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PCOS: putting the cycles back on track with Ayurveda

PCOS: putting the cycles back on track with Ayurveda

A holistic look at managing polycystic ovarian syndrome or PCOS with diet, lifestyle changes and herbal medication
herbs on a table
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About a year back, Nivya Thomas, 21, a student from Kochi, was diagnosed with PCOS or polycystic ovarian syndrome.

She did not gain weight as is common with this condition but her facial hair became noticeably excessive, and her menstrual cycle became irregular.

Looking back at it now, she recalls, “I used to get my periods once in four months for which I would take [routine modern] medicine. However, if I stopped taking them, the symptoms reappear. That is when I started exploring other treatments for my condition.”

Today, Thomas has completely changed her eating habits, exercises regularly, and includes herbs. Thomas is today a better version of herself after and tackling her symptoms.

“I feel much healthier than before, my cycles are regular, and my metabolism has improved,” she says.

In a woman’s body, follicles are sacs where eggs develop.  menstrual cycle involves about five follicles maturing and at least one mature egg released at ovulation. However, polycystic ovaries develop at least twice as many follicles, most of which do not mature or release eggs.

Although the symptoms may vary in every individual, common symptoms of PCOS are irregular menstrual cycle, light or heavy bleeding during periods, weight gain, and excessive facial hair.

Read more here about PCOD and PCOS  

 Individualised treatment

Dr Remya Pankajakshan, associate medical director, Rudraksha Ayurvedic Holistic Centre, Thrissur, Kerala, says Ayurveda manages PCOD and PCOS with customised diet, herbal medication, and lifestyle changes. The protocol includes regulating the person’s menstruation and correcting the agni (digestive `fire’) and metabolism.

“Primary lifestyle management focusses on creating steady routines in eating and sleeping. This helps to stabilise dosha (bodily energies) and hormone levels leading to improved uterine health,” she says.

Experts share a few basic ayurvedic methods to tackle PCOS.

The diet

  • Follow a 30-60 water rule. Make a habit of drinking water 30 minutes before and 60 minutes after meals.
  • Eat until you are 70 per cent full and stop.
  • Chew food thoroughly to improve metabolism
  • Eat three meals a day and at regular hours. The first meal should be between 8 a.m. and 9 a.m. and the second meal between 1 p.m. and 2 p.m..-The third meal to be had between 6 p.m. and 7 p.m. should be fruits and vegetables without snacks.
  • Twelve hours of overnight fasting. Do not eat between 8 p.m. and 8 a.m. the next morning.
  • Reduce consumption of sugar and iodised salt and replace them with palm jaggery and rock salt.
  • Avoid refined oils and opt for virgin cold-pressed oils like coconut oil, sesame oil or mustard oil.
  • If you are a meat-eater, follow a mix of 80 per cent plant-based diet and 20 per cent animal-derived foods; avoid dairy products and instead have plant-based dairy substitutes.

Eating locally-sourced, seasonally available, and home-cooked food is the key. An ideal diet is food that is fresh, warm, nourishing with whole grains, vegetables, spiced with digestive herbs and healthy fats like ghee, olive oil and coconut oil.

Common vegetables and spices

One should include a lot of leafy vegetables and eat starchy vegetables like potatoes, tapioca, peas, corn, yam, and squash in moderation.

Spices like fenugreek and carom seed (omum or ajwain) in lentils (dals) or soups can work wonders. They maintain the body’s glucose tolerance, which helps in weight loss.

Seeds like chia, flax, pumpkin, sunflower, and sesame are excellent protein sources for women following a plant-based diet. These seeds are a rich source of omega 3 fatty acids and help to restore hormonal imbalance.

Read more about how seed cycling helps with periods here.

Aerobics and stress relief

Exercise is the key to dealing with PCOS. Even if there is no considerable weight loss, one should take up an exercise regimen, which will PCOS symptoms.

The Australian National PCOS Guidelines are a set of evidence-based advices  for managing the condition. They suggest that one should be doing 150 minutes of exercise per week, and of them, 90 minutes of moderate to high-intensity aerobic workouts.

A person with PCOS can also benefit from certain yoga poses, among them maalasana (the garland pose) and halaasana (the plough pose).

To overcome the symptoms, it is also essential to reduce one’s level of stress. A study published in The Onyx Review: The Interdisciplinary Research Journal in 2017 suggests that practising mindful meditation for 15-20 minutes twice a day has shown a correlation with PCOS symptoms.

Herbs also help

Studies have shown that herbs such as shatavari (asparagus), giloy or guduchi, aloe vera, ashoka and wild yam have helpful effects. Turmeric, cumin, ginger and black pepper are some spices that help to balance the digestive fire and improve metabolism. The herbs are generally given as infusions or as herbal tea.

One study published in Biomedicine & Pharmacotherapy in 2018 showed that shatavari helps to regulate menstruation, correct hormonal imbalances, support the maturation of follicles, and reduce the incidence of high insulin levels.

Risk of diabetes

Those with PCOS have high chances of developing Type-2 diabetes. Another study in Phytomedicine suggested that guduchi aids in lowering insulin resistance.

Guduchi helps in building ojas (vigour and vitality) strength and immunity. Shatapushpa, also known as fennel seeds, is rich in phytoestrogens, which can reduce insulin resistance in PCOS. Ayurvedic experts consider ashoka a tonic herb that can help manage reproductive dysfunctions such as PCOS.

Other therapies

“Hot oil massages are recommended for hair loss and stress relief in those having PCOS,” says Dr Pankajakshan.  

Panchakarma consists of five therapies to clear ama or toxins and balance the digestive fire.

“Detoxification therapies are not advised in all cases. However, depending on the person’s condition, it may sometimes be necessary,” says Dr Kavitha Venkatesh, Kottakal Arya Vaidyashala, Bengaluru.

Virechana, or purgation therapy, alleviates pitta (fire element), which aids in balancing hormonal levels in the body. “Udvartanam can also help in weight reduction and lower lipid levels, but it is not required for everyone,” Dr Venkatesh adds. Udvartanam is rubbing the body with herbal powders.

According to Dr Pankajakshan PCOS is more of a metabolic endocrine disorder which requires lifestyle changes involving losing weight, changing diet, exercise and addition of herbs to one’s diet. A regular follow-up with the physician is equally important for tackling PCOS.

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