E-ISSN:2456-3110

Research Article

Primary Dysmenorrhea

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 2 FEBRUARY
Publisherwww.maharshicharaka.in

A Clinical Study of Pippalayadi Phanta in Kashtartava (Primary Dysmenorrhea)

Pariyani D1*, Sharma R2
DOI:10.21760/jaims.10.2.2

1* Divya Pariyani, BAMS Under Graduate Scholar, Post Graduate Institute of Ayurveda, Dr Sarvapalli Radhakrishnan Rajasthan Ayurved University, Jodhpur, Rajasthan, India.

2 Rashmi Sharma, Associate Professor, PG Department of Prasuti Tantra Evam Stri Roga, Post Graduate Institute of Ayurveda, Dr Sarvapalli Radhakrishnan Rajasthan Ayurved University, Jodhpur, Rajasthan, India.

Introduction: Primary Dysmenorrhea, also known as Kashtartava in Ayurveda, is a common gynecological condition characterized by painful menstrual cramps that significantly affect women's quality of life. Traditional Ayurvedic texts, including those by Acharya Charak, attribute Kashtartava to Vata vitiation and emphasize the importance of Vata pacification for its management. This study evaluates the efficacy of Pippalayadi Phanta, a polyherbal formulation consisting of Pippali, Marich, Sunthi, Ajwain, and Hingu, in alleviating the symptoms of Kashtartava.

Methodology: A clinical investigation was conducted to assess the formulation's impact on Shoolprashman (pain relief), Vata-Anuloman (Vata regulation), and Artavajanan (menstrual flow regulation). The preparation was presented as a heat-infused beverage in sachet form, similar to green tea, for enhanced convenience and palatability. Participants diagnosed with Primary Dysmenorrhea were evaluated through a scoring system pre- and post-treatment.

Results: The findings suggest that the traditional herbs in Pippalayadi Phanta, known for their anti-inflammatory, analgesic, and muscle-relaxing properties, effectively alleviate pain and discomfort in individuals with Kashtartava. The heat-infused beverage aids in relaxing uterine muscles, and the synergistic action of the herbal components reduces inflammation and pain. The innovative sachet form of Pippalayadi Phanta ensures therapeutic benefits while offering convenience and portability.

Discussion: This study contributes to the growing body of evidence supporting the use of traditional Ayurvedic formulations in managing gynecological disorders. By presenting Pippalayadi Phanta in a familiar and accessible form, the research bridges traditional Ayurvedic remedies with modern preferences, potentially offering a natural and effective alternative for individuals experiencing Primary Dysmenorrhea.

Keywords: Kashtartava, Primary Dysmenorrhea, Pippalayadi Phanta, Vedanahar

Corresponding Author How to Cite this Article To Browse
Divya Pariyani, BAMS Under Graduate Scholar, Post Graduate Institute of Ayurveda, Dr Sarvapalli Radhakrishnan Rajasthan Ayurved University, Jodhpur, Rajasthan, India.
Email: 		Pariyani D, Sharma R, A Clinical Study of Pippalayadi Phanta in Kashtartava (Primary Dysmenorrhea). J Ayu Int Med Sci. 2025;10(2):4-8.
Available From
https://jaims.in/jaims/article/view/4025/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-01-10 2025-01-25 2025-02-05 2025-02-15 2025-02-25
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None CCRAS, New Delhi and Dr. S. R. Rajasthan Ayurved University, Jodhpur. Yes 11.36

© 2025by Pariyani D, Sharma Rand 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 ArticleIntroductionMaterials and MethodsStudy DesignDiscussionConclusionReferences
Divya P et al. Clinical Study of Pippalayadi Phanta in Kashtartava

Introduction

Dysmenorrhea is defined as painful menstruation so as to incapacitated day to day activities. The term “Kashtartava” can be implied as the condition where in Artava is shed with pain. Acharya Charak has mentioned that Yoniroga can’t occur without vitiation of Vata.[1] As Vata is the main causative factor it should be treated first. According to Ayurveda, pain is an indication of Vata Vikriti - ‘Vaatadrite Nasti Ruja.’[2]

Pain is the main feature of Kashtartava, so it has strong relation with Vata Dosha. This research proposal aims to investigate the potential impact of an herbal hot infusion (Phanta) in the management of Primary dysmenorrhea. These herbs have been traditionally known for their anti-inflammatory, analgesic, and muscle-relaxing properties. Pippali, or Long Pepper, has been traditionally used to alleviate pain and inflammation. Marich, or Black pepper, contains Piperine, which can help reduce pain perception. Sunthi, or Ginger, possesses anti-inflammatory and muscle-relaxant effects, which may alleviate uterine contractions causing pain.

Ajwain, or Carom seeds are known for their anti-spasmodic properties and may ease muscle cramps. Hingu, or Asafoetida, has anti-inflammatory properties that could help in pain reduction. When combined in a hot infusion, these ingredients create a soothing and aromatic beverage that can provide relief to individuals suffering from Primary dysmenorrhea. The heat from the infusion may help relax uterine muscles, while the herbal components work together to reduce pain and inflammation. Kashtartava is one of the Artavaha Strotodushti Vyadhi in which pain during menstruation is the predominant feature.[3]

Primary dysmenorrhea classically begins within about 2 years of menarche or once ovulatory cycles have been established. It is more often a diagnosis made in adolescents and young adults. The cyclic pain starts within a few hours of the onset of menses and usually resolves within 72 hours.The pain is located midline in the pelvis and may radiate to the lumbar area of the back or upper legs.[4] It may be crampy and episodic and is usually similar in each menstrual cycle. Concomitant symptoms may include nausea, vomiting, headaches, dizziness, fatigue, and sleep difficulties.[5]

Kashtartava is expressed as "Kashtenmunchyatiti Kashtartavam"- Kashtartava is the condition where the Artava is discharged with great difficulty and pain. It has been compared to dysmenorrhoea based on the symptoms. Dosha -Vata Pradhana Tridosha; Dushya- Rasa, Rakta, Artava Sammurchana takes place in Garbhashaya and due to vitiation of Vyana and Apana Vayu the Aakunchana and Prasarana Kriya of Garbhashaya does not take place properly, this state resembles with the dysrhythmia of uterine muscles, which will hinder in proper flow of menstrual blood leading to Kashtartava.

Materials and Methods

For this study on Kashtartava, 32 patients were enrolled from the OPD and IPD of the P.G. Department of Prasuti Tantra & Stri Roga at Sanjeevani Ayurved Hospital, PGIA Jodhpur, following specific criteria. Monitoring occurred every 15 days, with a one-month follow-up post-treatment.

The study obtained Institutional Ethics Committee clearance DSRRAU/PGIA/IEC/2023-24/706 and registered at Clinical Trial Registry of India (CTRI/2024/04/065239)

Study Design

Table 1: Study design of project

Name of DrugPippalayadi Phanta
Number of Patients30
Dose20 ml BD (7 days prior to menses)
Type of StudyOpen label
No of groupsOne
Duration of Drug Trial2 months consecutive cycle
RouteOral
PurposeTreatment
End pointEfficacy

Participants Selection Criteria

A. Inclusion Criteria

  • Patients coming with chief complaint of Kashtartava [Primary dysmenorrhea] with scanty or average amount of menses (both married and unmarried) for more than 2 consecutive cycles.
  • Patients in age group 14 to 35 years of age.
  • Patient with history of using analgesics.

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Divya P et al. Clinical Study of Pippalayadi Phanta in Kashtartava

B. Exclusion Criteria

  • Patient with history of any systemic illness. Patients with menstrual irregularities.

Assessment criteria

A. Subjective Criteria

Assessment of Pain: A special scoring pattern is applied:

Table 2: Depicting WALIDD SCORE

Category0123
Wa (work ability)NoneAlmost neverAlmost alwaysAlways
L (Location)NoneOne site2-3 site4 sites
I (Intensity)
(Wong- Baker)		Dose not hurtHurts a little bitHurts a little more- hurts even moreHurts   a whole lot - hurts worst
D (duration - days of pain)01-23-4>or=5

Table 3: This result is in a total score between 0 to 12 and further it is assessed as follows-

ScoreTermGrade
0Without dysmenorrhea0
1-4Mild dysmenorrhea1
5-7Moderate dysmenorrhea2
8-12Severe dysmenorrhea3

B. Objective Criteria

Assessment of the therapy will be also carried out by comparing the Before Treatment and After Treatment, values of Objective Parameters.

  • CBC

Investigations

  • USG (Pelvis) - if needed

Observations and Results

The obtained data was analysed by application of statistics by using GraphPad In Stat DATASET3.ISD developed by GraphPad Software Inc. For evaluation of effect of the therapy/ treatment protocol on chief complaints statistical assessment was done using W - Wilcoxon sign rank test as a statistical tool for the available parameters in a sample size of 30.

Table 4: Showing overall assessment

Parameters% Relief
Work Ability37.78%
Location16.67%
Intensity40%
Duration-days of pain19.45%
Average % of relief28.475

Table 5: Depicting overall impact of therapy

Effect of Therapy% ReliefNumber of patients%
No Relief0%310%
Mild ReliefUp to 25%826.67%
Moderate Relief25-50%1653.33%
Significant Relief50-75%310%
Total30100%

Overall maximum patients (16) got moderate relief, some (8 patients) got mild relief while few (3 patients) got excellent relief and few (3patients) got no relief as well.

Discussion

In Primary Dysmenorrhea all aspects of pain (pain intensity, duration of pain, nature of pain) and incidence of associated complaints are affected and we can correlate this disease with Kashtartava. In this, Skashta Aartava Pravritti can be correlate to painful menstruation, Kati Prista Jangha Vedana with presence of referred pain at lower abdomen, lower back and radiating to thighs, Aartave Sa Vimukte Tu Tat Kshanam Sukham with pain subside after expulsion of menstrual blood, Granthibhuta Aartava Dushti (Vata Kapha Dushit Aartava) with presence of clots and Dhatvaagnijanya Vikara with associated systemic complaints.

Primary dysmenorrhea usually begins a few hours before or just after the onset of menstruation. The cramp is commonly accompanied by one or more systemic symptoms, including nausea and vomiting (89%), fatigue (85%), diarrhoea (60%), lower backache (60%), and headache (45%). Nervousness, dizziness, and in some severe cases, syncope and collapse can be associated with primary dysmenorrhea. Lasting a few hours to 1 day, the symptoms seldom persist for more than 2–3 days.[6]

Probable Mode of Action

Pippalayadi Phanta is a Kalpit Yoga, so no research work was available on this polyherbal drug combination named as Pippaliyadi. In this present study, it has been considered a trial drug. As all the 5 ingredients Pippali, Marich, Sunthi, Ajwain, Hingu are Ushna Virya and Katu, Tikta Guna possess the property of Kapha Vatahara. Katu Ras is having properties like Kaphshamak acts Agni Deepana, Srotovivarana property acts as vasodilation which in turn reduces the pain.


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Ushna Virya possess Vatahar and Kaphahar properties acts Deepan, Pachan Karma. All these properties help to alleviate vitiated Vata Dosha and clears the Margavrodh (obstructed path) thereby it avoids Sangh and Vimarga of Artavavaha Srotas, by Vataghnata and Shoolaghnata effect it directly acts on pain.

The property of Vatanuloman corrects the path of Apan Vata and help in Artava Nishkraman Kriya thus relieving the pain. Acharya Charak stated that because of[7] Vegavarodha (suppression of natural urges), the Apana Vayu (a type of Vata) gets aggravated and moves in the reverse direction and occupies the entire Yoni (vaginal canal).

This Apana Vayu forces the Raja (menstrual blood) upward and leads to pain and discomfort in menstruation. It is observed in various prevalence studies that the dysmenorrheal condition is present throughout the world. To work on Apan Vayu the medicine is administered at least half hour before meal (Pragbhakt).

Conclusion

The present research work entitled A Clinical Study on Pippalayadi Phanta on Kashtartava (Primary Dysmenorrhea) completed on 30 patients and following conclusions have been drawn. Primary Dysmenorrhea is a most common menstrual problem in India that affects 50% to 87.87%[8] of adolescence and college going girls.

Due to alteration of food habits, sleep pattern and stressful lifestyle women have higher level of prostaglandins and inflammatory mediators which leads hyper contractibility of uterine muscles and hypoxia. A special WaLIDD Score was used for the assessment before and after treatment.

These herbs used in present study have been traditionally known for their anti-inflammatory, analgesic, and muscle-relaxing properties. Drugs selected for the present study are Vatanulomak, Vedanashamak, Shoolprashman and Vatahara may effectively bring down the Pratilom Gati Vata which is mentioned for Udavartini Yonivyapad which is one of the main disease conditions compare with Kashtartava. Highlighting the novel approach towards making herbal sachet resembling green tea catering to modern generation’s interest, ease of consumption and portability.

Overall % of relief based on WaLIDD Score parameters 28.475%. Overall result on objective parameters is found to be significant.This innovative method integrates traditional herbal benefits with contemporary preferences, providing a convenient and portable option for health-conscious individuals seeking natural alternatives.

Acknowledgment

The author would like to express heartfelt gratitude to Prof. (Vaidya) Pradeep Kumar Prajapati, Hon’ble Vice Chancellor of Dr. S. R. Rajasthan Ayurved University, Jodhpur; Prof. (Vaidya) Mahendra Kumar Sharma, Principal/Director of the Post Graduate Institute of Ayurveda, Jodhpur; and Dr. Vijay Pal Tyagi, Director of Nagarjuna Pharmacy, for their invaluable suggestions and unwavering support.

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