Dysmenorrhoea (Kashtartava): An Ayurvedic Perspective

Abstract

In present day life women are effectively facing challenges encountered by stressful life resulting in Mithya Ahar, vihar, over exertion & malnutrition this may direct to vikruti in " Rutuchakra'' leading to various vyadhi allied to menstruation. Ayurveda recommends rutucharya and dinacharya, diet modulation and yoga in the form of asanas, pranayam and meditation on a regular basis so as to alleviate dysmenorrhoea effectively. Similarly, Uttarbasti, Garbhashaya balyaaushadhi, anuvasan or matrabasti can also be administered if necessary.

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International Journal of Herbal Medicine 2015; 3(3): 33-35
E-ISSN: 2321-2187
P-ISSN: 2394-0514
IJHM 2015; 3(3): 33-35
Received: 15-06-2015
Accepted: 17-07-2015
Bhagyashri Patil
PG Scholar, Department of
Swasthavritta, Bharati,
Vidyapeeth Deemed University,
College of Ayurved, Pune,
Maharashtra, India.
Rahul Kamde
Assist. Prof Department, of
Prasutitantra & Strirog KVTR
Ayurved College Boradi.
Vijay Bhalsing
Prof, Department of
Swasthavritta, Bharati
Vidyapeeth Deemed University,
College of Ayurved, Pune,
Maharashtra, India.
Kirti Bhati
Assist. Prof, Department of,
Swasthavritta, Bharati
Vidyapeeth Deemed University,
College of Ayurved, Pune,
Maharashtra, India.
Correspondence:
Bhagyashri Patil
PG Scholar, Department of
Swasthavritta, Bharati
Vidyapeeth Deemed University,
College of Ayurved, Pune,
Maharashtra, India.
Dysmenorrhoea (Kashtartava): An Ayurvedic Perspective
Bhagyashri Patil, Rahul Kamde, Vijay Bhalsing, Kirti Bhati
Abstract
In present day life women are effectively facing challenges encountered by stressful life resulting in
Mithya Ahar, vihar, over exertion & malnutrition this may direct to vikruti in “Rutuchakra’’ leading to
various vyadhi allied to menstruation. Ayurveda recommends rutucharya and dinacharya, diet
modulation and yoga in the form of asanas, pranayam and meditation on a regular basis so as to alleviate
dysmenorrhoea effectively. Similarly, Uttarbasti, Garbhashaya balyaaushadhi, anuvasan or matrabasti
can also be administered if necessary.
Keywords: Ayurveda, Kashtartava, Menstruation, Dysmenorrhoea
1. Introduction
Today stress is becoming an inescapable part of modern life. In the incessant quest for material
comforts, a woman has been losing her health. The basic reason why women are reeling under
myriad problems is because she has not been following the codes of healthy living. She has
disregarded the codes for the bodily health as well as healthy mind also.
Menstruation is a natural event as a part of the normal process of reproductive life in females.
Due to today’s sedentary lifestyle and lack of exercise, dysmenorrhoea is becoming today’s
burning problem throughout the world which causes discomfort for women’s daily ensuing
day to day activities and may result in missing work or school, inability to participate in sports
or other activities. A systematic review of studies in developing countries performed by
Harlow and Campbell (2002) has revealed that about 25-50% of adult women and about 75%
of adolescents experience pain during menstruation, with 05-20% reporting severe
dysmenorrhoea or pain [1].
In the treatment of dysmenorrhea, no addictive, analgesic, antispasmodics are prescribed
which are not good for health for longer use. During menstruation, many women experience
gastrointestinal upsets which are increased by analgesics and anti-inflammatory drugs, which
also produce headache, dizziness, drowsiness and blurred vision.
In Ayurvedic classics Kashtartava (dysmenorrhoea) is not described as a separate disease
because women were not suffering much from this problem in that era because of pin pointed
Ritucharya & Rajasvalacharya. According to Ayurvedic text there are many other diseases in
which Kashtartava is considered and is described as a symptom. Hence, this study is particular
about the description regarding Kashtartava on the basis of scattered classical references.
2. Artava
A substance of the body which flows out at the specific period of time is called as Artava [2]. A
substance which flows out from Apaty amarga without pain, burning and sliminess is known
as Artava [3]. Apana Vayu and Vyana Vayuis mainly responsible for Artava Utpatti [4].
3. Kashtartava
Kashtartava (dysmenorrhea) is not separately described as a disease. But there are many
diseases in which Kashtartava is considered and described as a symptom.
3.1. Nirukti
The term Kashtartava is made of two words- Kashta and Artava
Kashta: Painful, Difficult, troublesome, ill, forced, wrong, unnatural, a bad state of
Thing.
Artava: Belonging to reasons, period of time, menstruation.
Kashtena - with great difficulty [5].

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Thus the word Kashtartava can be expressed as-
“Kashthenamuchyatiiti kashtartava” i.e. the condition where
Artava is shaded with great difficulty and pain istermed as
“Kashtartava”.
4. Sampraptighataka
Dosha Vata Pradhana Tridosha
Vata Vyana, Apana
Pitta Ranjaka, Pachaka
Kapha as AnubandhitaDosa
Dhatu Rasa, Rakta, Artava
Upadhatu Artava
Agni Jatharagni, Rasagni, Raktagni
Srotasa Rasa, Rakta and ArtavavahaSrotasa
Srotodushti Sanga and Vimargagamana
Udbhavasthana Amapakvashaya
Rogamarga Abyantara
SthanaSamshraya Garbhashaya
VyaktiSthana Garbhashaya
5. Ayurvedic concept of pain related to Kashtartava
Acharya Charaka [6] has mentioned none of the gynecological
disease can be arise without affliction of aggravated Vata.
Vata is the main responsible factor, though other doshas only
be present as Anubandhi to it. So pain is produced due to
vitiation of only vatadosha or in combination with other
Doshas.
Modern Review
6. Definitions of Menstruation
Menstruation is a function peculiar to women and the higher
apes. It may be define as a “periodic and cyclic shedding of
progestational endometrium accompanied by loss of blood”. It
takes place at approximately 28-days interval between the
menarche and menopause [11]. Menstruation is the visible
manifestation of cyclic physiologic uterine bleeding due to
shedding of the endometrium following invisible interplay of
hormones mainly through hypothalamo-pitutary-ovarian-
endometrial axis [12].
7. Dysmenhorrhoea
7.1 Defination
The term dysmenorrhea refers to painful menstruation.
Dysmenorrhea is a cramp labor-like pain in the lower abdomen
that radiates to upper abdomen, waist and thighs and is
sometimes accompanied by systemic symptoms like nausea,
vomiting, diarrhea, headache and dizziness [17, 18].
7.2. Etymology
The word „dysmenorrhoea‟ has a Greek origin. Dis-men-o-
re‟ah
Dis: Prefix meaning difficult, bad, painfulmen: Monthrein: To
flow
Thus, Dysmenorrhoea-means painful or difficult menses [13].
7.3. Types of dysmenorrhea
There are two types of Dysmenorrhoea.
7.3.1. Primary dysmenorrhoea-
Primary dysmenorrhoea is the pain associated to ovulation
cycles, without demonstrable lesions that affect the
reproductive organs. Primary dysmenorrhea is related to
myometrial contractions induced by prostaglandins (Pgs)
originating in secretory endometrium, which result in uterine
ischemia and pain [14,15] In addition to the physiologic
perspective, various psychologic theories have also been
proposed, emphasizing the role of personality factors and
attitudes about menstruation [16].
7.3.2. Secondary dysmenorrhoea-
Secondary dysmenorrhoea is the pain associated with
ovulatory cycles caused by a demonstrable pathology.
8. Differential diagnosis
A. The most important differential diagnosis of primary
dysmenorrhoea is secondary dysmenorrhoea.
Secondary dysmenorrhoea
1. Endometriosis
2. Adenomyosis
3. Uterine myoma
4. Endometrial polyps
5. Obstructive malformations of the genital tract
B. Other causes of pain
Chronic pelvic inflammatory disease
Pelvic adhesions
Irritable bowel syndrome
Inflammatory bowel disease
Interstitial cystitis
C. Sudden onset of dysmenorrhoea
Pelvic inflammatory disease
Unrecognized ectopic pregnancy
Spontaneous abortion
9. Treatment as Per Ayurvedic Classics
1. These disorders (gynecological disorders) do not occur
without vitiation of Vata, thus first of all Vata should be
normalized, and only then treatment for other doshas
should be done [7].
2. In all these gynecologic disorders, after proper oleation
and sudation, emesis etc. all five purifying measures
should be used. Only after proper cleansing of dosas
though upper and lower passages, other medicines should
be given. These emesis etc. cleansing measures cure
gynecologic disorders in the same way as they cure the
diseases of other systems [8].
3. In menstrual disorders caused by Vata Dosha, the specific
treatment prescribed for suppressing that particular Dosha
should be used. Recipes prescribed for Yoni Rogas and
Uttarbasti etc. should also be used after giving due
consideration to the vitiated Doshā. [9].
4. Unctuous, hot, sour and salty articles should be used for
the relief from menstrual disorders due to Vata. Sweet,
cold and astringent substances for the purification of Pitta
and hot, dry and astringent for Kapha [9].
5. For Avrita Apana Vayu, treatment should be Agnideepaka,
Grahi, Vāta, Anulomana and Pakvashaya Shuddhikara
[10].
9.1 Treatment
Life-style changes
Exercise regularly-minimum thrice a week
Ensure sound sleep of at least 6-8 hours
Avoid smoking and alcohol
Reduce caffeine
Diet
Eat healthy, warm and fresh foods
Eat 5-6 small meals
Have fresh fruits like plums, dark grapes, apples,

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pomegranates.
Eat more leafy vegetables
Regularly use ginger in food preparations
Avoid high fat and sugar
Take supplements like calcium, magnesium, vitamin E, B6,
B12
Yoga: Yoga activities can help to reduce and prevent the
severity of many ailments that specifically women’s health and
give strength, stability, and suppleness. Yogasanas are
considered as the most convenient, drugless, and inexpensive
method. Yoga is also found to have encouraging effect on
increasing the pain threshold capacity in individuals. In Yoga,
various types of Asanas have been mentioned. Among them
Ushtrasana, Bhadrasana, Gomukhasana, and Vajrasana have
a pain relieving effect.
Ayurvedic Treatment: According to Ayurveda menstruation
is guarded by vata dosha. Derangement or aggravation of vata
dosha gives rise to this symptom. The treatment, which
alleviates vata, gives excellent results in this disease.
Panchakarma treatments like Uttarbasti, anuvasa or
matrabasti are the treatments which will specifically target
derangement of vata in menstrual problems. Garbhashaya
balya aushadhi will also reduce associated symptoms.
10. Discussion
Culturally, the abbreviation Primary Dysmenorrhea is widely
understood in the world to refer to difficulties associated with
menses, and the abbreviation is used frequently even in casual
and conversational settings, without regard to medical rigor. In
these contexts, the syndrome is rarely referred to without
abbreviation, and the intensions of the reference are frequently
broader than the clinical definition. The misery is going on
endlessly. Thanks we have the solution.
11. Conclusion
Ayurveda views Primary Dysmenorrhea as a doshic imbalance
that can potentially be impacted through balanced living that is
characterized by dosha appropriate diet, herbal supplements,
exercise, routine, yoga, meditation, as well as nourishing
inputs through all five senses.
12. Reference
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