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International Journal of Ayurvedic Medicine, Vol 13 (3), 2022; 657-660
Published online in http://ijam.co.in
ISSN No: 0976-5921
Research Article
Key Words: Male infertility, Vajikaran chikitsa, Kushmand paak, Benincasa hispida.
Introduction
Infertility is a disease of the male or female
reproductive system defined by the failure to achieve a
pregnancy after 12 months or more of regular
unprotected sexual intercourse.(1) Male infertility may
occur be due to various causes, it may be related to
a n at om i c a l or g en e ti c d e fe ct s , e n do cr i ne ,
immunological or inflammatory reasons etc. In
consideration with the semen it may be due to absence
or low levels of sperms, abnormal shape of sperms
(morphological defects) or may be due to sperm
motility defects. The science of male and female
infertility is dealt under the branch of reproductive
medicine. Ayurveda has dealt this health issue under the
treatment protocol of Vajikaran chikitsa (2). Many
herbal, herbo-mineral medicines have been quoted in
various Indian Classical texts of Ayurveda. Few plants
which have been used as aphrodisiac and spermatogenic
include Mucuna p ruriens, Withan ia somnifera,
Hygrophila spinosa, Asparagus racemosus, Benincasa
hispida, etc. Benincasa hispida has been used
medicinally in various diseases based on its antioxidant,
aphrodisiac, antidepressant, muscle relaxant, and anti-
inflammatory properties.(3) Further, based on toxicity
studies it has been reported to have no side effects.
Therefore, based on available literature citing the
benefits of this herbal medicine, we designed this study
where we have studied the effects (for 90 days) of the
ayurvedic herbal drug (Kushmand Paak) on sperm
production in 32 patients having the problem of
infertility and a low sperm count.
Materials and Methods
This study was a self-control clinical trial and
was conducted at a hospital attached to Ashtanga
Ayurved Mahavidyalaya of Pune. Male patients who
resided within a radius of 10 Kms. from the hospital and
those who fulfilled the acceptance criteria were
included in the study. The upper limit of patients was
fixed to 32 (thirty-two) in consultation with a qualified
statistician, but considering the possibility of ‘dropouts,’
it was decided to accept 40 (forty) patients. The patients
were chosen at random from a pool of candidates on a
first-come, first-served basis. There were no barriers
based on caste, creed, occupation, education, monthly
income, eating habits, or other factors. Patients between
the age range of 25 years to 45 years, who were married
for not less than 3 years and have no children, and have
previous sperm count records were included in the
study. The purpose of the trial was described to all
participants on the first day, and they were all asked to
sign the official written consent in the presence of a
witness. They were given instructions on diet and
behavior. Everyone was told to halt using any kind of
treatment for at least three days. The dose schedule was
described and were instructed to report any side effects
as soon as possible. However, patients having diseases
Role of Kushmand Paak in treating Male Infertility
Bhim Gaikwad1, Varghese Jibi1*, Gunvant Yeola2, Dipankar DG1,
Smritika Taware3, Aboli Patil4
1. Professor, 2. Principal and HOD, Department of Kayachikitsa,
3. Professor, Department of Stree Rog Prasutitantra, 4. Associate Professor, Department of Kaumarbhritya,
Dr. D.Y. Patil College of Ayurved & Research Centre,
Dr. D. Y Patil Vidyapeeth ( Deemed to be University), Pimpri – Pune. India.
Abstract
Objectives: To evaluate the efficacy of Ayurvedic herbal drug combination as a good and effective treatment on
sperm production without any side effects on prolonged use. Materials & methods: It was a self-control clinical trial
study. In this study, we enrolled 40 patients having complaints of infertility of age 25-40 years married for not less
than 3 years. All these participants were advised to take 30 g of Kushmand Paak after mid meals with a cup of warm
milk for 3 months. Sperm count, semen color, viscosity, and state were recorded before starting the treatment and
after 3 months of completion of treatment. Results: It was observed that ‘Kushmand Paak’ was accepted by all with
no complaints about any side effects. Viable, active, and morphologically perfect sperm count was also increased to a
significant level. Conclusion: Kushmand Paak can be used to improve sperm count without any side effects on
prolonged use.
657
* Corresponding Author:
Varghese Jibi
Professor, Department of Kayachikitsa,
Dr. D.Y. Patil College of Ayurved & Research Centre,
Dr. D. Y Patil Vidyapeeth ( Deemed to be University) ,
Pimpri – Pune. India
Email Id: vjayu82@gmail.com
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Varghese Jibi et.al., Role of Kushmand Paak in treating Male Infertility
Published online in http://ijam.co.in
ISSN No: 0976-5921
including tuberculosis, Malaria, Leprosy, HIV+ve,
malignant ulcers, breast cancer, uterine cancer,
convulsive disorders, who were mentally affected, and
who were residing beyond 10 km distance from the
hospital were not included.
Preparation of Kushmand Paak (jam)
In this study, we chose an herbal drug treatment
called Kushmand Paak a formula from the classical text
of Yog Chintamani (4).It has been indicated that it can
be consumed at all ages, those inflicted with rakta
vikara (haematological disorders), Stree prasakti
(engaged in regular sexual intercourse), krushsa
(malnourished), kshata (injury), trishna (excessive
thirst), Kasa (cough), arsha (piles), gudaruja (anal
diseases) and chardi (vomiting).
This preparation also had an additional advantage
of easy availability of its ingredients, good palatability,
and easy administration by oral route. Further, it’s all
ingredients are known to be nontoxic and thus can be
consumed for a prolonged period (90 days).
Kushmand (Benincasa hispida) was bought fresh
from the local market and was identified by experts in
Ayurved (Dravyaguna vidnyan) as well as botanist. Its
exterior skin was peeled, and the surface was cleaned
with potable water. It was chopped into 1-inch square
pieces and cooked for 15 minutes in a pressure cooker.
It was then placed in a stainless-steel wide-mouth skillet
with 200 g clarified butter ( cow’s ghee) and stir-fried
for 10 minutes, or until it formed a mushy mass. Sugar
was added and it was continuously stirred until the jam
was formed. Other components like maricha, pippali,
sunthi, twak, tejpatra , jeera and ela were added one by
one to this soft mixture, with continuous stirring after
each addition for a few minutes. The paak preparation
was completed and cooled and was stored in clean
airtight jars for dispensing.
Dose
30 g of Kushmand Paak was advised for 3
months (90 days) in the late afternoon after mid meals,
(in between 4 and 5 pm) with a cup of warm milk as
‘anupana’ (vehicle). This duration of treatment was
indicated since sperm maturation takes roughly 90 days
for spermatogenesis.
Collection of data
Data collection was done using a special case
paper in which the data entry was done on the same day
of the visit, or their arrival for the pathological
examination of semen analysis, on day 1, day 45, and
day 91.
Results
A total of 32 patients completed the 90 days
clinical trial without break. They reported every week
on a fixed day and time and on mobile every day. The
average age years of participants were 37.06 years, and
the average body weight was 62.72 Kg. All the
participants were fairly educated as three (3) of them
were graduates, twenty (20) had completed the
secondary school examinations and only nine (9) had
education up to primary level. All of them fulfilled all
criteria laid down for this study. No change was
suggested in their daily routine, and they all continued
their usual routine life such as food habits and daily
work patterns.
Table No 2: General information about participants
Semen examination
Initially, on day 1 examination, colour of the
fresh semen sample was found to be milky in twenty-
three (23) patients and exhibited a reddish tinge
indicating trauma to the urethra in seven (7) patients,
and yellowish indicating infection and suppuration in
two (2) patients. After 90 days of treatment this changed
to milky in twenty-eight (28), patients, a reddish tinge
could be observed only in four (4) patients, and no
sample had a yellowish appearance (Figure 1 (A).
On day 1, the viscosity of semen was thick in
twenty (20), thin in nine (9), and knotty in three (3)
patients. At the end of the stipulated period of 91 days,
it changed to thick in twenty-six (26), thin in five (5),
and knotty in only one (1) patient, and this was very
encouraging (Figure 1 (B)).
The quantity of semen on the first day was scanty
in seventeen (17) participants, medium in ten (10), and
adequate in five (5). This was changed to scanty in four
(4), medium in six (6), and adequate in twenty-two (22)
patients (Figure 1 (C)).
Sr. No
Ingredient
Botanical name
Quantity
1
Kushmand
Benincasa hispida
(Thunb.)cogn.
1kg
2
Maricha
Piper nigrum
10 g
3
Pippali
Piper betel
10 g
4
Sunthi
Zingiber officinale
10 g
5
Twa k
Cinnamomum
verum
10 g
6
Tejpatra
Cinnamomum
tamala
10 g
7
Jeera
Cuminum cyminum
10 g
8
Ela
Elettaria
cardamomum
10 g
9
Sugar Syrup
960 g
(60%)
10
Cow’s fresh
clarified butter
(Ghee) as required
Sr.
No
Parameters
Mean+SD
1
Average Age (years)
37.065±6.231
2
Average body weight (Kg)
62.71±7.778
3
Marriage history (years)
10.125±3.883
4
Education
a) Graduate
b) Secondary education
c) Primary education
03
20
09
5
Average monthly income
(Rs.)
18778.125±1862.79
658
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International Journal of Ayurvedic Medicine, Vol 13 (3), 2022; 657-660
Published online in http://ijam.co.in
ISSN No: 0976-5921
Sperm morphology and movement
On day 1, before starting the treatment, defective
sperms were observed in fourteen (14) participants,
such as short tails, double heads, absence of neck or
crooked appearance, and dead sperms in ten (10), and
sluggish sperm movements in eight (8) participants.
This changed to defective sperm count only in four (4)
participants, there were no dead sperms in any of the
participants and sluggish sperms were observed in three
(3) participants (Figure 1(D)).
This shows good development and nourishment
of sperms which are the essential factors of fertility.
Table No. 3: Comparison of semen characteristics on
day 1 and day 91
Discussion
In recent times, cases of infertility have been
rising at an alarming rate where male infertility
accounts for around 50% of such cases. In our country,
27.5 million couples suffer from infertility and
increasing marital age, stress, rising alcohol, poor eating
hab i ts, co n s umptio n of alc o hol, an d tobac c o
consumption are some of its leading causes. The most
important causative factors include compromised sperm
count and quality which have been explained by several
abnormalities. For ages, Ayurvedic medicines have been
used to treat many diseases including infertility.
Being childless is emotionally and physically
distressing. Further, stress and erratic lifestyle impact
both mental and physical well-being and can be
responsible for infertility. Yogasanas can help increase
the chances of conceiving by bringing about balance in
life, along with herbal ‘Rasayana’ and ‘Vajikarana’
treatment. In the present study one such herbal
Rasayana vajikaran treatment called ‘Kushmand Pak’
was tried clinically in 32 males of fertility age and from
the lower middle class with a modest monthly average
income of Rs. 18778.13/-. The fruit of this plant is
vrushya or aphrodisiac in nature, balances tridoshas (3
humours of the body), and has been recommended as an
Ayurvedic remedy for erectile dysfunction. Regular
consumption of matured pulpy fruit has also been
proven to improve the quality and quantity of semen. It
also improves the body’s strength, energy, and stamina.
It has been used to alleviate a wide range of symptoms
based on its antiulcer, anthelmintic, antioxidant, and
neuropharmacological activity.
In this study, we observed a marked improvement
in the quality as well as quantity of sperms and semen.
Further, these patients did not report any side effects
and completed the protocol for 3 months. This
impr ovement might be due to an increase in
testosterone levels which controls spermatogenesis,
motility as well as the function of accessory sex organs.
Further, there are published reports stating the role of
high cortisol in infertility. High cortisol increases stress
and might impact the level of testosterone. In our study,
we could not study the impact of this treatment on these
hormones. However, other studies using other herbal
medicines to treat infertility have reported this
relationship between cortisol, testosterone, and
infertility. Further, reaction oxygen species (ROS)
increase during stress. ‘Kushmand Paak’ has been
reported to have antioxidant properties and thus it might
also act by decreasing ROS and stress in the patients.
The total period of this study has been restricted to one
year. This work is being followed for another 9 months
for the incidence of conception. At present, it can be
safely concluded that the treatment of Kushmand Paak
for 91 days was responsible for this beneficial change in
sperm quality and quantity.
Conclusion
In conclusion, the herbal preparation ‘Kushmand
Paak’ used in the study was accepted by all and there
were no complaints about any type of side effects. This
psychological acceptance might have also contributed
to the most noteworthy results that were obtained in the
semen examination. This treatment led to significantly
improved sperm count with viable and morphologically
active sperms.
Conflict of Interest: None
Figure 1: Charts showing comparison of (A) color
(B) viscosity (C) quantity and (D) state of semen on
day 1 day 91
Sr.
No
Parameters
Types
Day1
Day 91
1
Colour of
semen
Milky
23
28
Reddish tinge
7
4
Yellowish
tinge
2
0
2
Viscosity
of semen
Thick
20
26
Thin
9
5
Knotty
3
1
3
Quantity
of semen
Scanty
17
4
Medium
10
6
Adequate
5
22
4
Sperm
count
14.2±
4.169
18.0875±
2.571
5
Sperm
state
Defective
14
4
Dead
10
0
Sluggish
8
3
659
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Varghese Jibi et.al., Role of Kushmand Paak in treating Male Infertility
Published online in http://ijam.co.in
ISSN No: 0976-5921
References
1. World Health Organization (WHO). International
Classification of Diseases, 11th Revision (ICD-11)
Geneva: WHO 2018.
2. Vagbhatta , Ashtanghridyam , Chap. 40. Shloka
1-3.Varanasi: Krishnadas Academy; edition 1997, p.
413.
3. Vijitha Vijayan et al, A review on Kushmanda
(Benincasa Hispida) with special reference to Visha
Chikitsa, The Pharma Innovation Journal 2018;
7(12): 245-248
4. Vai d y a Harsha Keetiji , Yog Chintamani
‘Paakadhikar - adhyaya 1’, page no. 7-8, pp 36;
published by Khemraj Shri Krishna Das, Mumbai,
Maharashtra.
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