Polycystic Ovarian Disease (PCOD) Through the Lens of Ayurveda: A Comprehensive Review of Aetiology, Pathogenesis, and Integrative Management

Abstract

Polycystic Ovarian Disease (PCOD) is one of the most prevalent endocrinological disorders afflicting women of reproductive age, with global prevalence ranging between 2–21%, yet approximately 70% of cases remain undiagnosed. Its rising incidence is strongly linked to sedentary lifestyles, disrupted circadian rhythms, and nutritionally deficient diets. Contemporary Ayurveda offers a robust framework - rooted in Dosha, Dushya, Srotas, and Samprapti - for understanding and managing this complex disorder. The present review systematically examines the aetiology, pathogenesis, and integrative management of PCOD through classical and contemporary Ayurvedic perspectives. Multiple classical nosological entities - including Pushpaghni, Artavakshaya, Granthibhuta Artava, Sthoulya, and Vandhya - correspond to the diverse phenotypic expressions of PCOD. The dominant pathogenetic mechanism involves Kapha Vriddhi, Agni Mandhya, Medovaha and Artavavaha Srotodushti, and Apana Vata Vaigunya, paralleling the biomedical triad of insulin resistance, anovulation, and hyperandrogenism. Shodhana Chikitsa comprising Vamana, Virechana, Basti, Nasya, and Uttara Basti- supplemented by Shamana formulations such as Kanchanara Guggulu, Shatapushpa, and Shatavari - has demonstrated significant clinical outcomes in menstrual regularisation, ovarian morphology, and hormonal normalisation. Nidana Parivarjana and Rasayana therapy further contribute to sustained disease modification. Ayurvedic management, validated by prior clinical investigations, offers a safe, holistic, and disease-modifying approach to PCOD.