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Case Report

Shweta Pradara

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 2 FEBRUARY
Publisherwww.maharshicharaka.in

Management of Shweta Pradara in Diabetic Women - Case Report

Ramadevi G1, Thakur C2*, Jain A3
DOI:10.21760/jaims.10.2.45

1 Ramadevi G, Professor and HOD, Department of PG and PhD Studies in Prasuti Tantra evum Stree Roga, Sri Dharmasthala Manjunatheshwara College of Ayurveda, Hospital and Research Centre, Kuthpady, Udupi, Karnataka, India.

2* Cynthia Thakur, Final Year Post Graduate Scholar, Department of PG and PhD Studies in Prasuti Tantra evum Stree Roga, Sri Dharmasthala Manjunatheshwara College of Ayurveda, Hospital and Research Centre, Kuthpady, Udupi, Karnataka, India.

3 Arpana Jain, Assistant Professor, Department of PG and PhD Studies in Prasuti Tantra evum Stree Roga, Sri Dharmasthala Manjunatheshwara College of Ayurveda, Hospital and Research Centre, Kuthpady, Udupi, Karnataka, India.

Shweta Pradara, a condition characterized by excessive white vaginal discharge, is described in Ayurvedic texts as a disorder arising primarily due to aggravation of Kapha Dosha and the vitiation of Rasa Dhatu. This condition can be correlated to leucorrhoea in modern medicine. Causative factors include improper dietary habits, poor hygiene, sedentary lifestyle, and excessive mental stress resulting in white discharge, fatigue, and pruritus which contribute to reproductive health issues. Here, patient had complaints of white discharge per vagina persisting for the past 1 month associated with itching in the vaginal area and burning micturition from past 5-6 months. She was advised Chandraprabha Vati 1 TID, Musalikhadiradi Kashaya 20ml TID with honey, Asanadi Kwath 50ml BD, Avipattikara Churna ½ tsf HS for 15 days as Shamana Chikitsa. Additionally, therapies like Sthanika Chikitsa (local treatment), Yoni Dhawana with Triphala Kwath f/b Yoni Pichu with Dhatakyadi Taila and Pathya-Apathya (diet and lifestyle modifications) play a crucial role in prevention and treatment. She got excellent relief in symptoms by above treatment. This case highlights the efficacy of Ayurvedic therapies in managing Shweta Pradara by providing symptomatic relief and improving the overall health of the patient. The combination of Shamana Chikitsa and Sthanika Chikitsa ensures a holistic approach by addressing both systemic and local imbalances.

Keywords: Shweta Pradara, Kapha Dosha, Rasa Dushti, Yoni Dhawana, Vaginal Discharge, Gynecological Disorders, Physiological leucorrhoea, Pathological leucorrhoea, Bacterial vaginosis

Corresponding Author How to Cite this Article To Browse
Cynthia Thakur, Final Year Post Graduate Scholar, Department of PG and PhD Studies in Prasuti Tantra evum Stree Roga, Sri Dharmasthala Manjunatheshwara College of Ayurveda, Hospital and Research Centre, Kuthpady, Udupi, Karnataka, India.
Email: 		Ramadevi G, Thakur C, Jain A, Management of Shweta Pradara in Diabetic Women - Case Report. J Ayu Int Med Sci. 2025;10(2):312-318.
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https://jaims.in/jaims/article/view/3984/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-01-08 2025-01-18 2025-01-28 2025-02-08 2025-02-24
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© 2025by Ramadevi G, Thakur C, Jain A and 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 2025;10(2)312
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Ramadevi G et al. Management of Shweta Pradara in Diabetic Women

Introduction

Throughout various stages of a woman's life, from puberty through menopause, maintaining a healthy reproductive system is crucial, as emphasized in Ayurvedic science. Due to the unique role of reproduction, women are susceptible to several distinct female health issues. Today, vaginal infections, collectively known as Yonirogas, pose a common concern for women of all ages and backgrounds and remain one of the most prevalent issues encountered by women. Normal vaginal discharge may appear clear or cloudy white and should not have any odour or cause local irritation. Changes in the consistency, colour, amount, or smell of vaginal discharge may indicate vulvovaginal infections or other underlying conditions of the genital tract.

Shweta Pradara is described in ancient Ayurvedic texts such as Sharangdhar Samhita,[1] Bhavaprakash,[2] and Yogratnakar.[3] In Charak Samhita, the management of Shweta Pradara is detailed under the description of Pandura Asrigdara. Commentator Chakrapani explained the term Pandura Asrigdara as Shweta Pradara in his commentary on Charak Samhita.[4] Also, Shweta Pradara or Yonisrava is mentioned as a symptom in various other diseases also.Based on the clinical features, Shweta Pradara can be considered a Kaphaja disorder in the region of Apana Vayu, as any type of Srava (discharge) is a result of Kapha Dosha. It can be said that vitiated Kapha, along with various factors, leads to white vaginal discharge due to Rasadushti caused by Kapha. Thus, Shweta Pradara is a result of Kaphadushti, Rasadushti, and Vatadushti.

Case Report

A 46-year-old female patient presented to the OPD of Prasuti Tantra & Stree Roga at SDM College of Ayurveda and Hospital & Research Centre, Udupi, with complaints of white discharge per vagina persisting for the past 1 month. The discharge was thin in consistency and persistent throughout the month. She also complained itching in the vaginal area and burning micturition from past 5-6 months. Additionally, she reported complaints of constipation and low backache.

History of past illness: K/C/O Diabetes Mellitus since 4 years under Tab. Metformin 500mg.

K/C/O of Hypertension since 8 years under tab Pinom 20

History of Surgery: nothing significant

Family History: nothing significant

Menstrual History:

Menarche - 13 years
LMP - 4 months ago
Duration - 5 days
Interval - Irregular
Amount of blood loss - moderate

Obstetrics History:

P1 L1 A1
L1-15 years, Male, FTND
A1- at 1 month, MTP done, 16 years ago.

Clinical Examination:

BP - 130/80 mm of Hg
Pulse - 80/min
Temp. - 98.4°F
RR - 18/min

Examination

Systemic examination:

  • Respiratory System: B/L Chest clear, Airway entry, breathing entry Clear
  • Cardiovascular System: S1 S2 heard.
  • CNS: All superficial reflexes are intact. Patient was conscious and well oriented.
  • GIT: Soft Abdomen, Bowel sound heard, No Pain or any other symptoms.

Local examination:

  • P/S - Cervix upper lip hypertrophied, vagina healthy, white discharge ++
  • P/V - Uterus retroverted, normal size, CMT Negative, B/L fornixes free

Dashavidha Pareeksha:

1. Prakriti - Kapha Pradhana Vata Anubandhi
2. Vikriti - Kapha
3. Sara - Madhyama
4. Samhanana - Madhyama
5. Satmya - Madhyama
6. Satwa - Avara
7. Pramana - Madhyama
8. Ahara:
Abhyavaharana Shakti - Madhyama


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Jaranashakti - Madhyama
9. Vyayama Shakti - Madhyama
10. Vaya - Madhyama

Investigations:

Lab investigations on 9/04/2024

Hb - 12.1 gm%
FBS - 160 mg/dl
PPBS - 205 mg/dl
Urine albumin and sugar - nil
Epithelial cells - 1-2 /HPF
Pus cells - 2-3/HPF
RBC - 0-1 /HPF
Cast, crystal, other - nil

USG Abdomen & Pelvis on 12/04/2024:

Liver - Grade 1 fatty infiltration. Normal in size. No intra hepatic duct dilatation. No obvious focal lesions.
Uterus - normal in size and echotexture. ET - 7-8mm
Both the ovaries appear normal. No free fluid in abdomen & pelvis.

Assessment Criteria

1. Shweta Srava (Vaginal White Discharge):

No vaginal discharge - 0
Mild (Occasionally wetting undergarments /slight discharge) - 1
Moderate (wetting of undergarments) - 2
Severe (Heavy discharge which needs Vulval pads) - 3

2. Katishoola (Backache):

No pain - 0
Mild (Can withstand pain & can manage routine work) - 1
Moderate (Cannot manage routine work & need to take rest) - 2
Severe (Cannot withstand pain & needs treatment) - 3

3. Yoni Kandu (Itching of vulva):

No itching - 0
Mild (Slight rub) - 1
Moderate (Instant rub causing redness) - 2
Severe (Continuous rub causing redness) - 3

Intervention

Shamana Aushadh: Patient was advised with;

SNDrugsDose
1. Chandraprabha Vati1 TID A/F
2. Musalikhadiradi Kashaya20ml TID with honey A/F
3. Asanadi Kwatha50ml TID A/F
4. Avipattikar Churna½ tsp HS with hot water

Sthanika Chikitsa:Yoni Dhawana with Triphala Kwath f/b Dhatakyadi Taila Yoni Pichu was given for 7 days.

Chandraprabha Vati ingredients[5]

SNDrugsQuantity
1. Chandraprabha (Karpura)3 gms (1 shana)
2. Vacha3 gms (1 shana)
3. Musta3 gms (1 shana)
4. Bhunimba3 gms (1 shana)
5. Amrita (Guduchi)3 gms (1 shana)
6. Suradaru3 gms (1 shana)
7. Haridra3 gms (1 shana)
8. Ativisha3 gms (1 shana)
9. Darvi3 gms (1 shana)
10.Pippalimula3 gms (1 shana)
11.Chitraka3 gms (1 shana)
12.Dhanayaka3 gms (1 shana)
13.Amalaki3 gms (1 shana)
14.Haritaki3 gms (1 shana)
15.Vibhitaki3 gms (1 shana)
16.Chavya3 gms (1 shana)
17.Vidanga3 gms (1 shana)
18.Gajpippali3 gms (1 shana)
19.Shunthi3 gms (1 shana)
20.Maricha3 gms (1 shana)
21.Pippali3 gms (1 shana)
22.Makshika3 gms (1 shana)
23.Sarjja Kshara3 gms (1 shana)
24.Yava Kshara3 gms (1 shana)
25.Saindhav Lavana3 gms (1 shana)
26.Sauvarchala Lavana3 gms (1 shana)
27.Vida Lavana3 gms (1 shana)
28.Trivrit12 gms (1 Karsha)
29.Danti12 gms (1 Karsha)
30.Patraka12 gms (1 Karsha)
31.Tvak12 gms (1 Karsha)
32.Ela12 gms (1 Karsha)
33.Vamslochana12 gms (1 Karsha)
34.Loha24 gms (2 Karsha)
35.Sita48 gms (4 Karsha)
36.Shilajatu96 gms (8 Karsha)
37.Guggulu96 gms (8 Karsha)

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Ingredients of Musali Khadiradi Kashaya[6]

SNDrugsViryaDoshaghnta
1. MusaliUshnaVatapitta Shamaka
2. KhadiraSheetaKaphapitta Shamaka
3. AmalakiSheetaTridosha Shamaka
4. Trikanta (Gokshura)SheetaVatapitta Shamaka
5. JambuSheetaKaphapitta Shamaka
6. Vari (Shatavari)SheetaVatapitta Shamaka

Ingredients of Asanadi Kwath Churna[7]

SNDrug nameKarmaDoshaghnta
1. AsanaMedohara, Rasayana, KeshyaKapha Pitta Shamaka
2. KhadiraKandughna, Medoghna, Mehaghna, Shothahara, PittasraharaKapha Pitta Shamaka
3. ManjishthaMehahara, Shothahara, VranaharaKapha Pitta Shamaka
4. SarivaKanduhara, Nehanashana, Amahara, Agnisada, Pradanut, DaurgandhanashakaTridosha Shamaka
5. UsheeraStambhana, Mehanut, Mutrakrichahara, DahaprashmanaVata Pitta Shamaka
6. AshwagandhaBalya, Rasayana, Shophahara, Kanduhara, KshayaharaTridosha Shamaka
7. HaritakiShothahara, Anulomana, DeepanaTridosha Shamaka
8. VibhitakiDeepana, Bhedana, Shothahara, Vedanasthapana, Anulomana,Tridosha Shamaka
9. AmalakiDahaprashamana, Rochana, Pramehaghna Amlatanashaka, Sramsana, Mutrala,Tridosha Shamaka
10.PunarnavaShothanashaka, Panduhara, Ruchya, Shulanut, Vranahara, KshaarKapha Vata Shamaka
11.HaridraPrameharaharanam, Mehanut, Vishodhini, Pitta Rechaka, AruchinashiniTridosha Shamaka
12.GokshuraBrihmana, Pramehahara, Agnikrit, Basti Shodhana, Sheetala, DeepanaTridosha Shamaka
13.SaptachakraKandughna, Premehara, Deepana, Kushthaghna, JwaraharaKapha Pitta Hara

Ingredients of Avipattikara Churna[8]

SNDrug nameKarmaDoshaghnta
1. ShunthiDeepana, Pachana, AnulomanaKapha Vata Shamaka
2. MarichaDeepana, Pachana, Anulomana, KrimighnaKapha Shamaka
3. PippaliMriduvirechana, Mutrala, DeepanaKapha Vata Shamaka
4. HaritakiShothahara, Anulomana, DeepanaTridosha Shamaka
5. VibhitakiDeepana, Bhedana, Shothahara, Vedanasthapana, Anulomana,Tridosha Shamaka
6. AmalakiDahaprashamana, Rochana, Pramehaghna Amlatanashaka, Sramsana, Mutrala,Tridosha Shamaka
7. MustaDeepana, Pachana, Grahi, Shothahara, MutralaKapha Pitta Shamaka
8. Vida LavanaDeepana, Rochana, VatanulomanaVata Shamaka
9. VidangaDeepana, Pachana, Anulomana, Mutrajanana, KrimighnaKapha Vata Shamaka
10.ElaDeepana, Pachana, Rochana, Anulomana, Mootrajanana, DahaprashamanaTridosha Shamaka
11.PatraVishagna, Mukhashodhana, Bastidoshaghna, Deepana, MootrajananaKapha Vata Shamaka
12.LavangaDeepana, Pachana, Ruchya, Vatanulomana, Krimighna, Shoolaprashamana, Mutrala, Amapachana, VranaropanKapha Pitta Shamaka
13.TrivrutSukhavirechaka, Bhedana, Rechana, ShothaharaKapha Pitta Shamaka
14.KhandaBalya, Brumhana, Chakshushya, VrushyaTridosha Shamaka

Ingredients of Triphala Kwath[9]

SNDrug nameKarmaDoshaghnta
1. HaritakiAnulomana, Sarvadosha Prasamana, Vatahara, LekhanaTridosha Shamaka
2. VibhitakiKriminashana, Bhedaka, KaphaharaTridosha Shamaka
3. AmalakiDahahara, Vrishya, PittaharaTridosha Shamaka

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Ingredients of Dhatakyadi Taila[10]

SNDrugGunaKarma
1.DhatakiLaghu, RukshaKapha-Pitta Shamaka, Krimighna
2.AmalakiRuksha, LaghuTridosha Shamaka
3.MadhukaGuru, SnigdhaVata Pitta Shamaka, Vatahara, Shothahara
4.UtpalaLaghu, SnigdhaRakta-Pitta Hara, Kaphahara
5.JambuRukshaKapha-Pitta Shamaka
6.AmraGuru, SnigdhaKapha-Vata Hara, Vranaropana
7.Kasisa-Vata-Kapha Hara, Vishaghna, Kandughna
8.LodhraRukshaPitta-Kapha Shamka, Vishaghna, Shothahara
9.KatphalaLaghu, TikshnaKapha Vata Shamaka, Premehara
10.TindukaLaghu, RukshaVatahara, Vranaropana
11.DadimaLaghu, SnigdhaPitta- Kapha Shamak, Deepana, Ruchya
12.UdumbaraRuksha, GuruKapha-Pitta Hara, Dahaprashamana, Stambhana
13.SourashtrikaGuru, SnigdhaTridosha Shamaka, Vranaghna, Raktastambhaka
14.StrotoanjanaSnigdhaKaphapittaraka Roganut, Lekhana

Results

Gradation of parameters at follows up

SNAssessment criteriaBefore treatmentAfter treatment
1.Shweta Srava31
2.Katishola21
3.Yoni Kandu20

Discussion

The treatment for this patient was based on the symptoms of her condition. In Shweta Pradara, Kapha is the primary pathogenic factor. Additionally, in this patient there was impaired metabolism of the Rasa Dhatu (Rasa Dhatwagni Mandya) and vitiation of Apana Vayu.

Chandraprabha Vati was beneficial in burning micturition and Diabetes mellitus. It is indicated in Prameha, Mutravaha Srotovyadhi and is having Tridoshamaka property. It possesses properties such as Tikta (bitter), Katu (pungent) Rasa, Laghu Ruksha Guna. It is predominantly Vatakapha Shamaka and Jantughna (antimicrobial), and Mutral (diuretic).[11] Yavakshara and Svarjika Kshara present in Chandraprabha Vati are alkaline substances which decrease the acidity of urine and gives relief in burning micturition. The drugs namely Pippali, Shunthi, Maricha, Chavya, Musta, Ela, Lavanas,

Ksharas help to relieve the state of Mandagni which is identified as one of cause in this case. Chandraprabha Vati has multidimensional actions and is effective for both acute and chronic cases.

Musalikhadiradi Kashaya possesses Raktasthapana, Balya and Vata Pitta Shamaka properties. Due to sheeta veerya property of drugs, it has Stambhana action which is used in vaginal discharge. It is indicated in Shweta Pradara(Leucorrhoea), Yoni Roga, Yoni Srava and is given along with Madhu, which is having Yogavahi Guna and Rakta Pithahara property.[12]

Asanadi Kwath: In Diabetic patients, achieving relief from vaginal symptoms requires better glycaemic control. The acidic environment of the vagina in diabetic patients promotes infections. Therefore, attaining normal blood glucose levels in this patient was essential to combat vaginal infections, despite her regular intake of allopathic medications. Hence, Asanadi Kwatha was advised to the patient. It possesses Kashaya Rasa (astringent taste), Sheeta Virya (cold potency), and acts as a Pittahara (Pacifier of Pitta) and Raktashodhaka (blood purifier). It has Deepana, Dahahara, Mala Vatanulomana, Kandughna, Virechana properties are seen in this formulation. It is indicated in Prameha (diabetes) and Medo Roga (disorders related to excess fat) due to its Kaphahara (Kapha-reducing), and Medohara (fat-reducing) properties.[13] Many pharmacological studies, on the drugs of Asanadi Gana, has proved that almost all the constituents possess Anti Hyperglycaemic, Antioxidant properties.[14]

Avipattikar Churna: It is indicated in Agnimandya (digestive impairment), Vibandha (constipation), Amlapitta (hyperacidity), Mutraghata (urinary retention), and Prameha (diabetes mellitus). The Deepana (appetite-stimulating) and Pachana Karma (digestion-promoting action) of the ingredients help regulate Agni (digestive fire) and prevent Ama (toxins) formation. Avipattikara Churna predominantly contains drugs characterized by Katu-Tikta Rasa (pungent and bitter taste), Laghu (light), Ruksha (dry), and Teekshna Guna (sharp qualities), along with a combination of Ushna (hot) and Sheeta Virya (cold potency). Ingredients like Trivrut, Triphala, Shunthi, and Lavanga, which are Ushna and Laghu, effectively stimulate Agni. Trivrut, with its Tikta Rasa (bitter taste), Ushna Virya, and Virechaka (purgative) properties,


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eliminates Kleda (moisture/toxicity) from the body, making it particularly beneficial in managing Prameha.

Sthanika Chikitsa (Local treatment) was advised for white discharge per vagina associated with itching, along with internal medicines.[15] Yoni Dhawana with Triphala Kwatha[16] followed by Dhatakyadi Taila Pichu was useful in cleansing and clearing excess secretion and discharges of vagina.

Triphala Kwath: Triphala is known for its Tridoshahara, Kledahara, Kandughna, Stambhak and Ropana properties.[17] It is a broad-spectrum anti-microbial, anti-inflammatory, anti-bacterial agent that accelerates the healing process.[18]

Dhatakyadi Taila has Kashaya Rasa, Ruksha- Laghu Guna and Kapha Dosha Shamaka properties. It has properties like Stambhaka (styptic), Shothahara (anti-inflammatory), Kandughna (antipruritic). Taila was used as it reduces the chances of infection as it is Yoni Vishodhana and having Vrana Ropaka and Vataghna properties.

Pathya and Apathya

Ahara (Dietary Recommendations):

1. Hydration: Drink plenty of water to maintain hydration and assist in flushing out toxins.
2. Fiber: rich Foods: Include green leafy vegetables, whole grains, and fibrous fruits like apples, papaya, guava, and pears to manage blood sugar levels and promote digestion.
3. Easily Digestible Food: Consume light and simple meals like khichdi, barley, or rice gruel, which are easy to digest.
4. Avoid:

  • Sugary and processed foods, as they can aggravate diabetes.
  • Excessive oily, spicy, or junk food that worsens Kapha and leads to mucus accumulation.

Vihara (Lifestyle Recommendations):

1. Maintain Personal Hygiene. Keep the vaginal area clean and dry. Wash daily with lukewarm water.
2. Clothing: Wear loose, cotton undergarments. Wash garments in boiled water mixed with antiseptic agents (like Dettol) and dry them under sunlight.
3. Physical Activity: Practice light yoga or brisk walking to enhance blood circulation and regulate blood sugar levels.

4. Sexual Hygiene: Practice proper hygiene during intercourse to prevent infections.

Conclusion

The concept of Shweta Pradara described in Ayurvedic literature shows a close resemblance to Leucorrhoea as mentioned in modern gynaecology. The Ayurvedic treatment of Shamana Chikitsa with Sthanika Chikitsa has significantly reduced the complaints of patient. For Shweta Pradara in patients with Diabetes Mellitus, achieving optimal glycaemic control is essential to manage vaginal infections effectively. Medicinal formulations with a predominance of Kashaya Rasa (astringent taste), along with Kapha Shamaka (Kapha-pacifying) and Stambhaka (stabilizing) properties, are recommended for treating this condition. Maintaining proper personal hygiene and adhering to suitable dietary regimens play a significant role in preventing Shweta Pradara.

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