Title of Project Report

Project Report Submitted to

G. D Goenka University, Gurugram, Haryana

In partial fulfillment of the requirements for the degree of

BACHELOR OF PHARMACY

Supervised By Submitted By
Name of Supervisor Name of Student
Educational Qualification B. Pharm. 8th Semester
Designation Enrollment No.
SoMAS SoMAS

School of Medical and Allied Sciences,

G.D. Goenka University,
Gurugram,
Haryana
2023
 CERTIFICATE

This is to certify that the work contained in this Project Report entitled “PCOS Today And
Tomorrow” submitted to G.D. Goenka University, Gurugram in the partial fulfillment of
the requirements for the award of the degree of Bachelor of Pharmacy embodies the original
review work carried out by Ms.Twinkle herself under my supervision and guidance at the
School of Medical and Allied Science, G.D. Goenka University, Gurugram. The work has
not been submitted in part or full for the award of any other Diploma or Degree in any other
University/Institute.

Dr. Amit Nayak

Ph.D, M. Pharma

Professor

School of Medical and Allied Sciences

G.D. Goenka University

Gurugram

Forwarded by: Forwarded by:

Dr. Nitish Bhatia Prof. (Dr.) Shailendra Bhat

Coodinator (UG) Principal (Pharmacy)

School of Medical and Allied Sciences School of Medical and Allied

Sciences

G.D. Goenka University G.D. Goenka University

Gurugram Gurugram
 DECLARATION

The Review work embodied in this Project Report entitled “PCOS Today And Tomorrow”
has been done by me at School of Medical and Allied Sciences, G.D. Goenka University,
Gurugram & is not submitted elsewhere for the award of any diploma/degree. All the facts and
figures adapted from other published/unpublished literature have been duly acknowledged. If
anything is detected to be false or plagiarised in future, I, myself shall be solely responsible for
the same.

Garima

(190100202018)
 ACKNOWLEDGEMENT

I would like to express my sincere gratitude to Dr. Amit Nayak whose guidance and support
were instrumental in the successful completion of my project work. His insightful feedback
and constructive suggestions have greatly enhanced the quality of my project The efforts and
guidance by the supervisor were indeed a real helping hand in moving forward in this
intricate work.

Garima

Enrollment no. 190100202018

 Table of content

S.no Title Page no.

Abstract

Abbreviations

List of tables

List of figures

1 Introduction

1.1 NIH
1.2 Rotterdam
1.3 Androgen

2 Review of Methodology

3 Objective of the proposed study

4 Rationale of the proposed study

5 Review of literature

5.1 Symptoms of PCOS

5.2 Causes of PCOS

5.3 Clinical presentations

5.4 Pathophysiology of PCOS

5.5 Etiology of PCOS

6 Diagnosis of PCOS

7 Treatment of PCOS

7.1 Ayurvedic treatment of PCOS

7.2 Ayurvedic treatment with herbal medicines for

PCOS

7.3 Ayurvedic diet for regular periods

8 Conclusion

9 References
 ABSTRACT

Polycystic ovary syndrome (PCOS) was hypothesized to result from functional ovarian hyper
androgens (FOH) due to deregulation of androgen secretion in 1989-1995. Subsequent
studies have supported and amplified this hypothesis. When defined as otherwise unexplained
hyper androgenic oligo anovulation, two-thirds of PCOS cases have functionally typical
FOH, characterized by 17-hydroxyprogesterone hyper responsiveness to gonadotropin
stimulation. Two-thirds of the remaining PCOS have FOH detectable by testosterone
elevation after suppression of adrenal androgen production. About 3% of PCOS have a
related isolated functional adrenal hyperandrogenism. The remaining PCOS cases are mild
and lack evidence of steroid secretary abnormalities; most of these are obese, which we
postulate to account for their atypical PCOS. Approximately half of normal women with
polycystic ovarian morphology (PCOM) have subclinical FOH-related steroidogenic defects.
Theca cells from polycystic ovaries of classic PCOS patients in long-term culture have an
intrinsic steroidogenic dysregulation that can account for the steroidogenic abnormalities
typical of FOH. These cells over express most steroidogenic enzymes, particularly
cytochrome. Over expression of a protein identified by genome-wide association screening,
differentially expressed in normal and neoplastic development, in normal theca cells has
reproduced this PCOS phenotype in vitro. A metabolic syndrome of obesity-related and/or
intrinsic insulin resistance occurs in about half of PCOS patients, and the compensatory
hyperinsulinism has tissue-selective effects, which include aggravation of hyperandrogenism.
PCOS seems to arise as a complex trait that results from the interaction of diverse genetic and
environmental factors. Heritable factors include PCOM, Paragraph hyperandrogenemia,
insulin resistance, and insulin secretary defects. Environmental factors include prenatal
androgen exposure and poor fetal growth, whereas acquired obesity is a major postnatal
factor. The variety of pathways involved and lack of a common thread attests to the
multifactorial nature and heterogeneity of the syndrome. Further research into the
fundamental basis of the disorder will be necessary to optimally correct androgen levels,
ovulation, and metabolic homeostasis.
 LIST OF ABBREVIATION

PCOS Poly Cystic Ovarian Syndrome

NHI Criteria National Institutes of Health 1990 conference diagnostic criteria

hCG Follicle Stimulating Hormone

AE-PCOS androgen excess –PCOS

FOH Functional ovarian hyperandrogenism

IGF Insulin growth factor

FSH polycystic ovary syndrome

IUD Intra Uterine Devices

LH Luteinizing Hormone

SHBG Sex Hormone Binding Globulin

TSH Thyroid Stimulating Hormone

LIST OF TABLES
LIST OF FIGURE
 Chapter 1

INTRODUCTION
 Figure1:

First described in 1935 by the American gynecologists Irving F Stein and Michael

L Leventhal.

Other names:-

• Polycystic ovary disease,

• Flnctional ovarian hyperandrogenism,

• Ovarian hyperthecosis,

• Sclerocystic ovary syndrome

• Stein-Leventhal syndrome

Two definitions are commonly used:

1.1 NIH- In 1990 a consensus workshop sponsored by the NIH/NICHD suggested that a person
has PCOS if they have all of the following:

1. oligo ovulation

2. signs of androgen excess (clinical or biochemical)

3. exclusion of other disorders that can result in menstrual irregularity and hyperandrogenism.
1.2 Rotterdam- In 2003 a consensus workshop sponsored by ESHRE/ASRM in Rotterdam
indicated PCOS to be present if any two out of three criteria are met, in the absence of other
entities that might cause these findings:

1. oligoovulation and/or anovulation

2. excess androgen activity

3. polycystic ovaries (by gynaecologic ultrasound) The Rotterdam definition is wider,

including many more women, the most notable ones being women without androgen excess.
Critics say that findings obtained from the study of women with androgen excess cannot
necessarily be extrapolated to women without androgen excess.

1.3 Androgen Excess PCOS Society- In 2006, the Androgen Excess PCOS Society suggested
a tightening of the diagnostic criteria to all of the following:

1. excess androgen activity

2. oligoovulation/anovulation and/or polycystic ovaries

3. exclusion of other entities that would cause excess androgen activity (Rotterdam
et.al.,2003).
 CHAPTER 2

REVIEW OF METHODOLOGY

A comprehensive literature search was carried out through electronic searches of PubMed,
Medline, Google Scholar and Science Direct database using multiple search termed related to
“ PCOS”, “ Pathophysiology”, “Surgical Treatments”.

This mentioned information is achieved by referring various research articles from

https://www.ncbi.nlm.nih.gov/ , https://link.springer.com/, https://www.sciencedirect.com/,

https://forestbiofacts.com/, https://pubs.rsc.org/, etc The matter is studied and approved under

the expert’s guidance.
 Chapter 3

OBJECTIVE OF THE PROPOSED STUDY

Women of reproductive age are frequently affected by the endocrine condition known as
polycystic ovary syndrome (PCOS). It is essential to have a clear target in tackling this
ailment because of the rise in its prevalence around the globe. Awareness-building among
women, medical professionals, and the general public is the first step in the fight against
PCOS. We may encourage people to understand the value of promptly obtaining medical
treatment by educating them about PCOS, its indications, symptoms, and related health
concerns. Public health programmes, instructional materials, and social media awareness
efforts can all work to reduce PCOS's stigma and promote candid conversations about the
illness. Effective symptom management and long-term problem prevention are greatly aided
by early PCOS screening. The intention is to get women to speak with their doctors if they
have irregular periods, excessive hair growth, acne, or problems becoming pregnant.
Additionally, encouraging routine health checkups that include hormonal evaluations and
ultrasound tests might aid in early detection. Early identification helps medical practitioners
to start the right therapies as soon as possible, lowering the potential health concerns related
to PCOS. Implementing efficient management methods is a crucial component of the PCOS
aim. The management of PCOS symptoms depends heavily on lifestyle changes such keeping
a healthy weight, getting regular exercise, and eating a balanced diet. Dietary adjustments can
have a good effect on insulin resistance and hormonal balance by lowering intake of refined
carbs and sugar and increasing intake of fiber-rich foods. The goal of PCOS is
multidimensional and includes increasing awareness, encouraging early identification, and
putting in place efficient treatment techniques. By attaining these goals, we can enable
PCOS-affected women to take control of their health, find the right medical treatment, and
make lifestyle changes that enhance their wellbeing.

Chapter 4

RATIONALE OF THE PROPOSED STUDY

PCOS is a common endocrine condition that significantly affects women all over the world.
For the reasons listed below, studying PCOS is essential;

Public Health Burden: Because of its high prevalence and related health hazards, PCOS is a
severe public health burden. Researchers can learn more about the prevalence, risk factors,
and effects of PCOS on women's health by studying the disorder. To reduce the negative
effects of PCOS, tailored therapies and public health initiatives must be developed.

Improved Quality of Life: PCOS may have a big influence on how people feel about their
lives. Researchers can examine the biological, psychological, and social facets of PCOS via
investigation. With the aid of this study, support networks, counselling services, and
educational materials may be created to specifically cater to the needs of people with PCOS
and solve their many issues. One of the most important goals of researching PCOS is to
improve the quality of life for those who have it.

Precision Medicine and Personalised Medicine: Every PCOS patient has a different mix of
symptoms, health risks, and treatment reactions. The discovery of phenotypes or subtypes
within PCOS is made possible by research, opening the door to precision medicine and
personalised treatment. Researchers can better target treatments and therapies to meet the
unique needs of each patient, increasing treatment efficacy and reducing adverse effects, by
knowing the many symptoms and underlying causes linked with PCOS.

Adding to Scientific Knowledge: PCOS is still a complicated, multidimensional disorder with

a number of unresolved components. Research on PCOS contributes to the advancement of
knowledge in endocrinology, reproductive health, genetics, and related fields. Researchers
can uncover the underlying processes, genetic predispositions, and environmental variables
causing PCOS via ongoing discovery and analysis, leading to improvements in both
diagnosis and therapy.

Chapter 5

REVIEW OF LITERTURE

5.1 Symptoms of PCOS

male insulin
Excessiv pattern resistanc
e body baldness e
acne
hair
growth
irregular
high
or
testoster
missed
one
periods

low sex
fatiuge
drive

ovariaan Symptoms mood

cysts of PCOS swings

Figure 3: Symptoms of PCOS

PCOS is a syndrome disease defined by a group of signs (physical findings) and symptoms
(patient complaints).Symptoms can vary from woman to woman. Some of the symptoms of
PCOS include:-

● Infertility (not able to get pregnant) - PCOS is the most common cause of female infertility.
Conception may take longer than in other women, or women with PCOS may have fewer
children than they had planned. In addition, the rate of miscarriage is also higher in affected
women.

● Infrequent, absent, and/or irregular menstrual periods- The menstrual irregularities in PCOS
usually present around the time of menarche.

● Hirsutism -increased hair growth on the face, chest, back, thumbs, or toes

● Acne, oily skin, or dandruff

● Weight gain or obesity, usually with extra weight around the waist

● Male-pattern baldness or thinning hair

● Patches of skin on the neck, arms, breasts, or thighs that are thick and dark brown or black

● Skin tags(excess flaps of skin in the armpits or neck area)

● Pelvic pain

● Anxiety or depression

● Sleep apnea (when breathing stops for short periods of time while asleep.

( acog.org/~/media/For%20Patients/ nichd.nih.gov/health/topics/PCOS/ )

5.2 CAUSES OF PCOS

The cause of PCOS is unknown. But most experts think that several factors, including genetics,
could play a role. Women with PCOS are more likely to have a mother or sister with PCOS. A
main underlying problem with PCOS is a hormonal imbalance. In women with PCOS, the
ovaries make more androgens than normal. Androgens are male hormones that females also
make. High levels of these hormones affect the development and release of eggs from the ovary
each month (a process called ovulation). Researchers also think insulin may be linked to PCOS.
Insulin is a hormone that controls the change of sugar, starches, and other food into energy for
the body to use or store. Many women with PCOS have too much insulin in their bodies because
they have problems using it. Excess insulin appears to increase production of androgen. High
androgen levels can lead to:-

• Excessive hair loss acne ,obesity

• Weight gain insulin resistance
• Problems with ovulation (womenshealth.gov/publications).

5.3 CLINICAL-PRESENTATION
 HYPERANDROGENISM
Hirsutism
Acne

Figure 4:

The clinical presentation of PCOS is variable. Patients may be asymptomatic or they may have
multiple gynaecologic, dermatologic, or metabolic manifestations. Patients with PCOS most
commonly present with signs of hyperandrogenism and a constellation of oligomenorrhea,
amenorrhea, or infertility. Workup for PCOS is sometimes prompted by an incidental finding
of multiple ovarian cysts after ultrasonography (Mani H, Davies MJ, Bodicoat DH, et al. 2015;
Legro RS, Arslanian SA, Ehrmann DA, et.al.,2013).

5.4 PATHOPHYSIOLOGY OF PCOS

The PCOS ovary is typically hypersensitive to LH stimulation. The initial studies of the
responses to GnRHag suggested abnormal steroidogenic dose-response relationships in
response to LH that were consistent with partial escape from desensitization . Subsequent
studies directly demonstrated hypersensitivity to sub maximal hCG test doses associated with
a similar pattern of increased androgen responsiveness.Initially, the possible causes of this
dysregulation of androgen secretion were postulated to include insulin excess, which is known
to sensitize the ovary to LH by interfering with the normal process of homologous
desensitization to LH as discussed above, or an intrinsic imbalance among intraovarian
regulatory systems.(Hirshfeld-Cytron J, Barnes RB, Ehrmann DA, Caruso A, Mortensen MM,
Rosenfield RL. 2009)(Cook-Andersen H. Et.al.,2013)
Support for an intrinsic theca cell defect has come from both in vivo and in vitro studies. In
vivo, ovarian steroidogenic hyperfunction in response to sub maximal acute hCG challenge
persists after the ovarian quiescence achieved by 1–3 months of gonadotropin suppression. In
vitro studies have shown the presence of an intrinsic theca cell abnormality that is independent
of LH receptor status by demonstrating that an overactive steroidogenic phenotype is
constitutively present in isolated theca cells and persists through long-term passage in cell
culture, which suggests an inherent defect(s) (Rosenfield RL, Barnes RB, Ehrmann DA
et.al.,2004).

Figure5:

5.5 ETIOLOGY Of PCOS: A Complex Trait(pathogenesis)

PCOS Etiology as a Complex Trait Involving 2 Hits:-

A .Congenital hit:-

• Gene variants affecting ovarian function

• Congenital virilization
• Disturbed fetal nutrition

B .Provocative hit:-

• Insulin-resistant hyperinsulinemia

- Type 2 mellitus-related gene variants

- Postnatal obesity

• Hyper puberty

5.5.1 Heritable traits and genetic linkages:-

1. Maternal PCOS
2. Polycystic ovarian morphology
3. Hyperandrogenemia
4. Metabolic syndrome and diabetes mellitus (DM)
5. Gene variants

5.5.2 Intrauterine environment:-

1. Congenital virilization
2. Disturbed fetal nutrition
5.5.3 Postnatal environment:-

1. Insulin resistance
2. Hyperandrogenism
3. Other precipitants and risk factors

5.5.4 Implications for evolutionary origin of PCOS

5.5.5 Summary

A number of hereditary and environmental factors contribute to ovarian hyperandrogenism

and/or insulin resistance. Polycystic ovaries, androgen levels, and insulin resistance have
hereditary components. Environmental factors may be congenital or acquired and include
intrauterine factors such as androgen exposure and prenatal nutrition, whereas acquired obesity
is a major postnatal factor influencing the phenotype. The complex interactions generally
mimic an autosomal dominant trait with variable penetrance: the disorder is correlated in
identical twins (r = 0.7); about half of sisters are hyper androgenic, and half of these also have
oligo-amenorrhea and thus PCOS; and polycystic ovaries appear to be inherited as an
autosomal dominant trait . Although estimates vary widely, 3%–35% of mothers of women
with PCOS also have PCOS, as do about 25% of sisters, and metabolic syndrome prevalence
is high in parents and siblings. The syndrome's phenotypic diversity is affected by ethnic
diversity (Sam S, Legro RS, Bentley-Lewis R, Dunaif A.et.al.,2005)(Govinda A, Obhrai MS,
Clayton RN et.al.,1999)(Vink JM, Sadrzadeh S, Lambalk CB, Boomsma DI et.al.,2006).

Chapter 6

DIAGNOSIS OF PCOS

The diagnostic workup should begin with a thorough history and physical examination.
Clinicians should focus on the patient's menstrual history, any fluctuations in the patient's
weight and their impact on PCOS symptoms, and cutaneous findings (e.g., terminal hair, acne,
alopecia, acanthosis nigricans, skin tags). Patients should also be asked about factors related to
common co morbidities of PCOS.
 The Endocrine Society advises clinicians to diagnose PCOS using the 2003 Rotterdam criteria,
although recommendations differ across guidelines.23 According to the Rotterdam criteria,
diagnosis requires the presence of at least two of the of the following three findings:
hyperandrogenism, ovulatory dysfunction, and polycystic ovaries.

Diagnosis can generally be accomplished with a careful history, physical examination, and
basic laboratory testing, without the need for ultrasonography or other imaging.
Hyperandrogenism can be diagnosed clinically by the presence of excessive acne, androgenic
alopecia, or Hirsutism (terminal hair in a male-pattern distribution); or chemically, by elevated
serum levels of total, bio available, or free testosterone or Dehydroepiandrosterone sulfate.
Measurement of androgen levels is helpful in the rare occasion that an androgen-secreting
tumour is suspected (e.g., when a patient has marked virilization or rapid onset of symptoms
associated with PCOS).sisters ,and metabolic syndrome prevalence is high in parents and
siblings . The syndrome's phenotypic diversity is affected by ethnic diversity (Vink JM,
Sadrzadeh S, Lambalk CB, Boomsma DL et.al., 2006)(Kahsar-Miller MD, Nixon C, Boots LR,
Go RC, Azziz R et.al.,2007)(Govind A, Obhrai MS, Clayton RN et.al.,1999)(Legro RS,
Arslanian SA, Ehrmann DA, et.al., 2013).

Table1:

Criteria for diagnosis of PCOS

National institute of Rotterdam Androgen excess and
health criteria 1990(must criteria,2003 (must PCOS Society,2009
Clinical finding
have both of the finding have any two of the (must have Aplus
marketed below) finding marketed either B or C
below)

Hyperandrogenism* X X A
Oligomennorrhea X X B

Polycystic ovaries C
PCOS- polycystic ovarian syndrome

*------clinical or biochemical evidence of excess androgen.

 Chapter 7

TREATMENT OF POCS

Pain reliving pills

Painful periods and heavy bleeding can be alleviated with pain relievers, which may be
obtained over the counter as well as with a doctor's prescription, depending on their strength.

Analgesic, or pain-relieving, medicine for irregular periods comes in two main type:-

Non-steroidal anti-inflammatory drugs (NSAIDs) - such as ibuprofen, naproxen, or

diclofenac - reduce menstrual flow and alleviate pain by inhibiting the production of
prostaglandins,compounds whose increase during a period is associated with menstrual
cramps. Acetaminophen may be beneficial for reducing low to moderate periods cramps,
although its exact mechanism of action is not completely understood.

Birth controlling pills

Figure

While the main purpose of birth control is - as the name suggests - pregnancy prevention, it is
also one of the most commonly prescribed hormonal medicines for irregular periods. It can
only be obtained by prescription.

The following are some of the most commonly considered birth control pills to regulate
periods:
 • Birth Control Pills contain either a low dose of estrogen and progestrone or
progesterone alone. They can be beneficial for alleviating anovulation, long
cycles, frequent menses, or amenorrhea.
• Hormonal intrauterine device (IUD) can also be inserted to relieve heavy or prolonged
bleeding.
• Birth control implants containing progestin may be useful for reducing dysmenorrhea,
or painful periods.

It is important to keep in mind that women who are already taking birth control pills might
suffer from irregular periods as a side effect. If so, it is important to consult a physician to
consider changing the type or dosage.

Fertility Medicine for Irregular Periods

Figure

Women planning to get pregnant whose menstrual irregularities concern ovulation

problems may be prescribed fertility medications to resolve them and restore their chances of
conceiving.

Fertility pills and injections are used to treat absent or irregular ovulation, often as part
of infertility treatment. They include the following:-

Fertility pills - such as clomiphene citrate, letrozole, or metformin - restore ovulation by

various modes of action. Some of them are used off-label in women with polycystic ovary
syndrome (PCOS), hyperprolactinemia, and other causes.

Fertility injections - human chorionic gonadotropin (hCG) or follicle-stimulating hormone

(FSH) - trigger ovulation by encouraging the ovaries to mature eggs (Ahmed Badawy &
Abubaker Elnashar et.al.,2011).

Other medicines for irregular periods

There are other medications for irregular periods that women may benefit from, depending on
their specific cause. By resolving the underlying root, women can achieve healthy ovulation
and regular cycles long-term.

These medicines for abnormal periods include, but are not limited to, the following:

Thyroid medications, including radioactive iodine therapy, may be suitable for women whose
menstrual abnormalities are due to thyroid disease.

Metformin, which is intended to treat insulin resistance and type 2 diabetes, can also be used
to stimulate fertility and regulate cycles.

Dopamine agonists may help regulate periods and restore ovulation in women with PCOS and
hyperprolactinemia.

Antibiotics or antifungals might be suitable medicines for irregular periods,

particularly intermenstrual bleeding, due to vaginitis or sexually transmitted diseases (STDs).

Tranexamic acid can be used to relieve heavy menstrual bleeding by improving blood clotting,
particularly from unknown origins.

7.1 AYURVEDIC TREATMENT FOR PCOS

The goal of Ayurvedic treatment PCOS is to restore the hormonal balance and fertility.
Avurvedic treatment for menstrual problem involves Ayurvedic medicines, herbal remedies,
diet, yoga and lifestyle changes. This holistic approach helps to detox, ignite digestive fire for
balanced nutrition, regulate menstrual cycle for regular ovulation and fertility, and reduce stress
for mental wellness and hormonal balance.

Here are the steps involved in Ayurvedic treatment for irregular menses;-

1. Detoxification to get rid of toxins and inflammation in the body.

2. Ignite digestive fire to promote digestion and nutritional sufficiency.

3. Hormone Balance to support regular ovulation & boost fertility.

4. Promote Mental wellness & stress reduction through ayurvedic remedies, yoga, pranayama
& meditation.

5. Rejuvenation with rasayana to boost immunity & raise energy level.

6. Balanced Nutrition with individual specific diet to nurture body tissues.

7.2 AYURVEDIC TREATMENT WITH HERBAL MEDICINES FOR PCOS

Ayurvedic remedies and herbal medicines are highly effective to treat period problem at root
cause level. Ayurvedic herbs work by balancing hormones, strengthening the reproductive
system, and promoting mental wellness here are some of the most Popular Ayurvedic
medicines for PCOS:

1. Aloe Vera: This herb has been used to treat menstrual disorder and establish downward
flow of apana vata doha. It is useful during all stages of the menstrual cycle.
2. Ashwagandha: It is an adaptogen that reduces stress and increases our body's strength.
It also used to treat male infertility.Regular consumption of Ashwagandha establishes
hormone balance and regulates the menstrual cycle..
3. Shatavari: A uterine tonic, Shatavari is extremely important Ayurvedic herb for women
health. It increases level of Progesterone, flushes excess Estrogen and nourishes the
uterus.
4. Ginger: It is one of the best common herb that acts as a natural pain killer for PMS
symptoms. It reduces intensity of menstrual cramp and elevates the level of brain
chemicals. Take it as ginger tea.
5. Turmeric: Reduces inflammation and helps to detox naturally and relieves pain.
Turmeric also helps to balance Vata dosha and establishes regular flow during periods.
Caution should be taken, if you have heavy bleeding menstrual disorder.
Black Sesame Seeds: Provide nutrients such as Magnesium, Iron and Calcium. Reduces
inflammation, establish menstrual.
6. Lodhra: It reduces heavy menstrual bleeding. The bonus point here is that it reduces
abdominal discomfort before and during menses to search.
7. Ashoka: It is the reliever of grief and can help offset depression and mood swings.
Further more, it directs apana vata downward.

7.3 Ayurvedic Diet for Regular Period and Healthy Menstrual Cycle:-

Let food be your medicine and medicine be your food! This is a popular saying and one of the
basic pillars of Ayurveda. A healthy and balanced diet nourishes your body and supports the
vital energy of life.
Additionally, make herbs and spices an integral part of your Ayurvedic Diet. They promote
digestion, provide one with essential nutrients and antioxidants, and relax your senses.

• Consume warm, unctuous, easily digestible, and lightly spiced foods.

• A light diet that consists of easily digestible vegetables, grain forms, and fruits should be
consumed.

• Spice up your meals with digestion promoting spices and herbs such as cinnamon, black
pepper, mint, carom seeds, ginger, and cardamom.

•Do not overeat. Consume food in small portions such that they are easy to digest and do not
overload the digestive system.

• Use healthy fats such as ghee, mustard oil, sesame oil, and coconut oil to prepare your meals.

• Stop or reduce caffeine, alcohol and smoking. All of these are stimulants that reduce sleep
and further aggravate hormonal imbalance.
• Reduce your salt and sugar intake. For sugar, replace it with natural sweeteners such as
molasses, jaggery, and honey.
• Hydrate the body well with herbal teas. Use herbs such as Cardamom, Ginger, Fennel,
Saffron, and Cinnamon. This will nurture your body and mind and also balance the
hormones. It will also support digestion and relieve symptoms of bloating.
[www.medhyaherbal.com]

Chapter 8

CONCLUSION

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder that affects many women
of reproductive age. It is characterized by a range of symptoms, including irregular periods,
hyperandrogenism, and polycystic ovaries. PCOS is associated with an increased risk of
metabolic disorders, such as insulin resistance, type 2 diabetes, and cardiovascular disease.

There are several diagnostic criteria for PCOS, but there is still ongoing debate about the most
appropriate definition. While there is no cure for PCOS, lifestyle modifications, such as weight
loss and exercise, can help to improve symptoms and reduce the risk of associated metabolic
disorders.
Treatment of PCOS is tailored to individual patient needs and may include hormonal
contraception, anti-androgen medications, and ovulation induction therapies for those trying to
conceive.

Overall, PCOS is a complex condition that requires a multidisciplinary approach for effective
management. Further research is needed to better understand the underlying mechanisms of
PCOS and to develop more effective treatments.

Chapter 9

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