Introduction
Polycystic ovary syndrome (PCOS) is a common multifactorial endocrine and metabolic disorder influenced by hormonal imbalance, insulin resistance, psychological stress, sedentary lifestyle, and dietary factors. It is characterized by ovulatory dysfunction, menstrual irregularities, and metabolic disturbances.1 From an Ayurvedic perspective, PCOS can be broadly correlated with Kapha–Vata predominant Yoni Vyapad, Artava Kshaya, or Arajaska. The condition is understood to arise due to Agni-dushti (impaired metabolic fire), Srotorodha (obstruction of physiological channels), and Dhatu vaishamya (tissue imbalance), which together disrupt reproductive and metabolic homeostasis.
In general, PCOS is often associated with features of Kapha–Vata imbalance, including weight gain, delayed or irregular menstruation, acne, and impaired digestion (Mandagni). Ayurveda recommends a stepwise treatment strategy in such chronic disorders, beginning with Shodhana (purificatory therapies) to eliminate accumulated Doshas, followed by Shamana (pacifying therapies) for long-term regulation and maintenance of physiological balance.
Role of Shodhana therapy in PCOS
Shodhana therapy plays a central role in addressing the root pathological factors of PCOS by eliminating vitiated Doshas and clearing obstructed channels.
- Among the various Panchakarma procedures, Virechana Karma is commonly indicated due to its action on Pitta and Kapha Dosha. It helps in detoxification, improves metabolic functions, and supports the clearance of blocked reproductive channels (Artavavaha Srotas).
- By enhancing digestive efficiency and removing metabolic toxins (Ama), Virechana contributes to the restoration of Agni and supports hormonal balance. Classical Ayurvedic texts emphasize its role in menstrual disorders and ovulatory dysfunction, making it a key intervention in conditions resembling PCOS.
Significance of Nasya therapy
Nasya Karma, the administration of medicated substances through the nasal route, is an important supportive therapy in PCOS management. It is primarily indicated for disorders affecting the head, nervous system, and hormonal regulation.
- Nasya is believed to influence neuroendocrine pathways through its action on central regulatory mechanisms. In Ayurvedic physiology, it is considered to act via the Nasa–Shiras–Hridaya pathway, which may be functionally related to hypothalamic regulation. By supporting stress reduction and improving neurohormonal balance, Nasya may indirectly contribute to the normalization of ovulatory function and menstrual cycles.
- Thus, Nasya is often used as an adjunct therapy following Shodhana to stabilize physiological and psychological functions.
Role of Shamana therapy
Following purification, Shamana therapy is employed to maintain balance and support sustained improvement.
- Herbal formulations commonly used in PCOS management are selected based on their properties such as Kapha–Vata pacification, Medohara (fat-reducing), Lekhana (scraping), and Rasayana (rejuvenating) effects.
- These medicines help improve metabolic activity, regulate menstrual cycles, support ovarian function, and reduce cystic changes. They also contribute to improving tissue nutrition and hormonal regulation, thereby addressing both metabolic and reproductive aspects of PCOS.
Clinical relevance and outcomes
Integrated Ayurvedic management using Shodhana and Nasya-based Shamana approaches has shown potential benefits in improving menstrual regularity, reducing ovarian volume, and correcting hormonal imbalance. Improvements in metabolic parameters and ovulatory function have also been observed in clinical settings. Importantly, these therapies are generally well tolerated when administered appropriately under supervision, with minimal adverse effects reported in classical practice and contemporary observations.
Conclusion
Ayurvedic management of PCOS through Shodhana and Nasya therapies offers a holistic approach aimed at correcting underlying Dosha imbalances, improving metabolic function, and restoring reproductive health. When combined with appropriate Shamana therapy, this integrative strategy supports both symptomatic relief and long-term physiological balance in PCOS.
References:
- Dason ES, Koshkina O, Chan C, Sobel M. Diagnosis and management of polycystic ovarian syndrome. CMAJ. 2024;196(3):E85-E94. Published 2024 Jan 28. doi:10.1503/cmaj.231251 https://pmc.ncbi.nlm.nih.gov/articles/PMC10833093/
- Kamble S, Darunde S. Ayurvedic management of PCOS with Nasya and Shodhana therapy–A case study. World J. Pharm. Res. 2025;14:690-699. https://wjpr.s3.ap-south-1.amazonaws.com/article_issue/bcbf34c0d8662320d6a91620aec892f6.pdf