Amenorrhoea – an ayurveda perspective

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Journal name: World Journal of Pharmaceutical Research
Original article title: Amenorrhoea – an ayurveda perspective
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Author:

Prof. Dr. Jasmine Gujarathi and Dr. Ritesh Gujarathi


World Journal of Pharmaceutical Research:

(An ISO 9001:2015 Certified International Journal)

Full text available for: Amenorrhoea – an ayurveda perspective

Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research

Doi: 10.20959/wjpr201818-13545


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Summary of article contents:

Introduction

Amenorrhoea, the absence of menstruation, is not classified as a disease but rather a symptom indicative of underlying disorders within the female reproductive system. In Ayurveda, menstruation is denoted by terms such as Artava or Rajah, with amenorrhoea referred to as Anartava, Nashtartava, or Artavakshaya. The literature on amenorrhoea in Ayurveda provides an extensive overview of its physiological and pathological causes, categorizing it into primary and secondary types. Primary amenorrhoea occurs in individuals who do not menstruate by specific ages, while secondary amenorrhoea is characterized by the absence of menstruation for three normal cycles or six months after established menstrual cycles.

Physiological Causes of Amenorrhoea

One significant aspect of amenorrhoea is its physiological classification, which encompasses primary and secondary types. Primary physiological amenorrhoea is seen in individuals who have not commenced menstruation by age 16, while secondary physiological amenorrhoea typically manifests during pregnancy and lactation due to hormonal changes that suppress menstruation. During pregnancy, increased levels of estrogen and progesterone prevent menstruation, categorized under physiological amenorrhoea. Additionally, menopause marks another stage of physiological amenorrhoea, characterized by the complete cessation of menstruation typically around the age of 51, due to the depletion of ovarian follicles.

Pathological Causes of Amenorrhoea

Pathological amenorrhoea includes a spectrum of disorders that affect the female reproductive system, which can be classified into primary and secondary forms. Primary pathological amenorrhoea arises from congenital abnormalities of the reproductive system, often related to genetic conditions such as Turner’s syndrome, where individuals may exhibit underdeveloped secondary sexual characteristics. Secondary pathological amenorrhoea can be induced by various factors, including systemic disorders, nutritional issues, or conditions like polycystic ovarian disease (PCOD). Ayurvedic texts identify numerous disorders like Vandhya and Shandhi that are linked to pathological amenorrhoea and elucidate their underlying etiologies.

Ayurvedic Treatment Approaches to Amenorrhoea

Ayurvedic treatment for amenorrhoea is multi-faceted, targeting both the symptomatic alleviation and underlying causes of the disorder. Key therapeutic approaches include panchakarma, such as Vamana (emesis) and Virechana (purging), to balance doshas, particularly Vata and Kapha, which are often implicated in amenorrhoea. Additionally, Uttarbasti, a specialized intrauterine therapy, has shown promising results in regulating menstrual cycles and enhancing endometrial health. The integration of herbal formulations, dietary changes, and lifestyle modifications also plays a crucial role in the holistic management of amenorrhoea, further illustrating the efficacy of Ayurvedic practices.

Conclusion

Ayurveda offers a comprehensive understanding of amenorrhoea by delineating its physiological and pathological causes, while also providing effective treatment modalities. Through the application of targeted therapies, including panchakarma and Uttarbasti, alongside dietary and lifestyle interventions, Ayurvedic medicine demonstrates its potential in addressing amenorrhoea and related reproductive disorders. Further research and clinical studies focusing on the effectiveness of various Ayurvedic treatments can contribute to a deeper understanding and broader acceptance of these ancient practices in modern healthcare settings.

FAQ section (important questions/answers):

What is amenorrhoea and how is it classified?

Amenorrhoea refers to the absence of menstruation. It can be classified into primary amenorrhoea, which occurs when a girl fails to menstruate by age 16, and secondary amenorrhoea, where menstruation stops for three cycles or six months in women with previously regular cycles.

What are the physiological causes of amenorrhoea?

Physiological causes include primary amenorrhoea before puberty, amenorrhoea during pregnancy or lactation, and menopause, which is the natural cessation of menstruation around age 51 due to the exhaustion of ovarian follicles.

What are the pathological causes of amenorrhoea?

Pathological amenorrhoea has various causes, including hormonal imbalances, structural abnormalities in reproductive organs, genetic disorders like Turner’s syndrome, and stress or nutritional deficiencies affecting menstrual function.

How does Ayurveda classify amenorrhoea causes?

Ayurveda classifies amenorrhoea according to its origin and etiology, distinguishing between physiological causes like pregnancy and menopause, and pathological causes linked to anatomical and functional disorders of the female reproductive system.

What Ayurvedic treatments are used for amenorrhoea?

Ayurvedic treatments include therapies for Vata and Kapha dosha balance, Panchakarma procedures, herbal formulations, Yoga basti with Shatpushpa tail, and dietary adjustments to restore menstrual functions and address underlying health issues.

What is the significance of endometrial thickness in amenorrhoea?

Endometrial thickness is crucial for menstruation. In cases of amenorrhoea, treatments like Uttarbasti with Phalaghrita are used to improve endometrial thickness, aiding in the resumption of normal menstrual cycles.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Amenorrhoea – an ayurveda perspective”. 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) Artava:
Artava refers to menstrual blood and the associated physiological processes in Ayurveda. It is considered an essential indicator of women's health, linking the menstrual cycle to overall well-being. By understanding Artava, Ayurvedic practitioners can diagnose menstrual disorders, manage reproductive health, and implement therapeutic interventions.

2) Kshaya (Ksaya):
Kshaya means depletion or loss, often referring to reduced levels of bodily elements such as Dhatus. In the context of amenorrhoea, Kshaya signifies the absence or scantiness of menstruation due to diminished Artava. Recognizing Kshaya helps identify underlying imbalances influencing menstrual regulation.

3) Anartava:
Anartava denotes amenorrhoea or irregularities in menstrual cycles in Ayurveda. It embodies various causes—physiological and pathological—that can lead to a lack of menstruation. Understanding Anartava allows practitioners to evaluate and treat conditions affecting women's health and menstrual function.

4) Basti:
Basti is an Ayurvedic therapeutic procedure delivering medicated oils or herbal concoctions through the rectum. It is employed to balance the Doshas, particularly Vata, and restore normal function in reproductive health, influencing menstrual cycles and alleviating conditions like Anartava and Kshaya.

5) Dhatu:
Dhatu refers to the fundamental tissues in the body, which are essential for sustaining life and health. The balance of Dhatus, particularly Rasa Dhatu influencing menstruation, is crucial. Kshaya of Dhatus such as Rasa can lead to amenorrhoea and related disorders.

6) Vata:
Vata is one of the three Doshas in Ayurveda, characterized by qualities of movement and communication. It governs physiological processes and when aggravated, can lead to menstrual dysfunction, including amenorrhoea. Managing Vata through diet and therapies is vital in treating related conditions.

7) Rasa (Rasha):
Rasa represents the nutritive fluid derived from digested food, essential for nourishing Dhatus and supporting the body’s vitality. Rasa sustains reproductive health; depletion or imbalance can contribute to Kshaya and amenorrhoea, hence restoring Rasa is part of dhatu-focused treatments.

8) Yoni (Yonin):
Yoni denotes the anatomical aspects of the female reproductive system, including the vagina and uterus in Ayurvedic texts. It encompasses issues related to women's reproductive health and Ayurvedic classifications of disorders that may affect menstrual cycles and fertility.

9) Vandhya (Vamdhya):
Vandhya describes a condition of infertility or inability to conceive, often correlated with amenorrhoea and associated disorders in Ayurveda. Recognizing the signs of Vandhya allows practitioners to explore underlying causes related to Anartava and implement targeted treatments.

10) Dravya:
Dravya refers to substances or medicinal materials used in Ayurvedic treatments. Understanding the properties and effects of various Dravyas is essential for formulating effective therapeutic strategies targeting amenorrhoea and promoting reproductive health.

11) Kapha:
Kapha is one of the three Doshas in Ayurveda, associated with formation and stabilization. When imbalanced, it can lead to reproductive issues, including disturbances in menstrual function. Correcting Kapha through dietary adjustments and therapies is important in reproductive health.

12) Sandhi (Shandhi, Samdhi):
Shandhi refers to a condition or diagnosis related to the development and health of the reproductive organs. It is used to denote abnormalities affecting menstrual function, making it relevant in assessing and treating amenorrhoea and related disorders.

13) Dosha (Dosa):
Dosha represents the dynamic biological energies in Ayurveda—Vata, Pitta, and Kapha—that govern physiological functions. Imbalances of Doshas can lead to health issues, including menstrual irregularities. Understanding Doshas guides treatment approaches for conditions like amenorrhoea.

14) Yoga:
Yoga encompasses various practices aimed at balancing body and mind. In Ayurveda, specific yogic practices can support reproductive health, promote stability in Dodhas, and enhance overall well-being, contributing positively to menstrual function.

15) Garbhashaya (Garbhasaya, Garbha-ashaya):
Garbhashaya refers to the reproductive cavity (uterus) in Ayurveda. It is crucial for conception and menstrual health. Issues in Garbhashaya can lead to disorders like Anartava, making it significant in diagnosing and managing reproductive conditions.

16) Ayurveda (Ayus-veda):
Ayurveda is an ancient system of medicine that emphasizes balance in bodily systems through diet, lifestyle, and herbal remedies. It is integral to diagnosing and treating conditions like amenorrhoea by exploring underlying causes and employing holistic therapies.

17) Krishna (Krsna):
Krishna, in this context, often refers to black sesame seeds, which hold significance in Ayurvedic formulations. These seeds are used to enhance Rasadhatu, promote reproductive health, and mitigate conditions leading to amenorrhoea and Kshaya.

18) Pitta:
Pitta is one of the three Ayurvedic Doshas, linked to transformation and metabolism within the body. An imbalance can cause various reproductive issues, including amenorrhoea, hence its management is essential in restoring menstrual health.

19) Tila:
Tila refers to sesame seeds, a vital component in Ayurveda noted for their nourishing properties. They are often used in treatments aimed at improving Rasa and enhancing reproductive health, thereby playing a role in restoring menstrual functions.

20) Vaha:
Vaha often describes conduits or channels within the body that transport vital elements. In relation to reproductive health, Artava Vaha Srotas pertains to the channels transporting menstrual fluid, important for diagnosing and treating amenorrhoea.

21) Ghrita (Ghrta):
Ghrita signifies clarified butter in Ayurveda, often considered a vital base for many formulations. It is believed to enhance Rasa Dhatu, support reproductive functions, and is a key ingredient in treatments for issues like amenorrhoea and Artava Kshaya.

22) Agneya:
Agneya refers to substances believed to stimulate digestive fire (Agni) in the body, essential for metabolic processes. In treating amenorrhoea, Agneya Dravyas restore balance and promote normal menstrual function by enhancing digestive capabilities.

23) Vamana:
Vamana is a therapeutic purging method in Ayurveda aimed at expelling excess Kapha from the body. It can be beneficial for treating amenorrhoea related to Kapha aggravation, helping to restore balance and regulate menstrual cycles.

24) Nidana:
Nidana refers to the causes or underlying factors of diseases. Identifying Nidana is crucial in Ayurveda, particularly in cases of amenorrhoea, as it guides treatment plans targeting specific imbalances and health concerns.

25) Srotas (Shrotas):
Srotas are the transport channels in the body that facilitate the flow of bodily substances. Understanding the Srotas relevant to reproductive health is essential for diagnosing issues like amenorrhoea, aiding the identification of blockages or imbalances.

26) Shatavari (Satavari):
Shatavari is an Ayurvedic herb known for its revitalizing properties, particularly for women's health. It supports reproductive functions, enhances fertility, and is often used in formulations to address amenorrhoea and other menstrual irregularities.

27) Samhita:
Samhita refers to the classic texts compiling Ayurvedic knowledge and principles. These texts serve as foundational resources for practitioners, guiding the diagnosis and treatment of conditions such as amenorrhoea based on traditional wisdom.

28) Varti (Vartin):
Varti denotes medicated suppositories used in Ayurvedic treatments, particularly those tailored for women's reproductive health. These are used to address various conditions, including amenorrhoea, by targeting local tissues and facilitating healing.

29) Matra:
Matra indicates a specific quantity of herbal substances or formulations administered for therapeutic purposes in Ayurveda. Accurate Matra in treatments is essential for effectiveness in addressing amenorrhoea and related reproductive health issues.

30) Patel:
Patel refers to a specific Ayurvedic institution or research associated with Dr. Jasmine Gujarathi, relevant for studying amenorrhoea in an Ayurvedic context. Thus, it ties to the exploration and clinical assessment of women's reproductive health issues.

31) Study (Studying):
Study signifies the process of researching or analyzing topics—in this case, the investigation of amenorrhoea and its management through Ayurvedic principles and practices. This is essential for advancing knowledge and treatment modalities.

32) Vati:
Vati indicates a formulation or typical dosage form in Ayurveda, often prepared as tablets or pills. It encompasses various herbs and substances aimed at treating issues like amenorrhoea, enhancing overall health and hormonal balance.

33) Vayu:
Vayu represents the element of air in Ayurvedic philosophy, closely related to the Vata Dosha. It governs many bodily functions, and its dysfunction can lead to reproductive health issues such as amenorrhoea, thus requiring careful management.

34) Matra-basti:
Matra-basti refers to a specific type of enema administered for therapeutic purposes in Ayurveda. It plays a crucial role in balancing Vata and restoring normal menstrual function, often applied in cases of amenorrhoea.

35) Rasadhatu (Rasa-dhatu):
Rasadhatu, the vital fluid derived from Digestion, nourishes tissues. It plays a critical role in women's reproductive health; its balance directly affects menstrual regularity, thus understanding Rasadhatu is essential for treating amenorrhoea.

36) Shodhana (Sodhana):
Shodhana denotes detoxification processes in Ayurveda aimed at cleansing the body. It is often a precursor to treatment for amenorrhoea, preparing the system for effective interventions and restoring balance within the bodily systems.

37) Avarodha:
Avarodha refers to obstruction or blockage in Ayurvedic practice, which can impede physiological processes, including menstruation. Identifying Avarodha is crucial in cases of amenorrhoea to facilitate proper therapeutic strategies.

38) Disease:
Disease refers to any deviation from normal physiological function or health. Understanding amenorrhoea as a symptom of underlying conditions helps guide treatment approaches in Ayurveda, addressing the root causes rather than just the symptoms.

39) Vedha:
Vedha refers to trauma or injury in Ayurveda, particularly concerning reproductive health. It highlights conditions or treatments that may affect the menstrual cycle, emphasizing the need to consider past injuries or surgical history in diagnosing amenorrhoea.

40) Nasya (Nashya):
Nasya is an Ayurvedic therapy involving the administration of herbal oils through the nasal passages. It aids in treating conditions through the head and neck, impacting overall health, including reproductive functions, hence its relevance in amenorrhoea treatment.

41) Taila (Thaila):
Taila means oil used in Ayurveda for medicinal purposes. It is significant in various herbal preparations for treating menstrual disorders, enhancing absorption and delivering therapeutic benefits directly to affected tissues.

42) Apana:
Apana is a type of Vayu associated with downward movement in the body, particularly in relation to excretion and reproductive health. Its proper function is crucial for menstruation; imbalances may lead to amenorrhoea.

43) Kayam:
Kayam indicates the body or constitution in Ayurvedic context. Understanding a patient's Kayam assists practitioners in tailoring treatments for amenorrhoea based on individual bio-constitution and health status.

44) Bija:
Bija refers to the seed or source of creation, encompassing genetic and hereditary aspects in Ayurveda. It implies that genetic predispositions can influence reproductive health and potential issues like amenorrhoea.

45) Kalyanakaghrita (Kalyanakaghrta, Kalyanaka-ghrita):
Kalyanaka-ghrita is a specialized Ayurvedic formulation prepared from clarified butter and medicinal herbs, employed to enhance women's health, particularly in regulating menstrual functions and treating disorders such as amenorrhoea.

46) Pravritti (Pravrtti):
Pravritti denotes the initiation or onset of physiological functions, such as menstruation. Understanding the factors influencing Pravritti is vital in addressing conditions like amenorrhoea effectively.

47) Samprapti:
Samprapti means the pathogenesis or development of a disease in Ayurveda. Analyzing the Samprapti of amenorrhoea helps practitioners understand its causes and tailor appropriate treatments.

48) Abhighata:
Abhighata signifies trauma or injury, emphasizing its potential impact on bodily functions and health. In the context of amenorrhoea, it highlights the need to consider personal history of trauma in diagnosing conditions.

49) Kalyanaka:
Kalyanaka refers to well-being or favorable conditions, often used in the context of formulations meant to promote reproductive health, signifying their importance in treating amenorrhoea and related disorders.

50) Dhatvagni (Dhatu-agni):
Dhatvagni represents the metabolic fire specific to each Dhatu, influencing its nourishment and functioning. A balanced Dhatvagni is crucial for maintaining regular menstrual cycles and overall female health.

51) Vartamana:
Vartamana describes the current state or condition of a patient’s health or symptomatology. In treating amenorrhoea, assessing Vartamana is crucial for determining the necessary interventions and expected outcomes.

52) Striroga (Stri-roga):
Stri-roga signifies female-specific disorders in Ayurveda, encompassing a range of conditions affecting women's reproductive health. Understanding Stri-roga facilitates targeted treatment approaches for conditions like amenorrhoea.

53) Prakriti (Prakrti):
Prakriti refers to an individual’s natural constitution, encompassing physical, mental, and emotional characteristics. Incorporating Prakriti assessments informs personalized treatments for amenorrhoea, aligning interventions with individual health profiles.

54) Avarana:
Avarana denotes a cover or obstruction that hinders natural physiological processes. It is a key concept in Ayurveda for understanding causes of amenorrhoea, advocating for treatment strategies that eliminate such obstructions.

55) Vyayama:
Vyayama relates to physical exercise, which, when excessive, can lead to amenorrhoea. Balancing appropriate levels of Vyayama is crucial in regulating menstrual functions and overall reproductive health.

56) Prakopa:
Prakopa signifies an escalation or aggravation of Doshas, which may lead to health issues, including menstrual ailments. Identifying Prakopa allows for targeted treatments to restore balance and support reproductive well-being.

57) Prasuti:
Prasuti refers to childbirth or related reproductive processes. Understanding Prasuti promotes an awareness of conditions like amenorrhoea that may arise during or after pregnancy, guiding appropriate management.

58) Pathadi:
Pathadi signifies a specific herbal formulation in Ayurvedic practice, often employed for therapeutic purposes. It encapsulates vital components used to treat reproductive health issues, including amenorrhoea.

59) Samana (Shamana):
Shamana indicates calming or alleviating treatments in Ayurveda aimed at balancing Doshas. It includes dietary, herbal, and lifestyle modifications critical in addressing conditions like amenorrhoea.

60) Jasmine:
Jasmine refers to the author, Prof. Dr. Jasmine Gujarathi, whose work focuses on amenorrhoea and Ayurvedic practices. Her contributions advance knowledge and treatments within the field of women's health.

61) Tantra (Tamtra, Tantrism):
Tantra denotes the traditional texts or teachings related to specific practices or disciplines in Ayurveda. It provides foundational knowledge essential for understanding and treating conditions like amenorrhoea.

62) Sahaja (Saha-ja):
Sahaja refers to natural or congenital factors influencing health. Understanding Sahaja aspects in amenorrhoea helps practitioners identify hereditary or intrinsic causes requiring specific therapeutic approaches.

63) Pittam (Pittham):
Pittam means Pitta Dosha, characterized by heat and metabolism. An excess can lead to reproductive issues, including amenorrhoea; managing Pitta is critical in restoring balance and normalizing menstrual functions.

64) Garbha:
Garbha represents the concept of the embryo or fetus in Ayurveda. It emphasizes the health of reproductive functions, linking both conception and issues like amenorrhoea to overall female wellness.

65) Vihara:
Vihara refers to lifestyle practices or conduct. Proper Vihara is essential to maintain balance in Doshas and overall health. Poor habits can affect menstrual health, emphasizing a holistic approach to treat amenorrhoea.

66) Sutika:
Sutika refers to the puerperium or postpartum period. Understanding Sutika conditions provides insights into potential amenorrhoea cases arising after childbirth, allowing for targeted postnatal care.

67) Nashta (Nasta):
Nashta means lost or absent, relating particularly to conditions of amenorrhoea. It encapsulates the phenomenon of lost menstruation and serves as a cornerstone in diagnosing reproductive health issues.

68) Labour (Labor):
Labour refers to the process of childbirth. It’s essential to consider the physical and hormonal changes during Labour that may contribute to postpartum amenorrhoea, guiding appropriate intervention strategies.

69) Phala:
Phala means fruit or outcome, often signifying the results of treatments or therapies in Ayurveda. Evaluating the Phala of various interventions is essential to determining their effectiveness in cases of amenorrhoea.

70) Karma (Karman):
Karma in Ayurveda refers to actions or therapeutic interventions directed towards balancing Doshas and improving health. It encompasses the procedures employed in treating conditions, including amenorrhoea.

71) Ahara:
Ahara denotes diet or food intake, critical in Ayurveda for maintaining health. The quality and nature of Ahara can influence menstrual regularity, making dietary adjustments foundational in treating amenorrhoea.

72) Kanji (Kamji):
Kanji is a fermented rice water drink, significant in Ayurvedic diets for digestive health. Its properties may help regulate bodily functions and indirectly support healthy menstruation, especially in cases of amenorrhoea.

73) Picu:
Pichu refers to a therapeutic process involving the insertion of medicated cotton into the vagina to treat conditions related to women's health. It aids in targeting local tissues for relief from amenorrhoea.

74) Roga:
Roga means disease or disorder in Ayurveda. Understanding Roga provides insights into the overall context of health issues, including amenorrhoea, guiding practitioners in diagnosis and treatment.

75) Guda:
Guda refers to jaggery, a sweetener valued in Ayurveda for its potential health benefits. It is often used in formulations for reproductive health, influencing conditions such as amenorrhoea through nutritional support.

[Note: The above list is limited to 75. Total glossary definitions available: 155]

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