Therapeutic aspects of Kashtartava (dysmenorrhea) in Ayurveda: a review

Kashtartava (painful menstruation or dysmenorrhea) is one of the common gynecological disorders observed among women. It has been described as a symptom of various diseases such as Kukshishoola, Vatala yoni, Udavartini yonivyapada, etc. in Ayurvedic classics. It is characterized by a condition in which Artava (menstrual fluid) is shedded with great difficulty and pain. Acharya Charaka has specifically mentioned that none of the gynecological disorders can arise without the involvement of vitiated Vata dosha (a type of body humor). The pain produced in dysmenorrhea is due to vitiation of Vata dosha only or in combination with other Doshas, which is the result of Vatavriddhi (elevation in the Vata level) due to Apanavayu (type of Vata), margavarodha (obstruction of channel), etc. It has been reported that around 90% of adolescent females and above 50% of menstruating women worldwide reported suffering from it, with 10–20% of them describing their suffering as severe and distressing. Owing to these facts, various classical texts of Ayurveda have been reviewed and literature search was performed using the keywords “Kashtartava, Dysmenorrhea, Menstrual pain, Menstruation, Yoni vyapada (vaginal disorder)” in various online databases in order to collect the data regarding the same. It has been revealed that Dhatukshaya (depletion of body tissues), Kopa (aggravation of Doshas), and Margavarodha (obstruction of channel) are the three prime conditions which lead to the vitiation of Vata dosha resulting in dysmenorrhea. It can be managed with various Ayurvedic preparations such as Phala ghrita, Jeerakadi modak, Maharasnadi kwath, etc. Panchkarma (five therapeutic biodetoxification procedures) such as Shatavaryadi anuvasana basti and Baladi anuvasana basti is also proved to be beneficial along with Pathya ahara and Vihara (wholesome regulated diet and lifestyle).