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Effect of Agneya Aahara Dravyas in the Management of Rajkshinata (Hypomenorrhea) - a Case Study

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Effect of Agneya Aahara Dravyas in the Management of Rajkshinata (Hypomenorrhea) - a Case Study Mehetre K, Jarange M. Effect of Agneya Aahara Dravyas in the management of Rajkshinata (Hypomenorrhea) - A Case Study. INTERNATIONAL JOURNAL OF RESEARCH IN AYURVEDA AND MEDICAL SCIENCES Peer Reviewed ISSN: 2582-2748 Indexed journal Vol 3, Issue 3. (Jul - Sept 2020) Case Study https://www.ijrams.com EFFECT OF AGNEYA AAHARA DRAVYAS IN THE MANAGEMENT OF RAJKSHINATA (HYPOMENORRHEA) - A CASE STUDY. Kaustubh Mehetre,1* Mangesh Jarange.2 1. M.S. (Prasutitantra-Streerog), Assistant Professor, Dept. of Prasutitantra-Streerog, SVNHT’s Ayurved College, Rahuri Factory, Dist. Ahmednagar, MS, India. 2. M.S. (Prasutitantra-Streerog), Associate Professor, Dept. of Prasutitantra-Streerog, PMT’s Ayurved College, Shevgaon, Dist. Ahmednagar. Received on: 28/08/2020; Revised on: 22/09/2020; Accepted on: 24/09/2020 ABSTRACT Menstruation is a normal physiological periodic and cyclic process. Menstruation begins in teenag- er girls which starts at or after age of 11 years. Due hormonal changes different symptoms occur before menstrual cycle, during the menstrual cycle and after menstrual cycle. Rajakshinata (Hypomenorrhea) is one of the menstrual diseases. In present case study a young unmarried female of Hypomenorrhea was suggested few dietary regimens viz. Kulitha (Macrotyloma uniflorum Lam.), Tila (Sesamum indicum Linn.) and Mash (Vigna mungo L.) in daily diet along with Drakshasava. All these foodstuffs are ushna (hot) in properties. Such Agneya dravyas (ushna gun- atmak) were used due to Santapanjanya samprapti observed in patient. Irregularity was improved by 66%, Amount of bleeding was improved by 50%, Period of menstruation was improved by 100% and Pain during menses was improved by 75%. Overall, we labeled it as moderate improve- ment. Large scale data is needed to have a strong evidence and to minimize biases. Dietary regi- mens explained in Ayurvedic classical texts are effective to treat various clinical conditions. Keywords: Rajkshinata, Hypomenorrhea, Menstrual disorders, Agneya ahara dravyas. 1. INTRODUCTION logical conditions in which female experience Woman is responsible of good and some difficulties such as Dysmenorrhea, Amen- healthy generation. In that perspective Yoni orrhea, Menorrhagia, Hypomenorrhea, Poly- (vagina) should be healthy. Yoni is important menorrhagia, Oligomenorrhea and Premenstrual organ in health of woman during and after her syndrome. reproductive life as vitiation of yoni is consid- Normal range of menstrual cycle is stat- ered as vitiation as Kshetra which hampers re- ed to be 28 to 35 days with difference of 2 to 3 productive life of female.1 Menstruation is a days. Normal range of duration of menstrual normal physiological periodic and cyclic pro- flow is 3-8 days. Expected average blood loss is cess. Menstruation begins in teenager girls 30-80 ml per day.3-6 Disorders of menstrual cy- which starts at or after age of 11 years. It is hor- cle regarding its irregularities are very common monal control process in which loss of blood in daily clinical practice among female of repro- through vaginal canal occurs. Due hormonal ductive age especially in adolescents before changes different symptoms occur before men- marriage. As per previous studies 27% of young strual cycle, during the menstrual cycle and af- females suffers from irregular menstruation. ter menstrual cycle.2 Menstruation depends on Almost 22% young females suffer from men- general health status of the girl, nutritional con- strual abnormalities and almost 90% suffer dition and genetic factor. There are some patho- from dysmenorrhea.7 In dysmenorrhea periods *Corresponding Author: Kaustubh Mehetre. Email: [email protected]. 232 Mehetre K, Jarange M. Effect of Agneya Aahara Dravyas in the management of Rajkshinata (Hypomenorrhea) - A Case Study. INTERNATIONAL JOURNAL OF RESEARCH IN AYURVEDA AND MEDICAL SCIENCES Peer Reviewed ISSN: 2582-2748 Indexed journal Vol 3, Issue 3. (Jul - Sept 2020) Case Study https://www.ijrams.com are painful along with severe spasmodic pain cant abnormality. She found hemodynamically during menstruation. If menstrual period is in- stable. Family history shown than both her frequent and gets delayed beyond 35 days it is Mother and Grandmother were suffering from termed as Oligomenorrhea. Hypomenorrhea is Oligomenorrhea and Dysmenorrhea. Obstetrics different condition in which volume of uterine family history was sound. bleeding is less (blood loss below 30 ml per 2.2. Examination cycle8) or duration of menstrual blood flow is less than 2 days or both. 2.2.1. Samanya Pariksha (General Examina- tion) In Ayurveda the pathological conditions related to menstruation are explained as ex- Nadi: Vata Pradhan, Guru plained as rajdusthi, rajkshinata, raktapradar Mala: Asamyaka, Kwachit malabaddhata and so on. Hypo menorrhea condition can be Mutra: Avishesh considered and correlated as Rajkshinata. Irreg- Jivha: Ishat sama ular menstruation, less amount of bleeding and Angi: Manda and occasional Vishama pain are the characteristics of Rajkshinata.9 The Koshtha: Madhyama Rajkshinata can be managed with the help of Prakruti: Vata Pradhan, Pittanubandhi, Sanshodhan i.e. Panchakarma (body purifica- Pulse: 76 per min tion) and use of Agneya dravya (drug having 10 BP: 124/78 mm of Hg. Ushna guna i.e. hot in properties). The variety Weight: 54 kg. of medicinal treatment options are available to treat Rajkshinata (hypomenorrhea). Many fe- 2.2.2. Gynecological Examination males don’t like or are not willing to take Menarche: At the age of 14 years drugs. Few don’t afford cost of treatment. Marital status: Unmarried There are many side effects of the hormonal Menstrual History: Menstrual cycle rang- treatment. Dietary regimens can be followed at ing from 28 to 34 days, Irregular, Painful home and very easy. Ahara (Diet) is important and Scanty. Duration: 1 to 2 days and Ir- as per Ayurveda philosophy. Diet is mentioned regular. as regimen in various diseases of Ayurveda as Per vaginal examination: Not done proper diet balances Tridosha helps in cure.11 and Here in this case simple diet regimens were 2.2.3. Investigations used which having agnyeya property as men- CBC: within normal limits 10 tioned by Sushrutacharya. We observed die- Urine Routine and Microscopic: within tary regimens effective. The study will be help- normal limits ful for further research in the stream of Ayurve- USG Abdomen and Pelvis: no significant da chikitsa in the management of Rajkshinata. abnormality 2. CASE REPORT Thyroid function test: within normal limits 2.1. Case History 2.2.4. Dietary regimen advised (Ahara A young unmarried female patient of 18 chikitsa) years old having with Hypomenorrhea came to The Agneya dravya viz. Kulitha (Macrotyloma OPD of Strirog and Prasutitantra. She was hav- uniflorum Lam.), Tila (Sesamum indicum ing symptoms viz. Aniyamita Rutu (Irregular Linn.), Mash (Vigna mungo L.), Asava menstrual cycle), Alparajastrava matra (Less (Drakshyasav)12 were given in regular diet for amount of bleeding), Alparajastrava avadhi three months. Patient was allowed to prepare (Less bleeding period) and Kati-udar shool recipes of above food stuffs as per her choice (Low back and abdominal Pain). Details gyne- and advised to consume them at least once a cological examination revealed no other signifi- daily. Ushirasava was given 15 ml BD after 233 Mehetre K, Jarange M. Effect of Agneya Aahara Dravyas in the management of Rajkshinata (Hypomenorrhea) - A Case Study. INTERNATIONAL JOURNAL OF RESEARCH IN AYURVEDA AND MEDICAL SCIENCES Peer Reviewed ISSN: 2582-2748 Indexed journal Vol 3, Issue 3. (Jul - Sept 2020) Case Study https://www.ijrams.com meal twice (Adhobhakta aushadha sevan Grade 0 to Grade 10 was used. 13 kala ). Follow up was taken every month and 4. RESULTS AND DISCUSSION progress was recorded. 4.1. Overview of Hypomenorrhea 2.2.5. Assessment of symptoms In hypomenorrhea less than 30 ml of blood is Aniyamita Rutu (Irregular menstrual cycle), Al- lost. Some causes and indicators of hypo men- parajastrava matra (Less amount of bleeding), orrhea can be enlisted as pregnancy, weight Alparajastrava avadhi (Less bleeding period) gain or loss, stress, hypothyroidism, use of birth and Kati-udar shool (Low back and abdominal control measures (OC pills, IUCD etc.), certain Pain) were symptoms under assessment. Symp- medical conditions (cervical stenosis, PCOS), toms were graded for ease of assessment as fol- menopausal syndrome etc. According Ayurveda lows. Assessment of symptoms was done for literature, Atisanshodhan, Atishaman, four consecutive cycles after administration of Vegdharan, Asatmya annasevan, Manastap, Ahariya dravyas. Avyayam, Anashan, Atimaithun are enlisted as Aniyamita Rutu (Irregular menstrual cycle)14 hetus (etiological factors) of Rajkshinata.17 Ab- normal variation in duration of menstrual cycle Grade 0: Regular menses on defined date is termed as irregular menstrual cycle. Variation Grade 1: Variation up to 8 days in men- in menstrual cycle up to maximum 8 days be- strual cycle tween shortest and longest menstrual cycle is Grade 2: Variation of 8 days to 21 days in considered as mild variation, variation in men- menstrual cycle strual cycle ranging from 8 to 20 days is consid- Grade 3: Variation of days 21 days or more ered as moderate variation and variation in in menstrual cycle menstrual cycle 21 days or above is considered Alparajastrava matra (Less amount of bleed- as severe variation.14 The average blood loss ing) with menstruation for normal women is ≤30 ml and menstrual blood loss more than 80 ml is Grade 0: Blood loss about 35 to 50 ml8 (5 considered abnormal.18 The Normal duration of to 7 pads during period) menstruation is considered 4 to 8 days with av- Grade 1: Blood loss about 20 to 35 ml (3 to erage duration 5 to 6 days.15 Mild-bearable pain 5 pads during period) before, during and after menses is common but Grade 2: Blood loss about 05 to 20 ml (1 to increased severity of pain indicates abnormali- 3 pads during period) ty. Grade 3: No or minimal blood loss up to 5 ml (No or 1 pad during period) 4.2.
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