E-ISSN:2456-3110

Review Article

Vandhyatwa

Journal of Ayurveda and Integrated Medical Sciences

2022 Volume 7 Number 6 July
Publisherwww.maharshicharaka.in

Cervical factors as a cause of Vandhyatwa

Maheshwari P.1*, Jana P.2
DOI:

1* Pallavi Maheshwari, Post Graduate Scholar, Department of Prasooti Tantra and Stree Roga, Sri Kalabyraveshwaraswamy Ayurvedic Medical College, Hospital & Research Center, Bengaluru, Karnataka, India.

2 Papiya Jana, Professor, Department of Prasooti Tantra and Stree Roga, Sri Kalabyraveshwaraswamy Ayurvedic Medical College, Hospital & Research Center, Bengaluru, Karnataka, India.

Vandhyatwa is the condition where a female is unable to conceive which could be due to various causes and one of the causes can be due to abnormality in the cervix either anatomical or physiological abnormality. Cervical factor can contribute to infertility to a large extent. It could be a cervicitis, cervical stenosis, cervical erosion, cervical mucus hostile to sperm, anatomical defects like or pin hole os of the cervix, even sometimes existing cervical carcinoma. In case of a cervical pathology, we can benefit the patient with specific line of management based on Ayurvedic references. Sodhana procedures prior to any treatment will be helpful in making the Yoni Shudha and Shodhana helps in controlling the excessive Dosha vitiation and further treats Vandhya. Ayurvedic formulations and Sthanika Chikitsas are well explained in the Ayurvedic classical texts to improve the cervical mucus quality.

Keywords: Vandhya, Vandhyatwa, Cervical factor

Corresponding Author How to Cite this Article To Browse
Pallavi Maheshwari, Post Graduate Scholar, Department of Prasooti Tantra and Stree Roga, Sri Kalabyraveshwaraswamy Ayurvedic Medical College, Hospital & Research Center, Bengaluru, Karnataka, India.
Email: 		Pallavi Maheshwari, Papiya Jana, Cervical factors as a cause of Vandhyatwa. J Ayu Int Med Sci. 2022;7(6):141-144.
Available From
https://jaims.in/jaims/article/view/1903

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2022-05-26 2022-05-28 2022-06-04 2022-06-11 2022-06-18
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 19%

© 2022by Pallavi Maheshwari, Papiya Janaand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Introduction

Vandhyatwa is a condition where the female fails to conceive due to Mithya Ahara and Vihara. Vagbhata mentions that due to Pradushta Beeja and also due to maldevelopment of the female reproductive tract, Vandhyatwa can result.[1] Shabdakosha mentions that a lady without progeny is termed as Vandhya.

Infertility is defined as the failure to conceive within one or more years of regular unprotected coitus.[2] There are various causes which can be lead of infertility including male and female factors. Based on WHO one in every four couples in developing countries are effected by infertility of 60 to 80 million couples suffering from infertility every year worldwide, probably between 15 and 20 million (25%) are in India alone. The uterine cervix plays an important role in conception and cervix is the part that connects the uterus to the vagina. Thus, any defect in the cervix anatomically and physiologically can cause infertility and incidence in infertility due to cervical factor is about 6% in infertile couples.

Causes of cervical factor in Ayurveda

Based on the Ayurvedic classical references the role of cervix as a part of female reproductive system in causing female infertility are following:

The two possible causes of infertility are congenital and acquired.

1. Ashudha Yoni: Acharya Bhela has mentioned that a women will remain infertile due to Vata vitiation and also due to Yoni Dosha. Thus, considering Yoni as part of the reproductive system i.e., cervix, if found unhealthy or defected can lead to Vandhyatwa. Ayurvedic management can be adopted to make the Yoni Shudha and as Shudha Yoni is considered to be ideal for conception. Thus, the treatment includes Shodhana, Shamana Chikitsa and Sthanika Chikitsa and there are various formulations too which can benefit the patients in correcting the cervical pathology.

2. Garbhashaya Beeja Bhaga Pradosha: Acharya Charaka has explained in Sharirasthana that a lady will be Vandhya when she has Shonita and Garbhashay Beeja Bhaga Pradosha.[3]

3. Suchimukhi Yonivyapad: There are various references which denotes that due to congenital abnormality of reproductive system,

the woman may be remain Vandhya and one such condition is Suchimukhi or Suchivaktra Yonivyapad. Here, Acharya Charaka mentions that pregnant lady who consumes Ruksha Ahara will have vata dushti that affects the yoni of female fetus leading to Suchimukhi Yoni Vyapad.[4] Pin hole OS of the cervix can be taken as Suchimukhi. Treatment adopted here is use of Vatahara Chikitsa. The patient is advised to undergo Vivarana of the Yoni Dwara that is dilation of the cervix.

4. Antarmukhi is the condition that has been explained by Acharya Charaka as bending of the Yonimukhae., Vakrayati Anana Yoni.[5] This condition is yet another form of anatomical defect where due to retroverted and retroflexed uterus, the cervical position may not be usually normal and thus hampering the ascent of sperm leading to Vandhyatwa. As this is the condition that is caused due to Vata Prakopa. Vatahara line of treatment can be adopted.

5. Karnini is a condition where there are Karnikas in the Yoni which resembles Mamsaankur. These growths obstructs of the Rakta Marga (Rakta Marga Avarodhniya) and thus this could be the cause of Vandhyatwa due to Sanga. Here the Doshas vitiated are Kapha and Rakta and there is vitiation of Vayu Thus, the management should be based on correction of Kapha, Rakta and Vayu.

6. Yoni Arshas is a condition where there are development of muscular sprouts which are umbrella shaped (Chatra Kara) and are caused due to vitiation of Doshas that causes destruction of Yoni and Artava (Te Tu Yonim Upagnanti Artavam).[6] This is one of the cause for infertility. This treatment is based on the type of Yoni Arsha and explained that it is Sadhya by use of Bhisaja, Kshara, Agni and Shastra.

7. Shlaishmiki Yonivyapad is a condition where the woman complains of excessive vaginal discharge with Yoni Kandu. The symptoms are very similar to infections like candidiasis and trichomoniasis. These in turn effects the health of the cervical tissues. The excessive thick mucoid discharge in the vagina hampers the ascent of the sperm. Thus, in such cases infertility is evident. Here Yoni Prakshalan and Yoni Pichu with medicated drugs can cure the condition and help in conception.

8. Garbhashayagreeva Mukhagata Vrana is yet another condition where there is presence


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of Vrana over the Mukha of the Garbhashaya Greeva and the symptoms present here are similar to that of the cervical erosion. Though cervical erosion may not be directly responsible for causing Vandhyatwa but it is the condition where cervix remains unhealthy and the various discharges mixed with blood and mucus may not allow the sperm to ascend up. Ayurveda provides better cure in the form of Sthanika Chikitsa like Yavakshara application and also Yoni Prakshalana, Yonipichu with Vrana Ropaka Dravyas.

The cervical factors leading to infertility

As a part of reproductive system, cervix plays an important role to achieve conception, any functional or anatomical defect in cervix could be responsible for infertility. In about 6% of infertile couples, the infertility is caused by the cervical factor.

The cervical glands secrete mucus that is normally thick and impervious to sperm and ascending infections. High estrogen level at mid cycle induces mucus to become thin and stretchy and to have a higher sodium chloride concentration. Estrogen - primed cervical mucus filters out non sperm component of semen and forms channels that help direct sperm into the uterus. Midcycle mucus also creates a reservoir for sperm. This allows ongoing release during the next 24 to72 hours and extends the potential time for fertilization.

Abnormality in mucus production is most frequently observed in women who have undergone cryosurgery, cervical conization or a loop - electrosurgical excision procedure for treatment of cervical neoplasia. Servical infection may also worsen mucus quality.

Laboratory Investigations

The post coital test, also known as the Sims - Huhner test, has been used historically to evaluate cervical mucus. A couple is requested to have intercourse on the day of ovulation and a sample of the cervical mucus is evaluated for elasticity (Spinn barkeit) and for the number of motile sperm per high power field.

Ayurvedic management in treating cervical factors

To benefit the patients suffering from cervical pathology and to treat Vandhyatwa in turn, the following treatment protocol can be adopted –

स्नेह स्वेद वमन विरेचनास्थापनानुवासनैः क्रमशः उपचरेन्मधुरीषधसिद्धाभ्यां क्षीरघृतपुष्टं पुरुषं स्त्रियं तु तैलमांसा भ्यामित्येके: सात्म्यैरेवेति प्रजापतिः॥ (का.सं.शा.5/3)

1. Shodhana[7]

Based on the Doshas involved - Vamana, Virechana and Basti can be administered.

2. Shamana: Based on the Doshas involved the formulations can be selected to treat cervical pathology mentioned in Ayurvedic texts.

3. Sthanika Chikitsa: The following local procedures can be adopted to treat cervical pathologies.

Yoni Pichu with Kasisadi Thaila, Yestimadhu Thaila, Jatyadi Thaila

Yoni Prakshalana with Triphala Kashya and Panchavalkala Kashaya.

Yoni Dhoopana with Haridra, Vacha, and Guggulu

Yoni Lepana with Phala Grita and Sukumar Ghrita

Yoni Purana with Jatyadi Ghrita, Phala Ghrita, Mahanarayana Thaila.

Shastra Karma: The surgical procedures should be followed wherever necessary to correct the cervical pathology for example in cases of Yoni Arshas, Acharya Susruta has mentioned about Shastra Karma based on the characteristic of Arshas. Thus, correcting the growths around the cervix through Shalya Karma clears the obstructed Artavavaha Srotas and helps in conception.

Discussion

Vandhya is the Stree who is infertile and it affects both the couples psychologically to a greater extent. Vandhyatwa caused due to cervical pathology are having varied reasons like cervical infection, cervical inflammation, and growth over the cervix or any other anatomical abnormalities can be successfully treated. Ayurvedic management can prove beneficial in correcting cervical factor and improving the quality of cervical mucus allowing the easy ascend of sperms and finally leading to conception.

Conclusion

Ayurvedic management in treating cervical factor in Vandhyatwa proves effective when followed appropriately.


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Reference

1. Gupta Kaviraj Atrideva. Astanga Samgraha.Vol 1. Varanasi: Chowkhamba Krishnadas Academy; Reprint 2005. p.279

2. Dutta DC. Textbook of Gynecology: New Delhi: Jaypee Brothers Medical Publishers; Reprint 2013.p.227.

3. Kushwaha Harishchandra Singh. Caraka Samhitha.Vol 1. Varanasi: Chaukhamba Orientalia; 2014. p.803

4. Kushwaha Harishchandra Singh. Caraka Samhitha. Vol 2. Varanasi: Chaukhamba Orientalia;2014. p.803

5. Kushwaha Harishchandra Singh. Caraka Samhitha. Vol 2. Varanasi: Chaukhamba Orientalia;2014. p.803

6. Thakral Keval Krishna. Susrutha Samhita: Dalhana Commentary: Varanasi: Chowkhamba Orientalia; Reprint 2014.p.721.

7. Tewari P. V. Kashyapa Samhita: Vruddha Jeevaka: Varanasi: Chowkhamba Visvabharati; Reprint 2008.p.134.


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