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RASAYANA- A BOON FOR AGING WOMEN IN MENPAUSE INDUCED ASTHIKSHAYA -A CONCEPTUAL STUDY Dr.Deepa.S.Patil1,Dr.A.S.Prashanth2, Dr.S.G.Chavan3. 1P.G Scholar, 2Professor and Head,3Professor, P.G Studies, Department of Kayachikitsa, Mahavidyalaya Hubballi Karnataka, India.

ABSTRACT Ayurveda is an ancient Science of life deals with the Preventive as well as Curative aspect. Asthikshaya has become the growing health problem in elderly population reaching Rajonivritti. The term Rajonivritti is not mentioned as disease in classical texts of Ayurveda. Yet, according to Acharya it can be considered under Swabhavabala pravritta vyadhi[1] and Acharya said it as „Swabhavo nishpratikriyaha‟[2]. Rajonivritti occurs Jarawastha, where Vata starts overpowering Pitta dosha and leads to Kshaya of all dhatus[3]. The Menopausal period is associated with significant increase in the incidence of age related medical conditions like Cardiovascular diseases and Osteoporosis. Asthikshaya in Menopause is a condition of major health importance because of its association with Fractures. Bone loss is only partially reversible. Hence treatment is aimed at minimizing the bone loss after the age of 40. These diseases cannot be managed with any treatment other than Shodhana followed by Rasayana. Keywords: Asthikshaya, Menopause, Shodhana, Rasayana.

Introduction reach menopausal age earlier due to Woman goes through variable stages used up ovarian reserve and suffer in her reproductive life where, from climacteric symptoms. As the Menarche and Menopause are lifespan of women is increasing, landmarks of it. The lifestyles changes approximately one third of her life has have made occurrence of menarche at to be spent in Menopausal years. an earlier age. Thus more women Statistical data reveal that

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Osteoporotic fractures are four times Rajonivritti though a more common than cardiovascular Swabhavikaawastha in woman, when disease and can lead to permanent it causes discomfort by either disability. It is a major public health interfering with normal functions of problem worldwide associated with mind or body, it needs attention. morbidity, mortality and socio- According to Acharya Sushrutha, this economic burden. It is the second phenomenon has been mentioned as most common metabolic bone disease Kshaya of the dhatu which occurs due in India[4]. Low calcium intake which to Jarapakwaavastha of sharira. All leads to vitamin-D deficiency, early Acharyas have mentioned Kshaya of menopause, genetic predisposition, artava as a normal , lack of diagnostic facilities and poor occurring at age of 50 years, owing to knowledge of bone health have dhatukshaya (depletion of body contributed towards the high tissues) and Jaraavastha, in the prevalence of Osteoporosis. World transitional kala from Pitta to Vata Health Organization defines predominance. The commentator Osteoporosis as “Progressive systemic Arunadatta has considered this age as skeletal disease characterized by low a probable one, which is also seen bone mass and micro architectural practically.[7] According to Acharya deterioration of bone tissue, with a Bhela, Rajahsrava starts occurring, consequent increase in bone fragility once Dhatuparipurnata (completion of and susceptibility to fracture”.[5] Low body tissues) has been attained which levels of Estrogen causes imbalance in explains the reason for absence of bone reabsorption and remodeling rajahsrava in tarunavayah.[8] This also which leads to accelerated bone loss[6]. explains the importance of dhatu It has been presumed that 35% of (body tissues), especially Rasadhatu in Postmenopausal women are at risk of formation of Rajah and the role of developing Osteoporosis. Osteoporotic Rasayana therapy in Rajonivritti janya fractures commonly occur at the spine, lakshanas. hip and wrist joint. PIJAR/July-August-2018/Volume-2/Issue-6 Page 12

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Role of in the pathogenesis hyper functioning of the apachaya part of Asthi kshaya[9] of Asthi dhatwagni leads to the vriddhi In the pathogenesis of Asthi Kshaya and kshaya of the Asthi dhatu the role of Jatharagni, Bhutagni and respectively. Hence the factors which Dhatwagni can be explained as cause the hypo functioning of follows; Jatharagni also causes the hypo The vitiation of Jatharagni leads to functioning of Asthi dhatwagni and improper digestion of the food results in improper conversion of resulting in the production of Ama poshaka Asthi dhatu into sthayi Asthi rasa, which contains very less dhatu leading to Asthi kshaya. nutrients or may totally be devoid of Similarly factors responsible for the nutrients leading to improper hyper functioning of apachaya, leads nourishment of the Asthi resulting in to the Asthi dhatu dushti leading to Asthi kshaya. The derangement of Asthi kshaya. Hence to summarize, Bhutagni especially Parthivagni and when anabolic function of Asthi Vavyagni affects the conversion of dhatwagni becomes manda and heterologous panchabhautika dravya catabolic function becomes tikshna, to homologous (Asthi specific) Asthi vyaya (bone resorption) over panchabhautika dravya which leads to powers Asthi utpatti (bone formation) nutritional deficit resulting in Asthi leading to Asthi kshaya. In some cases kshaya. The chief function of Agni is even though there is hypo functioning metabolism and metabolism is of catabolic dhatwagni we observe comprised of Upachaya (anabolism) dhatu kshaya. This is because of the and Apachaya (catabolism). Similarly dosha prabhava as explained by Asthi dhatwagni also has anabolic and Chakrapani. catabolic functions. The hypo Menopause[10] functioning and hyper functioning of Menopause is a normal, natural event- the upachaya results in the kshaya and defined as permanent cessation of vriddhi of the Asthi dhatu respectively menstruation at the end of where as, the hypo functioning and reproductive life due to loss of ovarian PIJAR/July-August-2018/Volume-2/Issue-6 Page 13

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follicular activity and is usually women going through menopause is confirmed when a woman has missed Hot flashes and Night sweats, other her periods for 6 consecutive months symptoms can include Vaginal dryness, (in the absence of other obvious Vaginitis, Cystitis, Urinary causes). Menopause occurs on incontinence, Digestive disturbances, average at age 50. Weight gain, Hair loss, Headaches, Stages of Menopause Fatigue, Palpitations, Tachycardia and As the menopausal transition occurs Loss of Libido. Emotional symptoms over months and years, menopause is can include Insomnia, Irritability, commonly divided into the following Nervousness, Anxiety and Depression. two stages: Ayurvedic Management of Asthi Perimenopause – Kshaya in menopause includes: This is the time when women begin 1. Nidana Parivarjana (Avoidance experiencing menopausal signs and of etiological factors): symptoms, even though they still Avoiding the indulgence in the menstruate. The hormone levels rise causative factors is of prime and fall unevenly. Perimenopause importance in Ayurveda. The person usually lasts four to five years or suffering from Asthi kshaya must avoid longer. the excessive indulgence in etiological Postmenopause – factors responsible for provocation of Once 6 months have passed since the Vata, vitiation of Mamsavaha srotas, last period, the woman has reached Medovaha, Asthivaha srotas. menopause. Her ovaries produce less 2. Shodhana Chikitsa estrogen and no progesterone. The (Biopurification): years that follow are called If the Rasayana prayoga is done postmenopause. without Shodhana then it seems like Symptoms dyeing a dirty cloth which does not Menopausal symptoms affect 70% of yield to proper nourishment of Rasadi women approaching menopause. The dhatus[14]. most common symptom affecting PIJAR/July-August-2018/Volume-2/Issue-6 Page 14

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Ama is unique concept of Ayurveda. Asthi Dhatu. Asthi also has Removing this Ama has become more preodominently Pruthvi, Vayu of a priority. Drugs like Chikrakadi vati, Mahabhuta so Tikta Rasa invariably Amruthothara kashaya, Shaddharana increases the Kharatva in the Asthi. choorna, Hingvachadi choorna, Ksheer and Sarpi has predominantly Agnitundi vati etc are given for Pruthvi, Jala Mahabhuta and Madhura Aamapacana. Rasa. These properties will check the Basti is considered as Ardha Chikitsa vitiated Vata Dosha. The provocation among all therapeutic measures in of Vata will result into Asthi Dhatu Ayurveda[11]. It is the best known Dushti. Basti is the best treatment treatment modality used for Vata explained for Vata Dosha so the Tikta dosha and the vitiated Doshas located Rasa in combination with Sneha below the umblical region. Pakvashaya Dravyas in the form of Basti have a is the place of Purishadhara Kala bifold nature i.e it provides sufficient where Basti dravya reaches and it is nourishment to the Asthi Dhatu as well also the main seat of Vata Dosha as balances Vata Dosha also. including Asthi therefore increased or Snehana provides Snigdhatva to the decreased formation of Vata affects all body, liquefies Dosha and increases the sites of Vata especially Asthi. Kledata in the body. Like this, it Hence Purishadhara Kala is also manages Dosha and helps in bringing considered as Asthidhara Kala. So it them from Shakha to Koshta[13]. Phala also nourishes the Asthi dhatu. While grita, Tankasree ghrita, Sukhumara describing management of Asthi ghita, Dadimadi ghrita, Amrita grita, Kshaya, Acharya Vagbhata quoted that Shatavari ghrita, Triphala ghrita are Basti containing Ksheer, Ghrita and given for Snehapana. Tikta Rasa should be given.[12] Virechana is considered as a Composition of Tikta Rasa is Vayu and Shodhana in the management of Akasha Mahabhuta and as per Asthikshaya. It is one of the prime Arunadatta, Tikta Rasa has a unique treatment modality for Pitta dosha. It property to maintain the Kharatva of also has a significant role in mitigation PIJAR/July-August-2018/Volume-2/Issue-6 Page 15

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of Vata dosha. It is one of the Shatavari Rasayana can be given. The Shodhana Karma advocated prior to Ajasrika Rasayana in the form of administering Rasayana and nutritious diet is of most significance. Vajeekarana[14]. Tivruth lehya, To balance the hormones and reduce Gandharvahastadi taila, Eranda taila, the symptoms diet should include Aragwadadi kashaya, Mishraka sneha plenty of essential minerals, milk, are given for Virechana. These act as calcium supplements. Organic food Sneha Virechana, Srotovishodhana, and vegetables rich in dietary fibers, Vayasthapana, Balakara, antioxidants and phytoesteroids should Vishodhaka. be used. Phytoestrogens are plant 3. Scope of Rasayana in based Estrogen that can mimic the Menopause effect of natural Estrogen. Managing Rasayana is a measure of attainment stress is one important way to reduce of complete health either physical or symptoms like fatigue, poor sleep etc. mental. The major type of Rasayana Effective way to relieve stress is to like Ajasrika, Kamya and Naimittika follow Achara Rasayana. prove very good effects on female in 4. Shamana Chikitsa (Palliative menopausal period. Shatavari, Vidari, Treatment): and Kumari are the drugs that reduce Acharya Sushruta has described the fatigue and vaginal dryness and give a Chikitsa of Asthi kshaya along Rasayana effect. For psychological with the Chikitsa of all 18 types of symptoms, like irritability, anxiety, or kshaya, depression, there are very effective The dravya which are of Swayoni i.e. drugs like Brahmi, Jyotishmati, similar to the respective dhatu are to Shankhapushpi can be given. All the be used for the treatment of the above mentioned Rasayana are respective dhatu kshaya.[15] Here, in Naimittika which are taken to cure Asthi kshaya, dravya similar to Asthi symptoms produced in the body. The dhatu should be used. This is based on Kamya Rasayana like Cyavanprasha, the Samanya Siddhanta. Rasayana, Triphala Rasayana, PIJAR/July-August-2018/Volume-2/Issue-6 Page 16

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Use of Taruna Asthi increases the Asthi Mahayogaraja guggulu, Lakshadi dhatu[16]. Preparations like guggulu, Adityapaka guggulu, 1)Ajasthi bhasma, 2) Yogaraja guggulu etc. prishthasthi bhasma 3)Mrigashringa Kshira paka: Arjuna kshirapaka, Asthi bhasma 4)Asthi bhasma of other Ashwagandha kshira Paka, Guduchi animals etc. kshira paka etc. Some of the Rasoushadhi used in the Rasayana: Dwitiya Brahma Rasayana, treatment of Asthi kshaya are; Tritiya Triphala Rasayana, Chathurtha 1)Pravala bhasma, 2)Pravala pishti Triphala Rasayana, Chyavanaprasha bhasma, 3)Kukkutanda twak bhasma, Rasayana, Shatavari Rasayana, 4)Shankha bhasma, 5)Shukti bhasma Shilajatu Rasayana etc. and 6)Kapardika bhasma etc. CONCLUSION Taila: Kshirabala taila, Chandana bala Menopause is a phase characterized by lakshadi taila, Dhanvantara taila, Bala a cluster of physical and psychological guduchyadi taila, Balashwagandhadi changes. Sometimes the Menopausal taila, Lakshadi taila, Mahalakshadi symptoms are so vigorous that can taila, murivenna taila etc. affect the routine life and requires Ghrita: Pancha tikta guggulu ghrita, treatment. The Postmenopausal period Triphala ghrita, Shatavari ghrita, is associated with significant increase Amrita ghrita, Patoladi ghrita, in the incidence of age related medical Mahatiktaka ghrita, Pancha tiktaka conditions like cardiovascular diseases, ghrita, Tiktaka ghrita, Indukanta fractures and osteoporosis. Shodhana ghrita. followed by Rasayana therapy can be Guggulu : Various Guggulu proved efficacious in Menopausal stage formulations mentioned in the providing Symptomatic cure and treatment of fractures and disorders of Preventive as well. Vata Dosha can be given to the Asthi REFERENCES: kshaya patients who suffer from 1. Sushruta of Maharshi Susruta, different types of pain. These Edited with Susrutavimarsini by Dr. preparations are: Abha guggulu, Anant Ram Sharma, volume-I, PIJAR/July-August-2018/Volume-2/Issue-6 Page 17

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