E-ISSN:2456-3110

Review Article

Paripluta Yonivayapad

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 3 March
Publisherwww.maharshicharaka.in

Ayurvedic management of Paripluta Yonivayapad - A Review

Choudhary M.1*, Sharma R.2
DOI: http://dx.doi.org/10.21760/jaims.8.3.9

1* Malika Choudhary, Post Graduate Scholar, Department of Prasuti Tantra & Stree Roga, Dr. Sarvepalli Radhakrishnan Rajasthan Ayurveda University, Jodhpur, Rajasthan, India.

2 Rashmi Sharma, Associate Professor, Department of Prasuti Tantra & Stree Roga, Dr. Sarvepalli Radhakrishnan Rajasthan Ayurveda University, Jodhpur, Rajasthan, India.

Yonivyapad comprises around 70% of gynaecological problems and commonly encountered in the practice of Gynaecology. Among them some are causing painful coitus, dysmenorrhoea etc., and Paripluta is one among them. Paripluta is one among the twenty Yoni Vyapads mentioned in the classics. In this disease Pitta and Vata Dusti are considered as primary cause. It can be correlated to pelvic inflammatory disease due its resemblance of clinical features. PID is of public health issue, especially in developing countries because of its high prevalence, economic and social implication. Delayed management of PID may result in higher rates of miscarriage, chronic pelvic pain, STD, progressive organ damage and long term reproductive disability due to its recurrence.

Keywords: Paripluta, Yoni Vyapads, Vata-Pittaja Vyadhi, Sodhana, Sthanik Chikitsa

Corresponding Author How to Cite this Article To Browse
Malika Choudhary, Post Graduate Scholar, Department of Prasuti Tantra & Stree Roga, Dr. Sarvepalli Radhakrishnan Rajasthan Ayurveda University, Jodhpur, Rajasthan, India.
Email: 		Malika Choudhary, Rashmi Sharma, Ayurvedic management of Paripluta Yonivayapad - A Review. J Ayu Int Med Sci. 2023;8(3):51-54.
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https://jaims.in/jaims/article/view/2274

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-01-30 2023-02-01 2023-02-08 2023-02-15 2023-02-22
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 17%

© 2023by Malika Choudhary, Rashmi Sharmaand 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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Choudhary M et al: Ayurvedic management of Paripluta Yonivayapad

Introduction

Women are responsible to create new generation. Under today’s circumstances women are bound to undergo ill-health and unhygienic means that ultimately leads to gynaecological problems. Pelvic inflammatory disease is a common reproductive tract infection seen in active reproductive women. Incidence of PID among sexually active women is 1-2% per year. About 85% are spontaneous infection in sexually active females of reproductive age.[1] Pelvic inflammatory disease is caused by multiple organisms like Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, non-haemolytic Streptococcus etc. This disease manifests with the irregular, excessive vaginal bleeding, bilateral lower abdomen pain, abnormal vaginal discharge, dyspareunia, nausea, vomiting, fever etc.[2] It is commonly managed by systemic antibiotic therapy in modern medicine but the infection doesn’t come under control even after giving an adequate course of broad-spectrum antibiotics. Leaving this condition untreated results in hydrosalpinx, pelvic abscess, pelvic adhesions, infertility, dysmenorrhea etc. In Ayurveda this painful condition can be compared to Paripluta Yonivyapad based on the clinical manifestations.[3]

Paripluta is one among the twenty Yoni Vyapads mentioned in the classics that is seen in women of reproductive age group. Many women have silent clinical features of Paripluta which has effect on her personal, interpersonal relationship between husband and wife. In this disease Pitta and Vatadusti are considered as primary cause. Acharya Charaka and Vagbhatta consider it as a Vata-Pittaja Vyadhi while Sushruta has mentioned it as a Vataja Vyadhi.[4] It is characterized by Saarti Neel, Peet Asrakasraveta (painful menstruation with yellowish or bluish color of menstrual blood) Gramyadharmeruja (Dyspareunia), Shotha (inflammation of Yoni), Sparsha-Asahatva (tenderness), & Vedana in Shroni, Vankshan, Pristha, Kati (pain in lumbosacral and groin region, backache) Jwara (fever).[5] Maharshi Sushruta says that the condition is characterized with severe dyspareunia, besides other pain and ache. Both the Vagbhatta have followed Charaka, however they have included heaviness in the regions of bladder and lower abdomen, Atisar (diarrhoea) and Arochaka (anorexia) etc. also in the list of symptoms.[6] Madhava Nidana, Bhavprakasha and Yogaratnakara etc. have followed Sushruta.

Nidana

Samanya Hetu (nonspecific etiology) of Paripluta Yonivyapad

Mithyachara (include abnormal diet and abnormal mode of life), Pradushta Aartva (hormonal disorders), Beeja Dosha (abnormalities of sperm and ova), Excessive indulgence in coitus, Daiva Prakopa (idiopathic), Apadravya Prayoga (use of iron objects for sexual pleasure) etc.[7]

Vishesha Hetu: Maharshi Charaka and Vagbhatta has discussed about Vishesha Nidana (specific etiology) of Paripluta.

Pittala - It means women having predominance of Pitta due to her Pitta Prakriti and consumption of diet which exaggerate Pitta.

Pitta Prakriti - Women having Pitta Prakriti develop Pittaja Roga quickly even by less etiological factors (Alpa Nidana, Sevana) and the Roga are Kasthasadhya.

The word 'Nrisamvaase' shows that in causation of this disease coitus (due to excessive coitus, coitus in abnormal position) is very important cause. Swayathu-Udgara Dharanata: In Charaka Sutrasthana the description of Adharniya Vega and its results are mentioned. Suppression of natural urges, lead to Vata Prakopa but the urges mentioned in Paripluta Yonivyapad have no direct relation in causation of this disease. So, we can conclude that by mentioning the two Vega, other Adharniya Vega should be considered and all these lead to Vata Prakopa.

Since Shotha is very important feature of Paripluta Yonivyapad so we should also know about Shotha Nidana which is explained by Acharya Charaka in Sutrasthana, 18 chapter, Trishothiya Adhyaya.

Rupa (symptoms) of Paripluta Yonivyapad

In Paripluta yonivyapad there is vitiation of Vata-Pitta. The symptoms of Paripluta Yonivyapad are -

  • Yonishoola/ Yonishotha - vagina/uterus gets inflamed
  • Yonisparsha Asakshama - tenderness in vagina/uterus
  • Nila-Peeta Asrak Strava - painful menstruation having yellowish or bluish discoloration of menstrual blood.
  • Shronimandal Vedana - severe pain in lumbo-sacral, pelvis and groin, backache

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  • Vankshanapradesh Vedana
  • Jwara - Fever

Other symptoms include -

  • Gramya Dharme Ruja Bhrusham - severe pain during coitus (Sushruta)
  • Vasti Kukshi Gurutwam - heaviness in urinary bladder and lower abdomen (Vagbhatta)
  • Atisara - diarrhoea (Vagbhatta)
  • Arochaka - anorexia (Vagbhatta)

Samprapti of Paripluta

Nrisamvaase (excessive coitus) + Shwayathu-Udgara or any Vega Dharana + Mithya Achara

↓

Dosha-Vaishmya (Apana Vata & Pitta Prakopa)

↓

Doshas vitiate Dushya (Rakta & Mamsa)

↓

Reaches the site of Kha-Vaigunya with Rasvaha, Raktvaha, Artavavaha Srotas

↓

Kshubdha Yoni

↓

Disturbance of normal defence mechanism of Yoni (Vyadhikshamatva)

↓

Paripluta Yonivyapad

Treatment protocol

Shodhana Chikitsa: Virechana Karma and Basti Karma

Basti Karma should be given as Yoga Basti follows - 1 Anuvasana with Sacharadi Taila then Niruha Basti with Dashmooladi Niruha next day in morning. It will help to pacifying Dosha.

Shamana Chikitsa

  • Pushyanug Churna - 10 g twice daily Tandulodaka (rice washed water) and honey. It is Vrana Ropana, Krimighna, Raktshodhak, Pittaghna, AartvaJanana, Shothaghna, Pachana, Vednasthapan, Rasayana, Garbhasaya Shodhaka, Pradarahara, Balya, Deepana, Jwarahara.
  • Chandra Prabha Vati - 2 tablet bd with lukewarm water. It is Balya, Vrushya, Sarwa Rogpranashini, Tridosha Nashak.
  • Kanchnar Guggul - 2 tablet bd with lukewarm water. It is Shothhar, Vrana Ropana.
  • Triphala Guggulu - 2 tablet bd with lukewarm water.
  • Kutaja Ghanavati - 2 tab/BD

Sthanika Chikitsa

Yonidhavan: Started after the 8th day of menses given with Kwath of 500 ml for 2 minutes.

1. Dashmoola Kwath:The main aim of the treatment is Vata Pitta Shamana, Vedana Sthapana, Yonishodhana and Vrana Ropana.

2. Panchvalkal Kwath: It is Kapha Shamaka, Sthambhaka and having properties like Kasaya Rasa (astringent), antiseptic and wound healing. Because of these properties it helps in increasing local cell immunity and prevents recurrence of symptoms in patients. In Panchvalkal Kwath most of the drugs are of Kasaya Rasa. Kasaya Rasa with the Shoshana, Stambhana, Kaphapittahar and Kledahara Guna acts in reducing the Strava, also due to Ropana Guna it may have helped in healing the cervicitis.

Yoni Pichu: Started after the cessation of menses and patients were instructed to retain the Pichu for 3 hours or till the urge to micturition. Patients were instructed abstinence for at least 7 days & later compulsorily use of barrier method for period of 1 month.

1. Panchvalkaladi Tail: Drugs of this formulation possess Rasa like Kashaya Rasa, Madhura Rasa, Tikta Rasa, Ruksha, Guru, Laghu Guna, Sheeta Virya, Katu Vipaka. Guru Guna cause Vata-Shamana, Brimhana, having the predominance of Prithavi and Jala Mahabhuta and Sheeta Virya causes Pittashamana, Stambhana, Balya, Vishyandana, having the predominance of Prithavi and Jala Mahabhuta. It pacifies mainly Pitta Dosha

2. Dashmoola Tail: It have Shothaghna, Jwaraghna, Shula Prashamana, Mutrala, Vrana Ropana, Vatashamaka Guna acts in reducing the Strava and Antibacterial Anti-pyretic, Spasmolytic, Uterine Stimulant properties of the drugs efficiently reduced the tenderness and helped in relieving other symptoms.


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Choudhary M et al: Ayurvedic management of Paripluta Yonivayapad

Discussion

Pelvic inflammatory disease is a most common female genital organ disorders which may lead to infertility. Herbal drugs have promising role in the treatment of PID. The review has successfully narrated all detail information regarding treatment of PID and prevention of infertility and any other complications.

Conclusion

Paripluta Yonivyapad is a Vata-Pittaja disorder, characterized by Gramyadharmaruja, Shotha, Sparshakshamatwa, painful menstruation having yellowish or bluish color of menstrual blood, Vedana in Sroni, Vankhshana, Prusta, Kati. Aggravated Pitta associated with Vata reaches Yoni leads to Paripluta Yonivyapad. Pelvic Inflammatory Disease presents with bilateral lower abdomen pain associated with tenderness, dyspareunia, vaginal discharge which is mucoid or muco- purulent in nature & menstrual irregularities. Similar clinical presentation can be seen in Paripluta Yonivyapad. The management is based on the Doshic vitiation i.e., Vata-Pitta Shamaka and Shothaghna and Ropana property. It can be managed in Ayurveda by following an extensive treatment protocol by oral and local therapy, thereby its complications and recurrence can be curbed effectively.

Reference

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3. J Stanley, J Robboy, C Malcolm. Pathology of Female Reproductive Tract. NEngl J Med 2003; 348:2267-8.

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