WOMENS HEALTH DISORDERS

  1. AMENORRHOEA & SCANTY MENSES
  2. KASTARTAVA (DYSMENORRHOEA)
  3. RAKTAPRADA (DISFUNCTIONAL UTERINE BLEEDING)
  4. RAJONIWRUTI (MENOPAUSAL SYNDROME)
A woman in Ayurvedic texts has been described as a mother of religion, culture & desirous of wealth of the whole world. Thus from time immemorial a pregnant woman deserves attention of all. Ayurved has vast knowledge about formation and development of pregnancy and its pathology. The same way Ayurvedic classics have described about Streeroga (Gynecology) and its management.

Motherhood is the crowning act of a woman's role of feminine life. It provides evidence that she is biologically adequate. It leads to the fulfillment of her maternal instinct. It gives her an opportunity to project herself into the next generation. It provides the closest bond that can exist between two human beings "bone of my bone and flesh of my flesh".

Almost all gynecological diseases in crowning stage lead to sub - fertility as a complication .Hence their identification in a proper stage is very important to prevent such complications.

Women's life

It is a common observation that the physiological state of the body does not remain one and the same throughout the life span. At certain periods, some physiological changes take place in the body. Taking into consideration, these changes, a woman's life is divided into three different stages, which are called as epochs. The rough criterion for grouping is the age, but the main aim of grouping is to point out the physiological state of the body during that epoch.

Age- 10 –12 (Child stage) ----- BALA
Age- 12 –16 (Adolescent )----- RAJOMATHI
Age- 16 – 40 (Adult)----------- YUWATHI
Age-40- 50 -------------------- PRAUDHA

Along with age factor menstruation and maturation are also taken into consideration. Thus, a particular epoch is an average age group in which certain changes regarding menstruation and maturation take place. There are mainly three epochs –
  1. Bala
  2. Rajaswala
  3. Vruddha
Concept of Menstruation
Menstruation is a normal physiological process indicating womanhood. It is a cyclical process and repeats every month.

Menstrual disorder

Amenorrhoea and scanty menses

Amenorrhoea and scanty menses are conditions which attracts immediate attention. It can be
  1. Physiological
  2. Pathological
Ayurvedic text have described this condition under following names
  1. Raja kshaya
  2. Raja ksheenata
  3. Artava kshaya
  4. Artava ksheenata
Etiology and pathology
Menstruation is absent in Childhood and old age it is physiological amenorrhoea. Charkaacharya has described amenorrhoea as first sign of pregnancy -Sutikawastha - purperum - is also a stage of physiological amenorrhoea.

Sushruta has described that imbalance of Vata and Kapha influences menstruation. He says if genital organs are encircled by Vata and Kapha amenorrhoea results which are pathological.

Similarly trauma to artavawaha srotasa causes amenorrhoea.

Various condition causing amenorrhoea or scanty menses.
  1. Atisamshodhana :- Vigorous curettage.- By Panchakarma chikitsa
  2. Atisamshamana :- Prolonged administration of drug decreasing the Amount of menstrual discharge.
  3. Vega-dhrana : - Due to with -holding natural calls.
  4. Asatmya ahar :- Due to consuming non tolerant diet .
  5. Manastap :- Psycho- neurosis
  6. Ati Vyayama :- Excessive exercise
  7. Anashana :- Fasting resulting in Nutritional amenorrohoea
  8. Atimaithuna : Repeated and excessive intercourse.
Further various condition causing Amenorrhoea or Scanty menses are
  1. 1. Arajaska yonivyapat - The cause of amenorrhoea lies in uterus
  2. 2. Shandhi yonivyapat - It is generally due to congenital deformity.
  3. 3. Vandhya yonivyapat -This type is secondary and is associated with Sterility
  4. 4 Raktagulma - Amenorrhoea with fibroid.
  5. 5 Rajodushti - Vata – pittaj scanty menses associated with pain in Pelvis
  6. 6 Shushka yonivyapat - Here genital organs are atrophic and constipation And pain is associated.
Treatment: -
Nidan parivarjana - Eradicating the causes.
Panchakarma.
  1. Snehan ------ Til oil + Sendhav
  2. Swedan ------ Dashamula nadi sweda.
  3. Shodhan – ------- Dashamul Basti Anuvasan Basti –Til oil
  4. Uttarbasti ------- By Phalghruth
Internal medicine - 1) Phalghruth
2) Milk medicated with Shatavari, Ashwagandha Yastimadhu, etc.
3) Herbal preparation like Ashoka, Lodhra , Jotishamaty, Shatavari, Shatapushpa, Nashtapushantak ras, Chandraprabha vati etc.

Diet:-
Fish, curds, kanji, masha, til,kulitha, butter, honey, gomutra, etc,are used in ample quantity .

Dr. Harsha Mundada Dr Praphulla Mundada (INDIA)

DYSMENORRHOEA

Defination -
Menstruation associated with pain is called dysmenorrhoea. The term kastartava- kruchchartava is synonilus to dysmenorrhea .

Etiology -
The disordered Vata causes pain. The main two causes of disorder of Vata are,
  1. Margavarotha (obstruction)
    May be either Physiological or anatomical, Here the apanavayu is the governing force to the menstrual flow. Any obstruction to the apanavayu causes pain. Obstruction in the passage may be due to blockage or apanavayu being Surrounded by Kapha. It causes pain.

  2. Dhatukashaya.
    Dhatukashaya turns women to be Heensatwa . Here mild pain & the slightest disorder is also intolerable. Dhatukashya may cause Vata vrudhi in the form of Ruksha and khara Which are responsible for pain. It may also make uterus hypo plastic and scanty menstrual flow results.
Various conditions
  1. Vataj rajodushty --- Menses with mild pain or of breaking type Here Flow is frequent but small in quantity.
  2. Rajoksheenata --- Scanty menses
  3. Rajovrudhi --- Excessive menstrual bleeding
  4. Vataj yoni vyapat ---The genitals become ruff and dry due to loss of Moisture and has tingling sensation. It may give Rise to Gulma as complication. Pain is present In the groin & flanks. And backache is Commonly observed.
  5. Sannipatic yoni vyapat --- All three dosha are disordered and the symptoms Appear as per dosh pradhannya.
  6. Udavarta yoni vyapat --- Menstruation is associated with Severe colicky Pain which disappear as the menstruation flow is Over
  7. Antarmukhi yoni vyapat --- There is abnormal pressure over the uterus Caused due to its disturbed position.
  8. Soochi mukhi yoni vyapat --- This is a congenital defect having narrow External-os or the vaginal opening.
Treatment
**Basic principles of treatments
  1. To remove the cause (Nidan parimarjan)
  2. To bring APAN to its normal nature and site
  3. To reduce pain
  4. To reduce Rukshata & Kharata
  5. To remove obstruction
  6. To remove Dhatukshaya
**Local treatment
Douches (after menses)
Decoctions of triphala, guduchi, dashmul, etc.

Pichu (after menses)
Ghee --- prepared with madhuka, milk & till kalka
Oil --- prepared with dashamula, saindhava, kusta, devadaru, rasana , Bala etc.
Fomentations --- Nadisweda with Dashmool kwath.

**Internal medicine
  1. Milk and Ghee prepared with Ashwagandha or Shatavari.
  2. Churna – Asoka, Kumari, ajamoda and chitraka
  3. Other preparation-- Rajapravartinivati , bolabadha rasa , Shankhavati,Sanjivanivati, yavakshar, Mahayograj goggul, etc
  4. Laxatives – Anulomak - treatment
**Panchakarma treatment
  1. 1. Sehan -Sendhav + tiloil or narayan oil
  2. 2. Swedan - Dashamul nadi sweda.
  3. 3 Shodhan – Basti---- Dashamool kadha Anuvasan Basti –Til oil Vaman, Virechan, Raktamokshana
Diet: --- Milk, Ghruta, butter, Rest, Frish & Light Food, etc. are advised

Dr. Harsha Mundada Dr Praphulla Mundada (INDIA)

RAKTAPRADA

( DISFUNCTIONAL UTERINE BLEEDING )

Defination –
Excessive bleeding per vagina is Raktapradar This type of bleeding is quite a common condition and the blood loss calls for special Attention.

This can be of various types.
  1. Increase in blood loss in quantity
  2. Increase in duration
  3. Shorting of intervals
  4. Irregularly irregular bleeding.
In Ayurvedic texts abnormal bleeding is described has
  1. Rajovrudhi
  2. Artvavrudhi
  3. Raktapradar or asragdar
Etiology
Uterus has very rich vascular supply. Thus certain changes in the body causing
  1. Any imbalance of dosha governing menstruation
  2. Irritation of Rajowaha and Arthawaha Dhamanees
  3. Any disorder of blood itself can cause abnormal bleeding per uterus.
The causative factor
  1. Increase in pitta level.
  2. Disorder of rakthadhatu
  3. Disorder of vata over the uterine vessels
  4. Apan vayu encircled by pitta
VARIOUS CONDITION
  • Raktaj rajodusti Here uterine blood flow foul smells and associated with symptoms Of pitta dusty .i.e. burning sensation, yellowish colour & liquid Consistency.
    Pittaj yoni vyapat Bleeding is associated with
    1. Paka - inflammatory changes
    2. Burning sensational in vagina
    3. Rise of temperature
    4. Bleeding is hot, yellowish and foul smelling- Due to excessive in Take off katu, amla and lavan substances in diet.
    Asruja yoni vyapat Due to excessive bleeding in this condition even if conception Takes place, the ovum can not get embedded. The etiological Factors are Pitta & Rakta dusty.
    Paripluta yoni vyapat This condition is marked more with signs of dyspareunia, than With bleeding. Marked tenderness and edema of genitals, Severe pain in the pelvis & groin, rise of temperature, Heaviness in bladder and flanks, loose motion & loss of Appetite are some of the associated symptoms.
    Rakata Arbuda Rakta arbuda is a new growth .it is also called as gulma. Here Doshas are disordered either in single or in combination and get Collected in dhamanees or mamsa of genital organs. Mainly Vata is predominant. Generally pak Awastha i.e. inflammation Is absent. The size of new growth may increase slowly or Rapidly and give rise to various discharges .If blood is affected Excessive bleeding takes place leading to anemia.
    Yoni arsha Uterine, cervical or vaginal prolypoidal growth. Disordered Doshas affect female genital tract and Produce Delicate, foul Smelling sticky growths which bleed and are of The shape of an umbrella. Yoni Arsha damage the Female Genital tract as well as menstrual cycle.
    Rakta pradara Raktapradar is sever bleeding may be associated with Menstruation – can be vataj, pittaj, kaphaj, and sannipataj.

    Etiology
    Repeated abortion, severe emaciations, sleeping in day time, Trauma to genital tract, mental shock, repeated excessive Intercourse, indigestion and hyperacidity.

    Pathology
    Increased disorderd Vata influences uterine vessels and Artva Resulting in sever bleeding namely rakthapradara.

    General Symptomse
    Mainly excessive bleeding per vagina with body ache and pain. May cause giddiness, pallor, burning sensation, delirium and Unconsciousness.
    Rakta gulma Etiology
    Raktha Gulma is described to occur in Rajaswala epoch and does Not occur in Bala epoch. Vata predominant due to particular diet And excessive intercourse during Rajaswala and Sootika Awastha, multiple pregencies and abortions or miscarrages and Diseases of genital tract are the etiological factors of Rakthagulma

    Signs and Symptoms
    Pain in abdomen & pelvic region
    Edema on feet
    Anemia
    Thirst
    Nausea
    Vomiting
    Loss of appetite

    Treatment :
    1. Shodhan -
    a) Local --- medicinal curettage (pichu) (Palashshara+til oil)
    b) Sarvadehic --- Kalabola, shatapushpa, Pippalamool, latakaranja, etc.
    c) Raktamokshana
    d) Virechan --- Trifphala ,Trivrita
    e) Basti --- Niruha basti - Dashamula + Sendhav Anuvasana basti - Phala oil
    f) Uttarbasti --- Phala ghruth,kasisaditel sahachar oil

    2. Shaman - Mocharasa , Ashoka , Durva , Nagkeshara ,Lodra, etc.

    3. Other preparation
    pushyanug choorna, shatavari ghruth, Kushmanda khand, pradari loha, Ashokarishta, dhataki Flowers, Poogi flowers, jeerakadhyaveleha,

  • DIET:
    Diet should be such as to improve metabolism and pachak in nature.

    Dr. Harsha Mundada Dr Praphulla Mundada (INDIA)

    MENOPAUSAL SYNDROME

    Menopause i.e. the Rajoniwrati is not a disease.

    It is natural process and milestone in women's life related to ageing and unique experience for her. It is the ending of the monthly menstrual cycle and ovulation. Because the ovaries produce lesser estrogen hormone at the age between 45-55 years. Starting from the age of 40, the ovaries reduce there production of sex hormones as a result the menses as well as many other body function are disturbed, Finally the menses stop permanently at about the age of 45 to 55 this is described as Menopause.

    Ayurved links menopause with aging. Aging is a 'Vata' predominant stage of life. With an increased life expectancy world over menopause has become and inevitable phenomena of life for today's women. as she needs to spend many years in menopausal state. In these millenniums a woman should perceives menopause as an oppournity to concentrate on new activity bring out the best in her instead of viewing it as the end of youth and sexuality. Consequently the management of menopause has now gained more attention and importance than ever before.

    COMMON SYMPTOMS
    1. Anaemia, weakness
    2. Hot flashes – feeling of intense heat in body on some occasion
    3. Profuse sweating at night
    4. Excessive - hair falling
    5. Irregular menstrual periods with excessive or scanty bleeding
    6. Burning and increased frequency of micturation.
    7. Vaginal dryness and itching
    8. Joint pain and edema
    9. Irritable nature and mood swings, anxiety and depression
    10. Sleeplessness, lassitude, weight gain
    11. Osteoporosis, mental and physical heaviness
    12. Heart disease
    13. Progressive loss of memory and concentration
    14. Loss of libido

    Treatment
    These symptoms which appear due to imbalance of dosha i.e. –hormones need attention to diet and lifestyle changes to insure grace full life without the burden of health problems.

    Ayurved the science of life advocates a holistic treatment for menopausal syndrome by utilizing various Panchakarma, herbs and minerals and offer a reliable option to be controversial treatment of hormone replacement therapy.

    PANCHARKAMA
    Ayurved describes that stubborn symptoms like frequent hot flashes, sleep disturbance, mood swings, anxiety and depression, night sweats, lassitude and mental heaviness are due to buildups of wastes and toxins referred to as Aama in the body.

    In this case a traditional and very much result oriented Ayurvedic detoxification programme - the rejuvenation therapy – the Panchakarma may be needed to clear the body channels (the srotasas )and gain relief .

    1. Snehan -- herbal oil massage
    2. Swedan ---Dashamula nadiswed
    3. Shirodhara --- Jatamansi or Brahmi oil
    4. Basti --- Niruha & Anuvasna
    5. Vaman
    6. Virechan --- Triphala, Trivruta, Castor oil.
    In my clinical experience Pancharkama has very transforming results eliminating the symptoms dramatically reducing the stress and fatigue after a week's treatment. The patient not only reports feeling much better but they radiate health, youthfulness and experience profound sense of well being and mental peace.

    Internal Medicine.
    Ashoka, Lodhra, Dashmul, Manjistha, Ashvagandha, Punarnava, Chandan, Anatmula, Guggal, Shatavari, Aloe Vera, Jatamansi, etc.

    Other Medicine
    Ashokarista, Shatavarikalpa, Gulvelsatva, Praval pisti, Mrugasrunga Bhasma,

    They are the substance known as phyto estrogens – estrogen like – derived from plants. They mimic the action of estrogen but are free from its side effect.

    Yoga
    Pranayama --- Anuloma viloma, Bramari, Omkar

    Asana --- Sarvangasan, Pavanmuktasan, Virasan, Halasan, Fast Walking, Shavasan


    USEFUL TIPS FOR LIFE STYLE
    1. Consume whole and natural foods avoid saturated fats of dairy product, avoid fried food. Consume unsaturated fats like sunflower and corn oils in diet.
    2. Avoid sedentary life style and make exercise a daily routine.
    3. Practice yoga and mediation for stress management.
    4. Avoids smoking and drinking alcohol .Limit in take of tea and coffee.
    5. Consume skimmed milk, fresh fruits, takes food in small quantity, warm and soupy and eat slowly.
    6. Take adequate rest and do not sleep in day time, unless exhausted and in hard summer.
    7. Drink warm water throughout the day.
    8. Developed positive approach towards menopause.
    9. Take it as next natural phage of life, a time of greater freedom and liberation from the restrictions. Of younger
    DIET
    Diet has important roll in balancing Harmon's during and after menopause. It is well known that Japanese women Rarely experience hot flashes probably because their diet contains large amount of Soya, a herbal product rich in plant estrogen which is also found in grains and cereals, dried beans, lentils, sunflower seeds and peanuts. Vegetable like carrots , sweet potato's, garlic, turmeric , nutmeg and liquorices , fruits like , pears ,plums , strawberry, all content estrogens .hence should be consume .

    Dr. Harsha Mundada Dr Praphulla Mundada (INDIA)