E-ISSN:2456-3110

Review Article

Female Menstrual Cycle

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 3 March
Publisherwww.maharshicharaka.in

Female Menstrual Cycle and its relation to Tridosha and Sapta Dhatu - A Literary Review

Malik G1*, Kumar Panda J2, Tanwar S3
DOI:10.21760/jaims.9.3.22

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

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

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

Ayurveda is the life science which specifies its two purposes very clearly, first maintenance of one’s health and second curing the diseased condition. Concepts of Ayurveda are based on Tridoshas, Sapta Dhatus and Trimala. Their balanced state is said to be the characteristic feature of a healthy individual. Beside the Doshas and Sapta Dhatus, Upadhatu also mentioned which plays a major role in individual health. Artava, the foremost of its category is the Upadhatu of Rasa Dhatu plays a significant role in reproductive health and conception. The word Artava is used for menstrual blood in Ayurveda classics. The menstrual cycle in Ayurveda is known as Rituchakra, consisting three phases which are Rajashravakala, the Ritukala and the Rituvyatita Kala and shows a time period of 28 days. The normal characteristics of Shudh Artava has been mentioned in Ayurveda classics and deviation from this characteristic are shown due to Tridosha imbalance leading to further problems in Menstrual cycle and reproduction. This abnormality has been described as Artavdushti, Yonivyapad in Ayurveda classics where they are classified on the basis of the three Doshas (Vata, Pitta, Kapha). Considering the normal physiology of menstrual cycle, the bleeding phase is facilitated by Vata dosha, whereas the time period during ovulatory/proliferative phase shows the predominance of Kapha dosha. During the luteal phase, the Pitta Dosha comes into action. Most of the discomforts, abnormalities during menstruation are the outcomes of the Doshas imbalances.

Keywords: Artava, Artavdushti, Rituchakra, Rajashravkala, Ritukala, Tridosha, Menstrual cycle

Corresponding Author How to Cite this Article To Browse
Garima Malik, Post Graduate Scholar, Department of Prasuti Tantra Evam Stree Roga, Institute for Ayurved Studies Research, Kurukshetra, Haryana, India.
Email: 		Malik G, Kumar Panda J, Tanwar S, Female Menstrual Cycle and its relation to Tridosha and Sapta Dhatu - A Literary Review. J Ayu Int Med Sci. 2024;9(3):150-155.
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https://jaims.in/jaims/article/view/3175

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-01-13 2024-01-23 2024-02-02 2024-02-12 2024-02-22
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None declared Nil Yes 20.78

© 2024by Malik G, 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

Ayurveda is the life science which deals with maintenance of healthy condition and curing the diseased one.[1] All the concepts of Ayurveda are described on the basis of Tridoshas, Sapta Dhatus,

Trimala, wherein Tridoshas include Vata, Pitta, Kapha. Sapta Dhatu including Ras, Rakta, Masa, Meda, Asthi, Majja, Shukra. And lastly Trimala including Mutra, Purish, Sweda.

Their balanced state is the characteristic feature of a healthy individuals along with other feature as mentioned by Acharya Sushrut.[2]

In all Ayurveda classics, Updhatus are mentioned as the subcategory of Dhatus as the word “up” suggests. All seven Dhatus have total of 7 Updhatu, wherein first Dhatu has 2 Updhatus namely Artava and Stanya.(3) This “Artava” Updhatu plays a significant role in reproductive health and conception. Hence, the healthy status of Artava is of prime importance when it comes to reproductive health. Any abnormality in Artava and its functions due to Agni Dushti, Sroto Dushti, imbalance of Tridosha’s has an impact on menstrual regulation as well as reproduction.

In Ayurveda, the female menstrual cycle is referred to as Rutuchakra.

Aims and Objectives

To explain about female menstrual cycle and its relation with Tridosha and Saptadhatu.

Materials and Methods

All the information regarding Rutuchakra was collected from ancient ayurvedic literature, related journals, research and review articles, and other authentic sources.

Artava

Artava is defined as the periodical expulsion of blood through the vagina of an adult female. It is the most important physiological process which enables the formation of Garbha. So the regular and uninterrupted occurrence of Artava is necessary for a healthy progeny. It is considered as Updhatu of Rasa and being directed by Vata and is expelled through the vagina.

The Rakta in Stree which reaches the Garbha Kostha (uterus) every month and expelled for three days in every month is called as Artava. From the essence part of rasa the Upadhatu Artava is formed. Artava is Agneya, which has characteristics of Rakta. Artava possess the same characteristics as that of Rakta and helps in the formation of Garbha.

Artava word is used in various contexts like as menstrual blood (raja), hormones (Updahtu), ovum (bija). Various other menstrual abnormalities are mentioned beside Ashtartava Dushti such as Asrigdraa, Artavakshaya, Artava Ativridhi, Nashtartava.

Rutu Chakra /Menstrual Cycle

The menstrual cycle occurring in females has been termed in Ayurveda as Rutuchakra

consisting three phases which are Rajashravakala, the Rutukala and the Rutuvyatita Kala.

Menstruation is the visible manifestation of cyclic physiologic uterine bleeding due to shedding of the endometrium following interplay of hormones through HPO axis, whereas menstrual cycle refers to the time period extending from the beginning of a period to the beginning of the next one.[4]

The first menstruation tends to occur between 11 to 15 years with a mean of 13 years known as menarche. The cycle intervals at 21-35 days with an average of 28 days whereas the menstruation phase lasts for 4-5 days in which a female tends to loss 20-80 ml blood with an average of 35 ml.

The menstrual blood consists of dark altered blood, mucus, vaginal epithelial cells, fragments of endometrium, prostaglandins, enzymes and bacteria. Physiologically the Menstruation stops due to pregnancy and lactation, and at last permanently ceases in between 45-50 years when menopause sets in.[4]

While explaining about the normal characteristics of “Artava” Acharya Charak mentioned “that should be regarded as healthy or normal mensus which occurs every month, which is not slimy, not associated with burning sensation or pain, lasting for five days and which is neither excessive nor very scanty. It should be the colour of the jequirity seed or the lotus or of lac or which resembles the trombidium, the scarlet insect.[5]


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Acharya Sushrut states that “the menstrual blood which resembles the blood of a rabbit or solution of lac and that which doesn’t stain the cloth is greatly praised.[6]

Rajahsrava Kaala (Menstrual Phase)

This phase comes at one month interval for three to five days. Acharya Sushrut has explained that dark coloured blood gets collected for whole month by Artava Vimochini Dhamani in Garbhasya which is expelled out by the action of Apanavayu through Yonimukha. This phase is called Rajashrav. According to contemporary theory, this phase is the menstrual flow phase, signifying that a new cycle starts when fertilization does not take place during the secretory period and the superficial two-thirds of the endometrium sheds.

Rutu Kaala (Follicular Phase)

The stage of Rutuchakra that follows the Rajahsrava Kaala is known as Rutukaala. The duration of this phase, as per Acharya Sushruta, is twelve days. Rutukaala is the name given to this stage of a woman's menstrual cycle because, similar to breeding season, there is a chance of conception if her Garbhashaya absorbs the seeds (sperms). The explanation for why conception occurs during Rutu Kaala is as follows: Just as a lotus flower closes itself after sunset, so too does a woman's Yoni become constricted after Rutu Kaala and refuses to allow Shukra or the entry of Beeja (sperms) into its inner parts, such as the uterus and fallopian tubes. Various characteristic features of Rutumati woman have also been mentioned. The Rutumati woman looks charming, her mouth and teeth are moist, she looks excited to hear love stories and wants to have sex, her flanks, eyes and hair are lax, she feels quivering or twitching over arms, breasts, pelvis, umbilicus, thighs and hips and looks very happy and excited.[7] This Rutukaala corresponds to the menstrual cycle's proliferative phase, which signifies the endometrial epithelium's recovery from the previous menstrual cycle.

Rutuvyatita Kaala (Luteal Phase)

This stage concludes with the start of the Rajahsrava Kaala and occurs shortly after the Rutu Kaala. The Yoni is closed or constricted during this stage of Rutuchakra. As a result, sperm entrance is prohibited, making fertilization impossible during this stage. The secretory phase of the

menstrual cycle, or the uterus getting ready to implant the fertilized ovum, correlates with the Rutuvyatita Kaala.

Rutuchakra and Tridosha

Prakriti of an individual is solely based on the predominance of Doshas at the time of conception till death which cannot be changed.[8] Each and every physiological function of human being depends upon Doshas including menstruation. Accordingly to our Ayurvedic classics, during the early stage of life, the Kapha Dosha predominates and as soon as adolescent stage reaches there is dramatic increased in Pitta Dosha which tends to dominate the body function until early thirties. Lately the Vata Dosha dominates. Generally, a female in her reproductive age experiences some discomforts in their menstrual cycles without any specific pathology which can be regarded as the causative factor. The menstrual cycle happens to be optimally if the Doshas are functioning in their normal state.

Normally in a specific prakriti person, there is predominance of a particular Dosha so technically there will be some variations in her cycles according to that Dosha. It is mentioned that Vata is responsible for pain in all cases, so in an individual of Vata Prakriti there are increased possibilities of painful menstruation. Pitta Prakriti individuals are more prone to mood swings(variations) whereas Kapha Prakriti individuals subjects to have more clots in their menstrual blood.

Types of Menstrual flow related to Tridosha’s

Vataja flowPittaja flowKaphaja flow
Blood arteries constrict due to the Sheeta and Khara properties of the Vata Dosha, which governs the uterus. Ruksha Guna eventually results in an early stop of menstrual flow by depleting the body's tissues. The overall flow and monthly discharge will be comparatively less because of the drop in plasma and blood tissues, the lowered nourishment to the uterine endometrial lining, and the presence of pain wherever there is an obstruction to the free passage of Vata. That's why the majority of the Vata-dominant cycles will hurt.Pitta is both Tikshana and Ushna. Thus, it increases the blood's fluidity to facilitate easy flow. Pitta is found in blood, and too much of it can result in severe bleeding. Due to its propensity to create swelling, it results in premenstrual syndrome symptoms such as acne, painful, swollen breasts, etc. for women.Kapha is Pichilla, guru, and Manda. A noticeable expansion of endometrial tissue is more likely to occur in cases where Kapha Dosha is stronger. The Kapha cycle is more likely to see a heavier flow than the Vata cycle as more blood vessels form to supply this growth.

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Role of Tridoshas

KaphaPittaVata
At Rutukala, Kapha Dosha is prominent. Rutukala, or Navina Raja Nirmana, is reported to occur during this time. Tarpana of the Garbhasaya, according to Acharya Vishwamitra, occurs at this time. This is made possible by Beejavaha Siras, which are similar to the Sukshma Kesha. Kapha Dosha is primarily responsible for the Tarpana process. Prithvi Mahabhuta and Jala Mahabhuta are more common in this period. This is done each month with the hope that if pregnancy happens, the Garbhashaya is prepared for implantation.Because the Yoni Mukha closes during the Rutu Vyatita Kaala, it is an unsuitable time to conceive. Concurrently, there are a number of adjustments made in the Artava; the Navina Raja is now referred to as Purana raja and is eventually driven out. Pitta dosha is important for the change from Navina Raja to Purana Raja. The Ushmata of Shareera also rises during this time. The progesterone hormone is at a higher level than other hormones during this period, and it has also been noted that the basal body temperature rises during this period, supporting the current concept. A number of alterations are observed in the endometrium's constituent parts aside from this. Thus, it can be said that Pitta Dosha is prominent during this time.Vayu brings the blood that has been drawn for the entire month by the Dhamanis—the uterine veins and their endometrial capillaries—down to the vaginal opening for excretion. The blood has a faint black tint and a certain odour. Thus, Raja Srava Kala is primarily affected by Vata dosha.

Hence, all the three Doshas have the influence at different stages of Rutu Chakra, any impairment in these Doshas leads to Artavavyapads.

Importance of Rituchakra

Rutu Chakra is the most important physiological event in woman’s life. An optimal menstrual cycle is mandatory for reproduction and continuation of progeny. It is essential to know about the normal physiology of Rutuchakra because after that only Prakrit and Vikrita Awastha can be assessed.

Acharya Charak has mentioned Stri as the root cause of progeny and various diseases of reproductive organs cause impediment in procreation.[9] As if then, various Acharya for the welfare of humanity, they explains the aetiopathogenesis, clinical features and management of Artava Vyapad, Yoni Vyapad and other gynaecological problems.

Abnormal menstruation is the most important and commonest cause of infertility. So for proper management of these conditions timely

diagnosis is required. The treatment protocols in ayurveda are based on Tridoshas.

Some of these diseases and their symptoms related with dominant Dosha are as follows:

Ashtartava Dushti[10]

  • Vataja Artavadushti: The Artava becomes red, black or dark violet in colour, thin in consistency, dry, frothy and scattered and patient complaint of piercing pain during
  • Pittaja Artavadushti: The patient describes the menstrual blood as yellowish or bluish in colour, smell like pus and putrid, the expelled blood is hot, association of burning sensation and feeling of heat at the time of expulsion.
  • Kaphaja Artavadushti: The Artava vitiated by Kapha becomes whitish or slightly yellow in colour, thick consistency, slippery and lubricious, unctuous and settles down if put in water.
  • Kunapagandhi Artavadushti: “Kunapa Gandhi” literally means smell of dead body. It is caused by Rakta. In this, the expelled blood is red like fresh blood and also more in quantity also associated with heat and burning sensation.
  • Granthibhut Artavadushti: This condition is caused by vitiation of Vata and Kapha Dosha and shows the feature of both Doshas.
  • Putipuyagandha Artavadushti: Putrid and purulent menstrual blood caused by Pitta and Kapha Dosha. So, it presents symptoms of both the Doshas.
  • Kshina Artava: Predominance of Vata dosha associated with Pitta Dushti where Vata due to its Ruksha Guna can lead to reduced quantity of Artava, leading to conditions like Kshinartava/Artavakshaya. In this condition menstruation is delayed and flow is scanty and is associated with pain in vagina
  • Mutrapurishgandhi Artavadushti: It is caused by vitiation of all the three Doshas and shows features of all three
  • Artavakshaya: In this menstrual disorder the menstruation gets delayed with scanty flow which does not happen in appropriate time.
  • Nashtartava: This condition present with symptoms of absence of artava due to the effect of Vata and Kapha Dosha.

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  • Artava Ativridhhi: The patient presents complaints of generalized bodyache, excessive menstrual blood with foul smell.
  • Asrigdara/Pradara: Due to Pradeeran(excessive secretion) of Raja is called Pradara and since there is Deeran of Asrik, it is called Asrigdara. Depending upon the predominance of Doshas it is of four types namely Vataja, Pittaja, Kaphaja,

Discussion

Physiological process of menstruation is governed by Doshas, in which each Dosha dominates in particular phase of menstruation.

Rajashravkala

Apana Vayu is primarily in charge of this phase. The contractions in the bleeding phenomenon that cause this phase correlate to Vata acting through Dhamanis.

Rutukala

Kapha has a major influence on this period. The Kapha Dosha is necessary for growth and anabolism. This stage bears similarities to the proliferative stage.

Rutuvyatitkala

Pitta has the most influence at this era. The body secretes different things depending on the Pitta dosha. It's comparable to the secretory phase.

As Doshas plays an important role in menstruation, their imbalance state causes abnormality. So, it is necessary to have balance state of Doshas.

We can clearly observe that the menstruation has been very well explained in both Prakrit and Vikrit Avastha in ayurveda with all the necessary characteristics and management.

In today’s fast forward world, every person is just going after work commitments and other things not even considering their health and diet schedule. Tending to have a lots of health issues considering the fact that people’s eating habits and preferences have drastically changed and are certainly not appropriate, eating a lot of junk and fast food, not consuming a balanced diet. Especially women who have to balance both professional and personal lives are facing a lot of health issues.

These lifestyle changes are disturbing the normal

physiological activities further leading to other medical issues. These menstrual abnormalities require proper management, which can be only provided if diagnosis is made timely. There are various points which can be considered while diagnosing it:

Age of Menarche and menopause Regularity and periodicity of cycle Amount of Rajashrav Colour, character of Rajashrav Association with pain and clots Any foul smell present or not Unctuousness of the Rajashrav.

Conclusion

Menstruation is a natural bodily procedure that requires assistance from a person. The unhindered flow can only be achieved with the best support from Tridosha. Any change in the Dosha's equilibrium will cause issues with the menstrual cycle. Therefore, in order to restore the physiological and optimal action of the monthly cycle, a necessity to preserve a woman's health, it is necessary to understand Doshik predominance and simultaneously manage the situation according to it, as well as to keep a good food and lifestyle.

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