A comprehensive conceptual analysis of PCOS in Ayurvedic perspective

Polycystic Ovarian Syndrome (PCOS) is a complex, heterogeneous disorder with reproductive, metabolic, endocrine, and cosmetic manifestations, contributing significantly to infertility and long-term lifestyle disorders. Due to its varied clinical and biochemical presentation, PCOS lacks a single precise definition and is commonly diagnosed using the Rotterdam criteria. As no distinct disease entity corresponding to PCOS is described in Ayurveda, it is considered an Anukta Vyadhi, requiring interpretation based on clinical features and underlying samprapti. The present study aims to elucidate the samprapti (pathophysiology) of PCOS from an Ayurvedic perspective, conceptualize samprapti vighatana, and propose rational management strategies based on individualized pathogenesis. Data were collected from classical Ayurvedic texts, modern medical literature, journals, online databases, and previous research studies, which were critically reviewed and analyzed. The analysis reveals that PCOS manifests through multiple and interacting sampraptis, predominantly kaphavruta vata, pitta–kapha samsrushta vata, and kevala vata, with involvement of rasa, rakta, mamsa, medo, asthi, and shukra dhatus, along with agni dushti, ama, and srotorodha. These mechanisms closely parallel contemporary concepts of insulin resistance, hyperandrogenism, chronic inflammation, and hypothalamic–pituitary–ovarian axis dysregulation. Ayurvedic management based on nidana parivarjana, shodhana, shamana, satvavajaya, and lifestyle modification addresses the root pathology rather than offering only symptomatic relief. Evidence from contemporary experimental and clinical studies supports the effectiveness of Ayurvedic interventions in improving clinical, biochemical, and sonological parameters of PCOS.