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What is PCOS and 3- pronged approach in Ayurveda?

As I approach 20 years of clinical practice, I am increasingly seeing more patients with myriad kinds of hormone imbalances. The cases of PCOS (Stein-Leventhal syndrome) are alarmingly on the rise. Though, concrete statistical data for Indian population is not available, some of the recent studies done with Indian females seem to come to the same conclusion. Reliable data suggests that about 18% of Indian women are affected by PCOS. A few other studies which help to establish the gravity of the situation are.

PCOS is a common female endocrine disorder with prevalence ranging from 2.2% to 26%. Most reports have studied adult women with age ranged from 18 to 45 years.

The overall prevalence of PCOS in the study population was, 41%. It was 16% in married women and 24 % in unmarried girls. Common menstrual irregularity was-oligomenorrhea (40%), Menorrhagia (12.8%) amenorrhea (11%). Common symptoms were hirsutism, acne, infertility and alopecia

What is the Ayurvedic approach to PCOS?

The golden rule for Ayurvedic treatment for any condition is the 3- pronged approach of Aahara(Food/ Nutrition)-Vihaara (Lifestyle/Exercise)- Aushadha (Medicine). This is even more relevant in the treatment of PCOS. Though the common diagnosis may be PCOS, the advice regarding the 3-pronged approach is individualistic owing to the prakriti (constitution), age, severity, occupation, location, habits and many other variables. This is because, Ayurvedic treatment is more Rogi (patient) specific than Roga (Disease) specific.

There is wide awareness about the importance of exercise in the treatment of PCOS. But the intense physical workouts is not yielding desired results in some of the patients. Some points to keep in mind are

  • In place of intensive physical programs, balanced exercise with rest and nutrition yields better results

  • Just like drastic weight gain can be a trigger for hormone imbalance, drastic weight loss is also not the best prescription to regularise the hormones

  • If you have not been exercising for a while, start your workout program with focus on building strength and flexibility

  • Choose a program which you enjoy doing, rather than choose something you may find boring and punishing. Such exercises, thoughrigorous may increase the stress levels which is totally counter productive.

  • Best to begin with slow stretches, followed by walking and conclude with slow stretches for the first 15 days. This will prepare the body for more intense workouts which can be started after a fortnight and help prevent injuries.

  • Exercising consistently for 40-60 minutes for 4-5 days a week is more useful than long intensive exercise only for a couple of days in the week or only on weekends.

  • Yoga has proven to be very effective as a therapy for PCOS. Including a sequence of therapy yoga will be immensely beneficial to manage PCOS.

A holistic yoga program for 12 weeks is significantly better than physical exercise in reducing AMH, LH, and testosterone, mFG score for hirsutism, and improving menstrual frequency with nonsignificant changes in body weight, FSH, and prolactin in adolescent PCOS.