E-ISSN:2456-3110

Case Report

Ksheena Shukra

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 12 DECEMBER
Publisherwww.maharshicharaka.in

Ayurvedic management of Ksheena Shukra - A Case Study

Mohan KSS1*, Pramod K2, Durgesh K3, Atal BT4
DOI:10.21760/jaims.9.12.36

1* Kumar S S Mohan, Post Graduate Scholar, Dept of Kayachikitsa, Ch Brahm Prakash Ayurveda Charak Sansthan, New Delhi, India.

2 Kapoor Pramod, Post Graduate Scholar, Dept of Kayachikitsa, Ch Brahm Prakash Ayurveda Charak Sansthan, New Delhi, India.

3 Kumar Durgesh, Post Graduate Scholar, Dept of Kayachikitsa, Ch Brahm Prakash Ayurveda Charak Sansthan, New Delhi, India.

4 Bihari Trivedi Atal, Associate professor, Dept of Kayachikitsa, Ch Brahm Prakash Ayurveda Charak Sansthan, New Delhi, India.

Male infertility has gotten less attention, despite its widespread coverage. A demographic survey found that males alone contribute 40-50%. Infertility management in modern medicine has limitations and drawbacks. Furthermore, it can only guarantee 30 to 40% results. It is quite expensive, and the average person cannot afford it. Low sperm count (oligospermia) and increased immotility of sperms (asthenospermia) is the main causes of male infertility and it can be correlated with Shukravaha Srotas Dushti and is a problem of global proportions. Worldwide infertility is affecting on an average 8-12% of couples. Acharya Sushrut has explained 10 types of Shukra Dushti which are incapable of producing a progeny. Shukravaha Srotas Dushti leads to Aharsha, Klaibya etc. there is no direct correlation of oligospermia but we can correlate it with Shukra Kshaya or Ksheena Shukra. A 28-year-old male who had been diagnosed as Oligonecrospermia with increased immotile sperm with 02 years of married life and his wife with regular menstrual cycle, were treated successfully with Ayurvedic management. After Aamapachana, the patient was given Shamana chikitsa (Tab Addyzoa Charak Pharmacy, Chandraprabha Vati, Gokshuradi Guggulu, Narasimha Rasayana, Punarnavasava).

Keywords: Ksheena Shukra, infertility, Asthenospermia, Pachana, Shamana

Corresponding Author How to Cite this Article To Browse
Kumar S S Mohan, Post Graduate Scholar, Dept of Kayachikitsa, Ch Brahm Prakash Ayurveda Charak Sansthan, New Delhi, , India.
Email: 		Mohan KSS, Pramod K, Durgesh K, Atal BT, Ayurvedic management of Ksheena Shukra - A Case Study. J Ayu Int Med Sci. 2024;9(12):270-275.
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https://jaims.in/jaims/article/view/3418/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-11-09 2024-11-19 2024-11-29 2024-12-09 2024-11-17
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© 2024by Mohan KSS, Pramod K, Durgesh K, Atal BTand 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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Download PDFBack To ArticleIntroductionAim and ObjectiveMaterials and MethodsCase HistoryMaterials and MethodsResultsDiscussionConclusionReferences
Mohan KSS et al. Ayurvedic management of Ksheena Shukra

Introduction

The inability of a couple to conceive after a year of consistent sexual activity without the use of contraception is known as infertility.

Infertility in men suggests that a particularly fertile female is incapable of becoming pregnant.[1] In India, male infertility is one of the most pressing yet neglected reproductive health issues at the moment. Because of this unsettling manner of living, the incidence of this problem is growing daily. Male factor was revealed to be responsible for around 30–40% of cases of infertility.[2] Typically, infertility affects 8–12% of couples.[3] male factors, or other unknown causes might all contribute to infertility. Men are affected by infertility in 2.5–12% of instances worldwide, while male issues account for 40–50% of situations when a woman is unable to conceive.[4]

Low sperm count is termed as the oligospermia which according to WHO is less than 15 million sperm/ml, consistent with the 5th percentile for fertile men.

Oligospermia can be classified as[5]

1. Mild: concentrations 10 million - 15 million sperm/mL
2. Moderate: concentrations 5 million - 10 million sperm/mL
3. Severe: concentrations less than 5 million sperm/mL

In Ayurveda, Aacharyas explained that the function of Shukra Dhatu is reproduction. Shukra is formed from the Majja Dhatu, hence Shukra is the essence of Majja Dhatu.

According to Acharya Sushruta: Vataja, Pittaja, Kaphaja, Granthibhuta, Putipuyanibham, Mutrapurisha Gandhi, and Ksheena are the eight Shukra Dushti kinds that are referenced in Ayurveda[6]. Ksheena Shukra Vikara's condition is characterized by impaired motility and decreased semen quality. Ksheena Shukra is a Vata Pittaja Vyadhi, manifested as a result of Shukravaha Srotodusti. Prevalence in Madhyama Vayas being a disease from Apana Vayu province, in which decreased quality and quantity of Shukra Dhatu is observed. The cause of infertility as explained in classics are due to defects in Beejansha (sperm and ovum), Aahar, Vihara, Vichara and Bala.

Systemic symptoms like Shrama, Dourbalya, Angamarda, Panduta, Sadana and delayed and blood tinged ejaculation are associated Ksheena Shukra.[7,8]

In conventional medication, numerous choices for primary infertility are accessible ranging from drugs to IVF with their own limitation.[9] The scope of Ayurvedic infertility treatment has been expanded, and it can quickly resolve complicated infertility problems. For the treatment of Shukra Dushti, Ayurveda had recommended Shamana and Shodhana Chikitsa.

Ayurveda has promoted a distinct branch that addresses spermatogenesis and the treatment of aberrant semen in addition to Sexual potency is referred to as the Vajikarana Tantra (medication for aphrodisiacs). According to Ayurveda, males over 16 and under 70 should undergo Vajikarana therapy to preserve optimal sexual activity and healthy semen. Treatment for oligospermia involves the use of Rasayanas and Vajikara Dravyas, or medications (aphrodisiacs or virilifactory); on the inside, Panchakarma and Vajikarnana therapies for rejuvenation and lifestyle adjustments will not only aid in improved conception but also in the production of healthy offspring.

Aim and Objective

To assess the efficacy of Ayurvedic management (Shamana Chikitsa) in the management of Ksheena Shukra Vikara w.s.r. to Oligoasthenospermia.

Materials and Methods

A single case study

Case History

A 28-year-old male resident of Gangur, Hassan district, Karnataka, Agriculture by occupation, moderately build, married for 2 years, was apparently healthy before 2021, then he started complaining of failure to conceive even after active married life and burning sensation in epigastric region and his 19-year-old wife had regular menstruation cycles. She had no significant past or family history of reproductive tract disorders and pelvic infections and had not undergone any surgical procedures since birth. But there was issue to conceive.


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Mohan KSS et al. Ayurvedic management of Ksheena Shukra

So, they approached to Gynaecologist, in the routine check-up, report if wife was normal but he was diagnosed as Oligozoospermia. Simultaneously, he as suffering from generalized weakness for 1 year.

Past history: N/K/C/O DM/ HTN / Thyroid dysfunction.

Family history: Nothing Specific

Personal history:

Diet - Mixed
Appetite - Good
Bowel - 1-2times/ day
Micturition - 3 to 4 times / day 1 time / night
Sleep - Good

Medical/ Surgical History: Nothing Specific

Dasha Vidha Pareeksha:

Prakruti - Pitta-Kapha
Vikruti - Vata -Pitta
Sara - Madhyama
Samhanana - Madhyama
Pramana - Dhairgya - 178cms
Dehabhara - 79kg
Satmya - Madhyama
Satva - Madhyama
Ahara Shakti - Abhyavarana Shakti - Madhyama
Jarana Shakti - Madhyama
Vyayama Shakti - Madhyama
Vaya - Youvana

General examination:

Built - Moderate
Nourishment - Moderate
Temperature - 98.2°F
Respiratory rate - 20/min
Pulse rate - 82 bmp
Blood pressure - 130/90 mmHg
Height - 163cms
Weight - 79 kg
Tongue - Uncoated

Systemic examination:

CVS: S1 and S2 heard
CNS: Conscious and well oriented with date, time and place.
RS: Normal vesicular breathing, no added sounds.
P/ A: Soft, Non tender

Samprapti

jaims_3418_01.JPG

Investigation:

Semen Analysis on 16/03/2023 (3days Abstinence)

Volume - 2.5ml
pH - 7.5
Specific gravity - 1.027
Total sperm no. - 08million/ml
Percent Motility - 10%
Sluggish Motile - 10%
Immotile - 80%
Pus cells - 8-10 cells/hpf

Materials and Methods

Pachana: For Amapachana and Koshtha Shodhana Haritakyadi Churna[10] 1tsp BD with hot water was given for 5 days.

Shamana Chikitsa: (for 30 days)

1. Addyzoa 1TDS
2. Chandraprabhavati 1 TDS
3. Gokshuradi Guggulu 1TDS
4. Narasimha Rasayana 1TSF with Milk
5. Punarnavasava 3TSF BD

Pathya-Apathya:Patient was asked to stop the Ratraujagrana. Advised to have Shadrasatmak Aahar without prolonging the hunger.

Results

Before treatment, the Sperm count was 08 million/ml and after treatment,


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Mohan KSS et al. Ayurvedic management of Ksheena Shukra

it increased to 22 million/ml and after 2 months of follow-up it doubled. Actively motile % increased from 10% to 30% and Immotile % reduced from 80% to 35%.

Test nameBefore treatment[16/03/2023]After Treatment[30/06/2023]
Volume2.5ml2.5ml
FructosePresentPresent
ColourGreyish WhiteGreyish White
Reaction7.57.7
ViscosityViscidViscid
Liquefication time30minsMore than 1hr
Total sperm count08millions/ml22millions/ml
Actively motile10%30%
Sluggish motile10%35%
Immotile80%35%

Discussion

Generally, in Oligozoospermia the sperm count as well as its motility is found to be low. Treatment of Oligozoospermia should be aimed at increasing the sperm count as well as their motility. Shukradushti is the causative factor for the infertility. Ksheenashukra is a type of Shukradushti which can be correlated to Oligoasthenospermia. The treatment of Ksheenashukra mainly aims at Shukrajanaka and Shukrapravartaka in-terms of increasing the sperm count and motility by using Vajeekarana Dravya.

Shamana Chikitsa

Haritakyadi Churna has Haritaki, Amalaki, Haridra, Shunthi, Pipalli, Vacha, Vidanga and Saindhav. Mainly these drugs being Katu, Tikta Rasa Pradhan, Ushna Veerya help to correct the Agnidushti as well as do Vaata and Mala Anuloman.

Patient was given oral medication for 2 months.

  • Addyzoa

Capsule Addyzoa is a proprietary Ayurvedic medicine manufactured by Charak Pharmaceuticals. Addyzoa is a herbomineral spermatogenic antioxidant. Addyzoa Capsule has varied free radical scavenging action and hence, Addyzoa limits successfully the damage to the sperm cells because of reactive oxygen species (ROS). Withania somnifera, Tinospora cordifolia and Emblica officanalis are potent antioxidants in Addyzoa,

which acts by lessening the excessive oxidative stress, which is answerable for sperm damage. Shuddha Shilajit, Mucuna pruriens and Withania somnifera improves sperm count. Asparagus racemosus recovers seminiferous tubules and builds spermatogenesis. In this way, Addyzoa improves sperm count, motility and morphology and furthermore increases semen density.[11]

  • Chandraprabhavati[12]

Chandraprabha Vati is a herbomineral compound preparation, which is choice of drug for urinary tract infections and furthermore improves the functioning of male reproductive organs. It does Apananulomana, acts as a spermatopoietic specialist, serves to rejuvenate the body, increases strength, appetite and Oja and has been accounted for to have enormous free radical scavenging activity.

  • Gokshuradi Guggulu[13]

Gokshura (Tribulus terrestris) is having Madhur Rasa,Guru- Snigdha Guna, Sheeta Veerya, Madhura Vipaka and pacifies Vata and Pitta. Vatapittahara Karmadoes theSamprapti Vightatanain theKshina Shukra, as it is aVata- andPitta-predominant disease. However,Madhura Rasa,Snigdha, andGuru Gunaincrease theShukra Dhatuqualitatively and quantitatively.Gokshurais known for its utility inMutravaha Srotas, by correction of theApana Vata, it exerts action on theShukraalso, along the lines similar to howShukra Visargais goverened byApana Vata. According to classics Whole drug is a choice for Mutrakrichra, Mutraghata andS hukradosha

  • Narasimha Rasayana[14]

the ingredients of Narasimha Rasayana have proven pharmacological action, having antioxidant, immunomodulatory, anti-inflammatory, anti-ageing, aphrodisiac and anti-cancerous activity. While evaluating the pharmacological actions of the contents of Narasimha Rasayana, it was observed that more than 50% of the drugs show antioxidant, antimicrobial and anti-inflammatory activities. Drugs like Amalaki, Shatavari, Haritaki, and Khadira have proven immunomodulatory action. The drugs like Chitraka, Shimshapa, Vijaysara, Bhallataka, Bhringraj, Shatavari, and Amalaki help counteract inflammation in the body. The present review revealed that the ingredients of Narasimha Rasayana are proven to be antioxidant, immunomodulatory, anti-inflammatory, antiaging, anticancer and aphrodisiac activity.


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jaims_3418_02.JPG
Before Treatment

jaims_3418_03.JPG
After Treatment


  • Punarnavasava[15]

Punanava, Guduchi, andGokshuraused to be Rasayana drugs. Punarnava, Guduchi, and Gokshuraare particularly effective in treating Mootravaha Samsthana disorders. These drugs should be recognized as Naimittika Rasayana for the kidneys and other organs of Mootravah Srotas. These drugs, by definition, impart Rasayana properties, as evidenced by clinical studies in which patients reported an increase in Jatharagni, quantity and quality of sleep, sense of well-being, functional capacity, and, to a lesser extent, a decrease in disease features.as per classics Punarnavasava is used for Dyspepsia, abdominal lump, abdominal diseases/enlargement, inflammation, spleen and liver disorders

Conclusion

Ayurvedic medicine treats infertility by Shodhana and Shamanaoushadhis. It concentrates on all factors, such as Aahara and Vihara, which are vital in the expression of any pathology.

In the current situation, we used Ayurvedic principles to treat Shukradushti. We discovered that after completing the right treatment based on Ayurvedic principles, as well as modifications in food and daily regimen, semen parameters such as sperm count and motility improved significantly. The improved status of Dhatus, as well as the action of the substances, resulted in increased sexual desire, duration of coitus, orgasm or sexual satisfaction, and increased sperm count and motility.

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2. Kumar P, Jeffcoate SN, Malhotra N. "Jeffcoate's Principles of Gynaecology." 7th Edition. Butterworth's, New Delhi.2008;985.


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3. Sciarra J. Infertility: An International Health Concern. International Journal of Gynecology & Obstetrics, 1994; 46(2): 155-63.

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