Clinical Yoga Therapy or therapeutic yoga is taking centre stage to help women deal with polycystic ovary syndrome

For 31-year-old Gurugram resident Khyati Gupta Babbar, polycystic ovarian syndrome was a part of her life. She had been suffering from the condition for 10 years so much so that her menstrual cycles were dependent on drugs. She has been married for six years and wanted to conceive for the last four, but was unable to do so.
After trying treatments with different doctors, she decided to try yoga to help her with the condition. “I was lucky to find Dr. Runvijay and this program is well structured, highly personalized and has a time line to it.” After a month of clinical yoga therapy, she began to have regular menstrual cycles without drugs. She even saw an improvement in her acne problem. Her UltraSound Reports indicated her Ovarian volume reduced from 10.8 / 10.6 cc to 4.8 / 4.2 cc which means that the ovary size has come back to normal; also over 15 cysts of 4-5 mm also disappeared. She conceived a month of completing the therapy which was 2-3 months in her case and is currently in her eight month of pregnancy.
Understanding the issue
PCOS is a common disorder associated with the hormonal or endocrine system of the female reproductive system. The word “polycystic” implies “many cysts” as in PCOS many small cysts form inside the ovaries which disturb the normal menstrual cycle. A study by AIMS reveals that 1 in every 10 Indian women suffer from PCOS. Women diagnosed with PCOS usually have increased level of male hormones and lower levels of progesterone. “PCOS is a syndrome or a group of symptoms including irregular periods or no periods at all, excess hair growth (known as Hirsutism) on face, back, stomach, arms, legs, heavy acne, pimples or blemishes, frequent mood swings, anxiety, depression, weight gain, infertility, fatigue and low energy levels related to poor sleep and blood sugar imbalance which may lead to diabetes and heart attack. Although PCOS has not yet been attributed to any specific cause but most doctors believe it to be a result of stress, a fallout of the modern-day unhealthy lifestyle,” says Dr. Kritka Bolia, Executive Physiotherapist, Motherhood Hospital, Pune.
Yoga as Medicine
While general yoga helps prevent or reduce symptoms of PCOS, it does not cure or reverse the problem. It takes a systematic targeted approach with medical goals called CYT that can actually help reverse the same. PCOS is not a gynecological problem but is actually an endochronology problem, a chronic condition of hormonal imbalances with effects on the gynecological system. A CYT therapist typically understands the specific issues of cysts in ovaries, ovarian volumes (ultrasound reports), hormone levels of Estrogen, Testosterone, FSH, LH, AMH in particular (blood tests) and medical history of the patient. “In India yoga is classified as a medical system and works on the hormones and PCOS is a problem of hormonal imbalance. We usually treat PCOS in three steps – the first stage is to arrest the declining hormone levels, the second phase is the heart of the therapy. The female menstrual cycle has four phases The Bleeding Phase, The Follicular Phase, The Ovulatory Phase and The Luteal Phase and each phase is controlled by different hormonal glands. We focus on the glands that are causing the problem to then ensure the issue is controlled. The last phase is to have the ovaries themselves heal the cyst. The cysts are formed by the ovary and there are reactions if they are not dissolved on time. Different people have different treatment plans based on their fitness levels and physical stamina and accordingly, a customized plan is prepared. Usually every yoga therapy session is different, and related to the hormone axes of the particular menstrual cycle phase. Diet plans are also matched to the type of therapy. Medications like hormone pills are slowly weaned off. Success is when the cysts have been dissolved, ovarian volume is normalized, hormone levels are normal and the menstrual cycle is a normal 28 to 35 days with 3 to 5 days of proper flow. Testosterone-symptoms like acne, hair loss, male hair growth go away in the program. Insulin-resistance symptom like high weight gain also goes away – weight reduction is a ‘side effect’ of the program. This usually takes 2 to 3 months,” says Dr. Runvijay, Chief Yoga Mentor, KarmaSpark Yoga Health Centre, Gurgaon.
Yogic Postures
Dr. N Venkatesh, Senior Consultant and HOD, Dept. of Obstetrics and Gynecology, Vikram Hospital, Bengaluru adds, “Regular practice of yoga helps release Endorphins or ‘feel good’ hormones, which helps a person relax both mentally and physically. Yoga asanas such as Pranayama and Surya namaskar help in improving the breathing technique and overall metabolism. By improving blood circulation, Yoga asanas help reduce the body fat and cuts / decreases the Insulin resistance thus aiding weight loss. Apart from practice of yoga, physical activities and lifestyle changes help. These include 20 – 30 minutes of brisk walking twice daily, 30 minutes of swimming, sound uninterrupted sleep for 6 – 8 hours in night, 3 liters of plain water intake daily, protein rich, high fiber diet and de-stressing by listening to good music.”
Women suffering from PCOS tend to put on more weight due to a state in the body called Insulin Resistance, which is nothing but a Diabetic like state. Due to this, fat starts accumulating in the body mainly over the belly, thighs and hips. Exercises/Asanas help in removing this resistance offered by the fat cells. Dr. Rukamani Nair, Naturopath and founder, Bapu Nature Cure Hospital and Yogashram adds, “exercises/asanas help in removing this resistance offered by the fat cells. Whereas, Pranayama and meditation helps in reducing the levels of stress hormone called Cortisol in the body which is mainly responsible for the imbalance caused in the Hypo-thalamo-Pituitary-Axis. But, a long term regular practice will only fetch results along with some dietary modifications and lifestyle corrections.” Nikitaa Parmar, Yoga Therapist, Reset – Holistic Living Concepts avers, “this common disorder, where the level of sex hormones – estrogen and progesterone – of women go haywire, induces growth of small ovarian cysts. Disruption of menstrual cycle, fertility issues, cardiac problems and unwarranted changes in appearance are some of the implications of PCOD. These cysts are mostly benign in nature but they cause imbalance of hormone level which results into pregnancy-related issues as well. Yoga can play an important role in the prevention and management of PCOD. One of the main reasons for disorders like PCOD is stress. A disturbed mind is eventually going to affect the body and its organs and disrupt their normal functioning. Yoga, unlike most physical activities, not just focuses on the physical aspect of a human being, but also takes into account, the mental, social and emotional aspect of that person, and thus plays a key role in keeping all these aspects healthy and balanced. This balance prevents and combats health disorders.” Yogic practices, including asanas (yogic postures), pranayama (breathing techniques) and meditation go a long way in helping a person remain calm and relaxed. “Quite a few of my students suffering from PCOD have proudly stated about how after just a few months of regular yoga practice have noticed that their menstrual cramps and pain has immensely reduced, while at the same time their cycles have become more regular in addition to loss of extra fat, clearer glowing skin, better management of stress levels and a feeling of lightness and positivity from inside out. Yogic postures help massage and stimulate the abdominal muscles and reproductive organs while stretching the pelvic region and also help in correcting hormonal imbalance which is vital for PCOD. They also help in losing extra weight, reducing menstrual discomfort, controlling blood pressure, ease childbirth and relax the mind. Some asanas especially work the hips and lower back by flexing the muscles within and this in turn increases energy and facilitates blood circulation to the ovaries. Most yoga practices are great as therapy for PCOD,” adds Parmar.
Take the case of Sadiya Faiz Khan, a 30 year old homemaker based in Hongkong. “I had always had slightly late periods and felt fatigued most of the time, attributing it to my Thalassemia trait and being slightly overweight I did not pay much attention to it. But after delivering my baby through C-section I gained a lot more weight and found myself in the obese category, I was diagnosed with PCOS and Pre-Diabetes. I discovered yoga could be fun thanks to my best friend who happens to be a Physiotherapist. A year later I have lost a lot of weight thanks to paying attention to what I need to eat and doing Yoga, I feel a lot more energetic and my PCOS seems to have vanished. I hope I can continue this lifestyle.” Khan practiced Sun Salutation which really helped her overall, right from toning of her body with weight loss and reducing the stress, Cat and Camel Exercises (for the pelvic floor muscle exercise and gaining back the flexibility), Bridging (for backache after C-section), Chakki asana (to lose the belly fat soon), Shavasana (to calm and relax herself) and Meditation (really helped her with her mood swings owing to PCOS and dealing with Post-partum Depression). She started with yoga about a year ago and did them early morning when her baby was sleeping and made sure to do them at least 5 times a week. With time the symptoms of PCOS subsided also, feeling to have a better body and a much healthier mind.
Good to Know
• Lose weight to cure PCOS is a common myth that is medically incorrect. PCOS leads to insulin resistance. This is often worsened by use of hormone birth control pills. One has to reverse the insulin resistance to lose the weight.
• To reduce symptoms, a combination of general yoga and healthy diet is quite useful.
• Cardio-exercises such as brisk walking, jogging and zumba also help reduce symptoms.

Yoga Exercises (Courtesy Motherhood Hospitals Pune)

BADHA KONASANA (Butterfly Pose) and SUPTA BADHA KONASANA (Reclining Butterfly Pose)
It is a simple and easy to do yoga pose that works wonderfully for natural PCOS treatment.
It helps relieve tension in the lower back and open the pelvic region and relieves menstrual pain.
ARDHA MATSYENDRASANA (Half Spinal Pose)
This massages the digestive and reproductive organs and promotes overall relaxation by rejuvenating the spine and muscles.
This pose also helps to loosen the muscles around the spine, low BP and soothe the nervous system and regulates the menstrual problem.

CHAKKI CHALANASANA (Mill Churning Pose)
This posture helps in improving abdominal function and exercises the uterus and reproductive organs.
It helps to promote endocrine functions and hormonal secretions.
It also massages the uterus, reproductive organs, liver, kidney and pancreas.
It is also one of the functional exercises to lose weight from the stomach.

BHUJANGASANA (The Cobra Pose)
It exerts soothing pressure on the stomach and aids to stimulate the functions of the ovary.
Also helps in better digestion and reducing stress.
It is best not to hold this posture for more than 30 sec at a time.

MARJARIYASANA & BITILASANA (Cat & Camel/cow Pose)
This helps to stimulate the CNS and loosen the muscles around the spine.
This pose also helps to massage and stimulate the abdomen, reproductive organs and relieves the ovarian pain.

PADMASANA (Lotus Pose)

It stretches your pelvic region and aids in correcting the hormonal imbalance and eases the menstrual discomfort, controls BP and is a great stress booster.

PRANAYAMA
Exercise like Nadi Shodhan(alternate nostril breathing), Bhramri (Bee Pranayama) and Kapalbhati are all very beneficial in calming the mind.

YONI MUDRA
This is a hand gesture and symbolizes the womb or the uterus. It is an excellent exercise to de-stress and to calm the mind and is very effective for PCOS when coupled with breathing exercise.

BALASANA (The Child Pose)
An easy relaxation pose for emotional and mental relaxation, this also stretches the spine.
It should be avoided if you have any knee pain or severe back injury.

SHAVASANA (The Corpse Pose)
It is essential to practice this asana after every yoga session.
It promotes relaxation by making you focus on conscious breathing while relieving stress and tension in the body and mind.

SUN SALUTATION (Surya Namaskar)

It is good for weight loss and enhances body flexibility while treating hormonal imbalances and helps to detoxify and de-stress the entire system.

This story appeared in the October 2018 issue of Smartlife Magazine here: