Artavakshaya: A Literary Review of Ayurvedic Concepts and Management

Abstract

The menstrual cycle is a complex physiological process regulated by the coordinated interaction of the hypothalamus, anterior pituitary gland, ovaries, and endometrium. Normal and rhythmic menstruation is essential for maintaining reproductive health. However, various internal and external factors can disturb this intricate mechanism, leading to menstrual disorders such as oligomenorrhea and hypomenorrhea, which have reported prevalences of 13.5% and 12.95%, respectively. In Ayurveda, these conditions can be correlated with Artava Kshaya based on their clinical manifestations, including reduced menstrual flow, prolonged menstrual intervals, and associated lower abdominal pain. Artava Kshaya is considered an Agnimandhyajanya Vikara characterized by a predominance of Kapha and Vata Dosha vitiation. Impaired digestive and metabolic activity (Agnimandya) leads to the accumulation of Kapha, which obstructs the normal movement of Vata and causes blockage of the Artavavaha Srotas, ultimately resulting in diminished menstrual flow. Menstruation reflects the hormonal and gynecological health of women and plays a crucial role in fertility. Ayurvedic classics emphasize the importance of Shuddha Artava for successful reproduction and identify Artava Dushti as a significant factor contributing to infertility. The management of Artava Kshaya focuses on correcting the underlying pathophysiology through Deepana and Pachana therapies, followed by Shodhana and Shamana Chikitsa. These therapeutic approaches enhance Agni, alleviate Kapha-Vata imbalance, and restore normal menstrual function. Thus, Ayurveda offers a holistic approach to the management of oligomenorrhea and hypomenorrhea by addressing both the root cause and clinical manifestations of the disorder.