Understanding PCOS Through The Lens Of Sthoulya (Obesity) And Artava Kshaya: An Integrated Ayurvedic Approach To Metabolic And Reproductive Dysfunction

Abstract

Polycystic Ovary Syndrome (PCOS) is a heterogeneous metabolic–reproductive disorder characterized by insulin resistance, obesity, hyperandrogenism, and chronic anovulation. This article presents an integrated Ayurvedic interpretation of PCOS through the dual frameworks of Sthoulya (obesity/Medoroga) and Artava Kshaya (diminished menstrual function). The proposed Kapha-Meda Avarana model explains how systemic metabolic derangement, originating from Agnimandya and Medo Dhatvagni dysfunction, leads to Meda vriddhi and subsequent obstruction of the Artavavaha Srotas. This obstruction impairs Apana Vata, resulting in anovulation, oligomenorrhea, and follicular arrest—clinical parallels of PCOS. The article also differentiates Sthoulya-linked PCOS from lean phenotypes, highlighting distinct doshic drivers. A comprehensive therapeutic protocol integrating Shodhana, Shamana, Tarpana, and Uttara Vasti is presented, demonstrating significant improvements in metabolic parameters, normalization of ovarian morphology, restoration of ovulation, and high conception rates in clinical observations. The findings support Ayurveda’s capacity to address both the metabolic root (Sthoulya) and the reproductive manifestation (Artava Kshaya), offering a causally coherent and effective management approach for PCOS.