E-ISSN:2456-3110

Review Article

women’s reproductive health

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 9 September
Publisherwww.maharshicharaka.in

An empirical review of fundamental principles of Ayurveda for women’s reproductive health and diseases

Patel M1*, Vishnoi S2, Neelima A3
DOI:10.21760/jaims.8.9.17

1* Mahima Patel, Post Graduate Scholar, Department Of Prasuti Tantra And Stri Roga, Post Graduate Institute Of Ayurved Dr S R Rajasthan Ayurved University, Jodhpur, Rajasthan, India.

2 Santosh Vishnoi, Post Graduate Scholar, Department of Prasuti Tantra and Stri Roga, Post Graduate Institute of Ayurved Dr S R Rajasthan Ayurved University, Jodhpur, Rajasthan, India.

3 A Neelima, 3Professor HOD, Department of Prasuti Tantra and Stri Roga, Post Graduate Institute of Ayurved Dr S R Rajasthan Ayurved University, Jodhpur, Rajasthan, India.

Ayurveda is known for its promotive, curative and therapeutic concepts. The main objective of Ayurvedic treatments is to promote healthy lifestyle through proper nutrition, prevention of disease and specialized treatments based on the diagnosis. The fundamental principles hold a firm ground in Ayurveda. From creation of living beings to issues of health, disease and its diagnosis & treatment, these fundamental principles are the roots. Woman’s Reproductive life is associated with drastic physiological, anatomical and psychological changes during menarche, reproductive period, pregnancy, menopause and post menopause.
Aim & Objectives: To promote and maintain the overall well-being of Women throughout their lives using the principles of Ayurveda.
Methodology: All the material and data are collected from ancient’s treaties, Ayurvedic books, Research paper under google scholar, PubMed, research gate etc. search engines.
Result: Ayurveda considers menstrual health, fertility, pregnancy, and postpartum care as essential aspects of a Woman's life. It focuses on natural and personalized methods to address Women's reproductive issues and promote overall wellness.
Discussion: Although any individual, regardless of constitutional type, can be provoked in any and it is the Vikriti, the imbalanced ratio of Doshas which we treat in Ayurveda, still these cyclical imbalances operate within a specific individual constitutional background which must be taken in account in formulating individual treatment plans.
Conclusion: Ayurveda dose provide principles and guidelines for diagnosis and treating the various Women’s health conditions & diseases.

Keywords: Women’s Reproductive Health, Prasuti Tantra & Stri Roga, Clinical Aspects, Tridosha, Dhatu, Agni

Corresponding Author How to Cite this Article To Browse
Mahima Patel, Post Graduate Scholar, Department Of Prasuti Tantra And Stri Roga, Post Graduate Institute Of Ayurved Dr S R Rajasthan Ayurved University, Jodhpur, Rajasthan, India.
Email: 		Patel M, Vishnoi S, Neelima A, An empirical review of fundamental principles of Ayurveda for women’s reproductive health and diseases. J Ayu Int Med Sci. 2023;8(9):105-111.
Available From
https://jaims.in/jaims/article/view/2772

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-07-13 2023-07-18 2023-07-23 2023-07-30 2023-08-26
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None declared Nil Yes 21.47%

© 2023by Patel M, Vishnoi S, Neelima Aand 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

Women’s Reproductive health is a condition in which the reproductive process is accomplished in a state of complete physical, mental and social well-being and is not merely the absence of disease or disorders of the reproductive process. Sexual and reproductive health problems are responsible for one third of health issues for women between the ages of 15 and 44 years.[1] Different life stages are associated with specific women’s sexual and reproductive health issues including: Menstruation, Fertility, Cervical screening, Contraception, Pregnancy, Sexually transmissible infections, Chronic health problems (such as endometriosis and polycystic ovary syndrome), Menopause, Unplanned pregnancy and Abortion. By addressing these issues and ensuring access to comprehensive reproductive healthcare, we can improve women's overall well-being and quality of life.[2]

Ayurveda, the ancient system of traditional medicine that originated in India, has a specialized branch called "Prasuti Tantra" and "Stri Roga," which deals with women's health and promotes a healthy lifestyle through proper nutrition, prevention of diseases, and specialized treatments based on diagnosis. Ayurveda not only defines all epoch’s of woman’s life like Bala, Kumari, Rajaswala, Ritumati, Garbhini, Prasava, Sutika etc., but also the health status in regards of Dosha and Dhatu variation and preventive steps in the form of diet and life style modifications to achieve health during all these epoch’s where drastic changes occurs which makes her susceptible for major illnesses. These diet and lifestyle modifications are known as Paricharya. Understanding the basic principles of Ayurveda can indeed provide valuable insights into Women's reproductive health and disease. The fundamental principles hold a firm ground in Ayurveda. From creation of living beings to issues of health, disease and its treatment, these fundamental principles are the roots. These can be computed as Tridosha, Dhatu-updhatu, Mala, Agni, Pancha-mahabhuta, Ama, Srotas, Avaran, Prakriti, Ojas, Arista etc. They were also placed on a sound scientific footing so that all physiological and pathological phenomena were interpreted logically. The Ayurvedic law of uniformity of nature was established which helped in applying the physical laws to the biological field.[3] It's important to note that while Ayurveda can provide valuable perspectives on Women's reproductive health.

Doshas & it’s relation to Women’s Health

The main components of human body are: Dosha, Dhatu & Mala. Principle of Purusha Loka Sammit Nyaya explain that Kapha, Pitta, Vata maintain body functions, just the same as moon, sun and wind do it in the nature.[4]

Vata

Vata Dosha is associated with movement, including all bodily movements and functions. It is believed to control processes like respiration, circulation, and elimination. In Ayurveda, the pelvis is considered the seat of Vata, and disturbances in Vata can affect reproductive organs in women. Regarding menopause, Ayurveda believes that a predominance of Vata during this phase can lead to Dhatu Kshaya, which refers to the depletion of tissues and vitality in the body. In Ayurveda, Apana Vayu is a specific sub-type of Vata responsible for the downward and outward flow of energy in the body. It governs functions like the elimination of waste, menstruation, ejaculation, and childbirth.[5] The concept of Garbhadhan Vidhi refers to the process of conceiving a child, and it is believed that the position and timing during intercourse can influence the Doshas and thus the chances of conception.[6]

Pitta

Raja is present in women and has characteristics of Pitta Dosha. Pitta Dosha is associated with qualities like heat, metabolism, and transformation in the body. Aartava Shonitamtvaagneyam refers to the fact that menstrual blood (Aartava) is essentially a form of Shonita (blood) which is of an Agneya (fiery or Pitta) nature.[7] The reproductive age, also known as the middle period, is when all the Dhatus (tissues) in the body, including Bala (strength), Virya (semen), Paurush (vitality), Parakrama (ability to perform physical activities), Grahana (sensory perception), Dharana (concentration), Smarana (memory), Vachana (speech), Vijyana (intelligence), and others are fully developed and mature. During this period, the dominance of Pitta Dosha is believed to be prominent.[8] Rutuvyatita Kala, also known as the secretory phase, is the time around the premenstrual period. It is believed to be dominated by Pitta Dosha, which can lead to premenstrual symptoms like anger, excessive hunger, insomnia, and acne.[9] Grabhadhana Vidhi refers to the process of conception or procreation. The text mention that coitus (sexual intercourse)


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performed in the left lateral position displaces Pitta, which burns the Rakta (blood) and Shukra (semen).[10]

Kapha

Shukra has characteristics of Kapha Dosha. Childhood to Puberty: During this stage, Kapha Dosha tends to dominate, as the body is still developing, and the individual may exhibit characteristics of Kapha, such as softness, immaturity of Dhatus (tissues), and delayed development of physical traits like facial and axillary hair. Rutukala (Proliferative Phase): This phase is also considered to be dominated by Kapha Dosha. The individual may appear bright and healthy, have moist mouth and teeth, and experience excitement and desire for sexual relations (Rutumati Lakshana).[11] Garbhadhana Vidhi: This refers to the ritual coitus (sexual intercourse) performed in the right lateral position, with the belief that it displaces Kapha, which then obstructs the Garbhashaya (uterus), possibly to aid in conception.[4]

 Here Doshas are structural and functional units of human body. To keep maintain healthy women reproductive life should maintain all three Doshas in balanced state, As per Acharya Vagbhata - ‘Rogastu Doshavaishmya Doshasamya Arogata’. An imbalanced ratio of the Doshas (either Vriddhi or Kshaya) leads to Roga (Diseases) in Women.[12]

Dhatus & it’s relation to Women’s Health

Human physiology depends on balanced state of Dosha, Dhatu & Mala. Doshas are the main bio-energies which are responsible for the physiological activities. These activities take place through the media of Dhatu-Upadhatu & Mala. Dhatus can be called as the stabilizing pillars of the body. Upadhatus are byproducts of Dhatu. Malas are excretory products formed during metabolic activity of the body.

The concept of Dhatus in Ayurveda refers to the seven fundamental tissues in the body, which are responsible for the maintenance and nourishment of the entire body. These Dhatus include Rasa (plasma), Rakta (blood), Mamsa (muscle), Meda (fat), Asthi (bone), Majja (bone marrow), and Shukra (reproductive tissue).[13] The proper formation of these Dhatus is vital for overall health and, specifically, for the healthy reproductive life of women. Women's health and reproductive system as more complex compared to men's due

to their intricate reproductive cycle. The health of the reproductive system in women is governed by Artava-Vaha Srotas, which is the channel responsible for the functioning of the female reproductive system. It influences the menstrual cycle, the growth of secondary sexual characteristics, and the monthly release of Raja (ovum and hormones). According to Ayurveda, the process of Garbhotpadhana (conception) and the formation of the Stri Bija (Ovum) and Purusha Bija (Sperm) are influenced by the Dhatus and Upadhatus. Proper nourishment and formation of Dhatus are crucial for the regularity and health of these physiological activities.

The monthly menstrual cycle, pregnancy, and the formation of Apara (Placenta) and Stanya (Breast milk) are all considered important aspects of a woman's reproductive health. Any imbalance or malformation of the Dhatus can lead to various obstetric and gynecological conditions in women.[14]

Ayurveda emphasizes the role of Ahara Rasa, which consists of nutrients derived from the seven Dhatus, in nourishing the body and supporting proper Dhatu formation. Jatharagni (digestive fire), Dhatvagni (tissue-specific metabolic fire), Srotasas (channels of circulation), and Dhatu Sarata (regularity of the Dhatus) all play essential roles in ensuring the proper formation and function of Dhatus.

To maintain a healthy reproductive life and prevent gynecological issues, Ayurveda recommends a balanced diet, lifestyle practices, and therapies that support the harmonious functioning of the Dhatus and Artava-Vaha Srotas. Ayurvedic treatments, herbal remedies, and lifestyle adjustments are often utilized to address specific imbalances and promote overall well-being in women. However, it is important to consult qualified Ayurvedic practitioners for personalized guidance and treatment plans tailored to individual needs.

Agni & it’s relation to Women’s Health

In Ayurveda, Pitta Dosha is indeed responsible for digestion and is associated with the fire element. Agni, which translates to "fire" in Sanskrit, is considered the digestive fire responsible for breaking down and assimilating the food we eat. Pitta and Agni work together, as Pitta's hot and sharp qualities help in the digestion process facilitated by Agni.


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There are different types of Agni in the body according to Ayurveda. The primary Agni responsible for digestion is Jatharagni, located in the stomach. Additionally, there are seven Dhatvagni responsible for metabolizing and nourishing the various tissues (Dhatus) of the body, and five Bhutagni responsible for metabolizing the five elements (earth, water, fire, air, and ether) in the body.[15]

In women, Pitta and Agni play important physiological roles related to the menstrual cycle (Aartava Utpatti), fetal circulation (Garbhaposhana), and complexion (Garbhavarna Utpatti). Imbalances in the Doshas and Agni can lead to vitiation, causing issues such as Vishama Agni (irregular digestion), Tikshnagni (hyperactive digestion), and Vishama Agni (variable digestion), which are believed to contribute to various diseases.

Applied Aspect

Vikriti, an imbalanced ratio of the Doshas relative to the individual's Prakriti, malnourished and malformed Dhatus and Dushtagni are actually treated in Ayurveda, and it is assessed by examining the patient, including reading the Doshas in the pulse, and by extensively questioning the person about symptoms and past history. Examine Dhatu Sarata of patient, Assessed Agni status by questioning about food habits and Koshtha Parikshana.

Those changes which have more universal and predictable causes, such as the cycling of the Doshas through the day, the year, and the life-span are described and accounted for in Ayurvedic diagnosis and treatment. The Ayurvedic understanding of the cycle of Doshas through the life-span is particularly important to issues of women's health. From the development of the fetus in utero through young adulthood, the time of normal body growth, Kapha dominates. Pitta begins its first dramatic increase at adolescence and comes to dominate the body process usually no later than the early thirties. It is highest in the middle years, when, driven by Pitta emotions, people typically are concerned with career advances, and risk is high for many Pitta disorders such as high blood pressure, non-congestive heart disease, ulcers, hyperthyroid, etc. It is also a high-risk rime for many female disorders. Vata begins to exert considerable influence during the sixties, and by the seventies it is the dominant creating the patterns of dryness

of tissues and decreased bone density associated with the aging process. Each month, with the ending of menstrual bleeding, women may experience a temporary feeling of depletion, due to the elimination of Pitta (through the heat and Rakta, or red blood cells) and Kapha (through the serum, or Rasa, part of the blood) which has just occurred in the process of menstruation. Artava in females is considered by some as equivalent to Shukra Dhatu in males as the precursor tissue for the formation of Ojas. This brief period of depletion is, however, followed quickly by a phase of Kapha increase as the endometrium is built up again. The influence of Kapha persists until a few days before ovulation, when Vata, the kinetic factor, becomes active in order to propel the egg through the fallopian tubes into the uterus. If fertilization does not occur, the dominance of Vata at ovulation gradually gives way to pain in the premenstrual days and during menstruation.[16]

Greater efforts toward rejuvenation in postmenopausal years are essential for Vata-dominant women, because the dry and emaciating effects of Vata, such as those seen in osteoporosis and loss of skin tone, can affect them more severely. Women who are dominant or provoked in Pitta who usually suffers the most extreme symptoms of cyclic changes, whether it be menopausal or menstrual, and who run the greatest risk of morning sickness and miscarriage during pregnancy.

Illness, whether its initial cause is internal or external (infectious organisms, change in seasons or adverse weather conditions, poor diet or inadequate living conditions, injuries or traumas), often takes root in the physical body through one of three avenues: through disorders of Agni (digestive capacity), through blockage of Strotas (the physical channels through which substances move), or through imbalance of the Doshas.

However, when Ama is present in the system, menstruation can become toxic, and the smoothness of the entire monthly cycle can be disrupted.

The Doshas will seek to escape the body through inappropriate channels, or will be blocked altogether and cause pain, infection, or abnormal growths. Fibroid tumors, ovarian cysts, and fibrocystic breast disease, as well as some types of infertility are examples of diseases which arise due to blockage of Srotas.


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Table 1: Tridosha & its relations to others Principles

Dosha Vata Pitta Kapha
DhatuAsthiRakta, SwedaRasa, Mamsa, Meda, Majja, Shukra
Pancha-mahabhutVayu, AakashaTejaJala, Prithvi
RasaVata Prakopa: Katu, Tikta, KashayVata Shamak: Madhur, Amla, Lavan Pitta Prakopa: Katu, Amla, LavanPitta Shamak: Madhura, Tikta, KashayKapha Prakopa: Madhur, Amla, LavanKapha Shamak: Katu, Tikta, Kashay
KoshthaKruraMruduMadhyam
AgniVishamTikshnaManda
PrakritiVatajPittajKaphaj
Vaya -AvasthaVriddhaMadhyamBala
Day-NightTime of end of day-nightMidday & MidnightStart of day & night
Ritu (Season)VarshaSharadVasant

Table 2: Tridosha & its clinical aspect in relation to Women’s Health

Dosha Vata Pitta Kapha
Women’s Reproductive Health Issues in different Age periods.Premenarcheal (5-11 years) Trauma to the genital tract, Developmental and Congenital Anomalies, Precocious puberty.Premenarcheal (5-11 years) Vaginal bleeding.Premenarcheal (5-11 years) Vulvoviginitis, Obesity, Delayed Puberty, Amenorrhea.
Reproductive period (15 to 44 years) Menstrual abnormalities, Dysmenorrhea, Chronic pelvic pain, Infertility,  Reproductive Period (15 to 44 years)PMS, Abnormal Uterine Bleeding, Infertility, Abortion, Hormonal Imbalance, Skin Disorders, Urinary tract infections, Inflammatory conditions, Digestive problems, Hirsutism, Pelvic Infections, PID, RTIs and STDs.Reproductive Period (15 to 44 years)Vaginal yeast infections, Benign tumor, Fibrocystic Breast & ovaries, Oedema, Obesity, Infertility, Menstrual irregularities, PCOS, Weakness, Depression
Post menopausal (Above 45 yrs)Neoplasm, Postmenopausal symptoms, Vaginal dryness, Dyspareunia, Osteoporosis, Dry skin and Hair, Anxiety, Insomnia,  
Shaman ChikitsaBrahmi, Vidari, Bala, Ashwagandha, Dhashmool, Vidari, Dhashmool Arishta, Rajah Pravartini Vati, Kanya Lohadi Vati, Prataplankeshwar Rasa.Shatavari, Chandan, Tagar, Guduchi, Nimba, Yashtimadhu, Amalaki, Kumari, Ela, Shankha Bhashma, Laghu Sutsekhara,Chandraprabha Vati,Aarogya Vardhini, Chitraka, Trikatu, Trifala, Guggulu, Ashoka, Lodhra, Shatpushpa, Pushyanug Churna
Pancha KarmaBasti, Nasya, Abhyang, ShirodharaVirechanaVamana
Sthanika ChikitsaUttarbasti, Yoni Prakshala, Yoni PichuYoni Pichu, Yoni PrakshalanYoni Dhupan, Yoni Puran
Pathya Diet - Wheat, Black gram, Sesame seeds, Mango, Onion, Garlic, Cinnamon, Sugar cane, Buttermilk, Butter, Almond, Hot and oily foods.   Diet - Butter, Jack fruit, Moth bean, Lotus, Sugarcane, Pointed guard (parval), Date (kharjoora), Fennel seeds, Grapes, Neem leaves, Rose, Coriander, Cucumber, Amla remedy, Carrot, Sweet potatoes, sprouts, Pumpkin, Rice, wheat, Mung dalDiet - Beans, Green grams, Bengal grams, Horse grams, Amla, Garlic, Neem, Turmeric, Bitter gourd, Mustard, Honey, Cow urine, Long pepper, Ginger, Trifala, Barley.
Lifestyle - Good sleep, attending hunger, thirst and natural urges as when they appear, Simple yoga & Meditation.Lifestyle - Moderate exercise, Meditation, Morning walking, Laughing, Cold water bath.Lifestyle - Exercise, Running, Keeping awake during night.
ApathyaDiet - Rajamasha (Cow pea), Peanut, Indian bean, Bengal grams, Peas, Green grams, Cold water, Dry & spicy namkins, junk foods, aerated drinks.Diet - Ripe Mango, Mustard, Fenugreek, Chillies, Papper, Ajown, Tulasi, Vacha,Diet - Dadhi, Cotton plan seed, Madhuka, Rice, Wheat, Corn, Sweets, Dairy products.
Lifestyle - Late night sleep, Excessive exercise, Avoid fasting, stress at work, excess talking & thinking, excess sexual activities, travelling.Lifestyle - Avoid Krodh (anger), Spicy and oily foods, Excessive sun exposure, Fasting.Lifestyle - Restricting Sleep and Day sleep, Avoid sedentary lifestyle.

Discussion

Although any individual, regardless of constitutional type, can be provoked in any and it is the Vikriti, the imbalanced ratio of Doshas which we treat in Ayurveda, still these cyclical imbalances operate within a specific individual constitutional background which must be taken in account in formulating individual treatment plans. Ayurveda indeed has a vast array of formulations and single herbs that are used to balance the Doshas and promote health. In case of Agnidushti Dipan & Pachan Chikitsa focuses on correcting imbalances in the digestive system and promoting healthy digestion through dietary modifications, herbal remedies, lifestyle changes, and other therapies. Treatment is to remove the digestive and systemic Ama as well as using herbs like turmeric (Haldi) which specifically act to cleanse the Rakta Dhatu. Immunity and strength of Dhatu can be improved by Rasayan Chikitsa. In such cases of Srotosanga (Blockage) various of the Purva or Panchakarmas, or Ayurvedic cleansing practices, may be indicated, as well as inclusion of various herbs which act to open blocked channels, liquefy mucous, decrease inflammation, or remove excess benign tissues, such as Guggulu preparations, myrrh, Trifala, Amla, castor oil, honey, turmeric, licorice root, Mahasudarshan, etc.[17] Panchmahabhautik Chikitsa involves understanding the elemental composition of a person's body and using various therapies and treatments to restore the balance of the elements and Doshas. The principle behind Panchmahabhautik Chikitsa is to address the root cause of the disease rather than just treating the symptoms.[18] Moderate daily exercise and Yoga Asanas, as well as the avoidance of heavy or sticky foods, such as meat, yoghurt, and fried foods are also important. A combination of Virechana (purgation) and Basti (medicated enema) is usually effective in such cases.

Conclusion

The person is called as Swastha (Healthy), if he has balanced or equilibrium condition of Dhosha, Dhatu, Mala, Agni, and happy and balanced state of soul, sense organs and mind. For that Ayurveda gives priority to maintain the Healthy state of a normal human being and also treat the disease of patient. Ayurveda dose provide principles and guidelines for diagnosis and treating the various Women’s health conditions & diseases. It is a well-known


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fact now that the diet, life style modifications with scientific approach in treatment considering Dosha, Dhatu and Agni has given encouraging results in treating disorders related to women’s reproductive health.

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14. Premvati Tiwari, Prasutitantra Part-1, Chaukhambha Orientalia Varanasi. 2011, Chapter 2 & 11.

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