochemical processes. In the case report, the imbalance of Pitta dosha along with Vata dosha was addressed to improve the patient's reproductive health.
36) Ashvagandha (Asvagandha, Ashwagandha, Ashvagamdha, Ashva-gandha):
Ashwagandha (Withania somnifera) is an adaptogenic herb used in Ayurveda for its rejuvenative properties. It was included in the Ksheera Basti to provide strength, improve hormonal balance, and support fertility in the treatment of lean PCOS.
37) Agnimandya (Agni-mandya, Agnimamdya):
Agnimandya refers to digestive fire (Agni) impairment in Ayurveda. Correcting Agnimandya is crucial for treating conditions like Karshya and lean PCOS, as it helps restore nutrient absorption and metabolism, improving overall and reproductive health.
38) Adhyayana:
Adhyayana refers to study or readings that can lead to physical or mental stress. In the report, Adhyayana is mentioned as one of the factors contributing to Karshya, which exacerbates conditions like lean PCOS and infertility.
39) Anutaila (Anu-taila):
[see source text or glossary: Anutaila]
40) Katurasa (Katu-rasa):
[see source text or glossary: Katurasa]
41) Vitiation (Vitiated):
Vitiation refers to the imbalance of doshas in Ayurveda, leading to disease. The case report discusses the vitiation of Vata and Pitta doshas, which contributed to the development of Artavakshaya and lean PCOS, necessitating specific treatments.
42) Gokshura (Goksura, Go-kshura):
Gokshura (Tribulus terrestris) is used in Ayurveda for its nourishing and tonic properties. It was part of the Ksheera Basti given to the patient to improve general health, support reproductive function, and address symptoms of lean PCOS.
43) Brimhana (Brmhana):
Brimhana refers to therapeutic measures that promote nourishing and strengthening in Ayurveda. The Ksheera Basti administered to the patient included ingredients with Brimhana properties to improve health and support the treatment of lean PCOS.
44) Langhana (Lamghana):
Langhana refers to therapeutic fasting or reducing the intake of food and is one of the contributing factors mentioned in the case for Karshya or leanness. This exacerbates conditions like lean PCOS in the patient, complicating fertility issues.
45) Vrishya (Vrsya):
Vrishya Dravya are substances that enhance reproductive capacity in Ayurveda. Terms like Ashwagandha, Vidarikanda, and Yashtimadhu in the Ksheera Basti fall under this category, aimed at improving fertility in lean PCOS patients.
46) Kshara (Ksara):
[see source text or glossary: Kshara]
47) Nidana:
Nidana refers to the etiological factors causing diseases in Ayurveda. Identifying Nidana, such as improper diet, stress, and lifestyle factors, helps in diagnosing and treating conditions like Karshya and lean PCOS in the case study.
48) Kumari:
Kumari, commonly known as Aloe vera, is used in Ayurveda for its benefits to the digestive and reproductive systems. Kumaryasava, a preparation containing Kumari, was used to manage hormonal imbalances and promote menstruation in lean PCOS treatment.
49) Jaipur:
Jaipur is the city in Rajasthan, India, where the NIA (National Institute of Ayurveda) is located. The authors and the case study are based in Jaipur, where the treatment for lean PCOS and infertility was administered.
50) Dosha (Dosa):
Dosha refers to the three fundamental bio-elements in Ayurveda: Vata, Pitta, and Kapha. The patient had an imbalance of Vata and Pitta doshas, contributing to Artavakshaya and lean PCOS, which the Ayurvedic treatment aimed to correct.
51) Karma (Karman):
Karma in the context of Ayurveda refers to action or treatment method. Various Karmas like Nasya Karma and Shodhana Karma were employed as part of the therapeutic strategy to address the patient’s lean PCOS and infertility issues.
52) Dhatu:
Dhatu refers to the bodily tissues in Ayurveda. Issues with rasa dhatu and other tissues were addressed through treatments like Shodhana and Rasayana, aimed at correcting deficiencies and imbalances contributing to lean PCOS and infertility in the patient.
53) Katu:
[see source text or glossary: Katu]
54) Vati:
Vati refers to tablets or pills in Ayurvedic medicine. Raja Pravartini Vati was used to induce menstruation and possibly promote ovulation in the patient with lean PCOS, serving as part of the therapeutic strategy.
55) Pain:
[see source text or glossary: Pain]
56) Pharmacological:
Pharmacological refers to the branch of medicine concerned with the uses, effects, and modes of action of drugs. The case study explores the pharmacological effects of Ayurvedic medicines in alleviating the symptoms of lean PCOS and improving fertility.
57) Prajasthapana (Praja-sthapana):
Prajasthapana refers to substances in Ayurveda that are used to uphold pregnancy. Shuddha Bala Taila used in Uttarabasti has Prajasthapana properties, enhancing endometrial receptivity and promoting a healthy pregnancy environment for the lean PCOS patient.
58) Madhuradravya (Madhura-dravya):
[see source text or glossary: Madhuradravya]
59) Artavajanana:
Artavajanana refers to the promotion of menstruation and ovulation. Various treatments like Raja Pravartini Vati in the case were used to induce menstruation and normalize ovarian function, addressing the lean PCOS condition effectively.
60) Garbhashaya (Garbhasaya, Garbha-ashaya):
Garbhashaya refers to the uterus in Ayurveda. Therapies like Uttara Basti aimed at Garbhashaya and Yoni Shodhana (cleaning the uterus and reproductive tract) were implemented to improve fertility and treat lean PCOS.
61) Antahpushpa (Antahpuspa, Antar-pushpa):
[see source text or glossary: Antahpushpa]
62) Nasyakarman (Nasyakarma, Nasya-karma):
[see source text or glossary: Nasyakarma]
63) Rasadhatu (Rasa-dhatu):
Rasa Dhatu is the primary nourishing fluid in the body. Malformation of Rasa Dhatu was linked to issues like lean PCOS and Artava Kshaya. The treatment aimed to correct the malformation through Rasayana and dietary changes.
64) Pravartana:
[see source text or glossary: Pravartana]
65) Vatapitta (Vata-pitta):
Vata-Pitta dosha were imbalanced in the patient, leading to conditions like lean PCOS. Ayurvedic treatments aimed to balance these doshas by using appropriate herbs and therapies to treat the hormonal and reproductive issues.
66) Vandhyatva:
Vandhyatva refers to infertility. The case study focuses on Anapatya Vandhya or primary infertility in a patient with lean PCOS. The treatment strategy aimed to correct the underlying dosha imbalances to improve fertility.
67) Discussion:
Discussion refers to the analysis and interpretation of results. The discussion in the case report elaborates on the Ayurvedic principles applied, the success of the treatment strategies, and the relevance of traditional therapies in managing lean PCOS and infertility.
68) Samprapti:
[see source text or glossary: Samprapti]
69) Rajasthan:
Rajasthan is a state in India where Jaipur and the National Institute of Ayurveda (NIA) are located. The case report was conducted at NIA, furthering the reach and impact of Ayurvedic treatments for conditions like lean PCOS and infertility.
70) Dashamula (Dasha-mula, Dasamula, Dashan-mula):
Dashamula is a traditional Ayurvedic formula including ten roots, known for its anti-inflammatory and tonic properties. Dashamula Kwatha was used to induce menstruation and support overall reproductive health in the patient's treatment.
71) Evolution:
[see source text or glossary: Evolution]
72) Upadhatu:
[see source text or glossary: Upadhatu]
73) Kashyapa (Kasyapa, Kashya-pa, Kashyapanamdana):
Kashyapa is an ancient Ayurvedic sage known for his contributions to pediatrics and gynecology. The treatment references Kashyapa’s work, particularly the use of Shatapushpa as a Rasayana, to correct hormonal and reproductive issues in lean PCOS.
74) Prakriti (Prakrti):
[see source text or glossary: Prakriti]
75) Striroga (Stri-roga):
[see source text or glossary: Striroga]
[Note: The above list is limited to 75. Total glossary definitions available: 103]
Other Science Concepts:
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