ROLE OF KAYAKARPAM DRUGS IN THE MANAGEMENT OF MALE INFERTILITY: A REVIEW FROM THE ANNAMAYA KOSAM PERSPECTIVE

Background: Male infertility is an increasing health concern worldwide with Siddha system of medicine offering a unique holistic approach through Kayakarpam (rejuvenation therapy) drugs. In Siddha philosophy, the human body is conceptualized through the Panchakosam theory, wherein Annamaya Kosam - the food-derived physical sheath - forms the structural and functional basis of the Udal Thathukkal (seven bodily constituents), the last of which, Sukkilam (semen/reproductive essence), directly governs fertility and reproductive competence in males. Objective: To review and consolidate the classical Siddha literature on Kayakarpam drugs indicated for the management of male infertility (Sukkila Kuraivu), and to correlate their mode of action with the Annamaya Kosam concept of body nourishment. Methodology: A narrative review of classical Siddha literature (Agathiyar Gunavagadam, Theraiyar Gunavagadam, Yugi Vaidya Chinthamani, and related Kayakarpa treatises) was conducted, supplemented by contemporary pharmacological studies retrieved from PubMed, Google Scholar, and AYUSH research portals. Six Kayakarpam drugs indicated for Sukkila Kuraivu — Tribulus terrestris, Piper longum, Hybanthus enneaspermus, Nelumbo nucifera, Ficus benghalensis, and Solanum trilobatum — were identified and analyzed for phytochemical constituents, pharmacological actions, and mechanism of action, with findings interpreted through the Annamaya Kosam concept of Saptha Thathu Parinamam. Results: All six drugs showed antioxidant and aphrodisiac properties attributed to flavonoids, alkaloids, and saponins. Tribulus terrestris and Piper longum improved testosterone, sperm count, and motility; Hybanthus enneaspermus and Nelumbo nucifera enhanced libido and hormonal regulation; Ficus benghalensis and Solanum trilobatum protected spermatogenic tissue via antioxidant action. Findings align with classical Siddha concepts of thathu viruthi and sukkila dosha correction, though evidence remains largely preclinical. Conclusion: Kayakarpam drugs offer a promising, time-tested therapeutic avenue for male infertility management. Integrating the Annamaya Kosam perspective provides a strong theoretical framework validating traditional Siddha practice and warrants further clinical and pharmacological validation.