PCOS and PCOD: what Ayurveda offers

The honest summary

How the texts understand it

Sushruta describes artavakshaya, diminished menstrual flow: periods that do not come at the expected time, or are scanty, with pain in the vagina. Only the timing and flow overlap with PCOS. The verse says nothing about raised male-type hormones or the ovaries.[7]

Kashyapa describes Pushpaghni, one form of Revati: a woman who menstruates at the proper time but in vain, or a woman with stout, hairy cheeks. The word "or" matters. The verse gives two separate pictures, not the modern PCOS pattern of weight gain, excess hair and missed ovulation together. The match is very loose.[8]

Granthi, sometimes linked to cysts, is Sushruta's word for a rounded, raised, knotted swelling of flesh, blood and fat. It is a general lump. Nothing in the verse points to the ovaries.[9]

Codes: ICD-11 5A80.1 (Polycystic ovary syndrome)[11]; ICD-11 TM2 SR4K (Diminution of menstrual flow pattern (TM2). The nearest traditional pattern, not a code for PCOS.)[11]; NAMASTE BA-3.1 (Artavakshaya, listed against SR4K. Not a code for PCOS.)[12]

What trials found

Systematic reviewMeta-analysis of five randomised trials of curcumin in women with PCOS. Compared with control, fasting glucose fell by 3.68 mg/dL and HOMA-IR, a measure of insulin resistance, by 0.94. The insulin resistance results varied a great deal between trials, and no blood fat measure changed. These are blood markers. They do not show an effect on periods or fertility.[1]

Systematic reviewScoping review, not a pooled analysis of results. Of 57 reports on Ayurveda in PCOS, 32 were single case studies, 13 randomised trials, 9 before-and-after studies, 2 case series and 1 non-randomised trial. Most were from India. Kanchanara guggulu and Rajapravartini vati were the most used formulas, and basti (medicated enema) the most used procedure. The authors say safety reporting needs to be done rigorously.[2]

RCTTriple-blind trial in Iran. Women with PCOS took 1,000 mg of curcumin a day or a placebo for 12 weeks. Afterwards, missed or infrequent periods were less common with curcumin, 13% against 22%. Testosterone, insulin and excess hair did not differ between the groups. The abstract does not say how many women took part, and its fasting sugar figure does not add up, so we have left that out.[3]

Signs that need a doctor

• Pelvic pain that is severe, getting worse, or hurts when you move or touch the area. Or pelvic pain with fainting or dizziness, pain in the tip of the shoulder, difficulty breathing, heavy vaginal bleeding or sudden confusion. Any one of these needs emergency care. Do not put them down to PCOS.[5]
• No period by age 15, or none more than three years after the breasts began to develop.[6]
• After the first year of periods, any single cycle longer than 90 days.[6]
• Between one and three years after your first period, cycles shorter than 21 days or longer than 45. After three years, cycles shorter than 21 days or longer than 35, or fewer than eight periods a year.[6]
• Periods that have stopped for a long time without treatment. This raises the risk to the lining of the womb, so talk to a doctor rather than waiting for herbs to bring periods back.[6]
• New, severe or quickly worsening signs of male-type hormones, such as excess hair growth. These need tests to rule out a hormone-making tumour or another ovarian condition.[6]
• Snoring with sleep that does not refresh you, daytime sleepiness or constant tiredness. Ask to be checked for sleep apnoea.[6]
• Symptoms that are affecting your everyday life, work or relationships.[4]

Withheld until review

Questions people ask

Related

Sources

1. Simental-Mendía LE, Shah N, Sathyapalan T, Majeed M, Orekhov AN, Jamialahmadi T, Sahebkar A. Effect of curcumin on glycaemic and lipid parameters in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials. Reproductive Sciences. 2022;29(11):3124-3133. PMID 34655047.
2. Rao VS, Armour M, Patwardhan K, Cheema BS, Smith C, Sharma R, Ee C. A scoping review of Ayurveda studies in women with polycystic ovary syndrome. Journal of Integrative and Complementary Medicine. 2023;29(9):550-561. PMID 36944117.
3. Ghanbarzadeh-Ghashti N, Ghanbari-Homaie S, Shaseb E, Abbasalizadeh S, Mirghafourvand M. The effect of curcumin on metabolic parameters and androgen level in women with polycystic ovary syndrome: a randomized controlled trial. BMC Endocrine Disorders. 2023;23(1):40. PMID 36788534.
4. NHS. Polyendocrine metabolic ovarian syndrome (PMOS), previously called polycystic ovary syndrome (PCOS): treatment.
5. NHS. Pelvic pain.
6. International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome, 2023. Recommendations 1.1.1, 1.3.8, 1.10.2 and 1.11.2-4.
7. Sushruta Samhita, Sutra Sthana 15.12, in the MIU transcription (other editions number this passage differently).
8. Kashyapa Samhita, Kalpa Sthana, Revati Kalpa 33b-34a.
9. Sushruta Samhita, Nidana Sthana 11.3.
10. Ayurvedic Formulary of India, Part I, 2nd revised English edition, 2003. Kanchanara Guggulu, 5:1, printed page 67.
11. World Health Organization. ICD-11 for Mortality and Morbidity Statistics, release 2026-01, simple tabulation.
12. Ministry of Ayush. NAMASTE portal, Ayurveda terminology, row 410.