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Question and answer session with Dr.Zankhana Buch on PCOS
Kripa: Hi, welcome to Bowl of Herbs podcasts. Today we have Dr. Zankhana Buch, who is passionate about Ayurveda and has made it a profession by completing BAMS and MD in Ayurveda. She has been in this profession for 14 years and currently working with AyurVAID hospitals, Bangalore, as a medical superintendent and senior physician. She is also a qualified NABH faculty, QCI, New Delhi.
Before joining AyurVAID, she has worked as a senior research fellow at Cancer complimentary clinic, Mumbai. She has also published many journals related to cancer and Ayurveda. It is a pleasure to have you with us Doctor.
When we hear the term PCOS, it seems very scary and complicated, so we would like to understand it in a better way with your help.
So doctor, can you please explain “what is PCOS and what causes it?”
Dr.Zankhana Buch: Thanks Kripa and Bowl of Herbs for choosing the topic about PCOS. PCOS is Polycystic Ovary syndrome which is one of the most common female endocrine disorders. We find that 5-10% of women, of the reproductive age between 12 – 45 years, are known to suffer from PCOS. PCOS is very common among the urban girls, who are entering into their adolescence or puberty. While allopathy system of medicine, considers the role of hormones and the change in lifestyle as the main cause of PCOS, Ayurveda understands the polycystic ovarian syndrome as metabolic disorder which is caused over a period of time by accumulation of toxins or doshas, which is due to faulty diet and lifestyle.
Kripa: Thank you doctor. What are the symptoms of PCOS that can be identified, so that we would know when to consult a doctor?
Dr.Zankhana Buch: Yes. Normally, the symptoms of polycystic ovarian syndrome begin in adolescence, that is with menstrual irregularities or women may not know that she has PCOS until later in the life when symptoms or infertility occurs. The other symptoms also include,
- Unexplained weight gain
- Hirsutism or excessive hair growth over chin
- Lethargy and tiredness for no obvious reasons
Along with that, there could be irregular menstruation like delayed periods, amenorrhea – that is no periods for long time and patient at the age of conception will find it difficult to conceive.
Kripa: Okay, so does it also cause thinning of hair doctor?
Dr.Zankhana Buch: Yes, it does cause thinning of hair, because again from an Ayurveda perspective, it goes to the root cause or the doshas of kapha pitta and vata, where the hair follicles which are nourished by the body tissues, they get affected and they get blocked in the process PCOS. Hence the patients complain of hair fall and thinning of hair.
Kripa: Okay. So lot of women keep asking that they feel very tired and fatigued. Are there any Ayurveda remedies which will be helpful for getting better?
Dr.Zankhana Buch: Yes. Ayurveda understands PCOS as a disease which is caused by excess of kapha or vata primarily. And also, we have an understanding of the process of accumulation of ama or indigestion, toxins in the body, which leads to blockage in the channels of nourishment and the tissues, circulation does not happen. That is why a patient feels tired, lethargic and loss of interest in day to day activities.
Kripa: Women with PCOS often suffer from terrible cramps during their periods, is there any suggestion which will help them ease the cramp and pain.
Dr.Zankhana Buch: Normally, during a menstrual period, uterus undergoes normal contractions which facilitates the bleeding. While somebody suffering from PCOS, has sluggish metabolism, suffers from chronic constipation, lot of vayu or vata in the lower abdomen. Because of this movement of uterus are obstructed. So, one should take care right before a week or 10-15 days in advance, when the periods are nearing to ensure that good warm diet like liquids, ghee intake and to clear constipation and ease bowel movements, so that the bowel movements are clear. This indirectly reduces pressure on the uterus and ease the menstrual periods.
Kripa: okay. That was really informative mam. It is often told that PCOS cannot be cured. It’s more like a myth. Does Ayurveda have a cure for PCOS?
Dr.Zankhana Buch: Yes. So let us understand main difference from PCOS and PCOD. We keep hearing about polycystic ovarian disease and we are now talking about polycystic ovarian syndrome. While, a women whose ovaries are ripe with follicles in certain numbers, but when they exceed the normal range and size, they keep multiplying and grow into multiple cysts, the outer edge if the ovaries become follicular in nature, which is known as polycystic ovarian disease, Where only the ovaries undergo a structural change and imparting a functional change. When this keeps continuing over a period of time and a women indulges in faulty diet/lifestyle with sluggish metabolism, the other tissues of the body get affected, which leads to polycystic ovarian syndrome. So, polycystic ovarian syndrome is an advanced condition of PCOD. PCOS also includes cluster of symptoms like, hair growth, weight gain, acne, infertility and etc. And one of the most important thing what is happening in PCOS is, insulin resistance. Patients are depleted of the glucose metabolism which is happening and they show signs of pre-diabetes or early diabetes.
So, now Ayurveda understands this complete pathway of disease metabolism, from PCOD to PCOS and it addresses the root of PCOS, with comprehensive tools of ahaar that is diet, Vihaar that is lifestyle, Ayurveda aushads that is medicines and panchakarma therapies. These are the deep cleansing or cellular cleansing, intensive therapies, which are meant to do a whole system cleansing. By doing this Ayurveda addresses the root cause of PCOS. Hence in our clinical experience we find that, when a patient undergoes this complete Ayurveda comprehensive approach, the symptoms of PCOD and PCOS getting corrected, we find the metabolism improving, the emerging the risk factors of early diabetes/pre-diabetes are cured.
Kripa: Okay, thank you doctor. Can a women have regular menstruation and still have PCOS?
Dr.Zankhana Buch: Yes, PCOS as I clarified, is a structural change, which keeps happening in the ovary. The ovaries turn into like multiple cysts, but less likely, once the process or disease of PCOS or PCOD sets in, slowly the menstrual cycle changes keep happening. But, if a women, along with having PCOS maintains a good diet, good lifestyle and Ayurveda regimen, she should be able to maintain good and regular periods.
Kripa: Okay. And it is often said that women with PCOS have more fertility issues. So, can a women with PCOS has any chances of conceiving or should she get it treated it first before planning for pregnancy.
Dr.Zankhana Buch: PCOS is one of the cause for sub-fertility and infertility, not necessary that all PCOS women who undergo the treatment are not able to conceive. One should address PCOS with correct lifestyle, correct diet and regimen, so that the fertility issues do not advance.
Kripa: When a women with PCOS conceives, are there any additional precautions required?
Dr.Zankhana Buch: Ayurveda states the concept of a Garbhini parichaya, that is, antenatal care, the complete antenatal regimen, right from first month to the ninth month and labor should be followed, which includes diet, lifestyle, exercise and the norms of having a good and easy labor. If all these things are followed, as per Ayurveda understanding, even women with PCOS would be able to have an easy childbirth.
Kripa: Is gestational diabetes somewhere connected to PCOS?
Dr.Zankhana Buch: So, as I told you earlier in our conversation, there is an underline insulin resistance which keeps happening in PCOS and the current conventional choice of medicine for PCOS is metformin. So intake of metformin again over a period of time, leads to further depletion of beta cells, and leading pancreas in short of insulin. One who has PCOS is already into risk of insulin resistance and she would also be obese. Both these are the risk factors, and if she conceives, has a higher chance of gestational diabetes than a normal women.
Kripa: Okay doctor. Since you said diet is very important for controlling PCOS, is there any specific food a women should be avoiding?
Dr.Zankhana Buch: Ayurveda gives a very good norm of cooking, eating and digesting. So, all those food items and the methods of cooking which leads to an increase of kapha and vata dosha, which lead to an impaired metabolism, should be avoided. For example, having breakfast and taking bath, so this is one regimen, where your agni gets impaired. Your digestive fire gets low. If this is followed over a period of time, the digestion is affected. So, changing this thing would help, in getting into a healthy lifestyle. Food items like cake, pudding, processed food items, maida, oil, which are very difficult to digest, which are slimy and sticky in nature, should be avoided. Curd (yogurt) for example, as against what people understand that curd is a probiotic, which is very healthy. But, Ayurveda says is that kapha dosha is increased by having a regular intake of curd. Such food items should be avoided.
Kripa: Okay, that was really surprising doctor. And, is there any regular workout necessary or any physical activity necessary?
Dr.Zankhana Buch: Again as I said, the underlying dosha is kapha dosha, low metabolism, one has to work hard to shed those extra kilos of weight to get into an active physical regimen and follow a healthy lifestyle/diet to have a control over PCOS.
Kripa: Is yoga helpful in anyway for PCOS?
Dr.Zankhana Buch: Yoga is a part of physical activity and is a part of mindfulness in relieving stress, imparts a balance of body, mind and spirit. So, I would recommend that yoga should be done under a proper medical supervision. And, those asanas which are useful should be practiced because we find lot of patients coming with the complaints that a wrong yoga posture would have done a lot more harm to the lower body, to back. So, yoga should be done mindfully under supervision and should be avoided during periods.
Kripa: Can PCOS be genetic?
Dr.Zankhana Buch: We do find that inheritance plays a role in development of PCOS. Also, mothers who have been diabetic, who has been suffering from hyperthyroid, their daughters are more likely to get into PCOS. So, while genetic part is important, genetic predisposition is important to understand PCOS. So, once you are aware of your strong family history, one should plan in advance to reduce the impact of genetic predisposition on PCOS.
Kripa: Thank you doctor. In general, for any women, is there is any preventive measures to be taken, just in case, if there is a chance of PCOS.
Dr.Zankhana Buch: Yes. This is a very interesting question Kripa and I think all the mothers, all the girls, should follow this right from childhood. We take care of the problem, we try to address the problem only when it arises. We do not pay much attention to the part of prevention and primal prevention. What Ayurveda understands is that, primal prevention and primary prevention are very important. So, what do you mean by primal prevention. Primal prevention is right from the time, when a mother conceives, when the child is the womb, the healthy lifestyle and diet should be followed by a mother. So that the child, a girl child, if she is born, is not impacted by the faulty diet and lifestyle of the mother. And she leads a normal and happy/healthy life ahead.
Now, comes the point of primary prevention, when the girls in their childhood, are into diet and lifestyle, with the impact of the current urbanization, westernization, we adopt more of things which we are not used to eating. We get into having chocos, biscuits, drinks, aerated drinks, pizzas, which our body is not used to. If we are subjected to all this, right from childhood, by the time we grow and get into the teenage, the years of puberty, our body is already loaded with lot of toxins and accumulated with all these things, which lead to an impaired metabolism. Such girls, such children are more prone to PCOS. Hence, I believe that we should have a nip in the bud concept of this problem, right from very young age. We should train our daughters, sisters, who are in this age to eat right things, to digest well and to have healthy and active lifestyle.
Kripa: I think that’s more in the “need of the hour” right now. And doctor one more question, Women who go to the menopausal stage, if they have had PCOS previously, will that cause any problem?
Dr.Zankhana Buch: So again, PCOS underlined issue is, lot of hormonal imbalance, hormonal issues, where treatments with harsh medicines and hormones, would have caused harm. So, such women when they enter into menopause, again as I told, that right before achieving menopause, right in their 40s, should start taking care, be mindful of having a healthy transition, a graceful transition to menopause.
Kripa: Okay. And coming to AyurVAID hospitals, what are the specific treatments, that is provided here to manage and treat PCOS.
Dr.Zankhana Buch: Okay. AyurVAID hospitals, are a pioneer hospitals in precision Ayurveda, they follow a rigorous process based assessment for all our patients. So, coming to the understanding of PCOS, we have an understanding in AyurVAID about this disease as something which goes to its roots. These doshas, the sub-sequent issues and the agni, impaired agni, is brought into focus. A reversal strategy is planned to correct these doshas, the tissues and the agni step by step. It is a prescription which entails the a comprehensive approach of diet, lifestyle, internal medication and panchakarma therapies, cleansing therapies to address the PCOS, symptoms and its implications, in terms of infertility, in terms of pre-diabetes, early diabetes, etc.
Kripa: Okay. Thank you for your time doctor and all for the information and tips. Hope to meet you soon again.
Dr.Zankhana Buch: Thank you Bowl of Herbs.
Kripa: Thank you.