Nasya Karma in Hypothalamic-Pituitary-Ovarian Axis Modulation

Abstract

The Hypothalamic–Pituitary–Ovarian (HPO) axis is the principal neuroendocrine system governing female reproductive function through a finely coordinated hormonal cascade. Any functional or structural disruption within this axis may result in menstrual irregularities, anovulation, infertility, and endocrine disorders such as polycystic ovarian syndrome (PCOS) and hypothalamic amenorrhea. Increasing prevalence of stress-related reproductive dysfunctions and limitations of conventional hormonal therapies have led to a growing interest in complementary and traditional medical systems. Ayurveda offers a holistic framework for understanding and managing reproductive disorders, emphasizing the role of Vata Dosha, Siras (central regulatory centers), and Artavavaha Srotas in the maintenance of reproductive health. Nasya Karma, a specialized Panchakarma procedure involving nasal administration of medicated substances, is traditionally advocated for disorders of the head and neurological regulation. Classical Ayurvedic texts describe the nose as the gateway to the head (Nasa hi siraso dvaram), implying its direct influence on higher neurophysiological functions. Recent advances in neuropharmacology have validated the intranasal route as an effective means of delivering therapeutic agents directly to the brain, bypassing the blood–brain barrier and influencing hypothalamic and limbic structures. This review aims to critically analyze the conceptual basis, probable mechanisms, and therapeutic relevance of Nasya Karma in modulating the HPO axis by integrating Ayurvedic principles with contemporary neuroendocrine science. The available classical references, experimental insights, and emerging clinical evidence are discussed to highlight Nasya Karma as a potential non-invasive and holistic approach for restoring reproductive neuroendocrine balance.