A Vandhya can be defined as a woman who has lost her powers of healthy menstruation and ovulation resulting in loss of fertility

Sushruta define Vandhya as a woman who has lost her Artava i.e ovulation

Vaghbhata explain that the congenital under development or deformity of female genital organs resulting vandhyatva or sterility

Sterility although not a disease but is a day to day problem to the solved by a gynecologist . It although do not effect the health directly but has a psychosomatic effects on the patient resulting in reflection over the physical and mental health female sterility presents more problem compare to male sterility because of the social stigma attached to it .

Before discussing sterility we need to go through the description of conception and fertility .

Factors of conception

Aurveda described that i.e.

1. Rutu
2. Kshetra
3. Ambu
4. Beeja

these are four important factors for conception . Madhav has described Female as field ( Ovem) and male as seeds ( sperm) . Aurveda considered avyapani yoni – un diseased healthy grabhashaya – genital organ – as essentials for conception

1. Rutu kala - i.e. the period of fertile phaged governed by Kapha – which in modern terminology can be defined as the well developed proliferative phage of uterus accompanied by ovulation
2. Kshetra – undiseased and healthy female genital organs
3. Ambu - it represents rasadhatu – the liquid product of nutritional factors of diet i.e the metabolities and harmones responsible for the groth of foetus
4. Beeja – it includes stree beeja and the purush beeja – oveum and the sperm which as described as " sudha shukra artava " in short healthy and normal sperm when unites with normal ovem in healthy uterus of a well developed proliferative state of uterine endometrium the conception take place

Types of Vandhya

Aurvedic text described Vandhya as

1. Balya – delayed puberty
2. Garbha koshta bhanga - Traumatised uterus. Modern science also described caesarean section as one of the causes of sterelity
3. Dhatu kshaya - Genaralised cachexra and loss of raja and artava i.e amenorrhoea and un ovulation
4. Anapatya – Primary sterility
5. Bala kshaya – lost ferlity power due to poor general condition off health
6. Garbha sravita – one having repeated abortions
7. Mruta vatsa – one having repeated miscarriages

Etiology

1. Unhealthy uterus
2. Damaged Artavwaha shrotasa – fallopian dubs
3. Trauma to female genital tract
4. diseased of female genital tract
5. Diseased of Artava – oveum
6. Congenital deformity of genital tract
7. A woman who has not attaint menarche where the genital organ not fully developed .

In addition Maithuna Disorders – coital disorders are also described as causes of sterility . They are as followes

1. Maithuna asahatva – dyspareunia
2. Maithuna anichha – frigidity
3. Asammyak Maithuna – improper coitus

Aurvedic text has described. Rutukala as they important factors of conception in contrast to modern science which gives more stress on safe period keeping in mind they contraception . Aurveda also described that along with healthy genital , stree and purush beeja the physiological state of mind of the woman is also equally important for conception .

Various condition associated with sterility

1. Rajodushti The ovem due not have the capacity of fertilization
2. Yoni vyapat –
   1. Asruja – lohita kshara yoni vyapat here there is excessive uterine bleeding hence even if conception text place nidation can not occur
   2. Arajasksa – lohit kshaya vyapat - secondary amenorrhoea following pallor and emaciation
   3. Soochi Mukhi yoni vyapat – vary narrow uterine cervical os
   4. Antarmukhi yoni vyapat – retroverded uterus
   5. Shandhi and sushka yoni vyapat - conginatal disorders
   6. Yoni arsha uterine cervical polips
   7. Maithuna asashatava – dyspreunia
   8. Medo vrudhi - obesity
   9. Pariprluta - infected genitals

Local condition –

1. Rakta gulma }
2. Arbuda } New growths of uterus

Generalized conditions

1. Rajayakshama - tuberculosis
2. Shosha - emaciations
3. Majja kshaya – Treatment

As sterility is not a diseased but it is the manifestation under line cause the treatment is directed to eradicate cause and also to treat the psychosomatic symptoms .

Madhava has described Vandhya as Nastartava which is loss of menstruation secondary to some other condition and has said that i.e. curable but in shandhi yoni cases the nastartava is primary and is not curable

Shodhan chikitsa

Pancharkama chikitsa

1. Sthanik ( local ) shodhan
2. Sarvanga shodhan by
   1. Vaman
   2. Virechan
   3. Nashya
   4. Basti
3. Use of medicated ghrut - phal ghrut , shatavari ghruth , brahat shatavari ghrut , sheet kalyan ghrut , kashmaryadi ghrut
4. Use of medicated oils - Maharasna di tail , preyangwadi tail
5. Basti of medicated decoctions
6. Pitta shamak preparation

In short shodhan shikista should precede any internal medication and the underline cause should be traced and treated
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