A little write up for the lovers of classical Ayurvedic text about Amenorrhea. Hopefully this will be interesting for the students of Ayurveda.
If you are you looking to deepen your understanding of Ayurveda in a practical and clinical setting you might like to read about the mentoring program offered at Lakshmi Ayurveda starting in February 2020.
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
• 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)
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.
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.
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 🙂
* 𝘗𝘭𝘦𝘢𝘴𝘦 𝘯𝘰𝘵𝘦 𝘵𝘩𝘢𝘵 𝘵𝘩𝘦𝘴𝘦 𝘤𝘭𝘢𝘪𝘮𝘴 𝘩𝘢𝘷𝘦 𝘯𝘰𝘵 𝘣𝘦𝘦𝘯 𝘢𝘱𝘱𝘳𝘰𝘷𝘦𝘥 𝘣𝘺 𝘵𝘩𝘦 𝘛𝘎𝘈. 𝘛𝘩𝘦 𝘪𝘯𝘧𝘰𝘳𝘮𝘢𝘵𝘪𝘰𝘯 𝘱𝘳𝘰𝘷𝘪𝘥𝘦𝘥 𝘪𝘴 𝘯𝘰𝘵 𝘮𝘦𝘢𝘯𝘵 𝘵𝘰 𝘣𝘦 𝘶𝘴𝘦𝘥 𝘵𝘰 𝘥𝘪𝘢𝘨𝘯𝘰𝘴𝘦 𝘰𝘳 𝘵𝘳𝘦𝘢𝘵 𝘢𝘯𝘺𝘰𝘯𝘦 𝘢𝘯𝘥 𝘴𝘩𝘰𝘶𝘭𝘥 𝘯𝘰𝘵 𝘣𝘦 𝘵𝘢𝘬𝘦𝘯 𝘸𝘪𝘵𝘩𝘰𝘶𝘵 𝘤𝘰𝘯𝘴𝘶𝘭𝘵𝘢𝘵𝘪𝘰𝘯 𝘸𝘪𝘵𝘩 𝘢𝘯 𝘈𝘺𝘶𝘳𝘷𝘦𝘥𝘪𝘤 𝘱𝘩𝘺𝘴𝘪𝘤𝘪𝘢𝘯. 𝘞𝘦 𝘥𝘰 𝘯𝘰𝘵 𝘨𝘶𝘢𝘳𝘢𝘯𝘵𝘦𝘦 𝘢𝘯𝘥 𝘢𝘴𝘴𝘶𝘮𝘦 𝘯𝘰 𝘭𝘦𝘨𝘢𝘭 𝘭𝘪𝘢𝘣𝘪𝘭𝘪𝘵𝘺 𝘰𝘳 𝘳𝘦𝘴𝘱𝘰𝘯𝘴𝘪𝘣𝘭𝘺 𝘧𝘰𝘳 𝘵𝘩𝘦 𝘢𝘤𝘤𝘶𝘳𝘢𝘤𝘺, 𝘤𝘶𝘳𝘳𝘦𝘯𝘤𝘺 𝘰𝘳 𝘤𝘰𝘮𝘱𝘭𝘦𝘵𝘦𝘯𝘦𝘴𝘴 𝘰𝘧 𝘪𝘯𝘧𝘰𝘳𝘮𝘢𝘵𝘪𝘰𝘯 𝘤𝘰𝘯𝘵𝘢𝘪𝘯𝘦𝘥 𝘪𝘯 𝘵𝘩𝘦𝘴𝘦 𝘮𝘢𝘵𝘦𝘳𝘪𝘢𝘭𝘴.