Introduction

PCOS is getting so much attention in the past decade due to its high prevalence. One in ten women is being diagnosed with having PCOS. It has a long-term effect on reproduction, metabolic disorders, and cardiovascular disorders. A holistic approach can have a better health outcome as PCOS has various signs and symptoms.

Here is an attempt to make you understand what can Ayurveda offer you to heal yourself. In Ayurveda, the PCOS condition does not correlate to a single disease or a syndrome. Rather we can understand based on the involvement of Dosha, Dhatu, and Upadhatu causing symptoms such as Anartava (amenorrhea), Asrugdara (Menorrhagia), Arajaska (oligomenorrhea), Vandyatva (infertility), Pushpaghni Jataharini (symptoms such as hirsutism, anovulatory cycles). The treatment is based on the present concern, causative factor, the involvement of Dosha and Dhatu, and also an assessment of Agni (Gut health) is done. Most of the time treatment plan differs from woman to women, as each individual is unique.

Nidana Parivarjana

The first line of advice is Nidana Parivarjana which means avoiding the causative factor which aggravates the symptoms of PCOS. PCOS symptoms can gear up by environmental factors like eating junk food, having a sedentary lifestyle, too much stress and anxiety, using plastic, cooking food in aluminium or non-stick utensils, etc. Assessing one’s lifestyle, nutrition status, mental health wellbeing is important to adapt to a new healthy lifestyle.  

Ahara (Diet)

The balanced diet should include proteins rich foods, low-glycaemic index (GI) carbohydrates, high in fiber foods, and also plenty of vegetables and fruits. This helps to balance the hormones in the body. Studies show that just by losing 7%-10% of the body weight will often restore normal menstrual cycle in PCOS women, and more likely making a successful pregnancy in people who are planning for it. However, losing weight is only the first step. The eventual goal is to achieve and maintain a lifelong healthy lean-to-fat tissue ratio. To achieve this your diet should be accompanied by regular exercise and increased self-awareness and self-care to ensure that you maintain your healthy habits.

What to eat and what to avoid?

Fruits and Vegetables

• Consume low GI(Glycaemic Index) Fruits like apples, dried apricot, under-ripe banana, peaches, oranges, cranberries, blueberries, plums, grapes, pears, coconut.
• Consume low GI Vegetables like carrot, green peas, onions, lettuce, greens (spinach, kale, collards, beet) green beans, tomatoes, cucumbers, mushrooms, broccoli, sprouts.
• Don’t consume fruits and vegetable which are off-season. Because seasonal fruits and vegetables grow under appropriate weather condition without any artificial influencer which is healthy, they have their own natural color, flavor and their nutrition level are high and affordable too.
• Sugar-sweetened carbonated beverages like soda, cola, fruit juice, bottled smoothies, etc., are zero or low in nutrients. Instead, eat fresh seasonal fruits which will help reduce insulin demand.

Grains/Legumes/Nuts/Seeds

• You can consume low GI grains like barley, whole wheat, all bran and fiber one cereals, oat bran, rice bran cereals. Legumes like all types of beans, spilt peas, black-eyed peas, lentils, lima beans.
• Also includes nuts (almond, walnut, roasted cashew, pistachios) and seeds like flaxseed, pumpkin seed, sesame seeds, sunflower seeds, quinoa, chia seeds, fenugreek.

Dairy Products

• Low GI dairy products and its substitutes- skim, low-fat milk, plain yogurt, cottage cheese, soy milk, and yogurt.
• Some studies suggest limiting or avoiding dairy products. Insulin growth factor-1 (IGF-1) which is found to be much higher in PCOS women, the exact same IGF-1 structure is also found in cow milk products. Therefore, PCOS women with insulin resistance can avoid or limit dairy products.

Carbohydrates

• Carbohydrate free and very low-carbohydrate foods are chicken, turkey, eggs, fish and shellfish, olive oil, ghee are good to consume.
• Avoid sugary foods like ice cream, candy, cookies, cake, biscuit, sweetened cereals, etc. Also, Reduce salt intake.
• Avoiding refined carbs like white bread, pastries, pizza dough, pasta, etc., helps in weight loss, further decreasing the androgen levels which is responsible for acne, facial hair growth, irregular cycles, etc.
• Avoid saturated fat and Trans-fat food like French fries, burger, pizza, doughnuts, fried chicken, nachos, and also all packed and processed food. Instead, you can use ghee (clarified butter), virgin olive oil, avocado, seeds, and nuts which are the good sources of healthy fats.

Anti-inflammatory diet

• An anti-inflammatory diet that includes the above-mentioned vegetables, fruits, legumes, grains, nuts and spices like turmeric, clove, cinnamon, ginger, black pepper, cayenne, garlic, etc., are good. These foods are high in monounsaturated fats, omega 3’s, fiber, and antioxidants.
• Avoid alcohol, coffee, and other caffeinated drinks like tea, green tea as it can cause more inflammation

Antioxidant foods

• Studies show that Antioxidant-rich foods help in the reduction of testosterone and insulin resistance.
• Be cautious about the chemical toxins which are seen in food stored in plastic containers, a plastic wrap made from PVC, and food cooked in non-stick or aluminum utensils. Avoid foods containing pesticides and chemicals in vegetables, fruits, meat, milk, poultry, etc.
• Buy fresh, organic products and cook in a clay pot or iron cast utensils.

Overall a healthy diet containing seasonal fruits and vegetables, lean protein source like beans, pea, lentils, skinless white meat poultry, cottage cheese (paneer), tofu, egg, low fat milk etc. are beneficial.

Vihara

In Ayurveda, the Vihara concept is subjected to Dinacharaya (day regimen), Ratricharya (night regimen), Ritucharya (seasonal regimen), Sadavritta (the norms to be followed). By following these the quality of life can be enhanced and helps in the prevention and management of PCOS conditions. The concept Vihara is vast, I shall cover this in a seperate post.

Physical activity

Studies reveal that exercise is very beneficial to improve mental health, also there is a significant improvement in the regularity of the menstrual cycle and ovulation. To see an effective result, indulge in physical activity for 4-5 days per week with the intensity of 20-60 minutes and practice for 12-24 weeks. Physical activity can be aerobics, resistance exercise, Zumba, yoga, swimming, or any kind of sport. Always start with a warm-up and end with cool-down stretching exercises. Among all kinds of physical activity, Yoga along with meditation is very beneficial. 

Yoga

Few of the asanas which directly act on the reproductive system are Suryanamaskara, Trikonasana, Pawanamuktasana, Setubandhasana, Prasarit Padottanasana, Halasana, Sarvangasana, Ustrasana, Bhujangasana, Shalabhasana, Dhanurasana, Paschimottanasana.

Herbal formulations

A single herb or a combination of the herb is selected to manage Oligo/Amenorrhoea, excess androgen, PCOS. Few herbs like Kumari, Twak, Methika, Amalaki, Yastimadhu, Shilajit, Shatavari, Ashwagandha, Vidarikhanda, Ashoka, Dasamoola, Triphala, Guggulu preparations, etc., will help in balancing the hormone levels and also improve most of the PCOS symptoms. These herbs improve gut health, increase metabolism, acts on the H-P-O axis (hypothalamus-pituitary-ovarian axis), induce ovulation. Also decreases androgen production, and improves skin and hair.

Seed cycling is a growing trend, where specific seeds are recommended to support the hormones of each phase in the menstrual cycle. During the first phase, from day 1-14 of the menstrual cycle eat a tablespoon of flax and a tablespoon of pumpkin seeds. During the second phase, from day 15-28 eat a tablespoon of sunflower seeds and a tablespoon of pumpkin seeds. These seeds are rich in magnesium, copper, thiamine, vitamin E, fiber, and fats which are necessary to balance hormones, reduce Premenstrual symptoms, and ease the period flow.

Panchakarma

Panchakarma along with Samanaushadi (internal medication) is one the effective method in managing PCOS condition. Panchakarma procedures include Vamana, Virechana, Anuvasana, Niruha, and Nasya. These procedures are selected by an ayurvedic doctor based on the aggravation of Dosha- Dhatu, Prakruti, Rutu(season), etc. of an individual. Panchakarma is a detox procedure that helps in removing the toxins from the body and will also help to reduce the risk of autoimmune reactions by removing the inflammatory triggers from your body.

PCOS treatment plan will differ based on an individual complaint like infertility, Oligo/Amenorrhoea, irregular cycles, or just skin and hair issues. Always a holistic and spiritual approach is required which includes a balanced diet, meditation, self-care, panchakarma procedures, and internal medication. You may consult a doctor for proper guidance to overcome PCOS.