A review on the therapeutic potential of Madhukadi charmalepa in managing hyperandrogenism-associated dermatological manifestations of Polycystic Ovary Syndrome

Samarawickrama B.S.1* and Karunagoda K.P.K.R.2

Abstract

Polycystic ovary syndrome (PCOS) is a metabolic, reproductive, and psychological disorder affecting 6– 20% of reproductive-age women world wide. Hirsutism, Acne, and Acanthosis nigricans are common hyperandrogenism features in PCOS that significantly impact the mental health and well-being of young women. In Ayurveda, this condition correlates with Arthava kshaya according to Susrutha Acharya and Pushpagni Jathaharani according to Kasyapa Samhitha. This comprehensive review analyzes the pharmacological properties of the ingredients in Madhukadi charmalepa, a traditional Ayurvedic formulation used at the National Ayurveda Hospital, Borella, to treat the hyperandrogenic features of PCOS. The components of Madhukadi charmalepa include Nelumbo nucifera, Terminalia chebula, Santalum album, Coscinium fenestratum, Glycyrrhiza glabra, Curcuma zedoaria and bee honey. Relevant literature was sourced from PubMed, Google Scholar, and classical Ayurvedic texts, with inclusion criteria focusing on research published between 2015 to June 2025.The findings indicate that these ingredients exhibit potent pharmacological properties, including anti-inflammatory, antioxidant, anti-acne, antiandrogenic, and skin rejuvenating effects. Specific biological actions such as estrogenic and androgensuppressing properties, wound healing, collagenenhancement, and antimicrobial activity contribute to alleviating PCOS related dermatological symptoms.

Ayurvedic attributes such as Tridoshaghna, Kustaghna, Varnya, and Rasayana further support the formulation's efficacy. The review concludes that the ingredients of Madhukadi charmalepa possess the potential to counteract facial hyperandrogenism in PCOS patients. A clinical study is recommended to scientifically validate these findings.