Female reproductive system is more complex than the male reproductive system, therefore subject to more frequent disturbances. Polycystic Ovary Syndrome (PCOS) is one such disturbance. It is mainly a lifestyle disorder which is getting more and more common during these times indicating our unhealthy lifestyle. Although, there is also a huge lack of information about menstrual health and one major reason for that is the ignorance and taboo towards menstruation in our society. Even at this point, menstruation is considered impure and women during their periods are restricted in their day to day lives. It is about time for us to understand our menstrual health and prevent severe disorders like PCOS before it gets the best of us.
- Introduction to PCOS
- What happens inside your body in PCOS?
- Causes of PCOS
- Symptoms of PCOS
- PCOS vs PCOD
- What is PCOD?
- What is PCOS?
- How Does Yoga Help Manage PCOS?
- Yoga For PCOS
- Yoga Poses For PCOS
- Pranayama (Breathing practice)
- Yoga For Weight Loss
- Yoga For Overall Health
- Key Tips
- FAQs (Frequently asked questions) on PCOS
- Conclusion on Yoga For PCOS
- References and Further Reading
Introduction to PCOS
A syndrome is really a collection of traits or features that run together. In fact, that’s the origin for the term, from the Greek “syn“, for “together“, and “drome“, for “run“. It can be caused by genetics or other factors. The symptom caused by a syndrome does not have an established reason behind it and treatment of a syndrome is mainly symptomatic.
Polycystic ovary syndrome (PCOS) is a collection of symptoms found in women during their reproductive age. It’s a disorder of the endocrine system. It is a widely studied subject and there is a variety of research done over it. The exact cause of PCOS is unknown. There can be a variety of causes for PCOS making it even more difficult to be diagnosed. It is affecting between 6 and 20% of reproductive-age women depending on the diagnostic criteria used considering there are more than one ways to diagnose PCOS.
What happens inside your body in PCOS?
In PCOS, the hormone (Follicle Stimulating Hormone; FSH) and Luteinising hormone (LH) are inadequate. LH pulses are high throughout the cycle. The surge in LH is responsible for making us ovulate mid cycle, due to the constantly high LH levels, there is no surge and hence, no eggs are released.
That is why there are multiple fluid filled structures in the ovaries and excess of androgen production.
As ovulation does not occur and periods become irregular. Women with PCOS may ovulate occasionally or not at all, so periods may be too close, or too far apart. There is no certainty. Some girls don’t get periods at all.
Causes of PCOS
As we know, there is a lot of hormonal imbalance involved in PCOS. There are both internal and external factors that develop PCOS.
Few internal factors indicated by research studies are:
Hyperandrogenism: Production of male hormones I.e. androgens in amounts higher-than-normal is hyperandrogenism. Androgens are the hormone responsible for male characteristics. It is produced in females in small amounts but in PCOS; there are excess androgens causing male characteristics in women. It leads to acne, male-pattern hair loss, irregular menstruation, excess hair growth in places such as the chin, abdomen, back, chest and groin.
Insulin resistance: Insulin is the hormone released in response to sugar in your bloodstream. A resistance to this hormone is insulin resistance. Insulin the sugar and use it for energy. When there is insulin resistance, insulin becomes ineffective, resulting in increasing blood sugar. When we intake a high carb diet our body pumps out high levels of insulin and our cells start to pay less attention to it, this is known as insulin resistance. But the sugar is still there. So our pancreas sends out more insulin. Insulin tells our ovaries to make androgens. So you can see, insulin resistance is a major villain when it comes to PCOS.
Genetics: Genes play some role in many medical conditions including PCOS. If any close relative, such as your mother, sister or aunt, have PCOS, the risk of you developing it sometimes increases.
There are several external factors that influence PCOS, such as:
Nutrition: The quantity and quality of our food intake is nutrition. Excess intake of processed and unhealthy food, lack of fresh and natural food, not providing our body with all the necessary nutrients needed for nourishment highly increases the possibility of PCOS.
Lifestyle: The way we live influences our health majorly. People who live a life that lacks movement and physical exercise tend to easily develop such disorders.
Stress level: Not having much or any control over the outcome of a situation causes stress, There are many studies that show that stress causes hormonal disturbances. Our current lifestyle is full of stress. Our environment causes a huge impact on our mental health.
Symptoms of PCOS
The symptoms of PCOS widely vary, hence it is a syndrome and not a disease. It is due to the variety of symptoms that we find it very difficult to diagnose it. Few of the very common symptoms are:
Irregular periods: The most common factor of PCOS is irregular periods, one could have occasional periods or no period at all. The excess of male hormones and inadequacy of hormones like luteinising hormone (LH) and follicle stimulating hormone (FSH) responsible for our ovulation in PCOS often leads to irregular menstrual cycle and resistrists eggs from maturing. The immature eggs might not dissolve and cause sacs/cysts in the ovary.
Infertility: Irregular periods and lack of matured eggs make it hard for women with PCOS to get pregnant. The hormonal irregularities make it really hard to conceive. There has to be a balanced hormonal and menstrual cycle to create an environment for the ovum (egg) to release and infuse with the sperm post-intercourse. Due to the high levels of androgen, conceiving becomes a challenge.
Hirsutism: Women with PCOS tend to grow abnormal body hair more which is one of the male characteristics caused by the higher than normal due to the excess in male hormone I.e. androgen. This symptom also brings along a lot of stress and insecurity.
Obesity: During PCOS, it is difficult for our body to use the hormone insulin that converts glucose to energy, this is insulin resistance. This causes more glucose buildup in the bloodstream to be converted into fat. Also, High insulin levels lead to high androgen levels which further triggers weight gain in the abdomen. That is where men tend to carry weight. Every woman with PCOS isn’t obese and every obese woman doesn’t has PCOS. Some women with PCOS. Although, being obese does worsens the situation and creates higher risk of diabetes, heart disease, sleep apnea, and uterine cancer.
Diabetes (type 2): PCOS might be caused due to insulin resistance but it also worsens insulin resistance, reducing the efficiency of the hormone responsible for breaking down of glucose i.e. insulin increasing the blood glucose level at all times and making you prone to type 2 diabetes.
Psychological disorders: Mood swings, stress, insomnia, anxiety and depression are very common in such a havoc caused by the hormonal disturbance in PCOS. The situation seems out of control and the stress only heightens.
Cardiovascular disorders: Researches have shown that PCOS can also lead to Cardiovascular diseases and eventually even heart attack.
PCOS vs PCOD
PCOD and PCOS are many times used interchangeably. PCOS is a metabolic disorder that is much more severe than PCOD. A syndrome is a collection of symptoms or abnormalities that occur together and are associated with a specific disease. PCOD is a disease with a specific cause whereas PCOS is a syndrome with many causes. PCOD is much more common than PCOS.
Almost one-third of women around the globe suffer from Polycystic Ovarian Disease whereas PCOS has a much lower number of patients. Genetics and hormonal imbalance plays an essential role in both conditions. The theory is that high levels of male hormones prevent ovaries from producing hormones and producing eggs normally. Insulin resistance and inflammation have also been linked to excess androgen production.
What is PCOD?
Polycystic Ovarian Disease is a condition where the ovaries contain multiple immature eggs which later get converted into fluid-filled spaces called cysts. It is usually limited to the uterus and is mainly hereditary and is passed from mothers through generations. It is a highly common condition and prevalent in women of the age group 12-45 years.
What is PCOS?
Polycystic Ovarian Syndrome is a condition more severe than PCOD. The ovaries produce more male hormones and inadequate LH and FSH, which leads to a higher number of immature follicles in the ovaries per cycle which eventually become cysts and no mature egg is available for fertilization. This leads to infertility, it also leads to many symptoms and severe disorders, much more than PCOD does.
How Does Yoga Help Manage PCOS?
Yoga is one of the best habits to add to your lifestyle. Since PCOS is a lifestyle disorder embedded in unhealthy habits, it is very important to make changes in lifestyle that work on the root causes. Yoga is especially recommended because unlike other physical exercises, it has a very holistic approach that focuses on all aspects of our health including coping with stress, restoring hormonal balance, and betterment of body functioning, helping us get back to not just a fit but a healthy body.
Yoga For PCOS
We can practice the following yogic practices 5-6 times a week. Please consult a yoga therapist for better guidance and proper sequencing. Make sure that you take it slow and gradual without straining yourselves and pushing your limits too hard. These practices include asanas (posture) and pranayama (breathing practices):
Yoga Poses For PCOS
Sun Salutation – Surya Namaskar
Also read – Sun Salutation – All You Need To Know
Step 1. Prayer pose (Pranamasana)
Keep your eyes closed and your feet together. Stand upright.
Slowly bend the elbows and place the palms together in front of the chest in namaskara mudra, mentally offering homage to the sun, the source of all life.
Step 2: Raised arms pose (Hasta Uttanasana)
Seperate the hands, while inhaling, raise and stretch both arms above the head, keep them shoulder width apart. Bend the head, arms and upper trunk slightly backward.
Step 3: Hand to foot pose (Padahastasana)
Exhaling, bend forward from the hips touching the palms on the floor on either side of the feet, keeping the spine straight. Bring the forehead as close to the knees as is comfortable. Do not strain. Bend the knees if necessary.
Step 4. Equestrian pose (Ashwa Sanchalanasana)
Inhaling, stretch the right leg back as far as is comfortable, keep your right knee on the floor and grasp the floor with your toes. At the same time, bend the left knee, the calf perpendicular to the floor and the foot on the floor in the same position. Keep the arms straight. In the final position, the weight of the body should be supported on both hands, the left foot, right knee and toes of the right foot. The head should be tilted backward, the back arched and the inner gaze directed upward to the eyebrow centre.
Step 5. Mountain pose (Parvatasana)
Exhaling, take the left foot back beside the right foot. Simultaneously, raise the buttocks and lower the head between the arms so that the back and legs form two sides of a triangle.
The legs and arms straighten in the final position and the heels come down towards the floor in the final pose. Bring the head and shoulders towards the knees.
Step 6. Salute with eight parts or points (Ashtanga Namaskar)
Hold your breath and lower the knees, chest and chin to the floor; the feet will come up on to the toes simultaneously. The buttocks, hips and abdomen should be raised.
Step 7. Cobra pose (Bhujangasana)
Slide the chest forward and inhale, raise first the head, the shoulders, then, straightening the elbows, arch the back into the cobra pose. This will lower the buttocks and hips to the floor. Bend the head back and direct the gaze upward to the eyebrow centre. The thighs and hips remain on the floor and the arms support the trunk and the arms will remain slightly bent.
Step 8. Mountain pose ( Parvatasana)
Do not move the feet and the hand, from bhujangasana assume parvatasana.
Keep the arms and legs straight, grip the floor with the toes and while exhaling, use the strength of the arms to raise the buttocks and lower the heels to the floor.
Step 9. Equestrian pose (Ashwa Sanchalanasana)
Inhaling, bring the left leg forward in between your hands, keeping the left foot on the floor and the calf perpendicular to the floor. Grasp the floor with the toes of the right foot, keeping the right knee on the floor.
Keep the arms straight. In the final position, the weight of the body should be supported on both hands, the left foot, right knee and toes of the right foot. The head should be tilted backward, the back arched and the inner gaze directed upward to the eyebrow centre.
Step 10. Hand to foot pose (Padahastasana)
Exhaling, bring the left foot forward. Keep the palms on the floor, bend the knees if necessary to keep the spine straightened.
Tip to deepen this yoga stretch: Gently straighten the knees, and if you can, try and touch your nose to the knees. Keep breathing.
Step 11. Raised arms pose (Hasta Uttanasana)
Inhaling, raise the back and hands ups, stretch the arms above the head, keeping them shoulder width apart. Bend the head, arms and upper trunk slightly backward.
Step 12. Prayer pose (Pranamasana)
Exhaling, first straighten the body, then bend the elbow and place the palms together in front of your chest. Relax in this position and observe the sensations in your body.
This completes half a round, two of these make one round of Surya Namaskar. Complete the round by repeating the steps but in the other half, while performing step 4, stretch the left leg backward and while performing step 9, bring the right leg forward.
Note: This style of surya namaskar is according to the book ‘Asana pranayama mudra bandha’ by Swami Satyananda Saraswati.
Churning the mill pose (Chakki Chalanasana)
Step1: Stretch out the legs in front of the body with the feet widely separated. Interlock the fingers of both hands and hold the arms out straight in front of the chest. Keep the arms straight throughout the practice without bending the elbows.
Step2: Bend forward as far as possible without straining. Imagine the action of churning a mill with an old-fashioned stone grinder.
Swivel to the right so that the hands pass above the right toes and as far to the right as possible. Lean back as far as possible on the backward swing.
Move from the waist. On the forward swing, bring the arms and hands to the left side, over the left toes and then back to the centre position. One rotation is one round.
Step 3: Practice a few rounds clockwise and then the same number of rounds anti-clockwise.
Pose of the moon ( Shashankasna)
Step 1: Sit in vajrasana, place the palms on the thighs just above the knees. Close the eyes and relax, keep the spine and head straight.
Step 2: While inhaling, raise the arms above the head, keep them straight and shoulder width apart. Exhale as you bend the trunk forward from the hips, keep the arms and head straight and in line with the trunk. At the end of the movement, the hands and forehead should rest on the floor in front of the knees. If possible, the arms and forehead should touch the floor at the same time. Bend the arms slightly so that they are fully relaxed and let the elbows rest on the floor.
Step 3: Retain the breath for up to 5 seconds in the final position. Then simultaneously inhale and slowly raise the arms and trunk to the vertical position. Keep the arms and head in line with the trunk. Breathe out while lowering the hands to the knees. This is one round.
Step 4: Practice a few rounds.
Note: Not to be performed by people with very high blood pressure, slipped disc or those who suffer from vertigo.
Cat and cow pose (Marjariasana)
Step1: Sit in vajrasana.
Step2: Raise the buttocks and stand on the knees. Lean forward and place the hands flat on the floor beneath the shoulders with the fingers facing forward. The hands should be in line with the knees; the arms and thighs should be perpendicular to the floor. The knees may be slightly separated so that they are well aligned under the hips.
Step 3: Inhale while raising the head and depressing the spine so that the back becomes concave. Expand the abdomen fully and fill the lungs with the maximum amount of air. Hold your breath for 3 seconds. Exhale while lowering the head and stretching the spine upward. At the end of exhalation, contract the abdomen and pull in the buttocks. The head will now be between the arms, facing the thighs. Hold the breath for 3 seconds, accentuating the arch of the spine and the abdominal contraction. This is one round.
Step 4: Practice a few rounds.
Note: Do not bend the arms at the elbows. Keep the arms and thighs vertical throughout.
Camel pose (Ushtrasana)
Step 1: Sit in vajrasana.
Step 2: Stand on the knees with the arms at the sides. The knees and feet should be together, but may be separated if this is more comfortable. Lean backward, slowly reaching for the right heel with the right hand and then the left heel with the left hand. Do not strain.
Push the hips forward, keeping the thighs vertical, and bend the head and spine backward as far as is comfortable. Relax the whole body, especially the back muscles, into the stretch. The weight of the body should be evenly supported by the legs and arms.
The arms should anchor the shoulders to maintain the arch of the back.
Step 3: Remain in the final position for as long as is comfortable. Return to the starting position by slowly releasing the hands from the heels one at a time.
Bow pose (Dhanurasana)
Step 1: Lie flat on the stomach with the legs and feet together, and the arms and hands beside the body. Bend the knees and bring the heels close to the buttocks. Clasp the hands around the ankles. Place the chin on the floor. This is the starting position.
Step 2: Tense the leg muscles and push the feet away from the body. Arch the back, lifting the thighs, chest and head together. Keep the arms straight.
Step 3: In the final position the head is tilted back and the abdomen supports the entire body on the floor. The only muscular contraction is in the legs; the back and arms remain relaxed. Hold the final position for as long as is comfortable and then, slowly relaxing the leg muscles, lower the legs, chest and head to the starting position.
Step 4: Release the pose and relax in the prone position until the respiration returns to normal. Then, repeat a few times.
Peacock pose (Mayurasana)
Step 1: Kneel on the floor. Place the feet together and separate the knees.
Step 2: Lean forward and place both palms between the knees on the floor with the fingers pointing towards the feet. The hand position will have to be adjusted according to comfort and flexibility. Bring the elbows and forearms together.
Step 3: Lean further forward and rest the abdomen on the elbows and the chest on the upper arms.
Step 4: Stretch the legs backward so they are straight and together. Tense the muscles of the body and slowly elevate the trunk and legs so that they are horizontal to the floor. Hold the head upward. The whole body should now be balanced only on the palms of the hands.
Try to elevate the legs and feet higher, keeping them straight by applying more muscular effort and by adjusting the balance of the body.
Do not strain.
Step 5: In the final position, the weight of the body should be supported by the muscles of the abdomen and not the chest.
Maintain the pose for a short period of time, then slowly return to the base position. This is one round.
The asana may be repeated when the breathing rate has returned to normal.
Shoulder pose (Kandharasasna)
Step 1: Lie flat on the back. Bend the knees, placing the soles of the feet flat on the floor with the heels touching the buttocks.
The feet and knees may be hip width apart. Grasp the ankles with the hands. This is the starting position.
Step 2: Raise the buttocks and arch the back upward. Raise the chest and navel as high as possible without straining, pushing the chest up towards the chin and head, but without moving the position of the feet or shoulders. Keep the feet flat on the floor.
Step 3: In the final position, the body is supported by the head, neck, shoulders, arms and feet. Hold the pose for as long as is comfortable and then lower the body to the starting position. Release the ankles and relax with the legs outstretched. Practice 5 to 10 rounds.
Boat pose (Naukasana)
Step1: Lie flat on your back. Keep your eyes open throughout.
Step2: Inhale deeply. Hold the breath and then raise the legs, arms, shoulders, head and trunk off the ground. The shoulder and feet should be no more than 15 cm off the floor. Balance on buttocks. Keep the spine straight. The arms should be held at the same level as toes. Hands should be open with the palms down. Look towards the toes.
Step 3: Remain in the final position and hold the breath.
Step 4: Breathe out and return to the supine position. Be careful not to injure the back of the head while returning to the floor. Relax the whole body.
Leg lock pose (Supta pawanmuktasana)
Step1: Lie flat on your back.
Step2: Bend both knees and bring the thighs to the chest.
Step 3: Interlock the fingers and clasp the hands just below the knees. Inhale deeply
Step 4: Exhaling, raise the head and shoulders and try to place the nose in the space between the two knees
Step 5: Hold here for a few seconds.
Step 6: While slowly inhaling, return to the base position and relax.
Do not perform in case of high blood pressure or serious back conditions such as sciatica and slipped disc.
Pranayama (Breathing practice)
Frontal brain cleansing breath (Kapalbhati)
Step 1: Sit in a comfortable meditation asana. The head and spine should be straight with the hands resting on the knees in either chin or jnana mudra.
Close the eyes and relax the whole body.
Step 2: Exhale through both nostrils with a forceful contraction of the abdominal muscles. The following inhalation should take place passively by allowing the abdominal muscles to relax. Inhalation should be a spontaneous recoil, involving no effort.
Step 3: After completing 10 rapid breaths in succession, inhale and exhale deeply. Allow the breath to return to normal. This is one round. Practise up to 5 rounds.
Yoga For Weight Loss
As mentioned earlier, obesity is not a certain symptom of PCOS, some people might get obese due to PCOS, some might not but there is still a close association of these two. Apart from being a symptom, obesity also contributes as an underlying cause for PCOS. Obesity is based on the excess body weight which is very strenuous on body systems and develops many serious metabolic disorders and also, mental disorders.
Researches have shown that obese women with PCOS had significantly elevated basal and post- glucose-load insulin levels, compared to weight-matched control women. It is very important to maintain a healthy weight to avoid the worsening of PCOS and making it hard for us to recover. The science of weight loss is based on calorie deficit, hence, regular practice of yoga along with a good and sustainable yogic diet helps us maintain a healthy weight and also avoid overwhelming stress and mental disorders which become a hindrance in maintaining our physical health.
Yoga For Overall Health
By now, we have understood that PCOS can create a vicious cycle and eventually cling to our whole body. It is very important to keep ourselves healthy and nourished to not just prevent and manage PCOS but also any such severe disorder. It is important to practice yoga 3-5 days a week for overall health and especially to cope with our stressful lifestyle which nowadays is the root cause for our unhealthy lifestyle.
Yoga is not just limited to asanas (postures), it also includes pranayama (breathing practice), shatkarma (cleansing practices), dhyana (meditation), mitahara (moderate eating) etc. Every yogic practice has its own benefit and when practice altogether maximizes the effectiveness of yoga on our health.
- Eat healthy
- Do some sort of exercise daily.
- Sleep for 7-8 hours during the same time daily.
- Reduce your sugar intake.
- Get general body checkup done regularly.
- Focus on the possible causes rather than just the symptoms.
- Bring lifestyle changes.
- Give yourself positive surroundings.
- Cut off toxicity from around you to avoid stress.
- Lastly, know that you are not alone and you are capable of creating a better life for you.
FAQs (Frequently asked questions) on PCOS
What is the main cause of PCOS?
There are many causes for PCOS, the most commonly recognised causes are hyperandrogenism I.e higher than normal level of the male hormones called androgens, insulin resistance I.e ineffectiveness of the hormone called insulin which breaks down glucose in our body and genetics.
Is PCOS a serious problem?
Yes, PCOS is relatively a very serious problem and requires proper medical attention and treatment. It affects our whole body in many ways and eventually causes very severe disorders like infertility, obesity, many psychological factors, cardiovascular disorder, type 2 diabetes etc.
Can PCOS go away?
Unfortunately, it is said that PCOS is not curable like diabetes. It can show symptoms even after menopause. Although, it is highly manageable. If PCOS is managed in the right way, you can have bare minimum symptoms and go on without even getting into notice. There are many ways to manage PCOS including practicing yoga frequently and following a healthy and sustainable diet. Making better lifestyle choices helps.
Can PCOS go away with weight loss?
PCOS doesn’t really go away but losing weight significantly manages PCOS if done in a healthy and sustainable manner. Obesity is the cause of many metabolic disorders and losing weight helps restore the hormonal imbalance and functioning of the body systems.
What happens if PCOS is left untreated?
As PCOS is a serious disorder, it has to be given medical attention and treatment because if not managed, it can lead to a very severe situation and can be hazards for the body. It causes mental disorders like anxiety and depression. It disrupts the menstrual cycle and causes infertility. It can go as severe as causing type diabetes, cardiovascular diseases and obesity.
How do I know if you have PCOS?
There are many ways of diagnosing PCOS. You have to have more than one symptom to be diagnosed with PCOS, the symptoms have to be hyperandrogenism, insulin resistance and irregular menstrual cycle.
Can a person have regular periods?
Yes, there are chances that you might have a regular menstrual cycle. The cycle could go on for longer days than normal and all the bleeding could be heavier. Although, usually women with PCOS have an irregular menstrual cycle.
At what age does PCOS start?
PCOS can start at a early pubertal age that is 11 or 12 year old as soon as the first menstrual cycle starts and can go on even after menopause.
Can I get pregnant with PCOS?
Yes, there are chances that you can get pregnant with PCOS although it is very hard to conceive with PCOS as infertility is one of the main symptoms of PCOS but with medical help and management of PCOS, women can conceive.
Conclusion on Yoga For PCOS
PCOS is a syndrome consisting of a lot of symptoms and the general treatment also is symptomatic so relying just on pills would never work until you focus on your overall health. Including some sort of exercise is a necessity in such a situation. It is much more severe than we can imagine, hence, if we don’t immediately take measures to prevent and manage PCOS and rescue ourselves from the vicious circle worsening our health, we can lead to many hazards to our health. Whereas, a few lifestyle changes like adding yoga to your routine and consuming yogic diet can save us from reaching that severity.
References and Further Reading Mehta, A. PCOD/PCOS–Problems, Symptoms, Solutions.
 Asana Pranayama Mudra Bandha by Swami Satyananda Saraswati
 Yogic management of common diseases by Dr. Swami Karmananda
 Venkatesan, A. M., Dunaif, A., & Corbould, A. (2001). Insulin resistance in polycystic ovary syndrome: progress and paradoxes. Recent progress in hormone research, 56, 295-308.
 Kuchipudi, P. Difference between PCOD and PCOS.
 Cabrall, J. PCOS explained: what happens in your body when you don’t ovulate.
 PCOS: Americanpregnancy.org
 PCOS Symptoms: Maple leaf medical center
 Asanas: Asana Pranayama Mudra Bandha
 Pranayama: Apnitricity.com