International Journal of Ayurveda a Case Study on Polycystic Ovarian

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ISSN: 2456-6640 International Journal of Ayurveda (A Monthly Scientific Journal of Kiban Research Publications) www.kibanresearchpublications.com

RESEARCH ARTICLE

A Case Study on Polycystic Ovarian Syndrome in Women with Bulky Ovaries

Bhakti Jaypal Mane1*, Pranali Namdeo Dandekar2

Dept. of Prasutitantra & Streerog, Y.M.T Ayurvedic Medical College and Hospital Kharghar, Navi Mumbai, Maharashtra, India.

*Corresponding Author Email: [email protected]

Abstract: Polycystic ovarian syndrome (PCOS) is an endocrine disorder affecting reproductive aged women. In this case study, female aged 18 years with acne, heavy menstrual bleeding, and weight gain who had not received hormonal treatment. Clinical data including age, weight, height, body mass index, menstrual history and androgenic sign i.e. hyperandrogenemia (hirsutism, alopecia, acanthosis nigricans) were recorded. Remarkable change was observed in ovaries and in menstrual bleeding with the Ayurvedic treatment.

Keywords: Polycystic ovarian syndrome, Bulky ovaries, Hyperandrogenemia, Menstrual bleeding. Article Received: 13 Nov. 2020 Revised: 24 Nov. 2020 Accepted: 29 Nov. 2020 Introduction Polycystic ovarian syndrome is a set of symptoms cause of hyperandrogenemia is PCOS. The and signs including menstrual irregularities, present case study is showing the success of weight gain, acne vulgaris, facial hair, acanthosis Ayurvedic management of reduced ovarian nigricans, and hyperandrogenism. One of the volume with PCOS subject. An 18 years old female typical signs we get in ultrasound is bulky with complain of heavy menstrual bleeding, ovaries. Polycystic ovaries include peripherally weight gain, acne and had not received any dearranged follicles measuring 2 to 9mm in hormonal treatment. Her history was regular diameter or increased volume of ovaries and it is menstrual cycle since menarche. Clinical data, termed as bulky ovaries [1]. In modern medicine including age (18 years), weight (58 kgs), height there is no comprehensive treatment for PCOS. (5’01’’), body mass index (normal), menstrual Not all women with PCOS have all of the history (regular) and androgenic signs were symptoms. Most women with PCOS grow many recorded. Hormonal assay and pelvic small cysts on their ovaries which lead to utrasonography were done. hormone imbalance. In females, the most common

Table1: General Data Age Marital status Occupation Social class Address Registration date 18 yrs Unmarried Student Middle Uran 26/09/2019

Personal History increasing with central obesity. The patient A detailed comprehensive history reveals was having junk food and sedentary lifestyle that in the beginning the weight is slowly which helps to aggravate the disease [2].

Table 2: Detailed comprehensive history Diet Mixed Appetite Normal Bowel Normal Micturation Normal Thirst Normal

Family History Duration of Menses No any paternal or maternal history. 7 to 9 days

Menstrual History Interval between Two Cycles Menarche at the age of 12 years. 28 to 30 days

LMP Previous BMI-27 22/09/2019 Current BMI-24.2

Present Menstrual History Examination Regular, Heavy bleeding (6 to 7 pads fully In general examination, patient having soaked/ day), painless. weight w 58 kgs with height 5’01’’. All vitals were normal. Table 3: General examination of patient Blood Pressure 110/80 Pulse 80/min Height 5’01’’ Weight 58kg Temperature Afebrile Respiration 18/min

Systemic Examination Platelet-2.59 lakhs/cumm

CVS – Heart sound (S1 S2) Normal. USG-Pelvis RS – Bilateral chest clear, air entry Polycystic Ovaries adequate. Right Ovary: 3.8 * 3.4 * 2.0 cms (Volume- Investigations 11.5cc) Hormonal Profile Left Ovary: 3.3 * 3.2 * 2.0 cms (Volume-10.5 cc) Sr. Lh-12.46 mIU/ml Advice Sr. Fsh-07.89 mIU/ml Patient was instructed to avoid cold, salty, Sr. Test- 99.10 ng/dl sour, fermented and spicy food and simultaneously to maintain stress free CBC lifestyle. Forward and backward bending Hb-12.56 gm/dl asanas with surya namaskara.

WBC-8400/cumm

Table 4: Patient details Visit Complaints Dietary regimen Treatment 26/09/2020 Heavy bleeding, acne, wt. gain Iron rich food, 1.Rasapachak Vati 2 BD Protein rich food, 2.Chandraprabha Vati 2 BD Plenty of oral fluids, 3.Aarogyavardhini Vati 2 BD Exercise 4.Syrup M2 Tone 10 ml BD 25/10/2020 Same as above Same as above Same as above 28/11/2020 Same as above Same as above Same as above 24/12/2020 Symptomatic relieved Pathya - Apathya advised Same as above

Results & Discussion According to Ayurved, PCOS is equated to the involvement of dosha, dhatu and mala is menstrual irregularities. It is a disorder seen. Main vitiation of vata is done through involving all three doshas i.e. vata, pitta, & medications which simultaneously regulates kapha with meda dhatu, rasa dhatu and H-P-O axis along with kapha and pitta artava upadhatu. Therefore in this disease, doshas.

With 3 months of regular treatment i.e. oral Chandraprabha vati and aarogyavardhini medication along with yoga, exercise and vati both includes maximum contents of tikta meditation therapy patient got relief from rasa which shows its lekhana, pachan and heavy menstrual bleeding and her rakta prasadak property. This helps to rectify ultrasound findings showed reduction in rakta dushti which ultimately corrects raja ovarian volume. Hence, understanding the dushti. Here with help of shamana chikitsa disease from ayurvedic point of view and in the form of oral medication menstrual planning proper treatment modality shows bleeding got reduced and all 3 doshas were in tremendous results from reducing androgenic samya avastha. central obesity to balancing hormones. It balances Apana vayu which controls the There were multiple factors in this case that ovarian function and overall reproductive made this case as challenging. Heavy system. Aarogyavardhini & Chandraprabha bleeding, acne and weight gain indicated as shows its action on scrapping and restoring symptoms of prognosis. The decreasing as well as the healing process. Probably on bleeding during menses was also pointing the metabolic syndrome and thus oral towards ovarian changes which would reduce medication has shown its effect on all vikrut her ovarian volume. The option of Syrup M2 doshas and dhatus by shaman chikitsa. tone (uterine tonic) in this case was selected on the basis of hormonal disturbance as it Conclusion acts as menstrual regulator. Pcos remain one of the major concerns in reproductive medicine due to repeat This helped in hormonal imbalance, to occurrence. Amongst them bulky ovaries with relieve anxiety and improve ovarian increased ovarian volume was the functions. Chandraprabha Vati, challenging part. In this case there were Aarogyavardhini Vati and Rasapachak Vati many factors that were impairing the natural was being chosen as a drug of choice. Keeping menstruation but with proper treatment and in mind that pcos is a stress induced disorder systematic management the case was chandraprabha vati was chosen to alleviate successful. Hence, depending upon this case stress & fatigue and to rejuvenate the body. study we should focus towards multiple It also balances vitiated vata and kapha factors and aetiology mentioned in literatures dosha. Aarogyavardhini vati was given for and their relevance in present scenario. metabolic correction, to reduce weight and to reduce acne too. References Rasapachak vati was chosen to reduce aam 1. DC Dutta (2016) Textbook of Gynecology and to reduce the rasa dhatu vikruti as it and Obstretics, 7th edition, Jaypee normalizes vitiated kapha and pitta dosha. publicatiom. All above medicines has property of lekhana 2. Dravyagun vignyayn Prof. P.V. Sharma and shamana karma. With correct drug of (1998) Chaukhamba bharti academy, choice, the qualitative improvement was seen Varanasi. on ovaries and quantitative effect was acquired on menstrual bleeding [3]. 3. Agnivesa (2005) Charak Samhita edited by Yadavji T. Probable Mode of Action