Heavy Periods, Menstrual Bleeding: Ayurvedic Treatment

By Dr MS Krishnamurty and Dr Hebbar
Heavy periods, menstrual bleeding are due to many physiological and pathological causes. Many factors such as hormonal imbalance, mental state, diet and lifestyle contribute to these menstrual problems.

Menorrhagia is the technical term for prolonged uterine bleeding. Uncontrolled uterine bleeding or excessive menstrual bleeding is also termed by this name in few of the instances. In Ayurvedic texts, it is named as Raktapradara or Asrigdara. ‘Asrik’ means blood and ‘dara’ refers to excessive flow.

menstrual cycle

Causative factors

Causative / worsening factors for Menorrhagia (heavy periods) include –
Excessive fasting – Fasting for a very long period of time causes an increase of Vata and Pitta Doshas. The same two Doshas are related to menorrhagia.
Excess of sexual indulgence – leads to Vata Dosha increase
Intake of spicy food – leads to Pitta dosha increase
Intake of food containing deep penetrative nature like garlic, asafoetida, mustard etc
Heavy exercise
Stress and tension etc
For the above reasons, the above activities are contra-indicated in people with heavy periods.

Origin of Menorrhagia (Asrigdara)

Due to the above said unwholesome diet and habits, both raktadhatu and Pitta doshas are vitiated. It leads to heavy periods, fatigue, back pain etc symptoms.

Symptoms of Asrigdara

The symptoms can be divided into four sets based on the Vitiated Dosha
Vataja Asrigdara:
Pain, frothy bleeding like the flower of palasha is found.
Pittaja Asrigdara: The bleeding will be blackish red, warm and associated with fever.
Kaphaja Asrigdara: Pallor, slimy, thick, stable( long-lasting) bleeding is observed in case of kaphaja asrigdara.
Sannipataja Asrigdara: It is associated with syncope and fever and mixed symptoms of all the three doshas; It is very difficult to treat.

Treatment of Asrigdara

Treatment to balance down Pitta dosha and Rakta (blood tissue)
Stambhana – blocking therapy
– is adopted. 
Line of treatment of Raktapitta – bleeding disorders
 is found to be suitable in Raktapradara or Asrigdara.
Sheetala upachara (Cooling treatment and medicines)
Sheetala annapana (Coolant food and beverages) are recommended.
To arrest the bleeding, the medicines with astringent property(Kashaya rasa)  are well advised.

Single herbs useful in Asrigdara (Menorrhagia)

The below herbs are not only useful in stopping the bleeding, but these also help in balancing Pitta Dosha and detoxifying of Rakta Dhatu (blood tissue)

  1. Draksha – raisins
  2. Padmakesara- stamen of lotus – Nelumbo nucifera
  3. Chandana- Santalum alba
  4. Usheera- Vetiveria zizanioides (Linn.) Nash.
  5. Sariva- Hemidesmus indicus Schult.
  6. Udeechya- Pavonia odorata
  7. Gokshura- Tibulus terrestris
  8. Bala- Sida cordifolia
  9. Doorva- Cynodon dactylon (Linn.) Pers.
  10. Lajjalu- Touch me not plant – Mimosa pudica
  11. Daruharidra- Berberis aristata
  12. Mocharasa- Salmalia malabarica & Endl.
  13. Lodhra- Symplocos racemosa
  14. Kutaja- Holarrhena antidysenterica (Linn.) Wall. Ex. G. Don.
  15. Dhataki- Woodfordia fruticosa
  16. Nagakesara- Mesua ferrea
  17. Shatavari- Asparagus racemosus

Ayurvedic medicines

Ayurvedic medicines for heavy periods –
Pushyanuga choorna – 
used in the Ayurvedic treatment for bleeding disorders.
Usheerasava – used in treating bleeding disorders such as nasal bleeding, heavy menstrual bleeding, skin diseases, intestinal worms, inflammatory conditions and piles.
Chandanasava – used in the treatment of spermatorrhoea. It is also used to improve strength. It is a natural cardiac tonic. It also improves digestive power.
Lodhrasava – used as a natural remedy for piles, anemia and bleeding disorders
Ashokarishta – used in Ayurveda treatments for many diseases like Pain menstruation, heavy periods, fever.
Drakshadi kashaya – used to treat hangover produced after having excess alcohol. It also reduces the ill effects of alcohol and helps in quick metabolism of alcohol from the liver.
Jatiphala choorna – used in the Ayurvedic treatment of digestive and respiratory conditions.
Chandrakala rasa – used in the Ayurvedic treatment of digestive and respiratory conditions.used in Ayurvedic treatment of diabetes and its complications such as neuropathy.
Shatavari Ghrita – used in the treatment of urinary tract disorders, difficulty in urination etc.
Musalyadi kashaya
Baladi kashaya
Shatavari guda – widely used in the treatment of gynaecological conditions, diseases of the urinary tract and liver complications. It is useful in establishing hormonal balance.
Kamadugha with mouktika – used in treating gastritis and bleeding diseases.
Pravala bhasma – is used in Ayurvedic treatment of cough, asthma, bleeding disorders etc.
Raktapittantak Loh –  used in the treatment of bleeding disorders. Also a source for natural iron.
Bol Parpati –  used in Ayurvedic treatment of menorrhagia, metrorrhagia and such other bleeding disorders.

Adjusting the doses – Certain medications such as Shatavari Guda, Baladi Kashaya, Mushalyadi kashaya, Usheerasava – strengthen body, immunity and balance Pitta. These are administered throughout the menstrual cycle.
Some medicines which are specific for stopping excess bleeding such as Bola Parpati, Raktapittantak Loh etccan be used from 20th day onward, so as to have controlled bleeding once menstruation sets in.
In case of bleeding in between periods or shortened menstrual cycle, medicines like Shatavari Guda, Pushyanuga Churna, Ashokarishta are administered throughout the cycle. Apart from reducing the menstrual flow, they also contribute to establishing hormonal balance.

Recommended diet

Wholesome diet and habits recommended in Rakta pradara
Following drugs and substances are considered to be, wholesome for the patients suffering from raktapradara (menorrhagia) –

  1. Godhuma (wheat)
  2. Shashtika shali (shashtika rice)
  3. Jangalamamsa rasa (desert animals)
  4. Pakwa kushmanda (matured ash gourd)
  5. Patola(Snake gourd)
  6. Tanduleeyaka(Spiranthis sp)
  7. dry grapes
  8. pomegranate
  9. date fruits
  10. Amla – gooseberries
  11. ghee and
  12. Honey

Unwholesome diet

The following foods are considered unwholesome for a patient of Raktapradara –

  1. pungent-sour and salty food
  2. Kshara dravya (alkaline substances)
  3. Fish
  4. Alcohol
  5. Spicy food
  6. Black gram
  7. Tila (sesame)
  8. Kulattha (horse gram)
  9. Lashuna (garlic) and
  10. Sour Dadhi (curd)

On the contrary, the above-mentioned diet is recommended in amenorrhea (lack of periods / delayed periods).

Home remedies

Simple home remedies useful in Asrigdara:

  1. Home remedy for heavy periods using saffron – learn how to use it.
  2. Home remedy using Ashoka tree bark – learn how to use it
  3. Nagakesara(Messua ferra-Stamens) and Usheera(Vittiver zizinoides-root) are made into fine powder and administered(3-5 gram) along with butter and sugar candy. This subsides even severe kind of menorrhagia.
  4. Lajjalu (Touch me not plant) whole plant is taken and crushed well. This medicated paste is administered along with tandulodaka(rice washed water) or fresh juice of Doorva (Cynodon dactylon), to cure the complaint of Raktapradara.
  5. Regular usage of raisins in the diet helps to balance Pitta and also to reduce bleeding during periods.

Any bleeding disorder makes the patient panic and helpless. That too when the patient gets the complaint like menorrhagia for a prolonged period of time, she will be worried which causes her health to deteriorate further. Hence consulting your doctor in early stages will help to a great extent.

Addition By –
Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S

Pradara – Definition, Causes, Pathogenesis, Types, Symptoms, Treatment

Asrgdara and pradara which are often used as synonyms of each other are types of menstrual disorders presenting with excessive bleeding. This condition is not included among the eight types of menstrual disorders i.e. artava vyapad, but fall under the umbrella of the same. Read – Physiology Of Menstruation, Menstrual Cycle – Ayurvedic Perspective

Definition of Pradara / Asrgdara

Due to pradirana i.e. excessive excretion of raja i.e. menstrual blood it is named as pradara.

Since there is dirana i.e. excessive discharge of asrk i.e. menstrual blood, it is called as asrgdara.

The above said definitions of both pradara and asrgdara look to have similar meaning. Both define excessive excretion / elimination / discharge of blood from vagina. Read – Vaginal White Discharge (Leucorrhea) Ayurvedic Treatment, Home Remedies

Understanding Asrgdara / pradara

From the definition of pradara / asrgdara, these conditions look similar to a condition explained by modern medicine i.e. menorrhagia.

1. While looking into the Ayurvedic pathogenesis of pradara, master Charaka and Chakrapani, the commentator of Charaka Samhita opine that when increased rakta i.e. blood gets admixed with raja i.e. menstrual blood, the quantity of menstrual blood increases, thus causing asrgdara / pradara. Read – Somaroga – Excessive Female Discharge With Loss Of Vitality

2. Dalhana, the commentator of Sushruta Samhita tells that asrgdara is a condition characterised by two or more of the below mentioned conditions –

  • Excessive bleeding during menstruation
  • Prolonged menstruation period
  • Bleeding during inter-menstrual period

Vagbhata is also of the same opinion and includes bleeding during both menstrual and inter-menstrual phases.

3. Chakrapani, in the context of explaining Vataja etc doshic types of yoni vyapad i.e. vaginal disorders, has specified that these conditions resemble vataja etc specific types of asrgdara and manifest inter-menstrual bleeding also. Thus, Chakrapani includes inter-menstrual bleeding in doshic types of asrgdara too. Read – Menstrual Pain, Painful Periods – Natural Ayurvedic Herbal Home Remedies

What conditions can be correlated to asrgdara from modern perspective?

  1. Menorrhagia – excessive and prolonged bleeding during menstrual cycle
  2. Polymenorrhea / Epimenorrhea – scanty bleeding during inter-menstrual phase
  3. Polymenorrhagia / Epimenorrhagia – excessive bleeding during inter-menstrual phase
  4. Metrorrhagia – excessive bleeding both during menstrual and inter-menstrual periods

All types of irregular and abnormal uterine bleedings can be included under asrgdara. But on the basis of pathogenesis, asrgdara can be closely correlated to menorrhagia or polymenorrhagia. Read – Ayurvedic Diet And Lifestyle During Menstruation (Periods)

Causative factors of Asrgdara

  • Excessive consumption of salty, sour, pungent, heavy, corrosive and unctuous foods.
  • Excessive consumption of meat of domestic, aquatic and fatty animals
  • Excessive consumption of krsara i.e. olio prepared with rice and pulses, payasa i.e. sweetened rice prepared in rice base, curds, vinegar, curd water and wine

Pathogenesis of asrgdara

1. According to Charaka
When the woman consumes the above mentioned food in excess, her vata aggravated by its own causes or due to it being surrounded by pitta, withholds blood which also gets vitiated due to the above said causes.

The vata further increases the amount of blood. Read – Gynecological Disorders Causes, Types As Per Ayurveda

Along with the increased blood, the vitiated vata reaches the raja carrying vessels i.e. branches of uterine and ovarian arteries.

Here it immediately increases the amount of rajas i.e. menstrual blood by adding the increased blood to the menstrual blood.

Thus, the menstrual blood gets increased in quantity when the increased blood gets added to it in the ovarian and uterine vessels of the uterus. This increase in menstrual blood is due to relative increase of rasa i.e. plasma contents.

Because of increase in the amount of blood, the experts call this disease as asrgdara. Since in this condition, excessive blood is discharged, it is also called as pradara. Read – Charaka Chikitsa Sthana 30th Chapter – Yoni Vyapat

2. According to Harita
In an infertile woman, the milk carrying channels are filled with vata. As a result, she has absence of milk secretion and she also suffers from excessive menstrual bleeding. Read – Srotas: Body Channels and Duct systems – Easy Explanation

3. According to Bhela
If the body blood goes to abnormal passages, the woman suffers from pradara.
Other causative factors (Madhava Nidana, Bhavaprakasha, Yogaratnakara)

  • Use of incompatible diet and wine
  • Eating before the previous food has been digested
  • Indigestion
  • Abortion
  • Excessive coitus
  • Riding
  • Walking
  • Grief
  • Emaciation
  • Weight lifting
  • Trauma
  • Day-sleeping etc.

What else is asrgdara / pradara?

Asrgdara / pradara is also said to be –

  • Shonita janya vyadhi – one of the disorders of blood (Charaka, Sushruta)
  • Rakta pradoshaja roga – one of the disorders caused due to contamination of blood by doshas (Charaka, Kashyapa)
  • Pittavruta Apana Vayu lakshana – one of the symptoms of functions of apana vata being obstructed by pitta (Charaka, Sushruta, Vagbhata)
  • Rakta ativriddhi lakshana – one of the symptoms caused due to abnormal increase in quantity of blood (Vagbhata, Bhavaprakasha)
  • Yoni roga upadrava – complication of vaginal disorders (Charaka, Vagbhata)
  • Pitta ati vruddhi lakshana – asrgdara is also manifested due to increase in pitta (Dalhana) Read – Pitta Increase Symptoms – Pitta Vriddhi Lakshana

Classification of Asrgdara

1. 4 types of asrgdara –

  • Vataja asrgdara – caused by vitiated vata
  • Pittaja asrgdara – caused by vitiated pitta
  • Kaphaja asrgdara – caused by vitiated kapha
  • Sannipataja asrgdara – caused by simultaneous vitiation of all three doshas

2. Asrgdara caused by dual vitiation of doshas –

Master Charaka, after enumerating above said four types of asrgdara, has explained the treatment of pitta-vataja asrgdara i.e. menorrhagia caused by dual vitiation of pitta and vata. Thus, Charaka has accepted the possibility of clinical manifestations of menorrhagia caused due to dual vitiation of doshas. Read – Vatala Yoni Vyapad – Causes, Symptoms, Treatment

To add to this, commentators Dalhana and Indu have accepted 7 types of asrgdara among which three are caused due to dual vitiation of doshas.

They are –

  • Vataja
  • Pittaja
  • Kaphaja
  • Vata-pittaja
  • Pitta-kaphaja
  • Kapha-vataja
  • Tridoshaja / sannipataja

3. Shleshmaja Asrgdara is counted as the first sub-type –

Pattern of counting the sub-types of any disease starts from vataja, followed by pittaja and kaphaja. In Madhava Nidana, Bhavaprakasha and Yogaratnakara treatises, this chronology is broken.They have first mentioned Shleshmaja menorrhagia first, followed by pittaja and then vataja menorrhagia.Madhukosha commentary clarifies that this chronology has been followed and shleshmaja menorrhagia is first to emphasize the presence of pain in kaphaja subtype of menorrhagia too. Read – Functions Of Doshas In Balance In The Body – Prakrita Dosha KarmaGenerally we see that pain is more in vataja and pittaja whereas in shleshmaja / kaphaja sub-types of any disease, pain or discomfort will be negligible or absent.In Bhavaprakasha it is said that kaphaja menorrhagia is mentioned first because relatively more bleeding occurs in this condition.

4. No classification but acceptance of types of asrgdara by Sushruta

Master Sushruta has not given the classification of Asrgdara. But while explaining signs and symptoms of this disease, Sushruta mentions ‘all types of asrgdara’. This clarifies that Sushruta, in spite of not giving the names of types of menorrhagia, has accepted that there are variants of this disease.He has further emphasised to treat asrgdara on the lines of treating raktapitta, a bleeding disorder caused by vitiated blood and pitta. Here, Sushruta emphasises that the predominance of dosha should be diagnosed by carefully observing specific features of dosha(s) in the discharged blood. This explanation also gives us an insight of Sushruta accepting doshic types of menorrhagia. Read – Role of Doshas In the Causation of Disease

5. Raktayoni and Asrgdara are similar conditions – Vagbhata

According to Vagbhata, raktayoni, a vaginal disorder and asrgdara are alike conditions. He has further given treatment of vataja, pittaja and kaphaja asrgdara, though not enumerating the names of types of menorrhagia, has accepted three types by advocating the treatments for the mentioned subtypes. He has advised to give importance to the color of discharged blood while prescribing the treatment for raktayoni.

General signs and symptoms of asrgdara

1. Local symptoms pertaining to vagina and uterus
Presence of excessive bleeding during menstruation

Bleeding during menstruation in excessive quantity and for prolonged time associated with bleeding in the inter-menstrual period in scanty proportions and for a short duration. The bleeding is different from the features of normal menstrual blood and would reflect the features of doshas depicting their involvement in causation of this disorder.

Each dosha sub-type of menorrhagia will have different set of signs and symptoms depending on predominant dosha(s) involved in the pathogenesis.

2. Generalised symptoms

  • Burning sensation in lower groin, pelvic region, back, region of kidney and flanks
  • Pain in uterus
  • Body ache
  • Pain

Prognosis of asrgdara

Menorrhagia caused by simultaneous vitiation of all three doshas is said to be incurable. Woman of sannipataja asrgdara having continuous bleeding, suffering from thirst, burning sensation, fever, anaemia and weakness is incurable.

Master Harita tells that the woman suffering from fever, having very short inter-menstrual period and continuous bleeding is incurable while describing the features of incurability of menstrual blood i.e. arishta lakshanas.

Complications of Asrgdara

Below mentioned are the complications of menorrhagia

  • Weakness
  • Giddiness
  • Mental confusion
  • Feeling of darkness
  • Dyspnea
  • Thirst
  • Burning sensation
  • Delirium
  • Anaemia
  • Drowsiness
  • Oedema
  • Convulsions
  • Vata disorders

Read – Comparative Study Of PID With Yoni Vyapath

Treatment of asrgdara

Hemostatic herbs and formulations – should be given after considering the dosha association, diagnosed on the basis of color and smell of the blood

Treatment mentioned in the contexts of vatala etc gynecological disorders should be used in respective doshic asrgdara

Treatments prescribed for the below mentioned conditions should be administered in menorrhagia –

  • Raktatisara – bloody diarrhea
  • Raktapitta – bleeding diathesis
  • Raktarsha – bleeding piles
  • Guhya roga – diseases of reproductive system
  • Garbha srava – abortion

Vataja Asrugdara

Menorrhagia Due To Vata (Vataja Asrugdara) – Symptoms, Treatment

Vataja Asrgdara is one of the types of Asrgdara/Pradara, i.e. menstrual disorders presenting with excessive bleeding and is caused by predominant vitiation of vata.
Read – Heavy Periods, Menstrual Bleeding: Ayurvedic Treatment

Causes –
Excessive consumption of dry and cold foods, pungent, bitter and astringent foods, excessive exercise and sex etc vata aggravating factors leads to vitiation of vata. This vata withholds the blood and causes vataja menorrhagia.
Read – How To Balance Vata Dosha? Line Of Treatment And Reasoning

Pathogenesis
Vata aggravated by its own causes or by being surrounded by pitta, withholds the blood which also gets vitiated due to the above said causes.

Vata causes increase of amount of blood. Aggravated vata along with increased blood reaches the branches of uterine and ovarian arteries of uterus.
Read – Physiology Of Menstruation, Menstrual Cycle – Ayurvedic Perspective

By adding increased blood to the menstrual blood, vata increases the menstrual blood in arteries. This increase in menstrual blood occurs due to relative increase of rasa i.e. plasma contents. Because of increase in amount of blood, this condition is called asrgdara. Since in this condition, excessive blood is discharged, it is also called as pradara.
Read – Nashtartava – Anartava – Causes, Symptoms, Treatment, Remedies, Diet

Signs and Symptoms of Vataja Menorrhagia

Nature of menstrual bleeding

  • Frothy
  • Thin
  • Rough
  • Blackish colour
  • Reddish colour
  • Resembles washings of the flowers of Palasha (Butea monosperma) in color
  • Bleeding occurs with or without pain
  • Blood flows in hurry (Sushruta)
  • Blood does not clot (Sushruta)
  • Aftertaste of blood is astringent(Sushruta)
  • Blood smells like iron (Sushruta)
  • Blood is cold to touch (Sushruta)
  • Resembles meat wash (Madhava Nidana)
  • Blood is discharged in small quantities and repeatedly (Madhava Nidana)
    Read – Menstrual Pain, Painful Periods – Natural Ayurvedic Herbal Home Remedies

Associated symptoms

  • Severe pain in sacral and cardiac regions, groin, flanks, back and pelvis regions
  • Associated with various vataja type of pains (Madhava Nidana)

Commentator Chakrapani has equated Vataja Yonivyapad (Vata type of menstrual disorder) with Vataja Asrgdara. According to him, there is inter-menstrual bleeding apart from excessive bleeding during menstruation in vataja or any types of asrgdara. Prolonged menstruation period is also seen in these conditions.
Read – Vatala Yoni Vyapad – Causes, Symptoms, Treatment

Treatment of Vataja Asrgdara / Pradara

Tila Churna Prayoga
Powder of sesame should be taken mixed with curds, ghee, phanita (treacle), muscle fat of pig / lard (shukara vasa) and honey.
Read – Sesame and Sesame Oil Benefits – Total Ayurveda Details

Varaha mamsarasa
Soup of hog’s fatty meat should be served mixed with decoction of horse gram. (read about benefits of horsegram)

Dadhi Prayoga
Curds mixed with sugar, honey, licorice and ginger is given for eating.
Read – Curds Benefits, Side Effects As Per Ayurveda

Rajadanyadi Kalka
Paste of leaves of cow pea (rajadana) and wood apple (kapitta) fried in ghee should be given to eat.
Read – Ayurveda Mahodadhi: Legumes Green Gram, Chickpea, Peas

Sauvarchaladi churna
Powder prepared by pounding together Sauchal salt, Cumin, licorice and water lily should be served mixed with curds and honey.
(Read about Licorice)

Nagaradi Yoga
Powder prepared by pounding together ginger and licorice, mixed with oil, sugar and curds in equal quantity should be churned together and served for eating.

Eladi churna
Cardamom, Pseudarthria viscida, raisins, Vetiveria zizanioides, Picrorhiza kurroa, sandalwood, black salt, Hemidesmus indicus and Symplocos racemosa should be taken in equal quantity, pounded and made into powder. This powder should be given to eat mixed in curds.
Read – Cardamom Uses, Research, Home Remedies, Side Effects

Modern correlation and comparative study

In description of clinical features of Vataja menorrhagia, master Charaka has mentioned that pain may or may not be present during menstruation. Later, he has also explained symptoms like backache etc. Summing up these descriptions, we can see vataja menorrhagia as a condition presenting with ‘presence or absence of pain during discharge of menstrual blood but with presence of constant backache etc symptoms’.
Read – Back Pain Relief Tips: How To Strengthen Lower Back

Due to the presence of severe pain and bleeding due to hyperemia of pelvic organs, vataja asrgdara can be closely correlated to pelvic congestion syndrome’ or ‘pelvic sympathetic syndrome’.

Pittaja Asrugdara

Menorrhagia Due to Pitta (Pittaja Asrgdara) – Symptoms, Treatment

Pittaja Asrgdara is a menstrual disorders presenting with excessive bleeding and is caused by predominant vitiation of pitta. It is one of the types of Asrgdara / Pradara.
Read – Heavy Periods, Menstrual Bleeding: Ayurvedic Treatment

Causes

Excessive consumption of sour, salty, hot and alkaline food substances, excessive exposure to heat, anger, etc pitta aggravating factors leads to vitiation of pitta produces pittaja menorrhagia.
Read – How To Balance Pitta Dosha? Line Of Treatment

Pathogenesis –

All asrgdaras / pradaras are inevitably caused by vitiated vata, immaterial of whichever dosha aggravation takes first. Vata aggravated by its own causes or by being surrounded by pitta, withholds blood which also gets vitiated due to the above said causes. Vata increases the quantity of blood.
Read – Vata Dosha – Mastermind Behind All Body And Mind Activities

Aggravated vata along with increased blood reaches the branches of uterine and ovarian arteries of the uterus. By adding the increased blood to the menstrual blood, vata increases the menstrual blood in the arteries. This increase in menstrual blood occurs due to relative increase of rasa (plasma contents).

Because of increase in amount of blood, this condition is called asrgdara. Since in this condition, excessive blood is discharged, it is also called as pradara. Since the initial pathogenesis started with aggravation of pitta, this condition is called as Pittaja Asragdar.
Read – Physiology Of Menstruation, Menstrual Cycle – Ayurvedic Perspective

Signs and Symptoms of Pittaja Menorrhagia
Nature of menstrual bleeding

  • Blue, yellow, green or blackish color
  • Hot to touch and feel
  • Comes in enormous amount, profuse bleeding
  • Menstrual bleeding happens repeatedly and is associated with pain
  • Presence of burning sensation during menstruation
  • Resembles water mixed with smoke (Sushruta)
  • Resembles Rasanjana in appearance (Sushruta)
  • Resembles cow’s urine in appearance (Sushruta)
  • Emits fishy smell during discharge (Sushruta)
  • Aftertaste of menstrual blood is bitter (Sushruta)
  • Menstrual blood repulses ants and flies (Sushruta)
  • Blood does not coagulate easily, since it is hot in nature (Sushruta)
  • When menstrual blood is put on the surface of water, it spreads like moon-light
  • Hot blood gushes out repeatedly with great force (Madhava Nidana)
    Read – Artava – Menstrual Blood Formation, Healthy Characteristic Features

Associated symptoms

  • Reddish discoloration all over the body
  • Thirst
  • Mental confusion
  • Fever
  • Giddiness
  • Associated with various pittaja type of pains (Madhava Nidana)

Commentator Chakrapani has equated Pittaja Yonivyapad (Pittaja type of menstrual disorder) with Pittaja Asragdara. According to him, the bleeding is also present in inter-menstrual period apart from excessive bleeding during menstruation in pittaja or any types of asrgdar. Prolonged menstruation period is also seen in these conditions.
Read – Pittaja Yoni Vyapad – Causes, Symptoms, Treatment

Treatment of Pittaja Asrgdara / Pradara
Payasyadi churna / kalka
Powder / paste of the below mentioned herbs should be mixed in milk, sugar and honey and given for oral consumption.

  • Payasya
  • Utpala
  • Shaaluka
  • Bisa
  • Kaliyaka
  • Ambuda

Read – Water Lily – Kumuda Benefits, Side Effects, Research

Madhukadi churna
Powder of below mentioned herbs should be consumed with honey.

Eladi churna
Cardamom, Pseudarthria viscida, raisins, Vetiveria zizanioides, Picrorhiza kurroa, sandalwood, black salt, Hemidesmus indicus and Symplocos racemosa should be taken in equal quantity, pounded and made into powder. This powder should be given to eat mixed in honey.

Nimbadi Yoga
Neem and Giloy should be given along with wine for drinking.
(Read about giloy)

Mahatiktaka Ghrita
Mahatiktaka and Vasa ghee are useful in this condition. Mahatiktaka ghee is also used to induce purgation.
(Read about Mahatiktaka Ghrita

Tanduliyaka
Root of Tanduliyaka (amaranthus spinosus) should be given with honey

Rasanjana
Powder of Rasanjana is given with rice-water
Read – Rasanjan Uses, Remedies, Dose, Side Effects, Research

Laksha
Powder of laksha (lac) is given mixed with goat’s milk for drinking
Read – Laksha – Laccifer lacca Benefits, Dose, Purification, Side Effects

Raktapitta Chikitsa
Treatment, formulations and diet prescribed for bleeding disorders (raktapitta) caused due to vitiation of blood and pitta should also be administered to cure pittaja menorrhagia.
Read – Raktapitta treatment

Garbha srava chikitsa
Treatment, formulations, diet and mode of life prescribed for abortions should also be administered for effectively treating pittaja menorrhagia.

Modern correlation and comparative study

It is very difficult to explain the manifestation of so many colors like blue, yellow etc since the menstrual bleeding associated with these colors is not seen in clinical practice.

Presence of fever as mentioned by master Charaka in this condition points out towards the inflammatory changes in backdrop. When we consider this, pittaja asrgdara seems to be ‘menorrhagia due to severe inflammation of female reproductive system’.
Read – Pelvic Inflammatory Disease: Ayurvedic Treatment, Therapies, Medicines

Pittaja yoni vyapad which is compared with inflammation of female reproductive system is said to have features of pittaja asrgdara. In both these conditions, we can find presence of fever, burning sensation etc symptoms; menstrual blood is blue, yellow or black in color and is hot in nature. Difference is that inflammation and suppuration is predominantly present in pittaja yoni vyapad whereas menorrhagia is predominant feature of pittaja asrgdara.
Read – Comparative Study Of PID With Yoni Vyapath

Pelvic Congestion – Inflammation of pelvis or reproductive system is one of the main causes for pelvic congestion. This can occur in two different forms.
They are –

Acute pelvic congestion – presenting with fever etc symptoms along with menorrhagia (resembles with explanation of master Charaka)

Chronic pelvic congestion – absence of fever etc symptoms along with menorrhagia (resembles with explanation given in Madhava Nidana, BhavaPrakasha and Yogaratnakara treatises)
Read – Menstrual Pain, Painful Periods – Natural Ayurvedic Herbal Home Remedies

Seeing all above said description, pittaja asrgdara can be closely compared and correlated to ‘meno-metrorrhagia due to pelvic congestion caused by infection or inflammation’.

Kaphaja Asrugdara

Menorrhagia Due To Kapha (Kaphaja Asrgdara) – Symptoms, Treatment

Kaphaja Asrgdara menstrual disorders presenting with excessive bleeding and is caused by predominant vitiation of kapha. It is one of the types of Asrgdara / Pradara.
Read – Heavy Periods, Menstrual Bleeding: Ayurvedic Treatment

Causes

Excessive consumption of foods predominant in sweet, sour and salty foods, cold, unctuous and heavy to digest foods, low moods and depression, exposure to cold etc kapha aggravating factors leads to vitiation of kapha produces kaphaja menorrhagia.
Read – Lifestyle, Food And Factors That Cause Increase Of Kapha Dosha

Pathogenesis –
All asrgdaras / pradaras are inevitably caused by vitiated vata, immaterial of whichever dosha aggravation takes first. Vata aggravated by its own causes or by being surrounded by pitta, withholds the blood which also gets vitiated due to above said causes. Vata causes increase in quantity of blood.
Read – Symptoms Of Vata Dosha Increase And Imbalance – Vata Vruddhi Lakshana

Aggravated vata along with increased blood reaches the branches of uterine and ovarian arteries of uterus. By adding increased blood to the menstrual blood, vata increases the menstrual blood in arteries. This increase in menstrual blood occurs due to relative increase of rasa (plasma contents). Because of increase in amount of blood, this condition is called asrgdara. Since in this condition, excessive blood is discharged, it is also called as pradara.
Read – Kaphaja Yoni Vyapad – Causes, Symptoms, Treatment

Since initial pathogenesis started with aggravation of kapha, this condition is called as Kaphaja Asrgdara.

Signs and Symptoms of Kaphaja Menorrhagia

Nature of menstrual bleeding

  • Pale in appearance
  • Slimy
  • Heavy
  • Unctuous
  • Sticky
  • Cold
  • Mixed with mucus
  • Thick
  • Menstrual blood is discharged with mild pain
  • Resembles water mixed with red ochre (Sushruta)
  • Resembles washings of paddy plant (Bhavaprakasha, Madhava Nidana, Yogaratnakara)
  • Menstrual blood is excreted slowly (Sushruta)
  • Blood gets clotted and gets a muscle / muscle fibres like appearance (Sushruta)
  • Color of blood appears like that of kovidara flower (Vagbhata)
  • Blood smells like fat (Vagbhata, Sushruta)
  • Aftertaste of menstrual blood is salty (Sushruta)
  • Excreted blood is mixed with ama (Madhava Nidana, Bhavaprakasha)
    Read – Artava – Menstrual Blood Formation, Healthy Characteristic Features

Associated symptoms

Commentator Chakrapani has equated Kaphaja Yonivyapad (Kaphaja type of menstrual disorder) with Kaphaja Asrgdara. According to him, bleeding is also present in inter-menstrual period apart from excessive bleeding during menstruation in kaphaja or any types of asrgdara. Prolonged menstruation period is also seen in these conditions.
Read – Menstrual Pain, Painful Periods – Natural Ayurvedic Herbal Home Remedies

Treatment of Kaphaja Asrgdara / Pradara

Below medicines can be administered with kapha balancing liquids such as wine or honey.

Nimbadi Yoga
Powder of Neem and Giloy (Tinospora cordifolia)
Read more about Neem

Nimba rasa
Juice of neem

Guduchi rasa
Juice of giloy (Tinospora cordifolia)
Read about Giloy

Rohitaka rasa
Juice of Tecomella undulata

Malayu rasa
Juice of Ficus hispida (read about benefits of Ficus hispida)

Kakajangha rasa
Juice of the root of Peristrophe bicalyculata mixed with powder of Symplocos racemosa and honey and given to drink to a woman suffering from kaphaja menorrhagia.

Modern correlation and comparative study

Tubercular endometritis – Due to presence of respiratory symptoms like cough, dyspnoea and also association of anorexia etc symptoms, kaphaja asrgdara can be equated with tubercular endometritis.
Read – Comparative Study Of PID With Yoni Vyapath

Tubercular endometritis or pulmonary tuberculosis is associated with menorrhagia in their earlier stages. Since the cervix is also involved along with endometrium, excessive mucoid discharges are evident.
Read – Vaginal White Discharge (Leucorrhea) Ayurvedic Treatment, Home Remedies

Chronic endometritis – Unctuous and pale discharges explained in kaphaja menorrhagia are found in chronic endometritis.

By seeing all the above said description, Kaphaja / Shlaishmika asrgdara can be closely correlated to ‘early stage of tubercular endometritis or chronic endometritis due to other causes’.

Sannipataja Asrugdara

Menorrhagia Due to Three Doshas (Sannipataja Asrgdara) – Symptoms, Treatment

Sannipataja Asrgdara is a menstrual disorders presenting with excessive bleeding and is caused by simultaneous vitiation of all three doshas. It is one of the types of Asrgdara / Pradara.
Read – Heavy Periods, Menstrual Bleeding: Ayurvedic Treatment

Causes –
Excessive consumption of foods and exposure to activities capable of aggravating all the three doshas produces tridoshaja / sannipataja menorrhagia.
Read – Ayurvedic Diet And Lifestyle During Menstruation (Periods)

Pathogenesis –
When severely ill and anemic woman consumes diet capable of aggravating all three doshas, then her excessively aggravated vata withholding kapha, which is already burnt due to heat of pitta, discharges kapha which smells fouls, slimy, yellow and has acquired opposite properties through vaginal passage.
Read – Vaginitis: Ayurvedic Treatment, Medicines, Home Remedies

Along with this, vata also forcibly discharges fat and muscle fat burnt by pitta and resembling ghee, bone marrow or muscle fat from the vaginal passage. This condition is called as Sannipataja Asrgdar and is incurable in nature.

Signs and Symptoms of Sannipataja Menorrhagia

Nature of menstrual bleeding

  • Kapha which has acquired foul smell, slimy, yellow and has opposite properties gets discharged through vagina.
  • Discharge of fat and muscle fat resembling ghee, bone marrow or muscle fat from vagina.
  • Continuous and frequent vaginal discharges
  • Menstrual blood has features of all three doshas (Sushruta)
  • Blood resembles kanji in color (Sushruta)
  • Foul smell (Sushruta)
  • Blood is blue in color like bronze, dirty and foul smelling (Vagbhata)
  • Excreted blood resembles honey, ghee and haratala in color, stimulates bone marrow and has putrid smell (Madhava Nidana, Bhavaprakasha, Yogaratnakara)
    Read – Somaroga – Excessive Female Discharge With Loss Of Vitality

Associated symptoms

Treatment of Sannipataja Asrigdara / Pradara

Rasanjanadi kalka
Paste of Rasanjana (extract obtained by processing the decoction of Berberis aristata) and Tanduliyaka Mula (root of Amaranthus viridis) mixed in honey should be given to drink along with rice water.
Read – Rasanjan Uses, Remedies, Dose, Side Effects, Research

Pathyadi Kwatha
Decoction should be prepared with Haritaki (Terminalia chebula), Amalaki (Emblica officinalis), Terminalia bellirica, Berberis aristata and ginger, mixed with honey and powder of Symplocos racemosus and given to drink.
Read – Triphala Kwath – Benefits, Dosage, Ingredients, Side Effects

Modern correlation and comparative study

Uterine or cervical malignancy – Owing to the presence of multicolored, foul smelling discharges and incurability of sannipataja asrgdara, it can be correlated to uterine or cervical malignancy.
Read – Cancer- Ayurvedic Understanding And Hopeful Treatment Modalities

On basis of clinical features of this disease, it appears to be the description of endometrial carcinoma or cervical carcinoma.

Based on pathogenesis it can be correlated to senile pyomentra.

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5 thoughts on “Heavy Periods, Menstrual Bleeding: Ayurvedic Treatment”

  1. Hi, in such case, medicines such as Pushyanuga cHurna, Bolabaddha rasa, etc which do not have any sugar content, can be selected for treatment.

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