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:10.5281/zenodo.23434897

DOI

INTERNATIONAL

JOURNAL

OF

DIAGNOSTICS

AND

RESEARCH

An Ayurvedic Approachtopolycystic Ovarian Syndrome (PCOS)

Dr.

Balaji Desai

1

,

Dr Archana Kulkarni

2

1

Second

year PG Scholar,Department of Rognidan,BSDT’s Ayurved Mahavidyalaya,Wagholi,Pune.

2

Guide,

Dr Archana A. Kulkarni,HOD,Department of Rognidan,BSDT’s Ayurved

Mahavidyalaya,Wagholi,Pune.

Article Info:

Article Received on : 13 /10/2026

Article Reviewed on: 14/10/2026

Article Published on : 15/10/2026

Corresponding Author:

Dr.Balaji Desai

ORCID

ID:

Abstract

Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders affecting womenof

reproductive

age.

Also

known

as

Stein-Leventhal

syndrome,

it

is

characterized

by

symptoms

such

as

irregular or absent menstrual periods, excessive hair growth,obesity, enlarged ovaries with multiple cysts,

acne, and elevated levels of male hormones like testosterone and androstenedione. While the exact cause of

PCOS is not fully understood, it is often associated with high insulin levels, obesity,excess of androgens,

and increased luteinizing hormone.

PCOS may be understood in Ayurveda through the concept of Anukta Vyadhi, as it is not described as a

distinct disease entity in the classical texts. The framework of TrividhabodhyaSangraha provides a useful

approach

for

understanding

its

etiopathogenesis

and

clinical

manifestations.

Based

on

a

review

of

Ayurvedic and contemporary literature, PCOS can be interpreted as a Kapha-dominant Tridoshaja disorder

involving

multiple

bodily

systems.

The

pathology

primarily

affects

the

RasavahaSrotas,

with

probable

involvement of the Artavavaha, Medovaha, and ManovahaSrotas. This Ayurvedic understanding highlights

the

complex

and

multifactorial

nature

of

PCOS

and

may

facilitate

a

comprehensive

approach

to

its

assessment and management.

Keywords:

Anukta Vyadhi, Trividha Bodhya Sangraha,Polycystic Ovary Syndrome, PCOS.

Cite this article as: -

Desai B, Kulkarni A. An Ayurvedic Approachtopolycystic Ovarian Syndrome (PCOS). International Journal

of Diagnostics And Research. 2026Oct17;4(1):68

–

77. doi:10.5281/zenodo.23434897

Issue : 01

INTERNATIONAL

JOURNAL

OF

DIAGNOSTICS

AND

RESEARCH

Volume : 04

Copyright @ : - Dr.Balaji Desai Inter. J.Digno. and Research IJDRMSID0146

|

ISSN :2584-2757

68

Introduction :

Polycystic ovarian syndrome (PCOS) is a common

disorder

that

affects

women

of

reproductive

age,

typically

between

18

and

40

years

old.

It

is

now

often

classified

as

a

lifestyle

disorder

due

to

its

strong association with sedentary habits, unhealthy

eating

patterns,

and

poor

lifestyle

choices.

Although

the

exact

cause

of

PCOS

is

not

fully

understood,

it

is

commonly

linked

to

high

insulin

levels,

an

excess

of

male

hormones

(androgens),

elevated

luteinizing

hormone

(LH),

and

infertility

[1]

.

Symptom

of

PCOS

may

include

delayed

or

irregular menstruation, acne, excessive hair growth

(hirsutism), hair thinning, obesity, and constipation.

Classical Ayurvedic texts do not provide a direct or

complete

description

of

Polycystic

Ovary

Syndrome.

However,

the

classics

reflect

various

features of the syndrome across multiple contexts.

Ayurveda

maintains

that

no

disease

manifests

without

the

vitiation

of

Tridosha

,as

stated

in

Charaka

Samhita

[2]

.

Furthermore,

the

same

doshas,

considered

the

body's

fundamental

regulatory

functional

factors,

can

give

rise

to

innumerable

disease

conditions

depending

on

variations

in

etiological

factors

(samutthanavishesha)

and

sites

of

manifestation

(

sthanantaragata

)

[3]

.

This,

inherent

variability

makes it impossible for classical texts to enumerate

and

describe

every

possible

disease

entity.

While

the

samhitas

comprehensively

document

the

commonly

prevalent

disorders

of

their

time,

they

also implicitly acknowledge the emergence of new

and previously undescribed conditions as lifestyles

and

time

change.

Such

conditions

are

categorized

under the

concept

of

Anukta

Vyadhi

.According

to

the

Charaka Samhita

, when a physician encounters an

anuktavyadhi

, management should be initiated after

a thorough understanding of three essential aspects

of

the

disease:

vikara

prakriti,

adhishtana,

and

samutthanavishesha

[4,5]

.

The

Sutra

Sthana

of

Charaka

Samhita

elaborates

the

fundamental

principles

of

Ayurveda.

In

this

context,

Acharya

Charaka

describes

the

important

concept

of

Trividha

Bodhya

Sangraha

in

the

18th

chapter

(

Trishothiya Adhyaya

) of the Sutra Sthana.

Trividha

Bodhya

Sangraha

comprises

three

essential

components: Vikara Prakriti (nature of the disease),

Adhisthana

(site of manifestation), and Samutthana

(causative

factors).

Together,

these

three

factors

help

explain

the

origin,

localisation,

and

pathogenesis

of

disease,

providing

a

strong

foundation

for

diagnosis

and

treatment

planning.

This

concept

is

further

supported

by

Acharya

Vagbhata

in

his

classical

texts,

emphasising

its

clinical relevance.

Here,

vikara prakriti

denotes the involvement and

predominance

of

vitiated

doshas

(

Vata,

Pitta,

Kapha

)

[6,7]

.

Adhishtana

refers

to

the

affected

structural

and functional

components of the body,

including

dhatus

such as

rasa

and others, as well as

specific

organs

or

systems

[8]

.

Samutthanavishesha

encompasses

the

etiological

and

precipitating

factors

responsible

for

vitiating

particular

doshas

and dhatus

[9,10]

.

This review interprets Polycystic Ovary Syndrome

through

this

Ayurvedic

framework.

Using

Charaka’s diagnostic protocol of Trividha Bodhya

Sangraha,

this

review

examines

PCOS

as

a

prototype of

anuktavyadhi

. This

Issue : 01

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approach

not

only

facilitates

a

deeper

understanding

of

PCOS

in

Ayurvedic

terms

but

also

provides

a

systematic

model

for

analysing

other

modern

disease

conditions

that

remain

unnamed or undescribed in classical texts.

Aim :

To

understand

and

conceptualize

Polycystic

ovarian

syndrome

(PCOS)

through

Ayurvedic

principles using the frameworks of

Anukta Vyadhi

and

TrividhabodhyaSangraha

.

Objectives:

To

review

PCOS

from

modern

and

Ayurvedic

perspectives. To analyse the role of

Dosha

,

Dushya

,

and

Srotas

in

PCOS.

To

identify

the

probable

involvement of

Rasavaha

,

Artavavaha

,

Medovaha

,

and

Manovaha

Srotas

in

its

pathogenesis.

To

formulate

an

Ayurvedic

understanding

of

PCOS

based on classical principles.

Material and methods :

We

compiled

data

on

the

pathophysiological

and

clinical presentation of Polycystic Ovary Syndrome

from standard endocrinology textbooks, established

clinical

guidelines,

and

peer-reviewed

scientific

literature.

These

features

were

subsequently

analyzed

in

the

context

of

principles

described

in

classical

Ayurvedic

texts,

particularly

the

CharakaSamhita

,

to

derive

the

components

of

Trividha Bodhya Sangraha

for this condition

Review Of Literature :

Polycystic ovary syndrome (PCOS) was originally

described

in

1935

by

Stein

and

Leventhal

as

a

syndrome manifested by amenorrhoea, hirsutism

and

obesity

associated

with

enlarged

polycystic

ovaries. According to the 2003 ESHRE/ASRM

(Rotterdam) criteria, PCOS is diagnosed as

Oligomenorrhea/anovulation,

Hyperandrogenism(clinical/biochemical).

Polycystic ovaries on USG

[11]

.

Etiologyofpolycystic Ovarainsyndrome

The

etiology

of

Polycystic

Ovary

Syndrome

remains incompletely understood; however, current

evidence

indicates

that

the

disorder

develops

through a complex interaction of genetic, hormonal,

metabolic,

environmental,

and

lifestyle-related

factors

[12]

.

Among

these,

insulin

resistance

and

hyperandrogenism

are

regarded

as

the

principal

pathogenic

mechanisms

responsible

for

the

development and progression of the syndrome

[14]

.

Genetic Factors:

A

strong

familial

predisposition

has

been

documented

in

women

with

PCOS,

suggesting

a

substantial

genetic

contribution

to

the

disorder

[13]

.

Several

candidate

genes

associated

with

steroidogenesis,

insulin

signaling

pathways,

gonadotropin

activity,

and

ovarian

follicular

function have been implicated in the pathogenesis

of

PCOS

[14]

.

Studies

have

demonstrated

that

first-

degree

relatives

of

affected

women

possess

an

increased

risk

of

developing

PCOS

as

well

as

associated metabolic abnormalities

[15]

. Researchers

have

extensively

investigated

genes

such

as

CYP11A,

CYP17,

insulin

receptor

genes,

and

follicle-stimulating

hormone

receptor

genes

for

possible pathogenic roles.

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Insulin Resistance and Hyperinsulinemia

Insulin

resistance

is

considered

one

of

the

most

important

etiological

factors

in

PCOS

and

may

occur in both obese and lean individuals affected by

the disorder

[12]

.Reduced tissue sensitivity to insulin

results in compensatory hyperinsulinemia. Elevated

insulin

levels

stimulate

ovarian

theca

cells

to

produce excessive androgens while simultaneously

suppressing

hepatic

synthesis

of

sex

hormone-

binding

globulin

(SHBG),

increasing

circulating

free

androgen

concentrations

[14]

.

This

endocrine

imbalance

contributes

to

chronic

anovulation,

menstrual

irregularities,

infertility,

and

metabolic

complications

including

Type

2

Diabetes

Mellitus

and metabolic syndrome.

Hypothalamic

–

Pituitary

–

Ovarian

Axis

Dysfunction :

Dysregulation of the hypothalamic

–

pituitary

–

ovarian axis plays a significant role in the

development

of

PCOS

[13]

.

Increased

pulsatile

secretion

of

gonadotropin-releasing

hormone

(GnRH)

leads

to

excessive

luteinizing

hormone

(LH)

secretion

relative

to

follicle-stimulating

hormone

(FSH).

Elevated

LH

stimulates

ovarian

androgen

synthesis,

whereas

relatively

low

FSH

impairs normal follicular maturation. Consequently,

ovulation

fails

to

occur,

and

multiple

immature

follicles accumulate in the ovaries, resulting in the

characteristic polycystic ovarian morphology

[16]

.

Hyperandrogenism

:

Hyperandrogenism

is

regarded

as

a

hallmark

feature

of

PCOS.

Excess

androgen production primarily originates from

ovarian theca cells and,

in

certain

cases, from the

adrenal

glands.

Increased

androgen

levels

are

responsible

for

clinical

manifestations

such

as

hirsutism, acne, androgenic alopecia, and menstrual

disturbances.

Persistent

hyperandrogenism

further

contributes

to

follicular

arrest

and

chronic

anovulation,

thereby

perpetuating

the

pathological

process

[16]

.

Obesity

and

Lifestyle

Factors

:

Obesity,

particularly central or visceral obesity, significantly

aggravates

the

clinical

and

metabolic

manifestations

of

PCOS

[15]

.

Increased

adipose

tissue promotes insulin resistance and chronic low-

grade

inflammation,

thereby

worsening

endocrine

and

metabolic

disturbances.

Sedentary

lifestyle,

calorie-rich diet, psychological stress, and physical

inactivity

are

recognised

contributors

to

the

progression of the syndrome. Even modest weight

gain

may

adversely

affect

reproductive

and

metabolic function in susceptible individuals.

Environmental

and

Developmental

Factors

:

Recent evidence suggests that intrauterine exposure

to excess androgens and environmental endocrine-

disrupting chemicals may predispose individuals to

the later development of PCOS

[16]

. Chronic stress,

altered

gut

microbiota,

and

developmental

programming

have

also

been

proposed

as

contributory

factors

in

the

pathogenesis

of

the

disorder.

Symptoms

of

PCOS

:

Irregular

Menstruation,

Irritation,

excessive

hunger,

infertility,

lethargy,

constipation, Constipation, Obesity, Obesity, acne,

and Pimples

[17]

.

Diagnosis According to Modern Medicine

[18]

1.

Diagnostic criteria for PCOS were first

established during a meeting hosted by the National

Institutes

of

Health

(NIH)

in

1990.

Experts

developed these criteria based on consensus rather

than clinical trial data. According to this approach,

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a diagnosis of PCOS requires the exclusion of other

known

disorders,

along

with

clinicalor

laboratory

evidence

of

hyperandrogenism

and

chronic

anovulation.

2.

The

Androgen

Excess

Society

(AES)

supports

the

use

of

the

NIH

criteria

and

emphasizes

that

PCOS should be viewed primarily as a disorder of

androgen excess.

3.

In

2003,

a

new

set

of

diagnostic

criteria

was

introduced by an international consensus workshop

sponsored

by

leading

reproductive

health

organizations.

These

Rotterdam

criteria

expanded

the

diagnostic

framework

to

include:Oligo-

ovulation

or

amenorrhoea

(irregular

or

absent

menstruation), Hyperandrogenism, either clinically

evident

or

confirmed

through

biochemical

testing,

polycystic

ovarian

morphology

on

ultrasound.According

to

ultrasound

criteria,

12

or

more follicles in either ovary (each measuring 2

–

9

mm in diameter) and/or an ovarian volume greater

than 10 cc indicates polycystic ovaries.

[19]

Correlation

of

PCOS

with

Trividha

Bodhya

Sangraha

1.

Vikaraprakriti

(Nature of Dosha Involvement)



PCOS is interpreted as

Kapha

predominant

disorder,

with

secondary

involvement

of

Vata

and

Pitta

.


Kapha

aggravation manifests as

medodushti

(vitiation

of

fat

tissue),

cyst

formation,

obesity, and sluggish metabolism

[3,5.6]

.


Vata

imbalance

contributes

to

irregular

menstruation, anovulation, constipation, and

alopecia

[14,15]

.


Pitta

aggravation

is

evident

in

acne,

irritability, and inflammatory changes

(16,17)

.

2.

Adhisthana

(Site of Manifestation)



Rasa Dhatu

: feeble

rasadhatvagni

leads to

improper

transformation

into

rakta

and

artava

,

resulting

in

menstrual

irregularities

[16,17]

.


Artava

Dhatu

/

ArtavavahaSrotas

:

ovulatory

dysfunction

and

infertility

are

rooted here

[26]

.


Medo

Dhatu

/

MedovahaSrotas

:

obesity,

insulin

resistance,

and

acanthosis

nigricans

reflect Kapha-Meda pathology

[21]

.


Shukra

Dhatu

:

hirsutism

and

altered

secondary

sexual

traits

arise

from

KaphaMeda

obstruction

at

the

level

of

shukradhatu

[28,30]

.


Romakupa

(Hair

Follicles)

:

alopecia

and

hirsutism

manifest

here

under

KaphaPittaVata

imbalance

[31,32]

.

3.

Samutthana Vishesha

(Etiological Factors)



Atisantarpana

(Over-nourishment)

:

excessive

intake

of

heavy,

oily,

processed

foods aggravates

Kapha

and

Meda

[19,21]

.


Sedentary

Lifestyle

:

lack

of

physical

activity promotes

Kapha

accumulation and

margavarana

(channel obstruction)

[21]

.


Stress

and

Sleep

Disturbance

:

vitiates

Vata

and

Pitta

,

contributing

to

menstrual

irregularities

and

psychological

symptoms

[12,13]

.


Environmental

Factors

:

endocrine

disruptors and modern lifestyle habits act as

nidanas

for

Kapha-Meda dushti

[37]

.

Symptomwise Ayurvedic Correlation



Irregular

menstruation

→

Kapha

predominance

with

rasadhatvagnimandya

and

Vata

dysfunction

in

ArtavavahaSrotas

[14,18]

.


Infertility

→

Kapha

obstruction with

Vata

imbalance,

artavaapravritti

due

to

margavarana

[26]

.

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

Hirsutism

→

Kapha,Meda

vitiation

obstructing

shukra

dhatu

,

manifesting

as

male pattern hair growth

[27,30]


Alopecia

→

VataPitta

prakopa

in

romakupa

,

KaphaRakta

obstruction

preventing regrowth

[31,32]

.


Acne

→

KaphaMeda

dushti

in

sebaceous

glands, with

VataRakta

contributing to pain

and inflammation

[34,36]

.


Acanthosis

nigricans

→

KaphaMeda

pathology comparable to

kacchapika

(a type

of

pramehapidaka

)

[38]

.


Obesity

→

Kapha

aggravation

leading

to

sthoulya

,

medovriddhi

, and

margavarana

.

Discussion:

Polycystic Ovarian Syndrome (PCOS) is a modern

endocrine

and

lifestyle

disorder

that

can

be

rationally

understood

within

Ayurveda

as

an

example

of

Anukta

Vyadhi

.

Ayurvedic

sages

anticipated

that

new

diseases

would

emerge

over

time

due

to

changes

in

diet,

lifestyle,

and

environment,

and

therefore

emphasised

diagnostic

reasoning

beyond

the

conditions

explicitly

mentioned in the

Samhitas

.

Charaka

, in particular,

instructed

that

when

a

physician

encounters

an

Anukta Vyadhi

,

management

should

be

initiated

only

after

a

thorough

understanding

of

three

essential

aspects:

vikara prakriti

(the nature and characteristics of the

disease),

adhishtana

(the site of manifestation), and

samutthanavishesha

(the

causative

factors

and

origin).

This

triad,

collectively

referred

to

as

TrividhaBodhyaSangraha

,

provides

a

structured

approach to diagnosis and treatment, ensuring that

even newly emerging conditions can be addressed

through classical principles

[20]

.

Applying

this

framework

to

PCOS,

the

vikara

prakriti

reveals

a

Kapha

predominant

tridoshaja

condition.

Kapha

aggravation

manifests

as

cyst

formation, obesity, and sluggish metabolism, while

Vata

imbalance

contributes

to

irregular

cycles,

pain,

and

psychological

disturbances.

Pitta

aggravation is evident in acne, hair fall, irritability,

and

hormonal

imbalance.

Thus,

PCOS

is

not

a

single dosha disorder but a complex interplay of all

three

doshas

with

Kapha

predominance

(21)

.

The

adhishtana

of

PCOS

lies

primarily

in

the

Artavavaha

Srotas

,

the

reproductive

channels,

particularly the ovaries

[22]

. Secondary involvement

of

MedovahaSrotas

explains

metabolic

disturbances such as obesity and insulin resistance,

while

ManovahaSrotas

involvement

accounts

for

psychological

symptoms

like

mood

swings

and

anxiety

[23]

.

The

samutthanavishesha

of

PCOS

is

rooted

in

modern

lifestyle

factors:

irregular

diet

rich in processed and oily foods, sedentary habits,

chronic

stress,

disturbed

sleep,

and

exposure

to

environmental

endocrine

disruptors.

These

causative

factors

vitiate

the

doshas

,

impair

the

dhatus

,

and

obstruct

the

srotas

,

leading

to

the

clinical manifestations of PCOS

[24]

.

From

a

symptom-wise

perspective,

irregular

menstruation

is

explained

by

Vata

vitiation

in

Artavavaha Srotas, ovarian cysts by Kapha-induced

srotorodha

, and infertility

by

Artava Dhatudushti

.

Obesity

and

insulin

resistance

reflect

Kapha

dominance and

Rasdhatu and Meda Dhatu vriddhi,

while

acne

and

oily

skin

reflect

Pitta

aggravation

affecting

Rakta Dhatu

. Hair fall and hirsutism arise

from

Vata-Pitta imbalance, and fatigue or lethargy

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is

due

to

Kapha

vriddhi

.

Psychological

features

such

as

mood

swings

and

anxiety

are

linked

to

ManovahaSrotasdushti

with

Vata

predominance

[25]

. This mapping confirms that PCOS, though not

Granthokta Vyadhi

, fits seamlessly into the

Ayurvedic framework of

Anukta Vyadhi

(26)

.

Conclusion:

Although classical Ayurvedic texts do not explicitly

describe

PCOS,

it

may

be

understood

within

the

framework

of

Anukta

Vyadhi

.

The

concept

of

Trividha

Bodhya

Sangraha

(

Vikara

Prakriti

,

Adhisthana

, and

Samutthana Vishesha

) provides a

rational

basis

for

its

interpretation.

PCOS

may

be

considered

a

Kapha

-predominant

Tridoshaja

condition involving primarily the

RasavahaSrotas

,

with

probable

involvement

of

the

Artavavaha,

Medovaha

,

and

ManovahaSrotas

.

The

correlation

of

its

reproductive,

metabolic,

and

psychological

manifestations

with

Ayurvedic

principles

suggests

that

classical

concepts

can

help

explain

this

contemporary

disorder.

However,

these

interpretations useful in treatment and prevention of

disease.

References:

1.

Kami

A

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110, 2009.

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74

Ashtangahrdaya,

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Rotterdam

ESHRE/ASRM-Sponsored

PCOS

Consensus

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ovary

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ESHRE/ASRM-Sponsored

PCOS

Consensus

Workshop

Group.

Revised

2003

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Diagnostic

Criteria

and

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Health

Risks

Related

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Polycystic

Ovary

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Al.

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Chowkhambha

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Modern

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prevalence in PCOS.

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76

37.

Srikantha

Murthy

KR

(translator)

Sharngadhara

Samhita,

Purvakhanda

,

description

of

Youvanapidaka

.

Edition

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Varanasi:

Chowkhambha Orientalia; 2013. p.32.

38.

Modern

endocrinology/dermatology

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–

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39.

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Trikamaji

(editor)

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Samhita,

Nidanasthana

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Pramehapidaka

)

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Varanasi:

Chowkhambha

Bharati

Academy; 2016

.

Declaration :

Conflict of Interest :

None

ISSN: 2584-2757

DOI

:10.5281/zenodo.23434897

Dr.

Balaji Desai

Inter.

J.Digno

.

and

Research

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