A little write up for the lovers of classical Ayurvedic text about Amenorrhea. Hopefully this will be interesting for the students of Ayurveda.

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In Ayurveda Amenorrhea is called (a Sanskrit word) Arajaska by Charaka and Lohitaksaya by Vagbhata.

Lohita is the synonym for rakta (blood). Lohita (Blood) + kshaya (decrease) = loss of blood

Meaning of Arajask is, Na + Rjaska = No menstrutation/ absence of menstruation.

Arajaska indicates that the woman is devoid of menstruation / rajas. Charaka defines it as a disease whereby Pitta is located in the vaginal tract and uterus and vitiates rakta therefore, halting menstruation. (Ch. Chi 30:17).

There are two types primary and secondary Amenorrhea.

Primary Amenorrhea– is the failure to menstruate at puberty. In Ayurveda this is called prathamika anartava and is mainly attributed to sahaja vikriti (congenital defects) or mandya of the piyusa granthi and graivika granthi (hypo-pituitarism and hypothyroidism).

Secondary Amenorrhea– is much more common and is the absence of menses for six months. Problems may arise due to a disorder occurring in the uterine endometrium, the ovaries, the anterior pituitary or the hypothalamus. Amenorrhea can also be a physiological condition for instance during pregnancy, lactation and menopause.

Hetu (causative factor) for secondary amenorrhea

Ahara/ Vihara (Food and lifestyle)
• As with most diseases mithya ahara vihaara is an important hetu.
Ahara sampat abhava (malnutrition)
Asatmyanna / nutritional amenorrhoea
Vyayama / excessive exercise
Anashana / nutritional amenorrhoea (chronic)
Atimaithuna / repeated intercourse

Manasika (mental/ emotional)
• Emotions, frustrations, mental shocks
Manastapa – psycho neurosis

Others
• Rakta kshaya- pandu roga (Anaemia)
• Vyadhi karsana – debility due to long standing diseases just as rajayakshma or madhumeha (Tuberculosis, HIV, IDDM)
• Pradushta artava / vitiated arthava hormones
• Phalaksoa nasa – destruction of ovaries due to tumors or cancer
• Upadrava of some types of jwara

Samprapti / etiopathogenesis

1. Nidana (causative factors)
2. Vata vitiation (Apana Vayu), the important function of Apana vayu is the elimination of menstrual blood, stool, urine and reproductive fluids.
3. Vitiated vata vitiates Pitta (Ranjaka and Bhrajaka). Vata covers the pitta
4. The vitiated Pitta acts on Rakta
5. Decrease in rakta
6. Improper formation of Arthava (menstrual blood)
7. Absence of menstruation
8. The woman becomes thin and discoloration (pale look, loss of complexion)

Chikitsa Sutra

The main doshas involved are Vata and Pitta. The line of treatment would be Vata pacifying and vata anulomana as well as pitta vardhaka.

1. Nidana Parivarjana

Eliminate causative factors such as unwholesome diet and lifestyle

2. Vayu reducing and pitta vardhaka diet

Chikitsa explained for raktayoni is beneficial

Recipes described useful according to Charaka are:

1. Ghrta with blood of deer, goat, sheep and hog, curd and juice of sour fruits should be given to drink.
2. Milk boiled with jivaniya group (jivaka, rsabhaka, meda, maha-meda, kakoli, ksira-kakoli, mudga-parni, masa-parni, jivanti and madhuka) of drugs should be given to drink.

Recipes described useful according to Astanga Samgraha:

1. Medicated oil is prepared with decoction of bala , payasya kalka, salaparni, magdhika, satavari, kakanasa, sravani, sarkara and drugs of jivaniya gana added with milk, ghrta and taila.

2. In Rakta ksaya, ghrta prepared with decoction of jutaja and kasmarya should be used for vaginal enema.

Useful herbs are, Chitraka, kumari, Lasuna, pippali, guggulu, satapuspa and shatavari. Drugs capable of increasing the rakta (menstrual blood) should be used.

Satapuspa and Satawari Kalpa are considered to be like nectar for the woman who suffers from amenorrhoea.

Panchakarma treatment

Before conducting panchakarma treatment, the patient will need to be examined to determine if she is a suitable (vaya, bala etc).

1. Snehana – the sneha will counteract the ruksha qualities of vata, abhyanga using chitraka, guduchi, bala with boiled milk and tila taila helps with the downward movement of Vata. Useful ghrtas are Phalaghrta and Vrhatsatavari.
2. Swedana – Nadi swedana is recommended with vata alleviating drugs.
3. Basti – the udhbhava sthana of Arajaska is the Amashaya and pakwashaya. The pakwashaya is the sthana of vata. Basti is given to eliminate the aggravated vayu from pakvasaya.
4. Uttara basti (vaginal or urethral douche) – this treatment is indicated in yoni vyapat.
Uttara basti improves the endometrial thickness and stimulates ovulation.

Rasayana

After the patient has undergone the shodhana therapy, it is very beneficial to administer Rasayana dravyas. It is important that the patient has undergone evacuation before administering Rasayana drugs.
Rejuvenation therapy administered without purifying the body does not help just like the coloring a dirty cloth does not shine.

Rasayana dravyas suited for yonivyapat are Bala, Shatavari, Ashwagandha, Amalaki
Satapaka Sahastra Paka, Cyavanaprasa (Ca. Chi. 1:62-74), Silajatu (Ca. Chi 30:148) and Musta.

We hope this was interesting for you.
With love from the Lakshmi Ayurveda team 🙂

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