Polycystic Ovarian Disease (PCOD)

Presenting Complaints with severity and episode duration

1. Complaints of rough coarse hair over chin
2. Scanty menstruation with spotting for the first two days associated with pain and clots, the menstrual cycle is for 4-5/50 days cycle , with blackish discoloration on Menstrual blood
3. Passing of hard stools once in 3 days

Family History:

Patient’s mother also has the same complaint of PCOD since her Menarche, later after hysterectomy the clinical symptoms have subsided.

Clinical Status

Allopathy Ayurveda
Vital Parameters

  • BP - 90/60 mmHg
  • Pulse - 62/min
  • Weight - 59.8 Kg
  • BMI - 23.5
  • Ht – 165 cms
Asta Sthana Pariksha

  • Nadi - Vata Kapha Pradhana
  • Malam - Once in three days/ Vibadha, relieved by taking hot water in morning
  • Mutra - 5-6 (D)/1 (N), Samyak
  • Shabda - Prakruta
  • Sparsha - Prakruta
  • Drik - Prakruta
  • Akruti - Madhyama

  • GC - moderate built
  • PA- On Inspection- No flabby abdomen,
    Umbilicus – central
    O/ palpation- tenderness over Bilateral iliac regions
    O/percussion- normal tympanic abdomen
    O/Auscultation - Normal
  • CVS- clinically NAD
  • CNS- clinically NAD
  • RS- clinically NAD

Dasa Vidha Pariksha

  • Prakriti- Vata kapha
  • Vikriti- vata kapha
  • Sara- madhyama
  • Samhanana- madhyama
  • Pramana- 59.8kg , madhyama
  • Satmya- avara
  • Satva- pravara
  • Aharashakti- avara
  • Vyayam Shakti- madhyama
  • Vaya- madhyama
  • Desha- jangala
  • Kala- sharad
Rogi Bala- Madhyama
Roga Bala- Balwan
DSQ findings Rating
1. ADRS low
2. ADSS Med
  • Nidana -Kapha Vriddikara Aharas like more oily foods, cheese, pizza
  • Purvaroopa - Chronic constipation
  • Roopa -pain in left side of the abdomen while lying, Pain during menstruation, Scanty menstruation with spotting for first 2 days, Hirsutism
  • Updrava:NIL
  • Arishta Lakshana:NIL
  • Samprapti:
    • Dosha: Kapha Vata
    • Dushya: Rasa, Rakta, Meda
    • Agni - Manda
    • Ama - Rasa, Rakta & Medo dhatwagnimandyajanya Ama
    • Srotas - Rasa, Rakta, Medo Artava vaha and Purisha vaha
    • Sroto Dushti Prakara - Sanga , Vimarga Gamana

Differential Diagnosis with reasoning

  • Cushings syndrome
  • Androgen secreting tumor
  • Thyroid disorders

PCOD(polycystic ovarian disease)
Symptoms like

Menstrual Irregularity


Hirsutisn acne etc

Symptoms present with Hirsutism, acne, obesity, Ovarian enlargement and Acantosis Nigricans confirms the PCOD which is supported by USG also.

Differential Diagnosis with reasoning

  • Vataja Artava dushti
  • Anartava
  • Udavartini Yoni Vyapat

Medavruta vata leading to arthava dusti

  • Arthava Kshaya
  • Shoola yukta arthava pravritti
  • Sthoulya
  • Vandhyatva

All the bold markedabove symptoms are present in the patient, so its diagnosed as Medavruta Vata leading to Arthava Dushti.

Evidence Based Diagnosis:

Current medication

Evidence Based Diagnosis:

Medavruta Vata leading to Artava Dushti

Chikitsa Vivechana:

Type – OPT/IPT
Duration – 8 days

Primary Treatments:

Deepana and Pachana: Panchakola Choorna 1tsp twice a day for 3 days

Main Treatments:

Snehapana: Guggulu Tiktaka Ghrita for 3 days in Arohana Karma, with 30ml on day 1 of Snehapana, 60ml, 90ml and 110ml on the consecutive days.

Swedana: Sarvanga Abhyanga by Dhanwantara Taila and Bashpa Sweda for the next three days

Virechana: On the third day of Swedana, Virechana Aushada with Mishraka Sneha 40 ml followed by Triphala Kashaya 150ml was given and advised patient to observe for the Vegas.

Vegas: Pittanta virechana with 10 vegas.

Post Treatments:
Lightness of body was observed
Apppettie was stabilized
Sukha prabhodana – patient used to feel enthusiastic once after waking up
Samyak pravartana of vid mootra
Weight was reduced after treatment to 57.8 kg i.e around 2 kgs after virechana

Chikitsa Paddhati with details of dose of medicine: After virechan

  • Kalyanaka kshara 2 pinch twice a day
  • Saptasara kashaya 15ml twice a day before food
  • Satavari gulum 1tsp, once at bed time
  • Guggulu tiktaka grita 10ml in empty stomach in morning followed by hot water.

The above medicines were continued for a period of one month followed by virechana Later a rescan was adviced, the reports of which are attached.

Arthava pravritti after treatment showed normal colour of arthava with no pain during menstruation , malabaddata was totally recovered with passing of stools once a day
But no improvement in hirsutism was observed.

Referral Opinion Sought if any: Patient after the rescan after one month was advised to take the opinion of the surgeon for the persisting endometrial cyst. For the same patient was advised to undergo laparoscopic excision of the same. The same was advised to be followed as the cyst was large enough.
Integrated View: PCOD is a disease which is said to be manifested as the result of medavruta vata leading to artava dushti manifested as a result of altered vata kapha and rasa rakta, artava and medovaha sroto dushti.

  • Specific Outcome scale used-
USG outcome before and after treatment:


Before treatment USG report: The uterus is normal in size and echo pattern The uterus, measures 59.4 *27.5* 38.1mm

The endometrium thickness is 5.9mm hyperechoic

Both ovaries have polycystic ovarian pattern

Right ovary is bulky with hypoechoic, poorly vascular cyst approximate 54.1*40.9*51.3mm and 59.4 cm3 vol

The right ovary measures 63.5* 51.4*59.0 mm and 100.8 cm3vol

The left ovary measures 52.2*26.2*20.2 mm and 14.5cm3 vol

No free fluid is seen in the pelvis

The uterus is normal in size and echo pattern

The uterus, measures 62.8 *24.7* 41.6mm

The endometrium thickness is 4.4mm trilaminar

Both ovaries have apolycystic ovarian pattern

Right ovary is bulky with large poorly vascular hypoechoic cyst? Endometriotic heamorrhagic corpus luteum?

Nature : measures approximate 78.5*58.3*78.2mm and 187 cm3 vol Occupy entire ovary right side
The left ovary measures 26.8* 17.1*25.4 mm and 6.1 cm3vol, has multifollicular pattern and is normal in size
No free fluid or mass is seen in the pelvis

Samyak Lakshanas achieved (Reference- Control Charts)

# Outcome Parameters
/ / Date-Time:
19/10/2014 24/10/2014 8/11/2014
1 Sleep (Nidra) Disturbed Sound Sound
2 Appetite (Agni) Manda Sama Sama
3 Bowels (Mala) Constipated Samyak Samyak
4 Urination (Mutra) Samyak Samyak Samyak
5 Stress (Manas) Low Low Low
8 BP 90/60 110/70 120/80
9 Pulse 62/min 70/min 75/min
10 Weight, Kg 59.8 57.8 57.5

Patient’s Outcome Scale

# Presenting Complaint Status_TSD Status_TED Status_2 Month
1 Hirsutism present present Present
2 Scanty menstruation Present for 4-5 days with spotting for first 2 days. present Absent
3 Painful menstruation present present Absent
4 Colour of the menstrual blood Black Dark red Normal
5 Hard stool Once in 3 days Regular, once daily Regular, once daily
5 Menstrual cycle 4-5/50 days cylce - 4-5/35 days cycle


Lab Reports At the start of Treatment
Post treatment
Lab Reports report report
Other reports Ca 125
ovarian cancer marker serum
Nil report

At the end of the classical Ayurveda treatments complete improvement in left ovary with multifollicular pattern and normal size restoration of the ovary was achieved. Clinically it was evident from the fact that the menstrual period was regular and normal – without pain, and normal in colour and amount. There was an improvement in meda dhatwagani which is evident from the fact that patient has lost 2kgs of weight during the course of treatment.