E-ISSN:2456-3110

Case Report

Primary Dysmenorrhea

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 8 August
Publisherwww.maharshicharaka.in

Role of Sahacharadi Taila Matra Basti in management of Udavartini Yonivyapad w.s.r. to Primary Dysmenorrhea: A Case Study

Kaushal S1*, Kumar Panda J2, Tanwar S3
DOI: http://dx.doi.org/10.21760/jaims.8.8.46

1* Sudhi Kaushal, Post Graduate Scholar, Department of Prasuti Tantra Evum Stree Roga, Shri Krishna Government Ayurvedic College And Hospital, Kurukshetra, Haryana, India.

2 Jitesh Kumar Panda, HOD Professor, Department of Prasuti Tantra Evum Stree Roga, Shri Krishna Government Ayurvedic College and Hospital, Kurukshetra, Haryana, India.

3 Suniti Tanwar, Associate Professor, Department of Prasuti Tantra Evum Stree Roga, Shri Krishna Government Ayurvedic College and Hospital, Kurukshetra, Haryana, India.

Introduction: Dysmenorrhoea is defined as painful cramps that occur with menstruation incapacitating enough to interfere with routine activity. Dysmenorrhea is an important health problem of adolescents in school, as well as health practitioners, that badly affects the daily activities and quality of life. Dysmenorrhoea can be correlated with Udavartini Yonivyapad in Ayurveda. Methodology: In this present case study, a 21 years old female patient consulted to the OPD with the complaint of pain in lower abdomen, back pain, nausea and vomiting during menses. Her ultrasonography (USG) was done which was normal. She was supposed to be treated with Sahacharadi Taila Matra Basti; the case was treated for three months with the goal of relieving symptoms. Result: Basti was given for 5 days every month for 3 consecutive cycles. Symptoms of patient were relieved and she had pain free menstruation after three cycles of treatment. Follow-up was done after every cycle. Discussion: The present study emphasizes the role of Ayurveda in bringing a positive result in the management of Primary Dysmenorrhea.

Keywords: Ayurveda, Menstruation, Dysmenorrhoea, Udavartini

Corresponding Author How to Cite this Article To Browse
Sudhi Kaushal, Post Graduate Scholar, Department of Prasuti Tantra Evum Stree Roga, Shri Krishna Government Ayurvedic College And Hospital, Kurukshetra, Haryana, India.
Email: 		Kaushal S, Kumar Panda J, Tanwar S, Role of Sahacharadi Taila Matra Basti in management of Udavartini Yonivyapad w.s.r. to Primary Dysmenorrhea: A Case Study. J Ayu Int Med Sci. 2023;8(8):283-286.
Available From
https://jaims.in/jaims/article/view/2717

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-06-14 2023-06-20 2023-07-01 2023-07-10 2023-07-29
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 17%

© 2023by Kaushal S, Kumar Panda J, Tanwar Sand 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].

J Ayu Int Med Sci 2023;8(8)283
Kaushal S et al: Sahacharadi Taila Matra Basti Udavartini Yonivyapad Primary Dysmenorrhea

Introduction

Dysmenorrhea is defined as painful menstruation of sufficient magnitude so as to incapacitate day to day activities. Dysmenorrhea is of two types. Primary and secondary dysmenorrhea. Primary Dysmenorrhea is one where there is no identifiable pelvic pathology. It is more seen in adolescent girls and more prevalent. It is usually associated with ovulatory cycles.[1] In Ayurveda, primary dysmenorrhea can be correlated with Udavartini Yonivyapad which is characterized by painful menstruation.[2]

वेगोदावर्तनाद्योनिमुदावर्तयतेऽनिलः |

सा रुगार्ता रजः कृच्छ्रेणोदावृत्तं विमुञ्चति ||

आर्तवे सा विमुक्ते तु तत्क्षणं लभते सुखम् |

रजसो गमनादूर्ध्वं ज्ञेयोदावर्तिनी बुधैः||[3]

In the classical Ayurvedic references, Udavartini Yonivyapad is due to “वेगोदावर्तना” i.e., suppression of natural urges like Adhovata, Mutra, Purisha etc., Vata gets vitiated and this vitiated Vata lead to difficult or painful menstruation i.e., "रजः कृच्छ्रेण विमुञ्चति". Apana Vata is responsible for the proper expulsion of Sukra, Artava, Sakrut, Mutra and Garbha.[4] "आर्तवे सा विमुक्ते तु तत्क्षणं लभते सुखम्” i.e., immediately feels relief after the discharge of menstrual blood. With respect to the above fact is seen that in Udavartini Yonivyapad there is difficult or painful expulsion of menstrual blood caused by impairment of Apana Vata. Therefore, Udavartini Yonivyapad can be correlated with primary dysmenorrhea. All classic texts have described Udavartini Yonivyapad as Vata predominant Yoni Roga. Modern treatment includes antispasmodics, analgesics, prostaglandin synthesis inhibitors etc. Pain can never occur without vitiation of Vata. Disorders of the Yoni does not occur without vitiation of Vata.[5] Expulsion of menstruation is function of Apana Vata, whose disturbance can cause pain in menstruation. Hence proper functioning of Apana Vata is essential. Medicines that can correct Vata Vaigunya can be beneficial in pain management during menstruation. It is mentioned that Vataja Yoniroga Chikitsa can be done in Udavartini Yonivyapad Chikitsa. Vataja Yoniroga Chikitsa include Snehana, Swedana, Basti along with Samana Oushadha which can alleviate Vata.[6] Hence the pacification & regulation of the vitiated vata becomes necessary.

Basti Chikitsa is considered the best management of vitiated Vata[7] and Yoga which can correct Apana Vata Vaigunya can be beneficial in treatment of Udavartini Yonivyapad. Since Matra Basti is a type of Anuvasana Basti[8], So the selected drug (Sahacharadi Taila) will be given in the form of Matra Basti. In present article, an attempt has been made to analyze Ayurvedic line of treatment in case of Udavartini Yonivyapad.

Case Report

A female patient aged 21 years reported at the OPD of Prasuti Tantra and Stree Roga at Shri Krishna Government Ayurvedic Hospital with complaint of painful menstruation since last 2-3 years. Her symptoms included crampy pain in lower abdomen for 2 days, back pain radiating to both thighs, nausea and vomiting 1-2 day prior to and on first day of menstruation. 

History of Present Illness 

She got menarche at the age of 14 years. Her complaints started since last 2-3 years. Crampy pain in lower abdomen starts from the first day of menstruation and continued for 2 days. Back pain radiating to both thighs starts with 1-2 day prior to menstruation and continued for 2 days. Nausea and sometimes vomiting from the first day of menstruation. Nausea exacerbated when menstruation started. These were occasionally followed by vomiting. She was frightened to eat despite her hunger due to dysmenorrhea at that time. Because of the agony from her periods, she was unable to go to college and had to use analgesics. 

Past History: Nothing relevant 

Family History: Nothing relevant 

Personal History 

Diet Mixed
Bowel Regular
Appetite Reduced
Micturition Within normal limit
Sleep Disturbed
Allergy Nil
Addiction Nil

Menstrual History 

Menarche - 14 years 

LMP - 24/01/2023 


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Kaushal S et al: Sahacharadi Taila Matra Basti Udavartini Yonivyapad Primary Dysmenorrhea

Interval - 26-28 days 

Duration - 4 days 

Amount - 2-3 pads/day 

Clots - Nil 

Lower abdominal pain - (VAS - 10/10)

Low back ache - (VAS - 5/10) associated with nausea and vomiting occasionally

General Physical Examination 

Built - Normal

Nutritional status - Moderate 

Height - 156 cm 

Weight - 49 kg 

Pulse rate - 72 beats /min 

BP - 110/70 mmHg 

Temperature - 98.6°F 

Laboratory and Ultrasonography Report

On laboratory investigations her haemoglobin was 11.2g/dL and her Ultrasonography Abdomen report was normal. 

Treatment: The patient was reassured about the fact that there was no structural gynaecologic pathology. She was advised to take Basti. She was given three cycles of Matra Basti for three consecutive cycles before menstrual cycle.

Treatment plan

Duration of treatment5 days per cycle for 3 consecutive cycles 10-12 days before menstrual cycle
DrugSahacharadi Taila
RouteMatra Basti by Rectal Route
Dose60ml


Date
12-02-2023 (1st cycle of Basti)
10-03-2023 (2nd cycle of Basti)
07-03-2023 (3rd cycle of Basti)

Purva Karma: Abhyanga with Tila Taila on Kati-Prushta-Parshwa-Adhodara for 15 min and Swedan.

Pradhan Karma: Matra Basti in left lateral position with 60 ml Sahacharadi Taila.

Pashchat Karma: Rest in supine position for at least 15-20 min.

Result: 10-02-2023 (Treatment Started) Painful Menstrual Cycle

Date LMPResult
12-02-2023 (1st cycle of Basti)20-02-2023Severity of Pain reduced (VAS: 8/10)
10-03-2023 (2nd cycle of Basti)17-03-2023Slight pain (VAS:5/10)
07-03-2023 (3rd cycle of Basti)15-04-2023Mild pain (VAS:2/10)No need of analgesics.

The intensity of pain was measured according to VAS Scoring Scale.

Discussion

Primary dysmenorrhea is the most common problem in adolescent age group characterized by severe cramping pain associated with menstruation which incapacitates a woman from her daily routine activities. Primary dysmenorrhea can be correlated with Udavartini Yonivyapad mentioned in Ayurveda which is included under Vataja Yonivyapad by all Acharyas. In Ayurveda, Vatiki Yoniroga Chikitsa can be applicable in Udavartini Chikitsa as both of them are Vata predominant Yoniroga. Vatika Yoniroga Chikitsa include Snehana, Swedana, Basti along with Samana Oushadha which can alleviate Vata.

Mode of action of Sahacharadi Taila: Drugs which have the property to bring about Anuloma Gati of Vata may relieve the symptoms of primary dysmenorrhea. Mulsthana of Aartavaha Srotas is Garbhashya and Aartava Vahini Dhamani[9] which is the main seat of Apana Vata. In this disease condition mainly Apana Vata Dushti is there and Basti is the most effective treatment on this. So, for this patient we choose Basti treatment as Vatahar Chikitsa. So, we give Sahacharadi Taila Matra Basti in patient. Contents of Sahacharadi Taila are 4 parts-Tila Taila and 16-part Kwatha of Sahachara, Devadaru and Nagara. Devadaru (Cedrus deodara) is Kapha, Vatashamaka having the properties like Vedana sthapana, Shothahara, Kusthaghna, Kaphanisaraka. Nagara (Zingiber officinalis) is Kapha-Vatashamaka useful in the conditions like Shothahara, Shulahara. Internally it is digestive. Sahachara (Barleria prionitis) is also Kapha-vatashamaka having the properties like Vedana Sthapana, Shothahara, Kusthaghna, Kaphanisaraka, Vranashodhana, Vranaropana.[10] Sahacharadi Taila which is mentioned by the Vagbhata containing three drugs among them all are having the Ushna Veerya and Kapaha Vatashamaka.[11]


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Kaushal S et al: Sahacharadi Taila Matra Basti Udavartini Yonivyapad Primary Dysmenorrhea

According to Acharya Charaka Sahacharadi Taila Basti is Sarvaroganashaka, Rasayana. Useful in Kshata, Vatakshaya, Pittavikara, Rupa, Varna, Bala, Mansa, Shukra Vradhana.

Conclusion

In Ayurveda, Udavartini Yonivyapad can be treated by using principles of Vatiki Yoniroga Chikitsa. Vatika Yoniroga Chikitsa include Snehana, Swedana, Basti along with Samana Aushadha which can alleviate Vata. Sahacharadi Taila mentioned in Ashtang Hridyam by virtue of its properties like Kapha Vata Shamak, Vedana Sthapana, Shothahara, Vata Anuloman relives symptoms of Primary Dysmenorrhea. Since Basti Chikitsa is considered the best management of vitiated vata. Hence Sahacharadi Taila given in the form of Basti proves effective treatment in Udavartini Yonivyapad (Primary Dysmenorrhoea) leading to painfree menstrual cycle.

Reference

1. Dutta DC. Textbook of Gynaecology. 6th ed. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2013. Chapter 13. Page No. 178.

2. Kapoorchand H. A Comprehensive Treatise on Striroga. 2nd ed. Varanasi: Chaukhambha Vishvabharati;2020. Chapter 5. Page No. 248.

3. Sastri K, Chaturvedi G. Charaka Samhita. Varanasi: Chaukhmaba Bharati Academy; 2016. Vol II Chikitsa Sthana Chapter 30 Verse 25-26. Page No.843.

4. Atridev Gupt K. Astanga Hrudayam. Varanasi: Chaukhambha Prakashan;2020. Sutra Sthana Chapter 12 Verse 9. Page No.121.

5. Sastri K, Chaturvedi G. Charaka Samhita. Varanasi: Chaukhmaba Bharati Academy; 2016. Vol II Chikitsa Sthana Chapter 30 Verse 115. Page No.858.

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8. Shastri A. Sushruta Samhita. Varanasi: Chaukhambha Sanskrit Sansthan; 2018. Chikitsa Sthana Chapter 35 Verse 18. Page No.191.

9. Shastri A. Sushruta Samhita. Varanasi: Chaukhambha Sanskrit Sansthan; 2018. Sharir Sthana Chapter 9 Verse 11. Page No.97.

10. Snehal Sakhare, Rajesh Raut, Vidya Dole, Karuna Dongare. Clinical Efficacy of Sahacharadi Tail Basti in Management of PCOS -A Single Case Study. AYUSHDHARA, 2022;9(2):128-132.

11. Atridev Gupt K. Astanga Hrudayam. Varanasi:Chaukhambha Prakashan;2020. Chikitsa Sthana Chapter 21 Verse 67-69. Page No.573.


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