Journal name: World Journal of Pharmaceutical Research
Original article title: Concept of kashtartava
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Subtitle: perspectives of ayurveda and modern science
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Dr. Upasana Sharma and Dr. Sushila Sharma
World Journal of Pharmaceutical Research:
(An ISO 9001:2015 Certified International Journal)
Full text available for: Concept of kashtartava
Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research
Doi: 10.20959/wjpr20194-14527
Copyright (license): WJPR: All rights reserved
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Summary of article contents:
Introduction
Primary dysmenorrhea is a common gynecological condition that affects a significant percentage of menstruating women, particularly during their adolescence. Defined as painful menstruation that severely limits daily activities without any identifiable pelvic pathology, its prevalence ranges from 25% to 90%. Despite its high occurrence, dysmenorrhea often remains underdiagnosed and poorly treated in both healthcare settings and self-management practices. This review aims to correlate the traditional Ayurvedic understanding of a condition referred to as "Kashtartava" with modern interpretations of primary dysmenorrhea.
Concept of Kashtartava
"Kashtartava" can be interpreted as a state in which menstruation (Artava) occurs with great difficulty or pain. Though the term itself is not explicitly found in classical Ayurvedic texts, its implications are discernible through various disease descriptions that present with similar symptomatology. Ayurvedic literature provides several references indicating that painful menstruation may stem from various disorders, particularly those related to vitiation of the Vata dosha. This emphasizes the need for a nuanced understanding of Kashtartava not merely as a symptom but as a distinct disease entity corresponding with the modern classification of primary dysmenorrhea.
Correlation of Ayurvedic Disorders with Dysmenorrhea
Several Ayurvedic conditions are identified as having symptoms correlating with primary dysmenorrhea, including Vatala, Udavartini, and Suchimukhi. For instance, Udavartini manifests as significant pain at the onset of menstruation with relief following menstrual discharge, closely mirroring the characteristics of primary dysmenorrhea. Similarly, conditions like Vataja Artavadushti and Artavakshaya highlight the correlation between Vata vitiation and painful menstruation. Clinical features associated with these disorders frequently emphasize pain without concurrent pelvic pathology, reinforcing their relevance to the modern understanding of menstrual pain.
Nidana and Its Role
The etiological factors for Kashtartava, as outlined in Ayurvedic texts, include various lifestyle and dietary habits that aggravate the Vata dosha. Factors such as irregular eating habits, excessive exercise, and high-stress levels contribute to Vata imbalances, leading to dysmenorrhea. Acharyas note the role of Mithya Chara (improper lifestyle) and Dusta Artava (vitiated menstrual blood) in the onset of pain, which can be parallelly observed in the increased prostaglandin release during menstruation seen in modern medicine. A proper understanding of these etiological factors aids in recognizing the multifaceted nature of primary dysmenorrhea.
Conclusion
In conclusion, there is a significant relationship between the Ayurvedic concept of Kashtartava and the modern medical understanding of primary dysmenorrhea. The similarities in symptoms, particularly concerning Vata imbalances and the nature of pain, position Kashtartava as a useful framework for enhancing the diagnosis and treatment of dysmenorrhea. Recognizing these connections aids in bridging traditional Ayurvedic practices with contemporary gynecological healthcare, emphasizing the importance of integrated approaches to women's health issues. Further research is essential to explore these correlations and improve management strategies for painful menstruation effectively.
FAQ section (important questions/answers):
What is primary dysmenorrhea and its prevalence among women?
Primary dysmenorrhea is painful menstruation affecting 25 to 90% of women, particularly adolescents. It often leads to incapacitation in daily activities, yet remains poorly treated by health professionals and often accepted as normal by women.
How does Ayurveda describe the condition of Kashtartava?
Kashtartava, meaning difficult menstruation, is not explicitly mentioned in ancient texts but can be inferred from symptoms described. It is correlated with primary dysmenorrhea through its clinical features and noted as a separate disease entity.
What factors are involved in the etiology of dysmenorrhea?
The etiology of primary dysmenorrhea is unclear but includes excess prostaglandin secretion from the endometrium, leading to increased uterine contractions, reduced blood flow to the uterus, and heightened peripheral nerve hypersensitivity.
What are the main symptoms of primary dysmenorrhea?
Symptoms include intense cramps starting before or just after menstruation, typically lasting 48 to 72 hours. Associated symptoms can include fatigue, nausea, and backache, caused by the release of prostaglandins affecting smooth muscles.
How does the Ayurvedic concept of Vata relate to dysmenorrhea?
Ayurveda attributes primary dysmenorrhea to the vitiation of Vata, specifically Apanavayu, leading to painful menstruation. Conditions classified under dysmenorrhea have pain as a major symptom and can be correlated to Vata imbalances.
Are there any distinct differences between primary and secondary dysmenorrhea?
Primary dysmenorrhea occurs without identifiable pelvic pathology, while secondary dysmenorrhea is linked to conditions such as fibroids or endometriosis. Symptoms of primary are primarily pain-related, whereas secondary may involve other systemic symptoms.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Concept of kashtartava”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Dysmenorrhea (Dysmenorrhoea):
Dysmenorrhoea is a medical term often used interchangeably with dysmenorrhea, denoting painful menstrual cramps without identifiable pelvic pathology. The clinical implications highlight the importance of addressing this condition to improve the quality of life and mitigate its debilitating effects on women.
2) Pain:
Pain is a fundamental symptom of many medical conditions, including primary dysmenorrhea. In the context of menstruation, pain can manifest as cramping, which may be sharp or dull, and can radiate to other parts of the body. Understanding pain is essential to address its quality, intensity, and impact on life.
3) Disease:
Diseases encompass a range of health conditions classified based on their symptoms, causes, and effects. In women's health, various diseases such as primary dysmenorrhea, artavakshaya, and others echo the complexity of menstrual health, necessitating a clear classification and understanding within Ayurvedic and modern medical frameworks.
4) Kashtartava (Kastartava, Kashta-artava):
Kashtartava, derived from Ayurveda, signifies difficult or painful menstruation. While not explicitly mentioned in ancient texts, it encapsulates symptoms that correlate with primary dysmenorrhea, highlighting the Ayurvedic understanding of women's health issues and their holistic treatment within traditional medicine.
5) Vata:
Vata is one of the three doshas in Ayurveda, representing movement and activity within the body. It is responsible for governing bodily functions related to rhythm and flow, including menstruation. A vitiation of Vata is often linked to discomfort and painful menstruation in Ayurvedic practice.
6) Dosha (Dosa):
Dosha is a fundamental concept in Ayurveda signifying the three vital energy principles that govern physical and psychological processes: Vata, Pitta, and Kapha. imbalances in these doshas can lead to disease, including conditions like kashtartava, affecting menstrual health and overall wellbeing.
7) Sharman (Sarma, Sharma, Sarman):
Sharma is the last name of the authors of the study who explore the connections between Ayurvedic principles and modern understandings of dysmenorrhea. Their work contributes to the academic discourse on women's health by bridging traditional practices with contemporary scientific insights.
8) Ayurveda (Ayus-veda):
Ayurveda is an ancient system of medicine originating from India that emphasizes holistic health and balance among body systems. It offers insights into women's health issues, such as dysmenorrhea, through concepts like dosha and emphasizes the integration of lifestyle and diet for disease management.
9) Artava:
Artava translates to menstruation in Ayurveda, and it refers to the female reproductive cycle's regularity and health. Understanding artava is pivotal for diagnosing and treating gynecological issues like dysmenorrhea, as it highlights the menstrual flow's characteristics and overall female reproductive health.
10) Life:
Life encompasses the vitality, experience, and health of individuals. In the context of women's health, conditions like dysmenorrhea can significantly impact a woman's life quality, underlining the necessity for effective treatment strategies to manage symptoms and maintain well-being.
11) Rajasthan:
Rajasthan is a state in India where the authors of the study are affiliated with Ayurvedic institutions. The cultural and traditional aspects of Rajasthan play a critical role in the understanding and application of Ayurvedic practices in addressing women's health issues.
12) Nidana:
Nidana refers to the causative factors or reasons leading to disease in Ayurveda. Identifying the nidana associated with conditions like kashtartava is essential for effective treatment and management strategies. It emphasizes the importance of diet, lifestyle, and other influences on women's health.
13) Vataja (Vata-ja):
Vataja refers to conditions arising specifically from vitiated Vata dosha. This is particularly relevant in gynecological health where imbalances in Vata may lead to painful menstruation, underlining the Ayurvedic perspective on treatment through restoring balance in this dosha.
14) Roga:
Roga translates to disease or disorder in Ayurveda. Studying roga emphasizes the need to understand symptoms, root causes, and treatments, particularly regarding gynecological conditions like kashtartava, to promote better health outcomes for women.
15) Yoni (Yonin):
Yoni refers to the female reproductive system in Ayurveda. An understanding of yoni health is essential for diagnosing and treating gynecological issues, including dysmenorrhea, as it involves various physiological and hormonal functions central to women's health.
16) Striroga (Stri-roga):
Stri-roga is a term in Ayurveda that signifies women's diseases. It encompasses a wide range of gynecological disorders, including dysmenorrhea, focusing on the unique aspects of women's health and the importance of addressing these conditions in a holistic manner.
17) Vitiation (Vitiated):
Vitiated refers to the disruption or imbalance within the doshas that lead to disease. Recognizing vitiated states is fundamental in Ayurveda for diagnosing conditions like dysmenorrhea and crafting treatments aimed at restoring balance.
18) Prasuti:
Prasuti relates to conception, pregnancy, and childbirth in Ayurveda. Understanding prasuti is essential for holistic women's health, emphasizing the importance of proper menstrual health, including conditions like dysmenorrhea, in supporting reproductive functions.
19) Ruksha (Ruksa):
Ruksha translates to dry in Ayurveda, often describing dietary qualities that can aggravate Vata dosha. This understanding aids in managing conditions like dysmenorrhea by balancing the qualities of food and lifestyle to prevent excessive vitiation of Vata.
20) Blood:
Blood is a vital body fluid and key component of the reproductive health cycle. In menstruation, the characteristics and quality of blood play significant roles in identifying and understanding conditions like dysmenorrhea and associated gynecological disorders.
21) Hetu:
Hetu refers to the causes or factors that contribute to health issues in Ayurveda. Identifying the hetu for dysmenorrhea allows for targeted interventions, including lifestyle adjustments and dietary modifications to improve menstrual health and alleviate symptoms.
22) Rasa (Rasha):
Rasa means taste or essence in Ayurveda and represents the fundamental qualities of food that affect bodily functions. Understanding rasa is crucial in formulating diets that support overall health and prevent disorders like dysmenorrhea through balanced nutritional intake.
23) Food:
Food is essential for maintaining health and balance within the body. In Ayurveda, the quality, quantity, and timing of food consumption can significantly affect conditions like dysmenorrhea. Proper dietary practices can alleviate symptoms and promote overall well-being.
24) Inflammation:
Inflammation is a biological response to harmful stimuli and can manifest in various conditions, including menstrual disorders. Understanding inflammation's role in dysmenorrhea helps discern between primary and secondary forms, impacting treatment approaches in both modern and Ayurvedic frameworks.
25) Garbhashaya (Garbhasaya, Garbha-ashaya):
Garbhashaya is a term referring to the womb or uterus in Ayurveda. A clear understanding of garbhashaya is crucial for diagnosing and treating conditions affecting menstruation and reproductive health, highlighting the importance of uterine health in addressing dysmenorrhea.
26) Vatadosha (Vatadosa, Vata-dosha):
Vata-dosha is one of the primary doshas in Ayurveda that represents movement, energy, and dynamics within the body. When Vata-dosha is imbalanced, it can lead to symptoms like pain during menstruation, highlighting its relevance in conditions like dysmenorrhea.
27) Asrigdara (Asrgdara, Asrij-dara):
Asrigdara refers to excessive bleeding or abnormal menstrual flow in Ayurveda. Recognizing asrigdara as a potential symptom alongside dysmenorrhea allows for a comprehensive understanding of women's health issues, leading to better diagnosis and treatment outcomes.
28) Samprapti:
Samprapti refers to the pathogenesis or progression of disease in Ayurveda. Understanding samprapti for conditions like dysmenorrhea provides insights into underlying mechanisms, guiding effective treatment strategies that restore balance and health in the female reproductive system.
29) Vagbhata:
Vagbhata is an ancient Ayurvedic scholar whose texts contribute significantly to women's health knowledge. His teachings emphasize the importance of understanding gynecological disorders, including dysmenorrhea, through a holistic lens, integrating lifestyle, diet, and body constitution.
30) Udavarta:
Udavarta is a term used in Ayurveda relating to retrograde movement of Vata, affecting menstrual health. It provides context for conditions like dysmenorrhea, where vitiation of Vata may lead to painful menstruation and other associated symptoms.
31) Activity:
Activity refers to physical or mental exertion that can influence health outcomes. In the context of women's health, certain physical activities can exacerbate conditions like dysmenorrhea. Hence, appropriate management strategies are essential to balance activities with rest.
32) Bleeding:
Bleeding is a critical component of menstruation, where the shedding of the uterine lining occurs. Understanding the nature and characteristics of bleeding patterns helps diagnose conditions like dysmenorrhea, contributing to comprehending women's health dynamics.
33) Upasana:
Upasana is the name of one of the authors of the study that connects Ayurvedic practices with modern gynecology. Her work is significant in bridging traditional understanding with contemporary medical practices for managing women’s health issues.
34) Samanya:
Samanya refers to generalities or common factors in Ayurvedic diagnosis. It emphasizes identifying shared underlying causes of conditions like dysmenorrhea, facilitating a holistic approach to treatment that addresses root issues effectively.
35) Sevana:
Sevana refers to actions or practices, particularly concerning lifestyle and health. In Ayurveda, proper sevana encompasses healthy habits that support menstrual health and may alleviate conditions like dysmenorrhea, promoting overall well-being.
36) Dushya (Dusya):
Dushya refers to the substance affected by the disease in Ayurveda. Identifying dushya in menstrual disorders helps in understanding the body's response to treatments and guides practitioners in restoring balance to rectify dysmenorrhea.
37) Sthana:
Sthana refers to the site or location of a problem in the body. In the context of gynecological issues, understanding the sthana of conditions affecting menstruation can target treatment approaches accurately towards areas that require intervention.
38) Mithya:
Mithya signifies incorrect or improper practices in Ayurveda. It includes lifestyle choices that can exacerbate health conditions like dysmenorrhea, emphasizing the need for dietary and behavioral modifications for better management.
39) Kshina (Ksina):
Kshina denotes weakness or deficiency in Ayurvedic terms. Often associated with vitiated doshas, recognizing kshina states is essential in treating conditions like dysmenorrhea, indicating a need for restorative practices to regain health balance.
40) Nature:
Nature refers to the intrinsic qualities and dynamics of health and wellness. In Ayurveda, understanding the nature of an individual's constitution is fundamental for personalized treatment strategies addressing conditions like dysmenorrhea.
41) Khara:
Khara means rough or harsh in Ayurveda, often related to qualities that may aggravate Vata dosha. Recognizing khara elements in lifestyle and food choices is central to preventing or alleviating conditions like dysmenorrhea.
42) Pitta:
Pitta is one of the three doshas representing transformation and metabolism in the body. While Vata is often implicated in dysmenorrhea, Pitta's involvement may be considered in cases where inflammation or heat-related symptoms are present in gynecological disorders.
43) Rakta:
Rakta refers to blood in Ayurveda, essential for nourishment and function in the body. Understanding rakta quality and balance is critical in addressing menstrual disorders like dysmenorrhea, as it impacts overall reproductive health.
44) Ahara:
Ahara means food in Ayurveda and has a pivotal role in health management. The quality, types, and timing of ahara directly influence bodily functions and may either exacerbate or alleviate conditions like dysmenorrhea.
45) Apana:
Apana is a sub-vata responsible for downward movement in the body, including menstruation. Understanding apana's functions provides insights into managing painful conditions like dysmenorrhea by restoring its balance and promoting healthy menstrual flow.
46) Fever:
Fever refers to an elevated body temperature often indicating an underlying infection or disease. In the context of dysmenorrhea, a fever may suggest secondary dysmenorrhea, warranting a more thorough medical evaluation to identify possible pelvic pathology.
47) Bija:
Bija refers to the seed or root cause, often relating to genetic factors influencing health conditions. Understanding bija aids Ayurvedic practitioners in addressing underlying issues that contribute to dysmenorrhea and other menstrual disorders.
48) Guna:
Guna denotes the qualities or characteristics of substances and energies in Ayurveda. Recognizing the gunas of food and lifestyle helps in designing treatment plans to balance doshas and mitigate conditions like dysmenorrhea.
49) Diet:
Diet plays a crucial role in Ayurveda for maintaining health and preventing disease. Specific dietary recommendations tailored to balance doshas can greatly assist women dealing with dysmenorrhea, emphasizing the relationship between nutrition and menstrual health.
50) Menstrual blood:
Menstrual blood is the shedding of the uterine lining and is crucial for assessing menstrual health. Analyzing the quality, quantity, and characteristics of menstrual blood provides insight into gynecological conditions like dysmenorrhea and indicates overall reproductive system health.
51) Young women (Young woman):
Young women often face unique health challenges, including menstrual disorders like dysmenorrhea. Understanding their specific health needs is vital for effective treatments, supporting their well-being and promoting a better quality of life during critical developmental phases.
52) Sthanasamshraya (Sthanasamsraya, Sthana-samshraya):
Sthana-samshraya pertains to the location of disease manifestation in Ayurveda. Identifying sthana-samshraya assists in diagnosing and treating conditions like dysmenorrhea by focusing on affected bodily areas, guiding therapeutic interventions effectively.
53) Amapakvashaya (Amapakvasaya):
Amapakvashaya explains the concept of the body’s receptacle for impurities or toxins. In cases of dysmenorrhea, addressing ama can help in detoxifying the body, which may alleviate painful symptoms by restoring proper balance.
54) Vishamashana (Visamasana, Vishamasana):
Vishamashana refers to irregular eating habits, which can disturb the body's doshic balance. In the management of dysmenorrhea, correcting vishamashana can support overall health improvements and symptom alleviation in menstrual disorders.
55) Madhavakara:
Madhavakara is a prominent figure in Ayurvedic literature whose contributions significantly enriched the field. His insights on diseases and treatments in women's health remain relevant, particularly in understanding and managing conditions like dysmenorrhea.
56) Apanavata (Apana-vata):
Apana-vata is a subtype of Vata that governs downward movement, including menstruation. Understanding the role of apana-vata in women's health is crucial for managing conditions like dysmenorrhea, as its balance is essential for normal menstrual flow.
57) Jatharagni (Jathara-agni):
Jatharagni refers to the digestive fire in Ayurveda, responsible for the metabolism and assimilation of food. A well-functioning jatharagni supports overall health, which is crucial for addressing menstrual disorders such as dysmenorrhea and maintaining proper nutritional balance.
58) Discussion:
Discussion refers to the examination of findings and interpretations within a study. In the context of dysmenorrhea, discussion facilitates critical insights into the symbiotic relationship between Ayurvedic practices and modern medicine, underscoring the need for integrated health approaches.
59) Apanavayu (Apana-vayu):
Apanavayu is specifically responsible for downward movements, playing a pivotal role in the menstrual cycle. Maintaining balanced apanavayu is essential for alleviating painful menstruation, as its correct functioning supports the body in expelling menstrual fluid effectively.
60) Adarshana (Adarsana):
Adarshana denotes ideal or standard conditions. In the context of health, adhering to adarshana principles aids in preventing disorders like dysmenorrhea by promoting healthy practices that align with Ayurvedic teachings.
61) Stiffness:
Stiffness is a symptom that may accompany dysmenorrhea, reflecting muscle tension and discomfort. Recognizing stiffness helps in managing menstrual pain effectively through targeted therapies such as stretching and relaxation techniques.
62) Tridosha (Tridosa, Tri-dosha):
Tridosha represents the balance of the three doshas: Vata, Pitta, and Kapha. Understanding their interactions is fundamental in Ayurveda for diagnosing and treating conditions, including menstrual disorders, where imbalances often lead to painful symptoms.
63) Upadhatu:
Upadhatu refers to the secondary tissues or interfaces in Ayurveda. The understanding of upadhatu is important in diagnosing menstrual disorders, including dysmenorrhea, as it highlights the interconnectedness of bodily systems and their responses to treatments.
64) Lakshana (Laksana):
Lakshana means symptoms or characteristics of a disease in Ayurveda. Understanding the lakshana associated with different conditions allows practitioners to accurately diagnose and tailor treatments for menstrual disorders like dysmenorrhea.
65) Pradhana:
Pradhana denotes primary or principal factors in Ayurvedic diagnosis. Identifying the pradhana features in a condition like dysmenorrhea allows for focused treatment strategies that address the most significant aspects of the disorder.
66) Raktagni (Rakta-agni):
Raktagni is associated with the blood-digestive fire in Ayurveda, emphasizing the role of blood quality in overall health. Understanding raktagni is essential for treating menstrual disorders, guiding practitioners in ensuring healthy blood flow during menstruation.
67) Maithuna:
Maithuna refers to sexual intercourse in Ayurveda. Insights into maithuna are crucial for understanding reproductive health, particularly how it relates to menstrual function and conditions like dysmenorrhea, influencing a woman’s overall well-being.
68) Vomiting:
Vomiting may accompany dysmenorrhea as a systemic symptom due to elevated prostaglandins. Recognizing in the context of dysmenorrhea provides a holistic view of the condition, prompting further investigation into underlying causes and effective management.
69) Fainting (Fainted):
Fainting can occur as a response to severe pain associated with dysmenorrhea, indicating the need for comprehensive care that addresses pain management and overall health support during menstruation. Understanding this relationship can lead to more effective treatment protocols.
70) Samhita:
Samhita represents the aggregated knowledge in Ayurvedic texts regarding health and disease. Delving into samhita literature offers essential insights into understanding conditions like dysmenorrhea and their treatments, combining age-old wisdom with modern medical understanding.
71) Bhojana:
Bhojana means food consumption in Ayurveda. The principles of bhojana are crucial for maintaining health, particularly in managing menstrual disorders through balanced nutrition that supports overall well-being and mitigates symptoms.
72) Purusha (Purusa):
Purusha signifies the human being or individual in Ayurveda. Each purusha has unique constitution and health needs, necessitating personalized approaches to managing conditions like dysmenorrhea based on their specific characteristics.
73) Pittala:
Pittala refers to conditions associated with Pitta dosha. Although primarily vata is implicated in dysmenorrhea, understanding pittala aspects helps address secondary symptoms related to heat or inflammation in menstruation, promoting comprehensive health management.
74) Vyayama:
Vyayama means exercise in Ayurveda. Recognizing the significance of vyayama emphasizes the need for maintaining physical health, which can impact menstrual function, providing distinct strategies for alleviating symptoms related to dysmenorrhea.
75) Ranjaka (Ramjaka):
Ranjaka refers to the aspect of Pitta dosha related to blood purification and quality. Understanding ranjaka is essential for managing menstrual health, as it influences the characteristics and health of menstrual blood, tying it back to conditions like dysmenorrhea.
[Note: The above list is limited to 75. Total glossary definitions available: 112]
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