EFFICACY AND MECHANISMS OF PANCHAKARMA IN WOMEN'S HEALTH: A NARRATIVE REVIEW OF POLYCYSTIC OVARY SYNDROME, INFERTILITY, AND MENOPAUSAL DISORDERS

Abstract

Gynecological and reproductive endocrine disorders, specifically Polycystic Ovary Syndrome (PCOS), female infertility, and menopausal disorders, pose significant global health challenges. Ayurvedic medicine offers systemic therapeutic interventions through Panchakarma (five biopurificatory procedures) to address the underlying physiological imbalances of these conditions. Objective: This narrative review aims to synthesise the clinical evidence, classical Ayurvedic rationale, and proposed modern physiological mechanisms of Panchakarma therapies in managing PCOS, female infertility, and menopausal disorders. Methods: A comprehensive search was conducted across databases including PubMed, Scopus, Google Scholar, AYUSH Research Portal, and DHARA, alongside classical Ayurvedic treatises. Peer-reviewed clinical trials, observational studies, and conceptual papers published up to January 2025 were analysed. Results: The literature indicates that purificatory procedures like Virechana (therapeutic purgation) and Basti (medicated enema)—including systemic and local Uttarabasti (intrauterine instillation)—exert positive outcomes. Clinical trials report improvements in menstrual regularity, ovulation rates, endometrial thickness, and the mitigation of autonomic menopausal vasomotor symptoms. Proposed mechanisms include regulation of the hypothalamic-pituitary-ovarian (HPO) axis, modulation of insulin sensitivity, reduction of systemic oxidative stress, and restoration of autonomic nervous system balance. Conclusion: Panchakarma therapies demonstrate clinical utility as supportive or alternative interventions in women's reproductive health. However, the existing evidence base is limited by small sample sizes and methodological heterogeneity. Further well-designed, multi-centre randomised controlled trials with standardised protocols are required to validate these findings.