A Critical Analysis of Dhatu and Dhatwagni Dushti in the Pathogenesis of Polycystic Ovarian Syndrome

Menstrual health is integral to women’s reproductive status and well-being. Regular menstrual cycles and normal uterine bleeding are hallmarks of a healthy reproductive system, whereas irregular cycle and abnormal flow often indicate underlying pathology and are considered as disorders of Artavavaha Srotas. Artava constitutes an essential component of the female reproductive system and is considered the Upadhatu of Rasa Dhatu which is the first dhatu formed in the process of metabolism. The human body sustains vital endocrinal and metabolic functions through the structural and functional integrity of the Dhatus and their respective Dhatwagnis that are influenced by the status of Jatharagni. The initial vitiation of Rasa and Rasagni causes Artavavaha Srotas dushti that is mostly seen in cases of females suffering from menstrual disorders. This pathological cascade further contributes to Uttarottara dhatu dushti, ultimately manifesting as a wide spectrum of disorders like polycystic ovarian syndrome (PCOS). According to WHO, PCOS affects an estimated 8 to 13% of reproductive-aged women. According to the Rotterdam criteria, PCOS is indicated by the presence of hyperandrogenism, oligo- or anovulation (manifesting as oligomenorrhea or amenorrhea), and/or ultrasound findings showing polycystic ovarian morphology.