Early Ayurvedic Care for Teenage Girls with PCOS

Written by- Vaidya Vibhuti Rao

Teenage is a lovely roller coaster ride. People on that ride think very different for the people who are watching them from the ground- the so called elders. The highs and lows, the hormonal things, the peer pressure make everything like an adventure for them. PCOS is such a complex issue as explained by modern medicines that many at times it is overly diagnosed or under diagnosed”. Dr. Vibhuti Rao puts her one of the recent cases. Most importantly, if you are a parent of a young girl please read this article. 

“Polycystic Ovary Syndrome (PCOS) is rapidly growing problem among young girls. Among Indian women almost 9.13% of young girls have PCOS. PCOS totally destruct the quality of life of a young girl and have serious health consequences if not diagnosed and treated in time. 

We are living in a constantly changing world. Generations have much more gap than before as things are moving faster than before. My mother and grandmother come from an age where things were slow and steady. They both use to think the same way and may be agree on things pretty quickly. Mobiles were not there and my mother always considered her mother’s advice as the best one. But now things are different among today’s generation. Before a mother realizes what would be the best suggestion for a problem, children are on google to search and learn. Parenting is quite challenging. For women’s health, which starts from womb, there are lot of health issues which also starts right from there.

Roma had a very different perspective of herself. She thinks that she is very different from other girls in her school. She had hit the puberty very early and ever since then her periods were irregular. Her mother- a doctor by profession told Roma that it takes time for hormones to get adjusted and not to worry too much about it and suggested to focus on her studies. At the age of 16, Roma had a difficult time managing her weight. Her cravings were making her feel guilty. She could not resist eating all the time. As if some fire is constantly burning in her tummy. She had collected lot of fat around her tummy, arms and thighs. Carbohydrates and sweets were her favorite. She had erratic moods and feeling tired most of the time without doing any sort of hard work.

The problems were endless for Roma. She was very much anxious. Soon she saw that her skin is breaking out, she had bad pimples by then and that’s when she asked her mother to take her to a doctor. Beauty issues can make anyone worried. Her mother took her to a dermatologist and who gave some ointments, creams and suggested to lose weight. But nothing seems to be working for her. She was putting on weight despite doing exercise and diet control. Her cycles stopped coming. And then her mother took her to a gynaecologist who advised her to take birth control pills to get regular cycle. Roma had her ultrasound done which showed Polycystic Ovaries. Roma’s mother was reluctant to choose the hormonal pills and then started looking for alternative ways rather the natural ways to correct things for her daughter. 

Four months back Roma and her mother came to my clinic. Roma told me about herself. She said, she has taken homeopathy medicines for 10 months and had visited naturopathy centres for few times to help lose the weight. She is putting all her efforts but her cycle is not coming and her weight is not going down. She was filled with shame, guilt and feeling of frustration. I could sense that she did not believe in any natural ways to help her problems. Her mother forced her to see me. During the history taking, I came to know that her mother also experienced the similar issues in her teenage. I asked if Roma had her blood tests done.
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Her mother said, all hormone tests have done and she has no thyroid issues and no other hormonal issue. I asked her mother if she had the blood sugar levels checked. I wrote the tests and asked them for a follow up. I checked her Nadi, asked few questions and diagnosed her as per Ayurveda. It was a clear case of imbalance in all the three doshas. Her Kapha dosha was high along with Vata. Agni was impaired and Dhatu were depleting with lack of nourishment. I put her on herbs for 15 days which help correct Agni and balance kapha-vata dosha.

After a week itself, Roma was in my clinic again with her reports. She was sitting silently with head down and confused mind. Her mother spoke,’ doctor I never expected this to happen to my daughter. Look at the sugar levels, her fasting blood sugar is 180 and HbA1C is 7.9. There were no symptoms of this. I am terrified. What would happen to my daughter? Would she need insulin for life long? She is just 16 years old.’ Her mother was filled with guilt of not able to know what was wrong with her daughter and how she did not realise it earlier. Roma is diabetic now.

I asked them to continue my medications and assured that Ayurveda can certainly help her, provided Roma follow strict diet and lifestyle changes. These early days of hard work will help her in future good gains in her health. We decided on a ‘do-able’ and easy, healthy meal plans, We made small steps at a time and I always mentored Roma about her health goals. I never forced her to follow a health advice in which she did not like. And if we met failures, I assured Roma that this is not an easy path and journey is longer but with good gains. I told her to do any kind of physical activity- not necessarily gym or Yoga. Other things like dancing also helps. I asked to do what she enjoys the most or have variety of activities in a week. I also suggested having rest days of meditation.

I also offered her to visit an endocrinology or other modern doctor if she was not ready to take Ayurvedic medicines. Actually, the diagnosis of PCOS among adolescent is a still not clear. Many at time, the PCO morphology in ultrasound is very common among teenage. And this is the growing age so hormonal imbalances is quite expected along with those teenage pimples and frequent no-ovulation.

Roma and her mother both showed significant support to Ayurveda and towards me a as an Ayurvedic vaidyas.  And that’s what you would expect from a patient- the trust in doctors and their medicines. Last week, Roma got her natural cycle. She is working on her weight and also taking proper mediation. She also has a positive outlook to PCOS. She is enjoying her life better than before now, with a hope to overcome her symptoms. Her sugar levels are coming down slowly and I hope soon she will be able to manage them well without insulin. We are very much hopeful for her complete recovery.

Ayurveda and Menstruation:
Ayurveda, talks in detail about female related problem, their treatment and how a women can restore her fertility and prevent all menstrual disorders.  Fertility is not required only to have babies but is a very “core concept” of being a women.  It is more to do with a healthy life.  A women’s body goes through a lot of changes which first starts from when she gets her first periods.  In medical terms it is called as ‘menarche’ and Ayurveda calls it – ‘Rajo darsham’. Ayurveda suggest that from this time onwards, a girl needs extra care and support to look after her body, should it be free from all kind of menstrual disturbance. 

Menstrual disturbance are the basically symptoms of underlying pathology.  For example, when there are imbalances between ‘doshas’ the body shows sign and symptoms of then abnormal doshas.  According to Ayurveda, health is balance status of Doshas, in sort being in Balance is Health – complete health.  Doshas are stated as bio energies in the body which initiate, sustain and complete all the functions in the body, they are three – Vata, pitta and kapha, for easy understanding we can see them as – vata – relates to wind and causes movements, pitta related to fire and cause metabolic activities and Kapha relates to earth and causes formation.  Vata is considered as special one and so, in female body all the fertility related functions are governs by vata itself examples – expulsion of blood during periods.  It is more to do with ‘Apana Vata’ – a subtypes of vata dosha whic is responsible for downwards movements.

How Ayurveda looks at PCOS:
In Ayurveda, it has been clearly explained that if a person indulges in improper and unhealthy lifestyle that results into impaired Agni which further does not digest the food properly and what is called as Ama (toxins) remains in the body. Because of this ‘Ama’ formation, the body does not absorb anything and moreover, does not get proper nourishment. This further hampers the tissues (Dhatu) of the body and the person suffers from various disorders such as sthoulyata, Madhumeha, etc. 

In Ayurveda, PCOS is not explained under one particular disease but it is understood on the basis of abnormal al the three doshas (energies) in the body along with impaired Agni, especially under Artava-dusti (physiological disorders of female reproductive organs). The three doshas Vata, Pitta and Kapha plays an important role in a women’s menstrual cycle. Their function gets impaired and thus, abnormal vata causes heavy or no bleeding, abnormal Pitta impairs follicular maturation and rupture and finally Kapha causes prolonged cycle with increasing the size of the ovaries and formation of cysts on them. Ayurveda talks about looking at the abnormal dosha and diagnosing it accordingly to plan an effective treatment for PCOS. For example, if the Vata is abnormal, the women may represent with the symptoms of severe menstrual irregularities- heavy or no periods.  And for Kapha imbalance, the women may represent with overweight, hard to lose weight, sugar cravings, growth of facial hairs and diabetic tendency.

Ayurveda, Teen age and PCOS
During puberty lot of changes happens in a body as some are, considered as very normal being a “process of puberty.”  Such as irregular periods, mood changes, changes in the breast, Acne etc.  Irregular periods however, considered as it takes time to set them alright and so people ignore the irregularities in menses, which is now considered as a big health problem. 

Onset of PCOS has been suggested in early adolescent age (14-15 years) and some research in India suggest that young girls living in cities are more prone to develop PCOS than the girls living in rural areas.  As some girls are maturing at very early age such as at 10 years age, the irregularities in periods- especially having excessive, or no periods are more likely to be associated with the history of diabetes in the family. Or also, if you develop PCOS, you are highly likely to get diabetes, high Blood pressure and other metabolic disorders which affect the fertility. 
Today, almost 10% of the young girls are suffering from PCOS and there are chances that these girls may pass the PCOS to their children in future.

In summary , If your mother had PCOS, in your family is diabetic, if you live in city and moreover, you don’t do any physical activity and are obese, then, it is the ‘time’ to take control over your health through Ayurveda. Ayurveda believe in the prevention of the disease. For the menstrual disorder not to occur, Ayurveda suggest that before the onset of periods itself you need an extra care to prevent all the symptoms of PCOS. 
Also, once you get your first periods you need to provide a good care to yourself during those bleeding phase.  Watch out what you eat and do.   Walking, yoga, or any physical activity is must for 20 minutes daily.  You can choose to avoid high sugary and refined diet and follow a healthy Ayurvedic diet to stay healthy specially Ayurveda talks about a particular care during those ‘bleeding days’, I think which has almost vanished as women today is more outgoing and required to shoulder the work load.
Final Words: Take your daughter to an Ayurvedic doctor even if there is no health issue. I am talking about prevention of such rapidly growing lifestyle problems. Ayurvedic doctor will help you provide detail healthy lifestyle plans and offer an excellent teen age to your daughter where she can be stress free, regular with periods and enjoys a healthy lifestyle.

Namaskara, 
Vaidya Vibhuti Rao

References:
ttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3410189/
https://pediatrics.aappublications.org/content/136/6/1154