E-ISSN:2456-3110

Review Article

Stree Roga

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 1 January
Publisherwww.maharshicharaka.in

Concept of Artava and its applied aspect in Stree Roga

Priyanka1*, Kumar Panda J2, Tanwar S3
DOI:10.21760/jaims.9.1.19

1* Priyanka, Post Graduate Scholar, Department of Prasuti Tantra Evam Stree Roga, Institute for Ayurved Studies and Research, Kurukshetra, Haryana, India.

2 Jitesh Kumar Panda, Professor and HOD, Department of Prasuti Tantra Evam Stree Roga, Institute for Ayurved Studies and Research, Kurukshetra, Haryana, India.

3 Suniti Tanwar, Associate Professor, Department of Prasuti Tantra Evam Stree Roga, Institute for Ayurved Studies and Research, Kurukshetra, Haryana, India.

Women represent the cornerstone of a family’s overall health. Healthy women, Healthy world embodies that women are custodians of family health; they play a critical role in maintaining the health and overall wellbeing of community. In Ayurveda word “Artava” denotes menstrual blood. Artava is related to 2 seasons i.e., it may be due to presence of Ritukala (ovulation period) and Rajakal (menstruation period) in women. Human body is controlled by the three energies called Tridoshas - Vata, Pitta and Kapha which are characterized under seven Dhatus. These Dhatus have Updhatus also. Artava (menstrual blood) is one of the Updhatus of Rasa Dhatu.[1] The specific characteristics of menstrual blood with its physiological and pathological variation described in Ayurveda classics as Shudhartava and Artavdhusti respectively help in identifying the hormonal status of women. Shudhartava plays crucial role in maintaining women’s healthy reproductive life. When Artava is not quite same as highlights of Shudhartava mentioned in classics then there may be Artavdushti or menstrual abnormalities like dysmenorrhoea, menorrhagia, amenorrhoea etc uterine disorders like endometriosis, adenomyosis, uterine fibroid, etc which may be cause of infertility. Ayurveda classics explains about colour, texture, specific smell, amount and other associated features like type of pain in various Artavdushti. So, only by observing menstrual blood variation we can find out the disease associated with it. Thus, study of Artava and Artavdhusti plays a very significant role in diagnosis of pathological disorders related with female reproductive system.

Keywords: Artava, Menstrual blood, Artavadhusti, Diagnostic tool, Panchindriya Pariksha

Corresponding Author How to Cite this Article To Browse
Priyanka, Post Graduate Scholar, Department of Prasuti Tantra Evam Stree Roga, Institute for Ayurved Studies and Research, Kurukshetra, Haryana, India.
Email: 		Priyanka, Kumar Panda J, Tanwar S, Concept of Artava and its applied aspect in Stree Roga. J Ayu Int Med Sci. 2024;9(1):137-142.
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https://jaims.in/jaims/article/view/3025

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-11-07 2023-11-17 2023-11-27 2023-12-07 2023-12-18
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None declared Nil Yes 21.63

© 2024by Priyanka, 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].

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Introduction

Life (Ayu) is the combination (Samyoga) of body, senses, mind and reincarnating soul. Ayurveda is the most sacred science of life, beneficial to humans both in this world and the world beyond. The main goal of Ayurveda is to maintain the healthy status of human being as well as to treat any pathological condition. In order to treat any disease, pathology of that disease which is the basis of diagnosis and treatment is required. For diagnosis of any disease (gynaecologic disorders also) various types of Pariksha are mentioned in classics. Especially in gynaecological pathologies Artava or menstrual blood is the potent indicator tool for underline pathology.

Though the word Artava refers to menstruation or menstrual blood, ovum and ovarian hormones with reference to context in Ayurveda, yet Artavadushti act as a main diagnostic tool for various types of menstrual disorders.

Aim and Objectives

To study Artava and Artavadusthti in detail as per Ayurveda and to understand clinical importance of Artavadushti as a diagnostic tool for Streeroga.

Materials and Methods

All the information regarding Artava and Artavadushti are collected from ancient Ayurvedic literature (Brihatrayee), related journals, research and review articles, Ayurvedic pharmacopoeia of India.

Artava

From Rasa (Dhatu), the Rakta named Raja is formed. Rakta reaching uterus and coming out for three days in every month is called Artava, which is formed in two stages. The hormones of hypothalamus to pituitary then to ovary and ultimately to their target organ i.e., endometrium is carried through Rasa, the plasma, in this endometrium the blood is accumulated and then discharged during menstruation. This very process has been explained by Chakrapani with the words Avirbhava (formation) and Tirobhava (discharge). Initially besides nourishment to endocrine glands as well as uterus and endometrium by Rasa, the transportation of hormones to target organs

through Rasa (plasma) is essential, then the blood accumulated in hair thin branches of Artavavimocini Dhamani (uterine artery) is discharged during menstruation.

Artava is Agneya, has characteristics of Rakta (blood), forms Garbha (fetus) and is also essential for life. The dominant Mahabhuta in this is Tejas. In Ayurveda characteristics of Shudha Artava (pure menstrual blood) are explained. At first, the colour of Shudha Artava (pure menstrual blood) according to different Acharyas.[2]

  • Gunjaphala Sannibham - Blackish Red
  • Padma - Pinkish Red
  • Aalaktsannibham - Brownish Red
  • Indergopsankasm - Bright Red
  • Shasakasruk Partimam - Red
  • Ishatkrushna - Slightly Blackish

Menstrual blood or Shudha Artava, has a texture of Nipicha meaning there are no clots or foaming and a smell of Vigandh[3], meaning there is no extra smell. Shudhartava or pure menstrual blood should not have Arti or pain, Daha or burning. The several properties of Dosha-vitiated Artava (menstrual blood) other than Shudha Artava (pure menstrual blood) are mentioned in classical writings that explain forms of menstrual disorder hearing Artava Dushti (menstrual disorder).

Artavadushti

Eight varieties of Aartavdushti are described in the classics. Acharyas has not addressed the specific causes of the eight menstruation diseases. According to Kashyap, Nasya during menstruation, eating extremely hot consumables and giving Mridukostha patients too many medications after Snehana and Swedana vitiate Artava which results in menstrual disorders. Thus, it may be inferred that Aartavdushti is caused by certain variables that contribute to Dosha vitiation in conjunction with predisposing factors.

Following are the 8 Artavadoshas[4]

1. Vataja

2. Pittaja

3. Shleshmaja

4. Raktaja - Kunapganthi

5. Vatapittaja - Kshina


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6. Pittakaphaja - Putipuya

7. Vatakaphaja - Granthibhuta

8. Tridoshaja - Mutrapurishaganthi

The vitiated Artava has no Beeja, and its clinical characteristics - such as color, discomfort etc. are in line with the Doshas that are involved. Dalhana explains that the clinical characteristics of Artava are identical to those of Shukra. Harita has discussed the clinical features and management of Vataja, Pittaja, and Kaphaja Aratavadushti in the context of Bandhyatva but he has not described Aartavadushti.

The idea of Tridosha and Panchmahbhuta or the "five great elements" is used in Ayurvedic writings. All things are composed of Panchmahabhuta. Menstrual blood or Artava is also Panchmahabhautik (with Tejas as the dominant Mahabhuta). In Ayurveda, Tridosha refers to Vata, Pitta and Kapha.

According to vitiated Dosha, menstruation blood or Artava, has a different colour and consistency. Because there were no such sophisticated laboratory methods in the past, the patient, Rogi, was examined using the following methods:

1. Dashvidha Pariksha (Ten-fold examination)

2. Ashtvidha Pariksha (8-fold examination)

3. Shadvidha Pariksha (6-fold examination)

4. Trividha Pariksha (3-fold examination)

Pariksha (examination) of Artava (menstrual blood) can be done with Shadvidha Pariksha (6-fold examination).

We comprehend the changes in menstrual blood color, texture, and fragrance based on Dosha under the title of Artava Dushti (menstrual disease). Menstrual blood or Artava, is visible and observable using the Panchendriya (five senses) system of Ayurveda. The following is a list of the alterations in Artava or menstrual blood, caused by various disorders of the female genital system.[5,6]

Vataj Artavadusti: Vataj Vrana or reddish, blackish red, and dark violet, is the color of menstrual blood in Vataja Artava Dushti. Artava or menstrual blood, becomes thin, dry, frothy, and scattered (very small clots mixed with liquid substance), excreting slowly, irregularly with pain, especially piercing or perforating pain.

Pittaj Artava Dushti: In it the hue and agony of Pitta is found. The Artava (menstrual blood) vitiated by pitta is yellowish or bluish in colour, is free from unctuousness, smells like pus, fungus, blood or has putrid smell; the expelled blood is hot, connected with strong burning sensation and feeling of heat at the time of its excretion. Harita has added Dysuria to the symptom and classified the hue as resembling the Japa flower, saffron, or blood.

Kaphaja Artava Dushti: Menstrual blood or Artava, becomes vitiated by Kapha and is ejected as a white or yellowish discharge that is excessively thick, slippery, and unctuous in texture. It sinks in water. Harita also causes increased tiredness, sleepiness, stiffness or inactivity, and urine retention.

Kunapagandhi Artavadusti (smells like dead body): Rakta or blood, is the cause of this menstruation illness called Artavadusti. When this condition exists, there is more red blood that comes out during the menstrual cycle, similar to fresh blood. Additionally, it is connected to burning sensations and heat.

Granthibhuta Artavadusti (non/in-complete liquefaction): It is brought on by the vitiation of Vata with Sleshma and is associated with traits of both Doshas, such as pain from Vata and immorality from Kapha.

Putipuya Artavadusti (putrid and purulent): Putrid and purulent Putipuya, also known as Puya Artavadusti, is caused by Pitta and Kapha. Susruta and Vagbhata believe that Dosas are caused by Rakta (blood) with Pitta, however Vagbhata disagrees. Other characteristics of Pitta and Kapha (heaviness, fever and heat from Pitta, burning sensation, etc.) are present in this menstrual illness.

Kshina Artavadusti (oligo zoospermia): Pitta combined with Vayu is the cause. Menstrual blood is sparse, menstruation is delayed, and vaginal pain is present with this disease. It also possesses the qualities of the Pitta and Vata Dosas.

Mutrapurisagandhi Artavadusti (smell like urine and faeces): It has characteristics of all three Dosas because it is the result of their vitiation.


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Discussion

Various characteristics of Artava (menstrual disorders) in different diseases according to Pancheindriya Pariksha[8]

Sparsh Indriyapariksha (consistency)Chakshu Indriya (colour)Stroto Indriya (Shabda)Rasa Indriya (senses examination)Ghran Indriya (smell)Vedana (pain)Other symptomsDiseases
Frothy thin, rough, coldBlackish, or reddish, or washing of flower Palash-Kashaya (astringent)Smells like ironWith or without pain (in sacral cardiac and groin region)-Vataja Asrigdara
Thin, dry, frothy, ScatteredAruna (red), Krishna (black), Violet, black---Perforating or piercing-Vataja Artavadushti
Thin, dry (absence of mucosa), frothyAruna (red), Krishna (black) pinkishWith sound--Severe pain in flanks and groin regionNumbness roughness, stiffness as if creeping of ants in yoni, fatigue, lethargyVatik Yonivyapad
Scattered, frothy, nonunctuousLight red, black, yellow and blue--purulent and putrid smellMay or may not beHeat and burning sensationKshinartava
NormalNormal----Pain in YoniArtavakshaya
Free from unctuousnessYellow or bluish--Visragandhi (like pus and putrid smellBurning sensation and feeling of heat-Pittaja Artavadushti
UshnaBlue, yellow or black in colour--Like dead bodyBurning sensation and feeling of heatFever, generalised heat, local suppurationPittaja Yonnivyapad
Hot, does not coagulateBlue, yellow in colour-Bitter (Katu)Fishy smellPricking or burning sensationIn profuse amount menstrual blood, thirst, feverPittaja Asrigdara
Too much thick, slippery or lubricousWhitish or slightly yellowish--Kaphaja GandhaKanduRetention of urine, stiffness or idealness, lethargy, drowsiness and sleepinessKaphaja Artavdushti
UnctuousYellowish---painlessItching, excessive coldness and dull pain in YoniKaphaja Yonivyapad
Slimy, unctuous, cold, thickPale-Salty-Mild painVomiting,
anorexia
Nausea,
dyspnoea		Kaphaja Asrigdara
Sparsh Indriyapariksha (consistency)Chakshu Indriya (colour)Stroto Indriya (Shabda)Rasa Indriya (senses examination)Ghran Indriya (smell)Vedana (pain)Other symptomsDiseases
SlimmyYellow or resembling Ghrit, bone marrow or muscle fat--Foul smellingBurning sensationFever, anaemiaSannipatik Asrigdara
UnctuousWhitish pale----Burning sensation and pain in yoniSannipatik Yonivyapad
Thick, mucoid---purulentPresent-Granthibhut Artavadushti
Red like fresh blood--Like dead bodyPresent Pitta Vedana-Kunapagandhi Artavadushti

In Ayurveda, we can use characteristics like color, consistency, odour and menstrual blood (Artava) to reach a diagnosis. Variations in menstrual blood are unique to Dosha vitiation and illnesses. Thus, from an Ayurvedic standpoint, Artava Pariksha or menstrual blood testing, is performed by Panchindriya or the five senses and will grow to be a highly significant diagnostic and therapeutic tool. Based on their most common symptoms, we may now associate menstruation disorders, such as Artavdusti, with a variety of illnesses. Pittaja Artava Dusti signs suggest that it may be associated with illnesses like trichomonas vaginitis, chlamydia trachomatis, chronic pelvic inflammatory disease, neoplasm etc. The symptoms of Kunapgandhi (dead body stench) Artavadushti (menstrual disorder) are associated with pyometra since they are caused by genital organ infections and cancer. Granthi Artavadusti with endometrial hyperplasia (not completely liquefying), Putipuya Artavadusti, a purulent and putrid condition accompanied by acute endometritis and cancer that might result in pyometra, Ksheena Artavadusti (oligomenorrhea) in oligospermia Mutrapureeshagandhi Artavadusti has a fourth-stage cervical carcinoma. Atrophic vaginitis and hypooestrinism in Vataja Yonivyapad. Pittaja Yonivyapad, a gynecological illness, is accompanied with a persistent inflammatory condition in the female genital tract. With Trichomonal or Monilial vulva vaginitis, Kaphaja Yonivyapd. Saannipatiki Yonivyapad suffers from a persistent reproductive system infection.[7]

Conclusion

Ayurveda is a field with a wealth of research. To employ Artavapariksha (the study of menstruation


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disorders) as a diagnostic or therapeutic tool, additional important research is needed. The consistency, colour, smell and other characteristics of Artava (menstrual disorders) vary throughout diseases. Therefore, it is a simple source to use when diagnosing ailments that are highlighted.[9] Ayurveda provides a comprehensive description of Artava (menstrual disorders) based on Panchindriya Pariksha (examination of senses). However, in the present era, we have much more sophisticated techniques to study the changes in menstrual blood in response to hormonal changes. We can study these Artava (menstrual disorders) changes in a different way in forms of proteomes by examining the visible menstrual blood or alternatively, we can say that it is the molecular relationship of color and texture change of menstrual blood that was examined in traditional Ayurvedic medicine. Because of this, Ayurveda practitioners may focus on and comment on Artava (menstrual disorders). Due to the lack of clarity in this diagnostic area, numerous investigations on Artavapariksha, or menstrual blood, are ongoing and will be necessary in the future.

References

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2. Tiwari P. Ayurvediya Prasuti Tantra Evam Streeroga. Part 2, Chapter 2. Varanasi: Choukhambha Publication; 2004. p. 64.

3. Astanga Hrdayam of Srimad Vagbhata. Delhi: Chaukhambha Sanskrit Pratishthan; 2012. Reprint Edition, Sarira Sthan, Chapter 1, Slok no 23,24; p. 489.

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5. Shastri A. Sushruta Samhita. Part 1, Hindi. Varanasi: Choukhambha Publication; 2012. Sarira Sthan, Chapter 10, Sloka 59; p. 89.

6. Tiwari P. Ayurvediya Prasuti Tantra Evam Streeroga. Part 1, Chapter 2. Varanasi: Choukhambha Publication; p. 142-148, 166.

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8. Yadav R. Artava - A Potent Diagnostic Tool in Gynaecology. Int Res J Ayurveda Yoga. 2021 Feb;4(2).

9. Yang H, Zhou B, Prinz M, Siegel D. Proteomic Analysis of Menstrual Blood. Mol Cell Proteomics. 2012 Jul;11(10):124-135.


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