Women's health and Ayurveda

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Ayurveda (आयुर्वेदः) is the oldest medicinal system originated in Bharatavarsha (भारतवर्षः). It offers knowledge of various methods to obtain health and longevity. This knowledge encompasses all the aspects of human life and is not restricted to a particular gender. In fact special attention has been given to the peculiar differences arising due to the male or female body types and then the ways to preserve and promote positive health have been put forward for both i.e. masculine and feminine. Thus one can find ample amount of knowledge regarding women's health in Ayurveda. Ayurveda advocates use of natural methods to preserve and promote positive health in woman. Special attention has been given to her potential of giving a childbirth and therefore measures to preserve her fertility and smoothly pass through the phases of menstruation, pregnancy, motherhood have been advocated. Ayurveda scholars seem to have minutely studied the intricate details of feminine balance, inter-relationship between diet, lifestyle , emotions and other environmental factors of a woman and her health at every stage of her life. This has led to the development and proposition of certain protocols or codes of conduct that a woman is advised to follow during different phases so as to stay healthy and young.

How Ayurveda differentiates women from men

Darshana shastras (दर्शनशास्त्राणि) discuss about Prakrti (प्रकृतिः) and Purusha (पुरुषः) while explaining the process of srshti utpatti (सृष्टि उत्पत्तिः | origin of the universe). Prakrti and Purusha both have some attributes in common while there are few characteristic features that make them different from each other and also are responsible for origin of the universe after their union.[1] Similarly, Ayurveda looks at male and female both as a purusha (पुरुषः human being) which indicates that despite having different bodies, there are some common life elements in both of them making them equal. But at the same time, there are few characteristic features of a female body which make her capable of nurturing a life within, giving birth and nourishing a new life till the later becomes capable of surviving on its own. These structural and functional aspects of body are exclusively found in women. For this reason, Acharya Charaka has called woman as a root of progeny (child) while discussing various gynecological disorders affecting females in chikistasthanam (चिकित्सास्थानम्) of Charaka Samhita (चरक संहिता).

यदपत्यानां मूलं नार्यः परं नृणाम्| (Char. Samh 30.5)[2]

In reference to this, Ayurveda samhitas mention about presence of various body organs like Yoni (योनिः), Garbhashayam (गर्भाशयम्), stana (स्तनौ), artavavaha srotas (आर्तववह स्त्रोतसम् The channels of transformation and transportation of female reproductive constituents) etc in female which make her body different than male. Also, acharyas clearly mention that a female is born after conception when there is abundance of artava (आर्तवम्) or rakta (रक्तम्/ शोणितम् feminine reproductive tissue) in the product of conception.[3] Artava inherently possesses excessive heat. [4] Thus, pertaining to it (high pitta levels in body), a female body develops certain characteristics like generally having less tolerance, strength and emotional stability than male counterpart. These multiple features make a woman different from a man and necessitate development of certain health protocols specifically designed for their feminine balance. Acharya Charaka also says that a vaidya should keep these differences in mind while selecting the drugs, their dosage for women so as to make the medicine tolerable and effective at the same time. Such peculiarities of female body or its specific response to a drug or certain situation (which is different than a male counterpart) are commonly observed in the clinical settings while treating the female patients. And these have been cleverly put forward by Acharya Charaka in Vimanasthanam (विमानस्थानम्).[5]

The branch of Ayurveda and treatise for women's health

Ashtanga Ayurveda (अष्टाङग आयुर्वेदः) refers to the 8 branches of Ayurveda dealing with 8 different aspects of life and health. Among these 8 specialties the one named as 'Kaumarabhrtya tantra' (कौमारभृत्यतन्त्रम् ) is that branch which provides knowledge of treating diseases occurring in neonates, infants and children. Diseases in this age group are considered to be caused by imbalances in nutrition, contaminated breast milk from feeding mother etc. Thus many of the feminine disorders particularly related to child birth, breast feeding etc can be considered to be the topic of discussion under Kaumarabhrtya tantra. Most of the gynecological, pregnancy related or ante-natal, post partum health conditions can be found to be described under various sthanas like Sharirasthana, uttarasthana of Ayurveda treatises.

Although all the treatises discuss about women's health, a lesser known treatise named Kashyapa Samhita (काश्यप संहिता) dedicates major part of it towards discussion on Kaumarabhrtyatantra in general and women's health in particular. However, the complete version of this samhita is not available currently. It is available in parts and thus many of the important topics related to women's health discussed in Kashyapa Samhita and known to bharateeyas in earlier times are missing today.

Important milestones in a woman's life

In reference to the childbearing capacity of a woman and various structural and functional peculiarities designed to facilitate the reproduction woman, is believed to have 3 important milestones in her life. These are health related milestones which are dependent on the hormones, strength and overall health of that woman. Menstruation is known as Rajapravrtti or rajodharma in Ayurveda. The start and end of the menstruation are considered 2 important milestones and development of ability to conceive and reproduce at a certain age so as to get healthy progeny and uneventful or safe motherhood is considered to be the other milestone. Acharyas have clearly stated the age at which a woman can reach upto these milestones as below.

रजप्रवृत्तिः तथा रजोनिवृत्तिः ॥ Menarche and Menopause

Menarche which means the beginning of menstrual cycle is the first milestone which is achieved mostly at the age of 12 years. From this time the menstrual cycle known as Rajapravrtti or Rajapraseka starts and continues till the conception occurs. At the age of around 50 years when the dhatus of sharira become senile or mature completely the rajapraseka stops permanently and it is known as Rajonivrtti meaning menopause. Thus age of 12 years and 50 years is thus considered significant in terms of menstrual cycle and hormonal balance as per Ayurveda.

तद्वर्षाद्द्वादशात् काले वर्तमानमसृक् पुनः | जरापक्वशरीराणां याति पञ्चाशतः क्षयम् ||११|| (Sush. Samh. 3.11)[6]

समत्वागत वीर्य वयः ॥ Minimum age appropriate for conception and safe motherhood

If the age of rajapravrtti (रजोप्रवृत्तिः) is normal as per the standards, the age at which that woman can bear a child or conceive and have a safe motherhood as well as a healthy progeny is considered the second milestone. This time was previously considered to be the minimum standard age of a woman to conceive so as to maintain good health and life as per Ayurveda. Samatavagata (समत्वागतम्) means to attain and veerya (वीर्यम्) refers to the necessary strength woman needs for reproduction. Ayurveda acharyas have stated that the age of 16 years in woman's life can be considered to be such an age.

पञ्चविंशे ततो वर्षे पुमान् नारी तु षोडशे | समत्वागतवीर्यौ तौ जानीयात् कुशलो भिषक् ||१३|| (Sush. Samh. 35.13)[7]

Commentary of Dalhana: समत्वागतवीर्याविति समत्वं परिपूर्णत्वमागतं वीर्यं ययोस्तौ समत्वागतवीर्यौ, रसादिधातुपरिपूर्त्या वीर्यपूर्तिः, परिपूर्णसर्वधातुकावित्यर्थः| अन्ये त्वेवं पठन्ति ‘समन्वागतवीर्यौ’ इति; “सम्यगनु पश्चादागतं वीर्यमुपचयशक्तिलक्षणं ययोः” इति च व्याख्यानयन्ति||

Different epochs of woman's life and related health regime

Ayurveda helps women in the journey of her life by offering a helping hand in the form of guidelines on code of conduct that a woman should follow during epochs of her life like Rajaswala (रजस्वला | Menstruating woman), Rtumati (ऋतुमती | Woman in a fertile period/pre-conceptional), Garbhini (गर्भिणी | pregnant), Sutika (सूतिका | Post partum) etc. All these mentioned epochs in her life are significant events related to her health since major physiological and even psychological changes occur within her during these times and those have potential to affect her overall health in present as well as future. Therefore considering the repercussions of these events on health of a woman Ayurveda acharyas suggested a particular diet and also lifestyle recommendations to be followed during these periods. These code of conducts are called as paricharyas. One can find Rajaswala paricharya (रजस्वला परिचर्या | for menstruating woman), Rtumati paricharya (ऋतुमती परिचर्या | for preconceptional or fertile woman), Garbhini paricharya (गर्भिणी परिचर्या | for pregnant woman) and sutika paricharya (सूतिका परिचर्या | for mother post child birth) in Ayurveda literature. Such guidelines on code of conduct during these phases are known as Paricharyas.

रजस्वला॥ Menstruating woman

The term Rajaswala refers to the menstruating woman. Usually a woman menstruates form the age of 12 to 50 years. That means for the major part of her life she menstruates and passes through the phase of rajaswala every month. Thus Rajaswala is the largest and the most important period in the lifetime of a woman and thus impacts her reproductive health to great extent. Also, it is the fertile period in her lifetime necessary for reproduction. The rajaswala paricharya helps women adapt well to the physiological changes taking place in the body during the menstruation and thus helps prevent occurrence of various diseases related to hormones, reproductive system and general health. It also helps her in conceiving a healthy offspring. But it is seen that the rajaswala paricharya is not followed now-a-days. Although the paricharya described in Ayurveda was exclusively designed for preserving the health of that menstruating woman and her progeny,[8] in the past years it was misunderstood as a practice to protect others from her (rajaswala) who is dirty and impure. This notion led to the development of the general consensus that bharatieeyas have always considered menstruation as dirty and impure and thus the practice of rajaswala paricharya was being followed. However Ayurveda has always looked at the process of menstruation as a completely physiological event in a woman's life and understood it in terms of doshas, dhatus, malas, agni etc. In fact the rajaswala paricharya was propounded for betterment of a menstruating woman and maximize her chances of delivering a healthy offspring. Ayurveda scholars studied, observed and concluded as to what type of diet, lifestyle would be suitable for such a woman so that she would suffer the least during this period and preserve her health like the normal healthy individual once the menstruation stops. Therefore all the guidelines given under Rajaswala paricharya in Ayurveda have relevance, background and logical explanation when those are studied from the lens of Ayurveda physiology.[9][10][11] The rajaswala paricharya is described below.

रजस्वला परिचर्या॥ Menstrual regime

All the Ayurveda samhitas (treatises) have discussed about Rajaswala paricharya (रजस्वला परिचर्या) and suggested following regimen for a menstruating woman.[12][13][8]

  • Thoughts and emotions: कल्याणध्यायिनी - The first important thing listed in the paricharya is about the thoughts and emotions of the rajaswala. It is advised that she should focus her attention on virtuous, generous and noble thoughts. It will naturally help her balance her emotions that might have got affected due to hormonal changes during menstruation. She shouldn't cry.
  • Lifestyle:
    • मृजालङ्काररहिता - Apart form basic cleaning and menstrual hygiene, she should abstain from other cleaning procedures she other wise performs in a day. This includes most of the activities under dinacharya (दिनचर्या) morning routines like anjana (अञ्जनम्), abhyanga (अभ्यङ्गम्), nasyam (नस्यम्), snanam (स्नानम्) etc. Also she refrain from wearing ornaments or taking efforts to beautify herself. Skipping these activities does not damage her image but instead save her efforts, gives her resting time and facilitate easy menstruation.
    • Exertion, running should be avoided. Rest is advised.
    • She should not cry or even laugh excessively. She should refrain from talking excessively or listening to anything for a long time. These activities can exhaust a female who is already feeling weak during menstruaiton.
    • ऋतौ प्रथमदिवसात् प्रभृति ब्रह्मचारिणी - It suggests that a menstruating woman should ideally practice sexual abstinence during 3 days of menstruation.
  • Sleep and mattress: दर्भसंस्तरशायिनी - It is advisable that she rests and sleeps on a mat made up from darbha (दर्भः | Desmotachya bipinnata) grass which is believed to be a detoxifying and sacred grass traditionally. Ayurveda scholars have specifically identified this grass since it is cooling in nature and has all the necessary gunas (गुणाः) and karmas (कर्माणि | medicinal properties) to treat menorrhagia (excessive bleeding during menstruation), urinary tract infections and also pain in abdomen[14] which can be present in a menstruating woman. She is also advised to avoid day time sleeping.
  • Diet: There are certain rules described related to the diet of a rajaswala. These are designed on the basis that during menstruation naturally the appetite of a woman decreases, her agni is weak, vata dosha is aggravated in her body and also that excess pitta (heat energy) levels can possibly aggravate her blood loss. Therefore rajaswala should follow a certain diet as described below.
    • क्षैरेयं यावकं स्तोकं कोष्ठशोधनकर्षणम् - Eat Havishya (हविष्यम् | meal made from Sali rice, ghee and milk) The food that is made up from Yawaka or meal made of barley and milk should be taken. She should eat in lesser amount that usual and the diet should be such that it facilitates easy evacuation of bowels. This suggests she should avoid food that is constipating in nature and heavy to digest. She should make sure that the entire process of digestion and excretion is easy and smooth during this period.
    • पर्णे शरावे हस्ते वा भुञ्जीत ब्रह्मचारिणी - She should eat in food plate made up of leaves, clay pot or food in her hands. This is possibly to ensure that the food that she consumes is lesser in quantity or in quantity which such vessel can accommodate.
    • तीक्ष्णोष्णाऽम्ललवणानि च वर्जयेत् - It is advised to avoid spicy, sour, salty food and food that is teekshna (तीक्ष्णम्) & ushna उष्णम् (hot) in gunas (गुणाः).

Apart from these, many cultural and traditional restrictions are prevalent in many societies in the form of menstrual taboos in which isolation, not to perform domestic work, religious activities, and sexual activities are major. However there is no clear mention about most of these restrictions in Ayurveda literature. The observance and non observance of menstrual restrictions and taboos are under debate since a decade. The issue of gender inequality and women empowerment is raised while discussing about the restrictions to be followed by female during menstruation. The 21st century woman considers these restrictions as burden and a path of obstruction towards her empowerment but the shastra behind following certain rules is not emphasized. One should understand the Ayurveda's perspective behind advocating paricharya and decide what is beneficial and not blindly follow all the campaigns.

ऋतुमती॥ Woman in a fertile phase

Rtumati or rutumati (ऋतुमती) refers to a woman in that time period of her life which appears regularly, at intervals, in a menstrual cycle. It is the fertile period in a monthly cycle which comes after the menstruation stops. Rtuchakra (ऋतुचक्रम्) in Ayurveda refers to the menstrual cycle. "Rtu" (ऋतु) means a specific time period while "chakra" (चक्रम्) indicates regular onset at regular intervals. A single Rutuchakra covers a period of one Chandramasa (चांद्रमासः)(28 days) and it has been divided into 3 phases, the Rajahsravakala (रजःस्रावकालः), the Rutu kala (ऋतुकालः) and the Rutuvyatita kaala (ऋतुव्यतीतकालः).[15] Once the menstruation stops a woman is called as Rtumati for a period of next 12 days.[16] This period is considered suitable for conception. Therefore the code of conduct that a woman is advised to follow during this period is believed to enhance the chances of healthy conception and promote successful fertilization. According to the vedic scriptures and culture the purpose behind the act of union of male and female is reproduction and not just pleasure. Therefore the rtumati paricharya was propounded to facilitate the process of reproduction. It includes codes of conduct or practices which prepare a female not just physically but also mentally to make her more receptive for conception.

ऋतुमती परिचर्या॥ Preconceptional regime

At the beginning, the acharyas have described the general appearance and signs of a woman who is Rtumati (ऋतुमती | which develop as a result of particular state of hormones in her body at that time).[17][18] Then the paricharya has been suggested. On the fourth day after stoppage of menstruation, a woman should take a bath, preferably a head bath. Then she is advised to wear the clean and new cloths (which are untorn or in good condition) and can adorn herself with the jewelry and ornaments. She should then start her day by offering prayers, performing puja, reading sacred scriptures etc. Some acharyas have also mentioned about the Putreeya vidhi or Garbhadhana samskara that one can perform in this period. Specific diet for a male and female partner in this period has also been recommended. A woman is advised to have a diet composed of Masha (माषाः | black) grams and tailam (तैलम् | oil) ideally for lunch. After all these, the ideal time for male and female union is said to be of that of night. Also the husband and wife are advised to communicate in such a way that they both would develop faith and confidence in each other and create positive and conducive atmosphere for their union. [19] The Rtumati paricharya is primarily advocated to enhance the chances of conception in a woman. Therefore along with this paricharya, the couple who is trying to conceive is also suggested to follow the regime prescribed under Garbhadhana samskara as well.

गर्भिणी॥ A pregnant woman

Garbha (गर्भः) refers to the fetus in a womb while Garbhini (गर्भिणी) means a pregnant woman. A specific regimen for a pregnant woman which includes specific diet and lifestyle has also been recommended in Ayurveda for wellbeing of mother and child in womb and it is known as Garbhini paricharya. Ayurvedic text states that, “If a pot filled with oil right up to the brim is to be carried without spilling even a single drop, every step  has  to be  taken with  care”,  the texts  emphasis  that a similar  care  and  attention  is  required in  taking care  of  a garbhini (pregnant woman). Along with Garbhini paricharya Ayurveda acharyas have also mentioned garbhopaghatakara bhavas (गर्भोपघातकराः भावाः) which refer to the various lifestyle factors of a pregnant woman that could cause serious harm to the baby developing in her womb.

गर्भिणी परिचर्या॥ Pregnancy regimen

Charaka Samhita, Sushruta Samhita, Ashtanga Hrudayam, Ashtanga Samgraham and also a treatise Harita Samhita describe Garbhini paricharya in depth.[20] [21] All the acharyas have suggested a month wise specific diet starting from liquid to solid foods. The recommended diet includes use of various recipes of milk, medicated ghee, butter and rice gruel. A specific type of basti is also advised in the last month of pregnancy to facilitate easy flow of vata dosha resulting in smooth delivery. Such measures to facilitate normal delivery like use of pichu (medicated vaginal tampon), basti have been suggested by Ayurveda and one seeking help for the same should also consult a trained vaidya .

It is advisable that a pregnant woman seeking guidance on garbhini paricharya for safe, uncomplicated motherhood and also for wellbeing of a baby should consult a nearby Vaidya for appropriate guidance and should not practice it just by reading the information.

सुप्रजनन संस्कारः॥ Suprajanana Samskara

Main article Suprajanana samskara .

The influence of factors like diet, psyche and other routines of mother on the fetus has been talked since ages. Ancient Ayurveda scholars believed that, if we make an effort to enhance the quality of these factors which affect the final status of the developing new life, we can certainly obtain healthier, stronger and superior offspring. To achieve this, one can eliminate the adversely affecting dietary and lifestyle factors from pregnant woman's daily regime and at the same time make use of beneficial food, activities and herbs to gain the lacking attributes. It also includes mother's counseling, motivation and meditation for developing a balanced and Sattva (सत्वम् one of the 3 attributes of mind that indicate the quality of goodness or excellence) predominant mind of a baby. Ayurveda describes many such simple methods to procure a healthy offspring and the planning of which starts from detoxifying the bodies of the partners for conception. These methods are popularized now-a-days as ‘Garbha samskaras’ (गर्भसंस्काराः) however, the classical treatises describe this regimen as 'Suprajananam' (सुप्रजननम्) samskara.

सूतिका॥ A new mother (post partum period)

The term Sutika in Ayurveda refers to the woman in her post partum period upto 1.5 months (or 6 months according to some acharyas) from the child birth. Ayurveda described different types of sutika rogas (post partum diseases) which specifically affect Sutika due to inappropriate management of her delicate state post childbirth. Thus Ayurveda has advised a specific diet & lifestyle regimen called Sutika Paricharya (post natal care of a woman) to prevent further complications & restore the health of a mother.

सूतिका परिचर्या॥ Post natal care

At least 12 days post delivery a new mother is advised to follow a strict diet plan. This diet plan includes use of ample amount of ghee, rice gruel, jaggery, milk, various soups made up from barley/horse gram etc and also meat broths for a non vegetarian woman. All these recipes have been described in brief and their day-wise schedule has also been given. Alon with the diet specific therapies like abhyanga (अभ्यङ्गम् | oil massage), udara-aveshtanam (उदरावेष्टनम् | wrapping the abdomen with a long cotton cloth), parisheka (परिषेकम् | pouring hot water in a stream), avagaha (अवगाहम् | sitz bath), dhupana (धूपनम् | vaginal fumigation) use of rakshoghna dravyas (रक्षोघ्न द्रव्याणि | similar to anti-microbial which protects mother and child from various disease causing micro-organisms) has been recommended.[22][23] All these measures employed under sutika paricharya. The Sutika who is weak due to development of fetus, loss of Dhatus, excretion of Kleda (क्लेदः), blood and exhaustion due to labour pain can regain  her  pre-pregnancy  state  by  following this Paricharya (परिचर्या).

It is advisable that a woman in post natal period seeking guidance on sutika paricharya for safe, uncomplicated motherhood and also for wellbeing of a baby should consult a nearby Vaidya (वैद्यः) for appropriate guidance and should not practice it just by reading the information.

आयुर्वेदे स्त्रीरोगाः॥ Various gynecological disorders described in Ayurveda

Ayurveda acharyas have discussed in depth about various menstrual disorders, gynecological conditions, infertility issues and also obstetrical disorders. Although the medical conditions described in Ayurveda are not identified with the same nomenclature in today's time, their causes, signs, symptoms match with multiple reproductive health issues in woman found in today's time. Ayurveda acharyas have explained 8 different types of menstrual disorders specifically arising due to vitiation of rajas (menstrual blood) which is the upadhatu (उपधातु) of Rasa dhatu (रस धातुः). Rajas is vitiated by vata (वातः), pitta (पित्तम्) or kapha (कफः) dosha (दोषाः) or even by combination of any 2 or 3 doshas. These are known as Rajo doshas (रजोदोषाः) or rajodushti (रजोदुष्टिः).[24] Medical conditions like Asrugdara (असृग्‍दरः | menorrhagia/dysfunctional uterine bleeding) Anatomical (structural) and functional issues related to the tryawarta yoni (त्र्यावर्ता योनिः | uterus, cervix, vagina) known as yonivyapadas, their causes and medical management has also been described in depth. Various types of specialized panchakarma (पञ्चकर्माणि) therapies have been effectively employed in these conditions. Along with these multiple Garbhavyapada (गर्भ्व्यापदाः | antenatal problems / pregnancy related medical conditions) and Sutika rogas (सूतिकारोगाः | post natal disorders / health issues arising post delivery) have also been addressed. At each stage of her reproductive life, the care has been taken to maintain her fertility to the best possible level and to achieve this various paricharyas (परिचर्या | code of conduct) have been suggested. If at all the woman happens to face infertility problems then the guidelines are given for assessment of her health status, finding out and working on the actual causative factor and multiple measures to treat such health concerns have been described in depth.

Woman's health issues in current time and how Ayurveda can help

With westernization and adoption of modern lifestyle which is not in tune with the nature, health of a woman is adversely affected. Modern day woman have all kinds of roles to fill in. They are expected to be feminine and masculine; powerful and gentle; attractive and motherly at the same time. This has led to build an excessive amount of stress, anxiety and tension in a woman right from her childhood. In the pursuit of her dreams and pressure to balance all these aspects smartly, somewhere the health is not given priority and thus neglected. The lifestyle and diet which are backbone of the health and well-being in any individual are not always carefully selected. Increase in the stress levels is directly proportional to the hormonal imbalances and menstrual disorders.[25] [26] [27] At the same time unwholesome diet which is deficient in necessary nutrients and sedentary stressful lifestyle untuned to the biological clock inside body negatively impacts health leading to weaker constitution and low immunity. It is seen that now-a-days there is high incidence of a variety of menstrual health problems in pre-menarche, during menstruation, perimenopause and post-menopause. PCOS like conditions are widely prevalent in today's woman causing menstrual irregularities and infertility. [28] Therefore there is an urgent need of measures for prevention and control of generalized an well as reproductive health disorders in woman. The ancient shastra of Ayurveda has already given the ways to prevent these disorders and preserve a woman health. Thus there is need to adopt the various paricharyas (codes of conduct) related to different phases of woman life to as much extent as one can. Along with that natural herbal medicine and panchakarma therapies can definitely help modern day woman to preserve her health while trying to maintain the work-life balance. Here is brief account on the common health issues faced by today's women and how the wisdom of Ayurveda can help them come out of these conditions and preserve health and well-being.

ऋतुचक्रसंबन्धिताः विकाराः॥ Menstrual problems

Irregular menstrual cycle, scanty menses, painful periods, PMS, heavy bleeding, prolonged bleeding etc are commonly observed menstrual disturbances in majority of girls and women in fertile age group. Many a times these are associated with increase or decrease in weight, weakness and digestive disturbances. These days, the symptoms like lower abdominal pain, backpain, mood swings, nausea etc are considered as just the associated symptoms of menstrual cycle and believd to be normal. But our classics have clearly mentioned that a normal menstruation should be devoid of pain burning sensation or any other discomfort. Thus it is necessary that even the minor discomfort during menstruation is indicative of some underlying health condition and this can be well managed with Ayurveda's wisdom. Ayurveda speaks about Rajakshaya (रजःक्षयः) and rajodushti (रजोदुष्टिः) by specific doshas which generally cover such menstrual disturbances. In such cases a vaidya (वैद्यः) usually assesses the diet and lifestyle of suffering woman, evaluates her general health to understand her agni (अग्निः) status, balam (बलम्), manas (मनस्) status, doshas (दोषाः) and dhatus (धातवः). Once these aspects are understood a course of natural medicines is usually designed to address all her health concerns that are interlinked and not just the menstruation is targeted. This helps to bring natural balance of doshas improving her general health condition and ultimately normalizing her menstrual cycle. Various herbs like kumari (Aloe vera), Ashoka (Saraca indica), Chitraka (Plumbago zeylanica), Amalaki (Embelica officinalis), Shatavari (Asparagus racemosus), Lodhra (Symplocos racemosa) are found to be very helpful in treating such disturbances effectively. Along with that, panchakarmas (पञ्चकर्माणि) like Vamana (वमनम्), Virechana (विरेचनम्), Basti (बस्ति) are advised if the imbalance is beyond the level of medicinal management. Also it is advisable to follow Rajaswala paricharya (रजस्वला परिचर्या | described earlier on this page) as much as possible to prevent the recurrence and preserve the reproductive and genralised health.

स्त्रीबीजग्रंथीविकाराः॥ PCOS (Polycystic Ovarian Syndrome)

Polycystic ovarian Syndrome is widely prevalent endocrine disorder in women of reproductive age group. It is associated with a broad range of health conditions including hyperandrogenemia leading to hair loss, unwanted hair growth on face and other body parts, acne etc, high BP & Cholesterol, insulin resistance leading to type 2 diabetes mellitus (T2DM) etc. PCOS is also one of the primary causes of infertility in women. Sedentary lifestyle, excessive stress levels and over weight are some of the factors that predispose a young girl or woman to PCOS. When compared to age related controls, women with PCOS are found to have 11-fold increased risk of developing metabolic syndrome and glucose intolerance. Therefore it is understood that PCOS is one such endocrine disorder in woman which hampers reproductive, metabolic and mental health of a woman. Looking at the rate at which the incidence of PCOS is increasing it is necessary to adopt measures to prevent occurrence of PCOS and also if already developed then search safe and effective measures to manage this condition.

As mentioned earlier, Ayurveda looks at any such disorder as an imbalance of agni (अग्निः), doshas (दोषाः), dhatus (धातु) etc and works at that root level of problem to achieve menstrual balance, optimize the metabolic function, prevent the complications and bring about the complete balance in internal bodily environment. Various herbs like amalaki (Embelica officinalis), trifala, Cumin, turmeric, kumari (Aloe vera), Punarnava (Borrhavia diffusa) are found very effective in balancing the hormonal levels in PCOS. Along with that medicines to address other associated health conditions, improve agni, cleanse bowel, strengthen dhatus are also given in combination. Panchakarma therapies like Basti, Uttabasti (उत्तरबस्तिः), vamana (वमनम्), Virechana (विरेचनम्), Abhyanga (अभ्यङ्गम्), Swedana (स्वेदनम्) etc are found to be very effective in re-establishing the feminine balance that tis disturbed in PCOS. Great emphasize is also given on diet and lifestyle. Woman with PCOS is given guidance about her lifestyle , Dinacharya (दिनचर्या | daily routine), Rtucharya (ऋतुचर्या) and advised not to suppress vegas (वेगाः | natural urges). She is also advised to follow Rajswala paricharya (रजस्वला परिचर्या) and Rtumati paricharya (ऋतुमती परिचर्या) once the hormonal balance is restored and menstrual cycle is regularised.

वंध्यत्वम्॥ Infertility

WHO report states that One in every four couples in developing countries has been found to be affected by infertility. [29] Female infertility is more common than males since their general health is affected to great extent by their reproductive health and thus while dealing with the cases of Infertility Ayurveda lays high emphasize on improving the general health of a woman rather than focusing and targeting on only her hormones. Ayurveda recognizes and mentions infertility as Vandhyatwa (वन्ध्यत्वम्). Ayurveda speaks about importance of 4 factors Rutu (ऋतु), Kshetra (क्षेत्रम्), Beeja (बीज) and Ambu (अम्बुः) for generation of a new life.[30] This includes consideration of woman's menstrual cycle pattern, healthy state of her entire reproductive tract (uterus, ovaries, cervix, vagina), her general nutrition and quality of her egg. Medicines and Panchakarma therapies are advised by considering all these 4 factors and efforts are focused on improvising her complete health so that naturally she can conceive and deliver a healthy offspring. This process can be time consuming because reproductive health is balanced in a stepwise manner and her body, mind are made capable to develop capacity to nurture another life. However if the efforts are made in this direction a woman can regain her complete health and regain her fertility without adverse effects. Quality of life of a woman is improved. A wide range of herbs, herbo-mineral formulations, decoctions, powders can be used in this treatment depending upon the case and expertise of the vaidya. It is advisable to consult a nearby vaidya (वैद्यः) for further guidance.

रजोनिवृत्तिः॥ Menopause

A woman can suffer from either premature menopause or variety of psychological and physical ailments in perimenopausal period. Ayurveda can offer a helping hand to such a woman to pass through these phases smoothly and prevent the possibility of premature menopause in early reproductive life. It is necessary to diagnose the possibility of premature menopause early so that immediate measures in the form of medicines, panchakarmas (पञ्चकर्माणि), yoga (योगः), diet, lifestyle and rasayana (रसायनम्) therapies can be implemented and the feminine balance can be restored.

अस्थिसंधिविकाराः॥ Bones and Joints

Sedentary lifestyle, lack of exercise, inappropriate ahara, deficient nidra (निद्रा | sleep), stress and sometimes also over exertion by a woman lead to multiple bones and joints related problems. In addition to that, post menopause many women also suffer from calcium deficiency and decreased bone strength leading to osteoporosis. In order to have healthy bones and joints Ayurveda recommends to have proper nutrition i.e. ahara (आहारः) and balanced agni (अग्निः). The ahara of woman should have inclusion of snigdha (स्निग्ध) ahara i.e. food that includes good fats. Since the nourishment of bones and other components of any joint is associated with generalized nutrition it largely depends upon the strength of agni and supply of necessary nutrients which can be obtained from wholesome diet. Thus more focus is given on optimizing the agni and nutrition. Along with that, abhyanga with medicated oils works best as a local therapy to relieve pain, stiffness and swellings. Oils can be different based on the doshas involved, type of illness, strength etc. Abhyanga can be followed by othe rpanchakarmas like Swedanam (hot fomentation) which works best to relieve stiffness, Basti (बस्तिः), raktamokshana (रक्तमोक्षणम्), Agnikarma (अग्निकर्मम् | fire or heat treatment) etc. Vyayama (व्यायाम्ः | exercises), Bandhas (supports/bandaging) has also been suggested in certain cases to strengthen the bones, muscles and joints. Herbs like guggulu (Comiphor amukula), giloy (Tinospora cordifolia), Punarnava (Borrhavia diffusa), Ashwagandha (Withania somnifera) and many other herbo mineral formutions give excellent results in managing these conditions.

सौंदर्योपचाराः॥ Skin, hair and beauty

It is one of the most sought after treatment segment by woman in any age group. Ayurveda strongly believes that radiant flowless skin, thick strong hair and all those elements that make any person look attractive and healthy are actually the end effects of better internal health and balance of doshas (दोषाः) as well as agni (अग्निः). Thus while treating the skin and hair related conditions considerable attention has been given to understand the underlying health issue and efforts are forcused on fixing the root cause. Along with that various local therapies have also been designed like Abhyanga (अभङ्गम्), lepana (लेपनम् | face packs), udwartana (उद्वर्तम्) etc which deliver medicines directly at the affected area help to restore its natural beauty. Ayurveda has never neglected the cosmetic issues, in fact great emphasis has been laid on the daily practice of procedures like Abhyanga, Udwartna, Nasya, Gandusha, anjana etc that enhance the health and beauty of skin and hair. And therefore all those have been included in Dinacharya (दिनचर्या). Thus a woman desirous of flowless, glowing skin, thick & strong hair, good eyesight should regularly practice these procedures after guidance of a vaidya. Various herbs like Bhringaraja (Eclipta alba), Kumkuma (Crocos sativus), Turmeric (Curcuma longa), Shikekai, Ritha, Amalaki (Embelica officinalis), lodhra (Symplocos racemosa), Mulethi (Glycerhiza glabra) have been found to be highly effective in treating varioisu skin and hair related ailments and restore the natural beauty of a woman.

विविधाःशेषाः विकाराः॥ Others

There are may other medical conditions ranging from anaemia to cancers through which a woman can suffer in different phases of her life. Although not all these diseases have been clearly mentioned in the Ayurveda literature, the guidance given on assessment, evaluation and diagnosis of diseases in Ayurveda can enable a vaidya to understand the disease pathology in that woman with the lens of doshas (दोषाः), dhatus (धातवः), malas (मलाः), agni (अग्निः) and balam (बलम्). This can open wide range of options in treatment for that illness which include herbo-mineral medicines, diet, lifestyle changes, panchakarmas etc. Therefore this ancient wisdom of Ayurveda can certainly help any woman to pass through all the epochs of her life effortlessly, prevent illnesses, increase strength and maintain her feminine balance to be able to nurture and raise a new life.


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