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Polycystic Ovary Syndrome: A Critical Review Through the Lens of Trividha Bodhya Saṃgraha (conceptual framework in Ayurveda)

 

Saniya S. Gosavi* Brijesh R. Mishra2

1PG, PG department of Basic Principles and Ayurved Compendium, Shri Ayurved Mahavidyalaya, Nagpur, Maharashtra, India.

2Principal, HOD and Guide, PG department of Basic Principles and Ayurved Compendium, Shri Ayurved Mahavidyalaya, Nagpur, Maharashtra, India.

*Correspondence
Saniya S. Gosavi
PG department of Basic Principles and Ayurved Compendium,
Shri Ayurved Mahavidyalaya, Nagpur
Maharashtra, India
Email: dr.saniya.ayurved@gmail.com

Received: 04 Apr, 2026;  Accepted: 14 Jul, 2026; ; Published: 27 Jul 2026

Citation: Saniya S. Gosavi, Brijesh R. Mishra “Polycystic Ovary Syndrome: A Critical Review Through the Lens of Trividha Bodhya Saṃgraha (conceptual framework in Ayurveda)” J Alter Med Ther (2026): 110. DOI: 10.59462/3068-532X.3.1.111

Copyright: © 2024 Alzeer J. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

 

Abstract

Ayurved is a well-established science that deals with every aspect of human life from disease prevention to health maintenance. The classical Ayurvedic texts, written thousands of years ago, offer profound diagnostic and therapeutic insights. However, as environments, diets, and lifestyles evolve, new diseases like Polycystic Ovary Syndrome (PCOS) a condition not described in classical texts have emerged. Affecting 8–13% of reproductive-aged women, PCOS is a multifactorial metabolic and endocrine disorder.

Ayurved provides a scientific methodology rooted in understanding Nidana (causative factors), Dosha, Dushya, and Samprapti (pathogenesis) rather than merely labelling diseases. Acharya Charaka's Trividha Bodhya Samgraha1 comprising Vikara Samutthana (etiology), Vikara Adhisthana (site of manifestation), and Vikara Prakruti Vishesha (nature and progression) addresses the principles of etiology and the various stages of disease pathology which offers a foundational approach to diagnosing and managing Anukta Vyadhi (unlisted/new-age diseases).

This article applies the Trividha Bodhya Samgraha to comprehend PCOS, establish a working Ayurvedic diagnosis, and formulate a rational treatment plan.

Keywords: Trividha Bodhya Samgraha, Anukta Vyadhi, PCOS, Ayurvedic diagnosis, Samhita Siddhanta

Introduction

Polycystic Ovary Syndrome (PCOS) is one of the most prevalent endocrine and metabolic disorders in women of reproductive age [1]. A comprehensive meta-analysis of 35 studies involving over 12 million women worldwide found that Global prevalence is around 9.2% (95% CI: 6.8–12.5%) overall and by diagnostic criteria: NIH – 5.5%, Rotterdam – 11.5%, AES – 7.1% [2]. A 2022 meta-analysis of Indian studies (2010–2021) reported a pooled prevalence of 11.33% (95% CI: 7.69–15.59%), with 10% prevalence per Rotterdam/AES criteria and 5.8% via NIH criteria [3]. The Rotterdam criteria (2003) remain the gold standard for PCOS diagnosis in contemporary medicine, requiring the presence of two of the following: oligo/anovulation, hyperandrogenism, and polycystic ovaries on ultrasound.

While allopathic treatments focus on lifestyle modification, ovulation-inducing drugs, hormonal therapy, and assisted reproductive techniques, Ayurved emphasizes a more holistic and individualized approach. PCOS, though an Anukta Vyadhi, can be comprehended through Ayurvedic principles, particularly using the Trividha Bodhya Samgraha model elaborated by Acharya Charaka.

Clinical Features of PCOS according to Ayurved

PCOS manifests with multiple signs and symptoms, many of which find parallels in Samhita texts:

  • Sthaulya (obesity) – especially central obesity
  • Artava Dusti – includes Anartava, Alpartava, or Atyartava (irregular menstruation)
  • Mukhadushika – acne
  • Prabha Hani / Varna Hani – pigmentation changes like acanthosis nigricans
  • Yonivyapad – Arajaska, Shushka, Shandi, Vandhya[4] (resembling ovulatory disturbances and infertility)

These features suggest involvement of multiple systems, hinting at Tridosha, Rasa, Meda, Artava, Manovaha systems, and Agnimandya.

Application of Trividha Bodhya Samgraha in PCOS

  • Vikara Samutthana (Etiology & Pathogenesis)
  • Dosha Involvement: Vata, Pitta, Kapha vitiation in different stages
  • Dushya: Rasa, Meda, Artava dhatus primarily involved
  • Mala: Purisha, mutra Avadharana (suppression of natural physical urges) 
  • Agni: Mandagni and Aamotpatti are central to PCOS pathogenesis
  • Manas Dosha: Chinta, Bhaya, Shoka are contributing factors
  • Lifestyle Factors: Excessive sedentary habits, improper dietary regimens, and psychological stress

Vikara Adhishtana (Site of Manifestation)

  • Sharir Dhatu Adhisthit
  • Srotas involved:
      • Rasavaha, Medovaha, Artavavaha, and Manovaha srotas
      • Srotodushti types: Sanga, Granthi
  • Dosha-Sthana:
      • g Vata: Pakwashaya
      • Pitta: Rasa, Rakta, Amashaya
      • Kapha: Amashaya, Meda
  • Pranayatana: Rakta, Shukra

Vikara Prakruti Vishesha (Nature & Prognosis)

  • Chronic, relapsing nature
  • Difficult to cure (Yapya Vyadhi) but manageable with lifestyle changes and regular treatment
  • Complex interplay of Sharir, Manas, and Agni 

diabetes-clinical-endocrinology

 

 

 

Treatment Plan Based on Ayurveda Principles

Nidana Parivarjana

    • Pathya-Apathya based dietary regulations
    • Dinacharya, Ritucharya, and Vihara Shuddhi
    • Mental and lifestyle hygiene

Dipan-Pachana-Anulomana (metabolism maintaining therapy)

    • Haritaki, Trikatu, Chitraka to enhance digestion and reduce Aama
    • Shodhana Chikitsa (purification and detoxification therapy)
    • Focusing on the vikara samutthana
    • Vamana (medicated emesis): A controlled clinical trial on 15 PCOS patients demonstrated that therapeutic emesis with Ikshvaku beeja significantly improved menstrual regularity, BMI, ovary morphology (follicle count), fasting blood sugar, and hirsutism (p < 0.05) [5]
    • Virechana (medicated purgation): Danti avaleha. A case study showed that Virechana Karma, following Snehapana (internal oleation) and Swedana (), regulated Kapha and Pitta, removed Ama, enhanced Agni, improved insulin sensitivity, balanced hormones, and normalized menstrual cycles [6].
    • Basti (medicated enema): Basti Karma is the most frequently used Panchakarma treatment in PCOS, improving ovulation, follicular health, menstrual regulation, and ovarian reserve [7]. Madhutailika, Shatapushpa taila, Yogabasti can be advised.
    • Uttar Basti: The review compiles multiple clinical trials where Uttara Basti with Panchagavya Ghrita improved outcomes such as low antral follicles, anovulation, and enhanced endometrial receptivity in PCOS and infertility cases [8].

Shamana Chikitsa

    • Herbal combinations: A recent scoping review (57 studies) highlighted that Shatapushpa (dill) and Krishna Tila [9] (black sesame) are among the most frequently used single herbs in PCOS clinical research. It also confirmed widespread use of Kanchanar Guggulu and Rajahpravartini Vati [10] in formula-based treatments
    • Most drugs used are Ushna Virya, Vatakaphahara, Medonashana, and Pittavardhaka

Yoga and Lifestyle Counseling

    • Apunarbhava chikitsa: long-term lifestyle adherence and regular follow-up
    • Regular mindful yoga practice including Asana & Pranayama for balancing Sharir and Manas as a method to improve androgen levels in women with polycystic ovary syndrome. Women who completed three 1‑hour mindful yoga classes per week for 3 months saw significant reductions in free testosterone (5.96 → 4.24 pg/mL; P < .05), along with improved anxiety and depression scores [11].
    • A structured 90‑minute yoga program, conducted thrice weekly for 12 weeks, significantly improved metabolic, hormonal, ovarian morphology, and infertility-related quality of life measures among infertile PCOS patients [12].
    • Systematic reviews show that yoga (asana, pranayama, relaxation techniques) consistently improves hormonal balance, ovarian morphology, weight, stress, and quality of life in PCOS [13].
    • A 12-week holistic yoga program (asana + pranayama + relaxation) significantly reduced anxiety symptoms compared to standard exercise, highlighting the importance of sustained practice [14].
    • Ten days of integrated naturopathy and yoga interventions yielded significant reductions in testosterone, BMI, oxidative stress markers, and anxiety/depression scores [15].

Results

The integrative application of Trividha Bodhya Samgraha to the pathogenesis and management of Polycystic Ovary Syndrome (PCOS) demonstrated promising conceptual and clinical clarity within the Ayurvedic framework. The analysis of PCOS using the three components i.e. Vikara Samutthana, Vikara Adhisthana, and Vikara Prakruti Vishesha facilitated a personalized, dosha-based diagnosis and targeted chikitsa protocol.

  • Clinical correlation with Sthaulya, Artava Dusti, Yonivyapad types (Arajaska, Shushka, Shandi, Vandhya), Agnimandya, and Srotodushti patterns confirmed the tridosha involvement and the chronic relapsing nature of PCOS (Yapya Vyadhi).
  • Shodhana Chikitsa, including Vamana with Ikshvaku beeja, Virechana with Danti avaleha, Basti (Madhutailika, Shatapushpa taila, Yogabasti), and Uttar Basti with Panchagavya Ghrita, showed statistically significant outcomes in clinical trials and case studies. Improvements included menstrual regularity, BMI reduction, follicular development, hormonal normalization, and insulin sensitivity.
  • Shamana Chikitsa using formulations like Shatapushpa Ghan Vati, Krishna Tila Kalka, Kanchanar Guggulu, Pathadi Kwatha, and Rajahpravartini Vati provided effective management of metabolic and reproductive symptoms, confirming their Ushna Virya, Vatakaphahara, Medonashana, and Pittavardhaka (in some cases) properties.
  • Yoga and lifestyle counseling, particularly the incorporation of Asana, Pranayama, and Apunarbhava Chikitsa, led to improved psychological and metabolic parameters. Randomized controlled trials reported reduced serum testosterone, improved menstrual patterns, and enhanced quality of life among women with PCOS following structured yoga regimens.

These results collectively validate the relevance of Ayurvedic principles in modern clinical contexts and support the utility of Trividha Bodhya Samgraha in diagnosing and managing Anukta Vyadhi like PCOS.

Conclusion

Trividha Bodhya Samgraha offers a precise and comprehensive Ayurvedic framework to understand and manage emerging conditions like Polycystic Ovary Syndrome (PCOS), which are not explicitly described in classical texts (Anukta Vyadhi). By examining the etiology (Vikara Samutthana), site of manifestation (Vikara Adhisthana), and disease nature and prognosis (Vikara Prakruti Vishesha), this approach supports an individualized and dosha-specific diagnosis.

When applied in conjunction with Shodhana, Shamana, Yoga, and lifestyle counseling, this model enables an integrative therapeutic strategy that addresses both somatic and psychological aspects of the disease. The success of interventions rooted in Samhita Siddhanta evidenced by both classical rationale and emerging clinical studies, demonstrates the enduring relevance of Ayurvedic wisdom in addressing contemporary health challenges.

Recognizing PCOS through this lens not only aligns with Ayurvedic diagnostic principles but also enables tailored, sustainable, and management rooted in the foundations of Samhita Siddhanta. Thus understanding PCOS through the lens of Trividha Bodhya Samgraha bridges timeless Ayurvedic insights with modern therapeutic needs, providing a sustainable, personalized, and holistic model for integrative women's health.

References

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