Unani literary review on PCOD and its management

Introduction Poly Cystic Ovarian Disease (PCOD) is the most common endocrine disorder, which starts appearing at 15-25 years of age and it may take years for its clinical presentation to appear. Overall incidence of PCOD is 4-22% in women and 50% of infertile women . Anovulation is the hallmark of PCOD, which is the leading cause of infertility. PCOD is a heterogeneous disorder. It was originally described by Stein and Leventhal in 1935 and its diagnosis is based on presence of any two of the following three criteria i.e. oligomenorrhea and or anovulation, hyperandrogenism (clinical and or biochemical) and polycystic ovaries on USG. PCOD treatment is directed to the ovary for normalizing its functions. Medications are used to regulate the menstrual cycles and to stimulate ovulation. As different drugs used in the treatment of PCOD cater to different symptoms, effective treatment to manage PCOD is a challenge. In conventional medicine, the best-known treatment of PCOD is clomiphene citrate, metformin, tamoxifen and troglitazone . All these drugs have their own side effects. Unani concept of PCOD In unani system of medicine the description of PCOD has been described vividly by various unani physicians under the headings of ehtebase tams and uqr. It has been mentioned that sue mizaj barid (abnormal cold temperament) of the liver may lead to abnormal production of phlegm. Dominance of khilte balgham (phlegm) may lead to formation of cysts in the ovaries. The cause of infertility in females due to obesity and PCOD as described by modern medicine are very much similar to the causes and features of uqr in unani medicine. Unani physicians recorded combination of signs conjoined with menstrual irregularities i.e. amenorrhoea, oligomenorrhea and DUB, including hirsutism obesity, acne, hoarseness of voice and infertility, which are suggestive of PCOD . It is also described that women become amenorrhoeic if their mizaj is transformed towards masculinity and develops male pattern hair growth, hoarseness of voice etc Symptoms of PCOD 1. Menstrual issues: PCOD mainly causes oligomenorrhea (lower than nine menstrual periods in one year) or even amenorrhea (no menstrual periods for 3 or more successive months). However other kinds of menstrual problems can also occur. 2. Infertility: This usually results directly from persistent anovulation. 3. Metabolic disorder: This shows up like a propensity towards fundamental weight problems along with other indicators connected with insulin resistance. Serum insulin, insulin resistance, and also homocysteine amounts are increased in females with PCOD. Asiansinfluenced by PCOD are not as likely to cultivate hirsutism as the ones from some other ethnic backgrounds. Ladies with PCOS are inclined to have fundamental weight problems, yet scientific studies are contradictory with regards to whether visceral as well as subcutaneous stomach fat is augmented, unaffected, or diminished in females with PCOD of reproductively. normal woman with similar weight index. In any event, androgens, like testosterone, androstanolone. Management of PCOD in conventional medicine : Women with PCOD are currently treated according to their presenting features like irregular periods, infertility and hirsutism. 1. Oral contraceptives in menstrual disturbance. 2. Clomiphene citrate, ovarian drilling/ laser treatment and assisted reproductive techniques in anovulatory infertility. 3. Cyproterone acetate, ethinylestradiol and spironolactone in hirsutism and acne. 4. Weight loss in menstrual disturbance and anovulatory infertility helps in improvement of metabolic perturbances and reduces the risk of coronary heart disease. 5. Insulin sensitizing agents (such as metformin) in obesity, androgen excess, menstrual disturbance, anovulatory infertility and metabolic perturbances. Unani management of PCOD The main aim of Unani treatment in women with PCOD is:  Detoxification of body  Strengthening and revitalizing the female reproductive system and regularizing menstrual cycles.  Rectifying hormonal imbalance by using unani medicineUnani system of medicine is the oldest system that prevails till date with its effective remedies. In unani medicine, the medicinal plant preparations have found widespread use particularly in the case of disease not amenable to treatment by modem methods. The drugs which correct ehtebase tams, uqr and sue mizaj barid are generally found to be useful in PCOD, but their efficacy has not been validated scientifically. Various single and compound drugs for amenorrhea such as Abhal, Badiyan, Aspand, Hab Balsan, Hab Khurtum, Habbul Qilt, Rewand Chini, Akleelul Mulk, Tukhm Kasus, Kharkhask, Parsiya-O-Shan, Jadwar, Akarkarha etc.8,11 which are widely used in the management of ehtebase tams and uqr. Compound formulations such as sharbat ersa, sharbat shikanjabeen asli, etc. , are also used. Moreover, unani literature mentioned to be used for hepatoprotection, which in turn refers for the correction of hormonal imbalance due to PCOD. These drugs are also containing phyto estrogens that mimic the estrogenic action and normalize the menstrual cycle. In PCOD these drugs having the properties of Mohallil Auram (Anti- Inflammatory) Muffateh (Vasodilators), Mudire Boul-o-Haiz (Diuretic and Emmenogague), Mulatif, Musakkin Dard (Analgesic), Muqawi Meda wa Jigar (Tonic To Stomach and Liver), Muqawi Dimagh (Tonic To Brain), Muqawi Bah (Aphrodisiac) etc .All these drugs are in the first degree of hot and dry temperament suggesting that the drugs possess moderate degree of hararat and yabusat, which suits for ehtebase tams and uqr, caused by sue mizaj barid. Moreover, these drugs contain flavonoids which have various biological activities such as hepato-protective, anti-inflammatory, uterine stimulant, antioxidant, digestive, anti-rheumatic, immunomodulatory, antihypertensive properties. This drug contains phyto estrogens also. List of unani drugs 1. Abhal Juniperus communis Emmenogague, anti-inflammatory, astringent, antiseptic 2. Badyan (Sounf) Foenicul vulgare Linn antioxidant, cytotoxic, anti-inflammatory, antimicrobial 3. Habbe Balsan Antioxidant, anti-inflammatory 4. Aspand Peganum harmala Linn Anti-depressant, 5. Rewand chini Indian rhubarb Hepatoprotective, antioxidant. 6. Kharkhask Tribulus terresteris Linn Hypotensie, Aphrodisiac, Diuretic, 7. Jadwar Delphidium denudatum linn Antioxidant, Hepatoprotective, Tonic 8. Akarkarha Anacyclus pyrethrum linn Aphrodisiac, restore premature ejaculation, Anti diabetic, Antioxidant, Immunomodulator, Diet in PCOD : When PCOD is linked to obesity or overweight, effective weight-loss is regarded as the efficient method of rebuilding natural ovulation/menstruation. Lower GI diet plan, wherein a substantial part of overall carbs are acquired from fresh fruit, veggies, as well as whole-grain resources, has resulted into more significant menstrual consistency as compared to a macronutrient-matched healthier diet.  Diet should be light, nutritious and easily digestible.  Use of fibrous food including green leafy vegetables and fresh fruits.  Avoid cold and dry food, late digestible food, heavy and spicy food.  Drink plenty of fluids. Conclusion Although PCOD treatment has no cure, still a patient can live a normal life through proper unani medical interventions and lifestyle changes can reduce the sign, symptoms and restore fertility.

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Nice informative post

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Useful Post thanks

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Useful post Dr

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Very informative post Good information about unani medicin of Copd .

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Very informative post Thank you so much

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