Polycystic Ovary Syndrome in Ayurvedic Perspective: Interpreting an Anukta Vyadhi through Trividha Bodhya Sangraha

Background: Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age. Since its first description in 1935, the understanding about this condition has evolved far- from being just a localized gynecological concern to a widespread, multisystem endocrinopathy. The multisystem presentation and elusive pathophysiology of PCOS make it a compelling topic for exploration through holistic frameworks like Ayurveda. However, the search for an Ayurvedic equivalent of PCOS in Ayurvedic classics doesn’t yield any disorder that entirely matches the clinical picture of this condition. Objectives: This review considers PCOS as an anukta vyadhi (a condition not explicitly mentioned in the Ayurvedic texts) and aims to explore it using the framework of Trividha Bodhya Sangraha- (the three essential elements for understanding a disease) as outlined in Charaka samhita. Based on this, an attempt is made to establish the disease within the Ayurvedic framework in terms of nidana panchaka (five diagnostic principles) (SAT-C.5). This approach also aims to offer a model for evaluating other emerging or unnamed disorders in contemporary practice. Methods: Data regarding the clinical presentation and pathophysiological aspects of PCOS were compiled from standard endocrinology texts, clinical guidelines, and peer-reviewed literature. These features were then analysed in the light of principles and references in Ayurvedic classics in order to derive the Trividha bodhya sangraha and nidana panchaka (SAT-C.5) for the condition. Results and Conclusion: PCOS is interpreted as primarily a kapha-predominant disorder, characterized by medoduṣhṭi (vitiation of fat tissue), feeble state of rasa dhatvagni (metabolic transformation at the level of rasa) ((SAT-B.491), and margavaraṇa (channel obstruction). The etiopathogenesis of the syndrome is identified as a unique variant of sthoulya samprapti (pathogenesis of sthoulya (ACB-1)) that manifests in women of reproductive age.