PROCEEDING OF INTERNATIONAL CONFERENCE

THEME-GERIATRIC DISEASES CARE AND CURE

SUKHAPRAUDHA-2021

Organized BY:
Department of Prasuti Tantra & Stree-Roga Faculty
of Ayurveda Parul University

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 Disclaimer

The responsibility for opinions expressed in articles, studies and other contributions in
this publication rests solely with their authors, and this publication does not constitute an
endorsement by the Book Rivers of the opinions so expressed in them.
Proceeding of International Conference Sukhapraudha -2021
Copyright: @ Principal Parul Institute of Ayurved, Parul University, Vadodara, Gujarat
All rights are reserved according to the code of intellectual property act of India,
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ISBN:978-93-5515-000-4
MRP:1299/INR

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 CHIEF – PATRON
DR. DEVANSHU J. PATEL
PRESIDENT PARUL UNIVERSITY

PATRONS

DR. GEETIKA PATEL

DR. PARUL PATEL DR.KOMAL PATEL MEDICAL DIRECTOR,
VICE-PRESIDENT MEDICAL DIRECTOR, TRUSTEE
PARUL UNIVERSITY TRUSTEE

EDITOR IN CHIEF
DR. HEMANT TOSHIKHANE
DEAN, FACULTY OF AYURVED,
PARUL INSTITUTE OF AYURVED,
PARUL UNIVERSITY,VADODARA

MANAGING EDITOR
DR. B. G. KULKARNI
PRINCIPAL, PARUL INSTITUTE OF
AYURVED AND RESEARCH,
PARUL UNIVERSITY,VADODARA

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 Editor

Dr. Manjusha R. Karkare

Professor and H.O.D.

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Associate editor

Dr. Rita Makim

Professor

Dr. Asokan V.
Professor

Dr. Shriniwas Jadhav

Associate professor

Dr. Lumi Bhagat Assistant professor

Dr. Thulasi
Assistant professor

R.JAYASHEELA GONI
PROFESSOR PRASUTI TANTRA &
STREEROGA DEPARTMENT
PARUL INSTITUTE OF AYURVED
& RESEARCH,
VADODARA

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 DR.VASANTHI THONDAMBATTI
ASST. PROFESSOR
PRASUTI TANTRA & STREEROGA
DEPARTMENT PARUL INSTITUTE
OF AYURVED & RESEARCH,
VADODARA

DR.MAULI VAISHNAV
ASST. PROFESSOR
PRASUTI TANTRA & STREEROGA
DEPARTMENT PARUL INSTITUTE
OF AYURVED & RESEARCH,
VADODARA

DR. AKANKSHA CHANDEL

ASSO. PROFESSOR
PRASUTI TANTRA & STREEROGA
DEPARTMENT
PARUL INSTITUTE OF AYURVED
& RESEARCH,
VADODARA

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 Report

Digital conference Sukhapraudha-2021 was organized by the department of Prasuti

Tantra and Stree Roga –Faculty of Prasuti Tantra and Stree Roga on 21/10/2021.
―KAGOF‖ was the special collaborator for this Digital conference in addition to other
collaborators for the Digital conference series. Professor and HOD Dr. Manjusha R.
Karkare was the co ordinator of the Digital conference .
The main theme being, ―Geriatric Diseases –Care and Cure‖, a few subthemes for the
department of PTSR were identified. They were as under-
1. Gynecological disorders in geriatric women.
2. Role of Ayurveda in menopause vs HRT
3. Herbs used in geriatric women
4. Sthanik chikitsa in geriatric care
5. Fertility related issues in elderly women
6. Ideal lifestyle for Geriatric women
7. Common formulations in geriatric women
8. Psychological problems in geriatric women
9. Rasayans for geriatric women
A brochure of the Digital conference giving a call for papers was circulated on social
media. An overwhelming response of 74 papers was received. The papers were
presented across 5 groups. The Digital conference was conducted on google meet
platform.
The inaugural was held on Thursday 21-10-2021 at 9.30am. Apart from google meet, the
inaugural was also live telecasted on Facebook and You tube. Dr. Harish Daga assistant
professor of Departmewnt of Shalya Tantra provided technical support for the online Dr.
Bhagyashree Satpathy co ordinated the session. Dr. Varsha rendered the Dhanwantari
Vandana. Professor and HOD Dr. Manjusha R. Karkare welcomed the invitees and
delegates. Respected trustee ‗ Dr. Komal Patel madam addressed the audience with her
inspiring words. Guest speaker of the session, Dr. Sujsta Kadam madam, HOD of PTSR
Department -All India Institute of Ayurveda-New Delhi delivered her Guest speech, ―The
role of Ayurveda in Geriatric women‘s diseases‖ The inaugural session concluded with a
vote of thanks by Dr. Lumi Bhagat.

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The sessions and their judges were as under –
1.Kashyap session
Chairperson - Dr. Manjusha R. Karkare
Co-chair person –Dr. Asokan V
Coordinators –Dr. Bhagyashree Satpathy and Dr. Varsha
Winners
1. Dr. Sindhu Umesha
2. Dr. Sruthi M.
2. Harit session
Chair person-Dr. Geeta Patki
Co-chair person-Dr. Shilpa Donga
Coordinators-Dr. Anjali Suthar and Dr. Megha Rathore
Winners-
1.Dr.Chitra G. Menon
2. Dr. Adrija
3.Chakrapani session
Chair person-Dr.Suhas Herlekar
Co-chair person Dr. Mangesh Patil
Coordinators- Der. Nisha Khorajiya and Dr. Jashmin Varaiya
Winners-
1.Dr. Sapna Rathod
2.Dr. Smita
4. Dalhana session
Chair person-Dr. Hetal Dave
Co-chair person-Dr. Shrinawas Jadhav
Co-chairperson- Dr. Divya Ramugade
Winners
1.Dr. Maheshwari D
2. Dr.Shruthi N. V.
5. Atreya session
Chair person- Dr. Veena Patil
Co-chair person-Dr. Seema Mehere
Co-chair person – Dr. Jayasheela Goni

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The results were announced on a whatsap group-Sukhapraudha specially made for that purpose.
E-certificates were distributed to presenters, delegates, winners and all chair and co-chair
persons. The scholars of the department had a valuable experience in organizing the Digital
conference and conducting various sessions. The Digital conference was a good experience in
team work for the entire department.

Dr.Manjusha
R. Karkare
HOD Department of PTSR
PIA-PU

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 FOREWORD

I feel honored to be requested to write the foreword for this excellent work as special
add on by the efforts from the Department of Pasuti Tantra and stree roga on conducting
Pre International conference Sukhapraudha 2021 under Azadi ka Amrut Mahotsav on
21/10/2021 presiding eminent guest speakers.

I am indeed happy to write a foreword to the book which is combined efforts from
the department of Pasuti Tantra and stree roga. It has taken a herculean task to compile
this book after referring voluminous literature of past and present with reference to
Geriatric practice: cure and care by the scholars. This is a genuine work compiling
original references by the authors from Ayurveda and contemporary sciences. The
resources provide comprehensive knowledge about the subject prepared in accordance
with the diseases, drugs involved and its etiopathogenesis. Ayurvedic system of medicine
has been practiced in the country and globally from time immemorial and has stood the
test of many adversities over centuries.

This book of proceedings on Pasuti Tantra and stree roga will be a timely contribution
to students, practitioners, scholars and researchers of ayurvedic medicine. It is
commendable that an elaborate work has resulted to compile the extensive reference
material from different classical texts and commentaries systematically under each
article. The purpose of this book will be served by the progressive discussions and
constructive feedbacks from the readers. I am sure the readers will be benefited
immensely by this book. I wish the department to get more such opportunities to convert
such intricate subject into an interesting and readable one.
Dr. Komal Patel
MBBS, M.S
Medical Director and Trustee
Parul University

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 INDEX

1 STHANIK CHIKITSA IN GERIATRIC WOMEN CARE ROLE OF 13

STHANIK CHIKITSA IN GERIATRIC DISEASE MANAGEMENT
Dr. P PRAVALHIKA,
Dr. R VIJAYA SANTHA KUMARI Dr.N.R.S
2 RASAYANA CHIKITSA IN GERIATRIC WOMEN CARE 18
Dr.Adrija P
Dr.G.Ramadevi
3 STHANIKA CHIKITSA IN GERIATRIC WOMEN CARE 23
Dr.Amritha.M.R
Dr.Manjusha Karkare
4 IDEAL LIFESTYLE FOR GERIATRIC WOMAN 31
Dr. Anjali Govind bhai Suthar
Dr.Manjusha Karkare
5 ROLE OF STHANIKA CHIKITSA IN GERIATRIC WOMEN- 39
YONI ABHYANGA AND PICHU IN FIRST DEGREE UTERINE
PROLAPSE –A CASE STUDY
Dr. Aswini S
Dr.Madhu M
6 RASAYANAS FOR GERIATRIC WOMEN 44
Role of Rasayana Therapy in Geriatric women care: A Review
Dr. Bhrunali P. Gharpure
Dr. Bhagyashri M. Khot
7 LIFESTYLE PROTOCOL FOR GERIATRIC WOMEN –―THE BETTER 49
WAY TO GROW OLD‖
Dr. Dharmista Pate
Dr. Rachana H V
8 AN AYURVED APPROACH TO GYNAECOLOGICAL DISORDERS 55
IN GERIATRIC WOMEN
Dr. Divya Prakash Pawar
9 IDEAL LIFESTYLE FOR GERIATRIC WOMEN 62
Ideal Lifestyle for Geriatric Women According to Ayurveda - A Review
Dr.Shrikant Atmaram Dighe
Dr. Bhagyashri Mahavir Khot
10 Management of Muhurmuhu Garbha Srava (Recurrent abortion) in Elderly 67
Gravida with Swarna Malini Vasanta Rasa- Observational Clinical study‖
Dr Sindhu Umesh
11 Management of Menopause and associated aging problems through 76
Ayurveda – Finding a safe and effective Treatment
Dr. Smita Mallikarjun Patil
Dr. Veena Ajay Patil
12 HERBS USED IN GERIATRIC WOMAN 80
Dr. Swati S. Andhale and
Dr. Vijaykumar Nawale

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13 Ayurvedic management of Senile Vaginitis – A Case Report 86
Anagha s
Madhu M
14 GYNECOLOGICAL DISORDER IN GERIATRIC WOMEN 92
Dr.Bhagyashree Satpathy
Dr.Asokan.V
15 PSYCHOLOGICAL PROBLEMS IN GERIATRIC WOMEN 98
AN AYURVEDIC REVIEW
Dr.Diksha Shrikant Kesur
16 Sthanik chikitsa (local treatment) in management of postmenopausal 103
problems Dr. Umesh Rameshchand Lunawat Dr. D.Y.Patil Dr. Jayashree
Patil Dr. Aarifa Shaikh
17 IDEAL LIFESTYLE FOR GERIATRIC WOMEN 111
Dr. Megha Rathore
Dr. Manjusha Karkare
18 Review of herbs used in geriatric women 115
Review of ayurvedic herbs used in geriatric women
Shriya Sunil Deo
Dr. Apoorva Sangoram
19 ―ROLE OF AYURVEDA IN THE MANAGEMENT OF MENOPAUSAL 121
SYNDROME VS HRT‖-A REVIEW ARTICLE
Dr Tejaswini K R
Dr Shruthi M
Dr Nanda K
20 Role of Ayurveda in Menopause vs HRT 128
C.S. Divya
Karkare Manjusha
21 SUKHPARUDHA 2021 132
HERBS USED IN GERIATRIC WOMEN
Dr. Madhura Rajendra Kadam
Dr. Jayshree Patil Dr. D. Y. Patil
22 Role of Ayurveda in menopause vs HRT 138
Pooja Thakur, Vd.Sunil
23 Sthanik chikitsa (local treatment) in management of postmenopausal 147
problems
Dr. Umesh Rameshchand Lunawat Dr. D.Y.Patil Dr. Jayashree Patil Dr.
Aarifa Shaikh
24 Importance of Rasayanas and Ayurveda Approaches for Restoring the 156
Health of Geriatric Women W.S.R. to the Management of Gynecological
Problems
Dr Harkiran Nehra, M.S. (Ayu).
25 GYNAECOLOGICAL DISORDERS IN GERIATRIC WOMEN 162
Dr . Jagruti Rajendra Patil
Dr .Prashant Dalvi,
26 GYNECOLOGICAL DISORDERS IN GERIATRIC WOMEN 168
AYURVEDIC MANAGEMENT OF GYNECOLOGICAL DISORDERS

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 IN GERIATRIC AGE- A REVIEW
Dr. Janabai Shrimant Sargar
Dr. Veena Ajay Patil
27 ROLE OF AYURVEDA IN MENOPAUSE VS HRT MANAGEMENT 173
OF MENOPAUSAL SYNDROME THROUGH AYURVEDA
Dr. JYOTI,
Dr. MADHU M
28 A CASE STUDY ON STANA ARBUDA 180
Dr.K.Thilagavathi Amma
Dr. L.V. Rathnakar, M.D. (Ayu)
Dr. C. Swathi, M.S
29 FERTILITY ISSUES IN ELDERLY WOMEN 185
AN AYURVEDIC APPROACH TOWARDS MANAGEMENT OF
FERTILITY ISSUES IN ELDERLY WOMEN A CASE REPORT
Dr Kanchan Malhotra
Dr Prathima
30 FERTILITY ISSUES IN ELDERLY WOMEN 191
31 FERTILITY ISSUES IN ELDERLY WOMEN EFFECTIVE 196
AYURVEDIC MANAGEMENT OF INFERTILITY DUE TO LOW
AMH IN ELDERLY WOMEN- CASE STUDY
Dr. Maheshwari Danappagoudar
Dr. Savita S Patil
32 GRACEFUL AGEING IN STREE 204
Dr. Nanda K O
33 AN ARTICLE ON GYNAECOLOGICAL DISORDERS IN GERIATRIC 210
WOMEN
Dr.Nidhi Sharma
Dr. Asokan V
34 THE EFFECT OF VAYASTHAPANA GANA KSHEERABASTI IN 214
GENITO URINARY SYNDROME OF MENOPAUSE ALONG WITH
DIFFUSE EPISCLERITIS - A CASE REPORT
Dr. Rachana Yadav
Laxmipriya Dei
35 ROLE OF SHATAVARI AND ASHWAGANDHA IN THE 221
IMPROVEMENT OF GERIATRIC WOMEN HEALTH -A REVIEW
ARTICLE
Dr Raneesha Thahira
Dr Prathima
36 RASAYANA CHIKITSA IN GERIATRIC WOMEN CARE 228
Dr.Adrija P
Dr.G.Ramadevi
37 MANAGEMENT OF PSYCHOLOGICAL PROBLEMS IN GERIATRIC 233
WOMEN WITH MURDHNI TAILA
Dr Reshma. E,
Dr Madhu.M

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38 ROLE OF AYURVEDA IN MENOPAUSE VS HRT AN AYURVEDIC 236
VS ONTEMPORARY OVERVIEW OF MENOPAUSE
Dr. Sapna Raghunath Rathod
Dr. Veena A. Patil
39 ROLE OF STHANIKA CHIKITSA IN POST MENOPAUSAL WOMEN 240
CARE
Dr.Shilpa J
Dr.Anupama V
40 ROLE OF AYURVEDA IN MENOPAUSE VS HRT ROLE OF 245
AYURVEDA IN ENOPAUSE VS HRT - A REVIEW
Dr. Shital Laxman Surjuse
Dr. Umesh K. Agawane
41 STHANIKA CHIKITSA IN THE GERIATRIC WOMEN SUFFERING 250
FROM DYSPAREUNIA – A CASE STUDY
Dr Shravani P
Dr Savita S Patil
42 Herbs used in geriatric women 257
Review of ayurvedic herbs used in geriatric women
Vd. Shriya Sunil Deo
Dr. Apoorva Sangoram
43 MANAGEMENT OF ATROPIC VAGINITIS BY STHANIKA 264
CHIKITSA – A CASE STUDY
Dr. Shruthi M
Dr. Tejaswini KR
Dr. Vidyanarayan
44 HERBS USED IN GERIATRIC WOMEN 268
Dr.Shruthi Pandith K
45 COMMON AYURVEDA FORMULATIONS IN GERIATRIC WOMEN 273
CARE
Dr SINDHURA. K. S.
PG SCHOLAR
46 RASAYANAS FOR GERIATRIC WOMEN 278
AN EFFECT AND BENEFITS OF RASAYANATHERAPY IN
GERIATRIC WOMEN.
Dr. Sonu Mariam Rajan,
Dr. Rachana H. V
47 GYNAECOLOGICAL DISORDER IN GERIATRIC WOMEN 283
(RASAYANA FOR GERIATRIC WOMEN) ACTION OF
MEDHYARASAYANA IN MENOPAUSAL WOMEN
Dr.K. Sribala
Dr. Kola Vijaya Kumari
48 BEYOND HORMONE THERAPY – THE CONCEPT OF AYURVEDA 287
FOR MENOPAUSE AND ITS MANAGEMENT
DR. SUDARSHAN GOPICHAND PATIL.
DR. SUNIL SADASHIV

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49 Psychological problemsin geriatric women 293
Dr. Vaibhav Mishra
50 Psychological problems in geriatric women 301
Vidhya M Sanker
M Jithesh.

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 STHANIK CHIKITSA IN GERIATRIC WOMEN CARE ROLE OF
STHANIK CHIKITSA IN GERIATRIC DISEASE MANAGEMENT
Dr. P PRAVALHIKA,
Dr. R VIJAYA SANTHA KUMARI
P.G Scholar, 3rd year, Guide & Associate professor,
Department of Prasuti Tantra and Stree Roga,
Dr.N.R.S
Govt Ayurvedic Medical College,
Vijayawada, Andhra Pradesh.
Email id: pravalhikar@gmail.com
Mobile number: +91 8639949104

ABSTRACT
Geriatrics is a progressive phenomenon of the body. Geriatric women are not a just
old age women they become structurally, functionally and mentally different from what
they were in their young age. As the age progresses women attains menopause, vata
plays major role and shows its effect (degenerative) on all the body organs including
reproductive system further leads to disease conditions like Sushka yoni, Prasamsrini
Yoni, Karnini, Pariplutha, Swethapradara, Andini, Mahayoni etc., By altering the vaginal
PH , Hormonal imbalance and Apanavata dusti. Acharyas explained vruddhaavastha as a
swabhavaja vyadi. In old age agni bala is reduced both in its jarana shakti and
abhyavarana shakti. Hence oral administration of drugs shows minimal effect on above
said diseases. Sthanika chikitsa like ( yoni dhavana, yoni pichu, yoni varti, yoni poorana,
yoni lepana etc) gives best results as yoni is having rich blood supply and presence of
mucous membrane having good absorption capacity. In the present topic ―ROLE OF
STHANIK CHIKITSA IN GERIATRIC DISEASE MANAGEMENT‖ is taken to give a
brief elaborated information regarding sthanik chikitsa in preventing and cure of the
geriatric diseases.
Key words – Sthanik Chikitsa, Yoni Prakshalana, Yoni Pichu, Yoni Purana, Geriatric
Diseases
Introduction:
Aging is a national process in which body shows continuous degeneration process as
like explained by Acharya's i.e shiryate iti shariram. Vriddhavastha is grouped under
natural disease that is caused due to swabhava (nature) and depends on kala (time).
Natural diseases are hunger, thirst, jaravastha, death etc. Geriatrics are a natural
phenomenon it's an important task to escape from it, but by following dinacharya ,

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ruthucharya and sthanika chikitsa one can delay the process of aging up to some extent.
As the aim of the Ayurvedia is " swasthasya swastha rakshanam athurasya vikara
prashamanam " sthanika chikitsa plays a major role in maintaining the health of the
healthy person and curing of the diseased one.
As the age advances, several changes take place in the body i.e in (Dosha, Dathu,
Mala, Agni and Ojas etc). Vata dosha plays a major role in old age and it leads to
continuous degeneration process, agni bala reduced in it jarana Shakthi and abhyavarana
shakthi. It's the physiology that when aahara is taken it comes in contact with agni and
aahara get digested followed by formation of rasa which is divided into prasadha baga
and kitta baga, from Prasada baga uttarottara dathus are produced. Oral administration of
drugs also got in contact with agni and digestion and absorption takes plays. But in old
age agnibala is in ksheena avastha and less chances of proper digestion and absorption of
the drugs taken through oral route. Hence sthanika chikitsa plays a great role in
Gynaecological geriatric care.
Due to vata vitiation there will be formation of different types of diseases in
representative system like ( yoni srava, swethapradara, yoni shoola, yoni daha, pariplutha
etc) of women by alteration in hormonal balance, vaginal ph and apanavata dusti. The
above conditions are best cured with sthanika chikitsas like ( Yoni Dhavan(Vaginal
Douching), Yoni Pichu (VaginalTampooning) ,Yoni Dhupan (Vaginal Fumigation) ,Yoni
Lepan(Vaginal Painting) ,Yoni Varti (Vaginal Suppository).
Aims and objectives:
1. To study the probable mode of action of Sthanik Chikitsa in geriatric diseases
2. Importance of sthanika chikitsa in geriatric care
Materials and methods:
Sthanika chikitsa in geriatric care
Yoni prakshalana:
Yoni dhava or prakshalana means cleansing of vagina. It is one of the treatment
procedures amongest sixty types of vrana chikitsa. The drugs used in the form of
following formulations kwatha, kshirapaka, siddha jala , oil, ghrita etc.
Indications : yoni srava, yoni daha, yoni picchilya, yoni kandu etc Drugs used for yoni
prakshalana :
1. In Vata Dosha involvement- triphala, guduchi kashaya or sarala mudgaparni kashaya
should be used.

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2. In Pitta Dosha involvement- panchvalkala or panchtikta kashaya should be used. 3. In
Kapha Dosha involvement- aragwadhadi or nimbadi kashaya should be used. 4. Yoni
Dourgandhya - aragwadhadi, sarvagandha dravya kashaya are used 5. Yoni Shoola -
guduchi, triphala and danti kashaya are used 6. Yoni Daha - Chandana or lodhradi
kashaya.
7. Yoni shrava - Triphala kwatha
Mode of action : It cleanses the vaginal area and helps to cure from infection
As yoni prakshalana is doing with Kashaya of the drugs having vranaropana, vrana
shodhana, sthambana , shothaghna etc properties it cures local infections and helps to
maintain vaginal hygiene.
Yoni pichu:
Vaginal tampon made of cotton or gauze soaked in taila/ghrita/kshara/kashaya is
termed as pichu,when placed in vagina it is called yoni pichu.
Indications :Yonidaha, yoni kanda, prasramsini yoni, mahayoni, viplutha, upaplutha,
karnini etc
Drugs used for pichu dharana:
1. Yoni daha - chandanadi taila
2. Yoni paka - chandanadi taila
3. Yoni dourgandhya - sarva dravya sidda taila
4. Yoni shoola - saindhavadhi taila or dhatakyadi taila
5. Yonishathilya- suramanda
6. Yonikanda - mushak taila
In general the following oils are used Guduchyadi taila, Bala taila, Dhatakyadi
Taila,Udambaradi Taila,Jatyadi Taila, Kasisadi Tail, Dashmool Taila, Taila, Ghrita
Time duration for pichu dharana:
2 to 3 hours is the time limit for pichu dharana but in some conditions where the pichu
is adviced for hemostasis pichu can be kep for the maximum duration of 40 hours. If
pichu remains in vaginal region for more than 48 hours it may leads to
Mutrakricha(Burning and painful micturition), Yonishotha(Inflammation in vagina),
Yonishula(Pain in vagina)etc. will be develop as a complication.

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Mode of action:
According to sushruta, Pichu helps in Lekhana karma and thus, removes slough. In
Yonipichu, mostly medicated Kashaya, Sarpi and taila are used. These preparations have
two main functions i. e. Shodhana (purification) and Ropana(healing). It's various mode
of action will depend upon the various types of medicine that used, as different medicines
have different action. Depending on the drugs yonipichu can act as an antibacterial, anti
inflammatory, controls vaginal discharges, helps in wound healing.
Conclusion:
Thus it is to be conclude that the sthanik chikitsa of ayurvedic system of medicine
gives excellent results to the patients suffering from geriatric diseases (Gynaecological)
. As intra vaginal controlled release drug delivery system is an effective means for
achieving continuous delivery of drug and it not only acts on local level but also acts on
systemic level because due to the presence of destent network of blood vessels in the
vaginal wall. Medicines used here are cheap, effective and easily available. Each Sthanik
Chikitsa holds its own importance and shows marvelous results when applied with proper
indications, strict aseptic precautions
Bibliography:
1. Dr. Hemlatha Kapoorchand, Comprehensive treatise on streeroga Gynaecology,
Chokhamba Vishwabharti, 1st Edition 2018, Pg. No. 679.
2. Jaymala Shirke Ayurvediya Streeroga vighyan, Tathagat Prakashan, Pune 2003
1st Edition, Pg.No. 164.
3. Jaymala Shirke Ayurvediya Streeroga vighyan, Tathagat Prakashan, Pune 2003
1st Edition, Pg.No. 159.
4. Kaviraj Ambikadutta Shastri, editor, Shushrutasamhita of Maharishi Susruta
edited with ‗Ayurveda-TatvaSandipika‘ Hindi Commentary, part-1, Chaukambha
Sanskrit Sansathan, Varanasi, 11th edition-1997, Pg. No7.
5. KavirajAmbikaduttaShastri, editor, Shushrutasamhita of Maharishi Susruta edited
with ‗Ayurveda-TatvaSandipika' Hindi Commentary, part-1, Chaukambha
Sanskrit Sansathan, Varanasi, 11th edition-1997, Pg. No4.
6. Streeroga-Vijnan AText Book Of Gynaecology, By prof. Dr. V. N. K. Usha,
Chaukhamba Sanskrit Pratishthan Delhi, pg. No. 586
7. Streeroga-Vijnan Made easy, By Gayatri Devi, Chaukhamba sanskrit pratishthan,
pg. No. 259

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8. Dr. Hemlatha Kapoorchand, Comprehensive treatise on streeroga Gynaecology,
Chokhamba Vishwabharti, 1st Edition 2018, Pg. No. 679

***

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 RASAYANA CHIKITSA IN GERIATRIC WOMEN CARE
Dr.Adrija P
Dr.G.Ramadevi
12nd yearPG scholar,Dept.of
Prasuthi tantra and stree roga,SDMCA Udupi.
2Professor &HOD, Dept.of
Prasuthi tantra and stree roga,SDMCA Udupi.

INTRODUCTION
Ayurveda means the science of life which consists of 8 branches. Jarachikitsa is the
7th branch of ayurveda which explains about rasayana chikitsa .The term rasayana
consists of two words rasa and ayana ,rasa means taste or essence or flavor or juice etc
.Ayana means a path or to increase or to circulate.The rasayana will increase and promote
the circulation of vital essence all over the body causes the nourishment of uttarottara
dhathu with good quality and quantity.According to sushrutha, rasayana tantra means
which endows vayasthapana-imparts longevity, age sustainer,rogapaharan through
enriching the immunity. [1]
―Menopause is just puberty‘s evil older sister‖. Geriatric women are passing through
various process of the body like-premenopause-peri menopause menopause &
postmenopause. Perimenopause is the beginning of the next phase of a reproductive
women where she faces irregular menstruations, sweaty nights, sleepy mornings etc. That
will continue upto 4-8 yrs till she attains menopause. Menopause is defined as permanent
cessation of menstruation at the end of reproductive life due to the loss of ovarian
follicular activity. It is the point of time when last and final menstruation occurs.
Post-menopause is the last phase of a women‘s life counting from her puberty
.because from there on wards the hormones will not have any major shifts as such
previously happened in her life. Geriatric women are currently passing through this phase
, where the estrogens lowered their activity and other functions of the body where highly
effected due to that.
Aim and objectives
• To study about physiological changes in geriatric women
• To study the role of rasayana chikitsa in geriatric women care

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MATERIALS AND METHODS
Literary references are collected from Charaka samhitha, Susrutha samhitha,
Ashtanga hrudaya and various other ayurvedic samhithas and books of modern medical
science.
Physiological changes in geriatric women
Geriatric women are who attained menopause and going through a postmenopausal
stage of their life. During the menopausal transition, estrogen levels decline and levels of
FSH and LH increase. The menopausal transition is characterized by variable cycle
lengths and missed menses, whereas the postmenopausal period is marked by
amenorrhea. The menopausal transition begins with variability in menstrual cycle length
accompanied by rising FSH levels and ends with the final menstrual period.Menopause is
defined retrospectively as the time of the final menstrual period, followed by 12 months
of amenorrhea.
Post-menopause describes the period following the final menses. The major
consequences of menopause are related primarily to estrogen deficiency. It is very
difficult to distinguish the consequences of estrogen deficiency from those of aging, as
aging and menopause are inextricably linked.Many symptoms are found related to
postmenopausal syndrome: Hot flushes, irritability, mood swings, insomnia, dry vagina,
difficulty concentrating, mental confusion, stress incontinence, urge incontinence,
osteoporotic symptoms, depression, headache etc.The deficiency of estrogen decreases
the energy of brain and causes the above psychological symptoms and increases the stress
.
effects on
brain stem
incresed increased causes
stress cortisol
effects on insomnia
Hypothalam Aging of
decreased
us causes neurons
estrogen hotflashes
Estrogen
in brain
effects on decreased
Amygdala energy
causes production
moodswings in brain
effects on
Hippocampus
causes
Memory loss

{23}
 Deficiency of estrogen in cardiovascular system can leads to risk of myocardial
infraction ,in urogenital mucosa it causes dry vagina , urge incontinence &in bones it can
cause osteoporosis. More changes happens in central nervous system than the other
systems. So the geriatric care in women care should be focused on the neuro protective as
well as balancing of the other systemic changes.[2]
Discussion
 Rasayana chikitsa
Rasayana chikitsa is the heart of jara chikitsa.It is the best way to prevent
diseases.The benefits are focused on attaining strength (balya) life giving (jeevaneeya),
deerghamayu, medha, smruthi, kanthi, pranathi,vaaksidhi, bulk promoting(brumhaniya)
and stabilizing the aging process (vayasthapana).It maintains the equilibrium of dosha
,dhatu,mala which brings health.[3]
 Probable mode of action
Rasayana may act at three levels of biosystem to promote nutrition such as -
1. At the level of Agni by promoting the digestion and metabolism.
2. At the level of Srotasa by promoting the microcirculation and tissue perfusion.
3. At the level of Rasa itself by acting as direct nutrition.
Rasa Agni srotas Dhatu poshana

Improved function of body & mind

Longevity ,vitality
Medas & Immunity
• According to Allopathic mode of action rasayana have anti oxidative action which
postulates the age associated oxidative reductions, immunomodulatory actions,
Antiaging effect, Adaptogenic effect, Neuroprotective action, Hemopoietic action
&Anabolic actions [4]
 Rasayana used in geriatric care
RITHU ASAYANA RASAYANA SINGLE DRUGS ACHARA RASAYANA
YOGAS
• In vasanta-hrita • Chyavana prasha  Ashwagandha Satyavadinam
preparation with • Brahma rasayana  Amalaki Akrodham

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 aragwadhadi gana+ • Narasimha  Satavari Madya Nivrati
vastsaki gana rasayana  Vidari Maithuna Nivrati
• In Varsha- • Dhatri rasayana  Gokshura Ahimsa
Anayasaka
vidaryadi • Vidangadi  Bala
Dheera
gana+rasnadi kalka- rasayana  Mandukaparni
Soucha Para
ghrita sevana[5]  Guduchi
Japa para
 Yashtimadhu Priyavadinam
 Shankhupushpi Prashantam
 Brahmi Dana etc.

Rasayanas should be used only after the shodhana of the patient otherwise it will to
diseases.Agni of the patient should be well enough to digest the rasayanas other wise
should be continued with deepana pachana chikitsa.Alongwith this achaara rasayana
should be followed.[6]
Geriatric women are very prone to disease and always with minimal psychological
issues due to their postmenopausal phase.Rasayanas are the best remedy to them because
it reaches upto the subtle level of mind through the sapnjavaha srothas and nourishes the
further .Most of the preparations have phytoestrogens ,antioxidants ,immunomodulators
etc are can be recommended instead of hormone replacement therapy in geriatric women.
Conclusion
Aging is not a disease ,it‘s a natural process of life. Geriatic people are faced with
numerous challenges- physiologically & psychologically.Geriatric women needs special
care to balance their hormonal changes which is fulfilled by Rasayana chikitsa by which
body tissues attain its best capacity to perform their systemic activities.Research studies
shown- Hormonal replacement therapy can manage menopausal symptoms it can also
leads to breast tenderness, low back pain, vaginal bleeding, mood changes.If properly
implemented, rasayana chikitsa can give a better result instead of hormonal replacement
therapy.
Reference
1. Susruta, Susruta Samhita, Edited with Ayurveda-Tattva-Sandipika by Kaviraja
Ambika Dutta Shastri, Chaukambha Sanskrit Sansthan, Varanasi, Reprint 2007.
Part I, Sarbopghat Samni Rasayan Adhaya page 120.
2. D.C. Duttas. Textbook of Gynaecology, 6th ed. 2008.pageno 60
3. Caraka Samhita of Agnivesa, Revised by Caraka and Drdhabal with elaborated
vidyotini Hindi commentary by Pt. Sastri Kasinatha & Chaturvedi Gorakhanatha,

{25}
 edited by Pt. Rajeswara Datta Sastri, Chaukhambha Bharti Academy, Varanasi,
Reprint 2007. Part I, Rasayana Adhay Prathum Paad page no 499.
4. Elements of Rasayan therapy in Ayurveda,prof. Sharma Ajay kumar, Sri Satguru
publication ,Delhi, First edition 2005,page no. xv
5. Paradkar H.S. Rasayan Vidhi Adhyaya. In A.M.Kunte & K.R. Navare (Eds),
Ashtanga samgraha.Varanasi:Chaukhamba Publications, 2009; 923–939.
6. Caraka Samhita of Agnivesa, Revised by Caraka and Drdhabal with elaborated
vidyotini Hindi commentary by Pt. Sastri Kasinatha & Chaturvedi Gorakhanatha,
edited by Pt. Rajeswara Datta Sastri, Chaukhambha Bharti Academy, Varanasi,
Reprint 2007. Part IV, Rasayana Adhay Prathum Paad page 501

***

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 STHANIKA CHIKITSA IN GERIATRIC WOMEN CARE
Dr.Amritha.M.R
PhD Scholar
Dept. Of Prasutitantra & Streeroga
Parul Institute of Ayurveda
Dr.Manjusha Karkare
Prof & HOD
Dept. Of Prasutitantra & Streeroga
Parul Institute of Ayurveda
mrkarkare@gmail.com

ABSTRACT
Even though ageing is a natural inevitable biological phenomenon, it causes many
biological changes leading to various physical and psychological manifestations. In a
woman as part of ageing, when she attains menopause, due to deprivation of oestrogen
long term symptomatic and metabolic complications causing various systemic disorders
including gynaecological manifestations. Due to the increased life expectancy about one-
third of life span will be spent after the menopause. Therefore geriatric women care is of
great importance to improve the quality of their life; especially in India having more than
53 million elderly female population. For the common gyneacological issues during this
stage like per vaginal discharge, vaginal dryness, burning sensation, pruritis etc various
treatment modalities in Ayurveda classics like panchakarma, rasayana, sthanika chikitsa
and life style modifications can be adopted. Among which sthanika chikitsa or local
therapies like yoni prakshalana, yoni pichu, yoni lepana, are the procedures where local
route of drug administration is performed at the site of the lesion where high
concentration of drug is expected to act at the target organ in a faster and efficient manner
than only oral administration. These procedures when applied appropriately in safe
accurate manner will be very much beneficial to improve the condition as well as to
prevent further progression to serious life threatening conditions like malignancy. This
paper is an attempt to analyse the common gynecological disorders of the aged women
and the appropriate local therapies or sthanika chikitsas in those conditions. Can provide
Key words: Geriatric women care, Sthanika chikitsa,
INTRODUCTION
Ageing is a natural progressive inevitable biological phenomenon leading to various
physiological and psychological changes. This process of growing old varies widely in
different individuals. According to Population Census 2011 there are nearly 104 million

{27}
elderly persons (aged 60 years or above) in India; 53 million females and 51 million
males1. As per latest report by United Nations Population Fund and Help Age India
suggests that the number of elderly persons is expected to grow to 173 million by 2026.
According to WHO, about 25 million women pass through menopause each year and by
2030, the world population of menopausal and postmenopausal women is projected to
increase to 1.2 billion, with 47 million new entrants each year2. According to Indian
Menopausal Society, the projected figure of menopausal population in India in 2026 is
103 million3. Due to the increased life expectancy about one-third of life span will be
spent after the menopause. In a woman as part of ageing, when she attains menopause,
due to deprivation of oestrogen long term symptomatic and metabolic complications
causing various systemic disorders including gynaecological manifestations. Therefore
geriatric women care is of great importance to improve the quality of their life; especially
in India having more than 53 million elderly female population. During menopause,
various hormonal changes take place resulting in development of several signs and
symptoms affecting the daily routine activities. In Ayurveda the phenomenon of
menopause is mentioned as rajonivritti which is a jara pakva avastha during which vata
dosha tends to get dominated along with dhatu kshaya. The common signs and symptoms
associated with menopause are hot flushes, palpitation, fatigue, weakness, dysuria,
increased frequency of anxiety, head ache, insomnia, irritability, depression, osteoporosis
etc along with other gynaecological issues such as vaginal infections, dryness, pruritis,
leucorrhea, dyspareunia. Ayurveda also considers these lakshanas after menopause as
svabhavika vyadhi which can be managed by proper administration of dinacharya,
rtucharya, panchakarma, rasayana chikitsa, sthanika chikitsa, yoga, pranayama, etc.
Among which sthanika chikitsas are the local therapies like yoni prakshalana, yoni pichu
etc which can provide very effective management for the gynaecological symptoms.
REPRODUCTIVE SYSTEM CHANGES AND COMMON GYNAECOLOGICAL
ISSUES IN GERIATRIC WOMEN
Gynaecological disorders in old age group of women differs from those who are
younger or in reproductive age group. The urogenital changes happening after the
menopause make the women more prone to gynaecological morbidities. During
menopause many physiological changes takes place in all the tissues due to the hormonal
variation especially the estrogen deprivation stage results in long term systemic and
metabolic complications. The entire reproductive system undergoes atrophic changes.
Ovaries shrink in size with thinning of cortex. The muscle coat of fallopian tube becomes
thin. The uterus becomes smaller with body : cervix ratio as 1:1. The endometrium also
becomes thin and atrophic. The vagina becomes narrower due to gradual loss of
elasticity. The vaginal epithelium becomes thin with absent of less doderlein‘s bacteria
{28}
resulting in alkaline vaginal pH. The labia become flattened and the pubic hair becomes
scantier resulting in vulval atrophy and narrow introitus. The pelvic cellular tissues
become scanty and the ligaments supporting the uterus and vagina lose their tone
resulting in pelvic relaxation and uterine descent4.
The important symptoms and the health concerns of women after menopause are,
vasomotor symptoms like hot flush, palpitation, weakness, osteoporosis, anxiety, head
ache, insomnia etc. Estrogen palys an important role to maintain the epithelium of
vagina, bladder, and the urethra. Therefore estrogen deficiency produces atrophic
epithelial changes in these organs which causes dyspareunia, dysuria etc. The urinary
symptoms like urgency, dysuria, and recurrent urinary tract infections and stress
incontinence are also common in this age group. Other common gynaecological issues
include vulvo vgainal infections, vaginal dryness, pruritis, leucorrhea, pelvic organ
prolapse and post menopausal bleeding. Due to the estrogen deficiency, psychological
changes as well as atrophic changes of the genitourinary, system sexual desire also
becomes reduced5.
MANAGEMENT THROUGH AYURVEDA
According to Ayurveda ageing can ageing can be considered as vridhasvastha or
jaravastha which is characterised by the predominance of vata dosha. In vardhakya there
will be gradual decline of dhatu, indriya, shareera bala etc. In this phase of vardhakya
females attain menopause or rajonivritti during which vata dosha vikaras like insomnia,
osteoporotic changes as well as pitta dosha vikaras like hot flushes, irritability etc. As it is
a period of increased susceptibility to various disorders, it is very necessary to give
utmost care during this geriatric phase. Various treatment modalities in ayurveda like
panchakarma, rasayana, rtu shodhana, life style modifications following proper
dinacharya and rtucharya can be adopted to improve the quality of life. For the
gynecological issues along with vatahara treatments sthanika chikitsas or local therapies
explained in the context of streeroga chikitsas can be adopted. These procedures when
applied appropriately in safe accurate manner will be very much beneficial to improve
the condition as well as to prevent further progression to serious life threatening
conditions like malignancy.
STHANIKA CHIKITSA
Sthanika chikitsas or local therapies described by Ayurvedic Acharyas in the
management of streerogas have outstanding outcomes. In these procedures where local
route of drug administration is performed at the site of the lesion where high
concentration of drug is expected to act at the target organ in a faster and efficient manner
than only oral administration. The commonly practiced sthanika chikitsa or local
{29}
therapies in prasootitantra and streeroga are yoni prakshalana, yoni pichu, yoni varti, yoni
dhoopana, yoni lepana, yoni poorana, yoni abhyanga, avagaham and utharavasthi6,7.
Yoni prakshalana / dhawana
Procedure of washing external genitalia as well as genital tract and cervical os with
specific medicated decoctions(kashayas). The commonly used drugs for yonidhawana are
having anti-microbial, anti-inflammatory and healing properties with the benefit of
washing out the accumulated secretions.
It is effective in leucorrhoea or vaginal discharge, vulval or vaginal itching, genito
urinary infections, infertility, irregular menstrual cycles, vaginal polyp etc.
Yoni pichu
Placing a tampoon (cotton swab wrapped in a gauze piece and tied with long thread)
soaked in medicated oil or ghee inside the vaginal cavity. The tampoon may also be filled
with other medicated preparations like powders (choorna) / crushed raw drugs (kalka) /
mamsa according to the condition.
It is used in gynaecological conditions like vaginal itching, burning sensation, pelvic
organ prolapse, vaginal discharge, genito urinary infection etc
Yoni varti
Vartis are wicks made by mixing finely powdered drugs with adhesive drugs or
binding agents. It is effective in chronic vaginal discharge, genital infections,
amenorrhoea etc.
Yoni dhoopana
Yonidhoopana is the procedure in which aromatic vapours are produced from the
combustion of herbs to fumigate the genital region. It is indicated in gynecological
conditions like vaginal discharge, tenderness, itching etc. The references of dhoopana is
found in the management of obstructed labour, retained placenta and post natal care.
Yoni lepanam
Medicines in the form of paste is used for local application. Thee kalka or finely
powdered churna mixed with water or medicated liquid and paste with uniform
consistency is made. This paste is then applied to affected areas locally. It is effective in
uterovaginal prolapse, yoni arshas.

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Yoni pooranam
This procedure is defined as filling the vaginal cavity with oils, pastes, powder or
bolus. The commonly used form of medications in this procedure are the kalkas or pastes.
It is indicated in vataja yonivyapat, pittaja yonivypat, vaginal itching
Yoni abhyangam
This procedure consists of abhyanga of yoni (genital tract). Here luke warm
medicated oil or ghrita are applied in the yoni for a specific time in a consistant pressure.
This helps in nourishment and strengthening of the local musculature. The main
indications are pelvic organ prolapse and stress incontinence
Avagaham
The word ‗Avagaha‘ means to immerse. Avagaha sweda is a type of sudation therapy
which is included in drava sweda, in which the patient is made to sit/lie in a tub
containing medicated dravadravya to produce fomentation to the body.
Uthara vasti
Vasti which is given through uthara marga i.e through the upper passages (urethra and
vagina) is known as utharavasti i.e, Insertion of medicated oil or decoction into intra
uterine cavity / urinary bladder. It is indicated in various gynaecological diseases like
amenorrhoea (absence of menstruation), menorrhagia (excessive menstrual bleeding),
dysmenorrhoea(painful menstruation), irregular menstrual cycles, infertility, retention of
urine, dysuria, dyspareunia.
COMMON GYNAECOLOGICAL DISORDERS IN GERIATRIC WOMEN &
POSSIBLE STHANIKA CHIKITSA
Gynaecological symptoms/ Sthanika chikitsas Formulations
disorders
Vaginal discharge (Vaginitis, मोनन वनति पऩप्ऩल्मादद वनति
Cervicitis)
मोनन प्रऺारन ऩञ्चवल्कर क्वाथ/ आयग्वध
क्वाथ/ त्रिपरा क्वाथ
मोनन धूऩन गग्ु गर
ु ,ु कुष्ठ, अगरु, घत
ृ etc
मोनन ऩयू ण ् शमा्भादद कल्क/ ऩञ्चनतक्तक
कल्क
मोनन पऩचु मष्ष्िभधु तैर / जात्मादद तैर
Pruritis(Vulvo vaginitis) मोनन रेऩन त्रिपरा चण
ू ि
अवगाह आयग्वध क्वाथ/ त्रिपरा क्वाथ
मोनन प्रऺारन आयग्वध क्वाथ/ त्रिपरा क्वाथ

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 1
Vaginal dryness मोनन रेऩन परसपऩि/ सक
ु ु भाय घत
ृ / जात्मादद
घत
ृ
मोनन अभ्मङ्ग परसपऩि/ सक
ु ु भाय घत
ृ / फरा तैर
मोनन पऩचु परसपऩि/ सक
ु ु भाय घत
ृ / मष्ष्िभधु
तैर
Urinary symptoms (dysuria, अवगाह ऩञ्चवल्कर क्वाथ/ गड
ु ू च्मादद
incontinence, incomplete
emptying, increased क्वाथ/ दशभर
ू क्वाथ
frequency, urinary tract मोनन प्रऺारन गड
ु ू च्मादद क्वाथ/ ऩञ्चवल्कर
infections)
क्वाथ/ फह
ृ त्मादद क्वाथ
मोनन पऩचु मष्ष्िभधु तैर
Pelvic organ prolapse मोनन अभ्मङ्ग फरा तैर, सक
ु ु भाय घत
ृ , पर सपऩि
(cystocele, rectocele, uterine
prolapse) मोनन पऩचु सक
ु ु भाय घत
ृ , फरा तैर, मष्ष्िभधु
तैर
मोनन ऩयू ण रज्जारु कल्क , वेशवाय
मोनन प्रऺारन त्रिपरा क्वाथ, ऩञ्चवल्कर क्वाथ,
गड
ु ू च्मादद क्वाथ

DISCUSSION & CONCLUSION

The common reasons for per vaginal discharge(yoni srava) in old age women are
vaginitis and cervitis for which made of teekshnoshna drugs like pippalyadi varti can be
used which will help in draining the discharge and promote healing. Yoni prakshalana
with the kvatha preparations according to the dosha predominance can also be done
which drains out the abnormal discharge and
Yoni prakshalana or vaginal douche can be done in conditions characterised with per
vaginal discharge. The appropriate kvatha like triphala kvatha, panchavalkala kvatha,
aragvadha kvatha etc according to the dosha predominance should be selected will help
in draining out the discharge, cleansing the vaginal cavity and there by promote the
healing. In conditions of recurrent urinary tract infection and itching in the genital region
also the process of yoni prakshalana will be beneficial. Pelvic organ prolapse especially
with decubitus ulcer like conditions also douche with medicated decoctions are very
much effective.
Insertion of vartis like pippalyadi varti made of appropriate powdered drugs into the
vaginal cavity is another effective method for the infections like trichomoniasis,

{32}
moniliasis, cervicitis etc. This varti absorb the sravas as it is hygroscopic in nature. Yoni
dhoopana or fumigation of genital region with medicated smoke using guguulu, agaru,
haridra etc drugs acts as sroto shodhaka, kaphagna, kledaghna and srava stambhaka.
Therefore it is also indicated in yoni kandu or pruritis, vaginal infections etc.
Yoni poorana or filling up of the vaginal cavity with medicated kalka, choorna,
veshavara, pinda etc is also indicated in pelvic organ prolapse, per vaginal discharge etc.
Yoni pichu or vaginal tampoon soaked with oil or vatahara decoctions diminishes the
chances of infection in the genital tract and urinary tract softens the vaginal canal,
supports pelvic organ prolapse etc. Acharya Sushruta mentions that just as water
extinguishes fire instantly likewise lepana cures vrana shoola, cleanses wound or
infection and reduces swelling or inflammation8. Therefore it will be effective in yoni
arsha, srasta yoni etc.
Avagaha sveda or sitz bath with herbal kashayas will provide local sudation effect,
anti inflammatory action and promote ropana of the tissues. Hence it can be practiced for
the conditions like pruritis vulvae, vulvovaginitis, recurrent urinary tract infections etc.
Avagaha with vatahara kashayas like dashamoola kashaya also provides strength to the
pelvic musculature. Yoni abhyanga or gentle massage done in the genital tract or vaginal
wall after administration of bala taila or sukumara ghrita or phala sarpi increases the tone
and strength of perineal musculature so that it will be beneficial for genital prolapse as
well as stress incontinence.
The practice of sthanika chikitsas or local therapies in an appropriate judicial manner
with all aseptic precautions is very much beneficial for urogenital issues. In this age
group of geriatric women especially during the estrogen deprivation period after
menopause along with the shamana chikitsa with herbs having phytoestrogenic effects,
shodhana, panchakarma chikitsa, rasayana chikitsa, administration of sthanika chikitsas
will provide wonderful results and there by improves the quality of life of geriatric
women.
REFERENCES
1. https://vikaspeda.in/social-welfare/senior-citizens-welfare/senior-citizens-status-
in-india
2. K Hill, The demography of menopause https://pubmed.ncbi.nlm.nih.gov/8735350
(PMID: 8735350 DOI: 10.1016/0378-5122(95)00968-x
3. Jyothi Unni, Third consensus meeting of Indian Menopause Society(2008): A
summary, J Midlife Health. 2010 Jan-Jun; 1(1): 43–47. doi: 10.4103/0976-
7800.66987 PMCID: PMC3139265 PMID: 21799640 (https://www.ncbi.nlm.nih.
gov/pmc/articles/ PMC3139265/)
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4. D.C.Dutta, D.C.Dutta‘s Text Book of Gynoecology, Revised Reprint of Sixth
Edition; 2013; Jaypee Brothers Medical Publishers(P) Ltd; P.58
5. D.C.Dutta, D.C.Dutta‘s Text Book of Gynoecology, Revised Reprint of Sixth
Edition; 2013; Jaypee Brothers Medical Publishers(P) Ltd; P.59 - 60
6. V.N.K Usha, Streeroga Vijnanam, Reprinted 2019, Chaukhamba Sanskrit
Pratishthan, Varanasi, Chapter 13, P.585 -600
7. Thorat Priti, et-al, Article on Sthanik Chikitsa a boon – Streeroga in Ayurved,
Ayurlog National Journal of research in Ayurveda Science 2014, 3(2).
8. DarshanaYelne et al, Local therapies (sthanika chikitsa) used in streeroga,
International journal of Creative Research thoughts, Volume 8, Issue 8, August
2020, ISSN 2320 – 2882

***

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 IDEAL LIFESTYLE FOR GERIATRIC WOMAN
Dr. Anjali Govind bhai Suthar
Dr.Manjusha Karkare
1styear P.G .Scholar , Prasuti tantra and Streeroga,
Email: 200202206004@paruluniversity.ac.in
Mob. No - 8780391913
Guide, Professor & HOD, Dept. of Prasuti tantra evum
Stri roga, Parul institute of Ayurveda, parul university,
P.O. Limda,Ta.Waghodia-391760 vadodara, Gujarat.
E-mail: mrkarkare@gmail.com

ABSTRACT:
Throughout the human life cycle, the body constantly changes and goes through
different stages. Accompanied by considerable hormonal changes, the life stages of
women are generally divided into infancy, puberty, reproductive age, climacteric period,
and geriatric. Many health problems occur or intensify simply as a result of the aging
process. In the geriatric woman, more chances of Chronic health conditions, Cognitive-
Mental- psychological problems, Menopause, Osteoporosis, Malnutrition, Sensory
impairments, Oral health, Bladder control problems , constipation etc. So they needs care
and cure with more attention. Geriatric condition is described in Ayurveda as Jara
avastha , and it is predominant of vata dosha. Geriatric Care Management includes Meals
– diet supervision and scheduling, Medications – up-to-date lists and schedules,
Socialization – keeping the patient from isolation, Prevention – understanding symptoms
that could need attention. Keeping the above four factors in balance can help an
individual to lead a life of fulfillment even in the old age. In the same way, women can
incorporate various principles of Ayurveda like Dinacharya Ritucharya, pathyapathya,
swasthvritta, Abhyang, nasya, vyayam, aachar rasayan, healthy diet( Anna varga, phala
varga) Deepan, pachan, yogasan ,pranayam, Panchkarma, etc in their life style to improve
their quality of life in old age.
KEY WORDS: Geriatric wome, Life-style, Swasthvrrita, Panchkarma, Pathyapathya in
geriatrics.
INTRODUCTION:
There are seven stages a human moves through during his or her life span. These
stages include infancy, early childhood, middle childhood, adolescence, early adulthood,
middle adulthood and old age. Accompanied by considerable hormonal changes, the life
stages of women are generally divided into infancy, puberty, reproductive age,

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climacteric period, and geriatric. The stage that follows early adulthood is known as
middle adulthood where people are generally caught between being productive and being
stagnant. This stage reflects the need to create a living legacy: they would either need to
feel they have become an important figure for the next generation to follow or they would
develop a sense of purposelessness which is generally known as a ―mid-life crisis‖. This
crisis can be solved by having the adults care and nurture children or help the fore-
coming generation in other ways or means, however if the crisis remains the person
would persist in random non-age-appropriate behavior as well as a continued feeling in
stagnation. During this stage adults lose some of their physical aspects as their muscular
strength, ability and agility weakens. 1
With changing demographic profile India has more older women than men as life
expectancy for women is 67.57 as against 65.46 for men. Gender differences in the aging
process reflect biological, economic, and social differences. Both social and health needs
of the older women are unique and distinctive as they are vulnerable.
GERIATRIC DEFINITION AND IT‘S EFFECT :
Aging refers to the inevitable, irreversible decline in organ function that occurs over
time even in the absence of injury, illness, environmental risks, or poor lifestyle choices
(eg, unhealthy diet, lack of exercise, substance abuse). Initially, the changes in organ
function are not affect baseline function; the first manifestations are a reduced capacity of
each organ to maintain homeostasis under stress (eg, illness, injury). The cardiovascular,
renal, and central nervous systems are usually the most vulnerable (the weakest links).
Diseases interact with pure aging effects to cause geriatric-specific complications (now
referred to as geriatric syndromes), particularly in the weak-link systems - even when
those organs are not the primary ones affected by a disease.
GERIATRIC WOMAN PROBLEM:
Throughout her life, a woman plays different social roles, viz. daughter, wife, mother,
grandmother and care giver, which influence the health of her family. While older men
have the privilege to retire from work, women are never relieved of their social
responsibilities. At this stage, the protective advantage of hormones is lost and women
become more vulnerable to certain diseases than men. It is time now to focus on issues
concerning health of this special group. The social problems revolve around widowhood,
dependency, illiteracy and lack of awareness ,Emotional problems,like feeling of
useless, helpless, Lonlines etc.The most common mental and neurological disorders in
this age group are dementia and depression, which affect approximately 5% and 7% of
the world‘s older population, respectively. Anxiety disorders affect 3.8% of the older
population, substance use problems affect almost 1% and around a quarter of deaths from
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self-harm are among people aged 60 or above. Substance abuse problems among older
people are often overlooked or misdiagnosed.
Among the medical problems, vision (cataract) and degenerative joint disease top the
list, followed by neurological problems. Lifestyle diseases form another single-most
important group of health problems in the elderly women. The risk of cardiovascular
disease doubles with the outcome being poorer than men. The most common causes of
death among women above the age of 60 years are stroke, ischemic heart disease and
COPD. Hypertensive heart disease and lower respiratory tract infections contribute to
mortality in these women. Common malignancies viz. Cervical, breast and uterus in
women are specific to them and account for a sizeable morbidity and mortality. In a study
done at Lady Hardinge medical college in Delhi, Hypertension (39.6%) and obesity (12-
46.8%) were very common in postmenopausal women.
Half or more women had high salt and fat intake, low fruit and vegetable intake and
stress. There is a need to recognize the special health needs of the women beyond the
reproductive age, to be met through strengthening and reorienting the public health
services at all levels starting from primary health care to secondary till tertiary care level
with adequate referral linkages. All policies and programs need to have a gender
perspective. At present there is lack of sensitization and appropriate training of the health
personnel in dealing with the needs of elderly. Women too need to be aware to adopt
healthy lifestyle and seek timely care. 2
Hormonal imbalance leads to so many gynecological problems,The most common
problems encountered in elderly women are vulvovaginal inflammation, genital prolapse,
postmenopausal bleeding, and alterations in bladder function.
GERIATRIC IN AYURVEDA:

स्वबापवकास्तु ऺुष्त्ऩऩासाजायाभत्ृ मुननद्राप्राकृतम्

I (Su.su.1/33)
Avurveda has considered Jara or vdrdhiikya as a natural (Swabhavika vyadhi) and
inevitable . Jara involves a structural & functional change in the body and the role of
Dosa, Dhatu; Mala, Satwa, Agni, Srotas, Oja has been considered with respect to the
aging process. In old age as the Kshaya of Saptadhatus is observed, naturally it leads to
Ojokshaya which is again of three types; 1. Ojovisramsa, 2. Ojovydpat , 3. Ojoksaya . In
old age Vata dominancy and Agnimandya is prime condition along with manodaurbalya.

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Sequential Kshaya in Aging: Balya vriddhi chavi medha ……sukra vikram(Sha. Ma.
Khand) Acharya Vagbhatta and Sdrangadhara presented an interesting scheme for loss of
different biological factors during the lifetime, as a function of aging in different decades
GERIATRIC CARE:
Includes,
1. Meals – diet supervision and scheduling,
2. Medications – up-to-date lists and schedules,
3. Socialization – keeping the patient from isolation,
4. Prevention – understanding symptoms that could need attention. Keeping the
above four factors in balance can help an individual to lead a life of fulfillment
even in the old age.
GERIATRIC LIFE STYLE BY AYURVEDA:
women can incorporate various principles of Ayurveda like Dinacharya Ritucharya,
pathyapathya, swasthvritta, Abhyang, nasya, vyayam, aachar rasayan, healthy diet( Anna
varga, phala varga) Deepan, pachan, yogasan ,pranayam, Panchkarma, etc in their life
style to improve their quality of life in old age.
According to dominancy of Doshas whole day devided as follow;

First cycle: Sunrise to Sunset-(6:00 am – 6:00 pm)

 6:00 am – 10:00 am – Kapha
 10:00 am – 2:00 pm – Pitta
 2:00 pm – 6:00 pm – Vata
Second cycle: Sunset to sunrise (6:00 pm – 6:00 am)
 6:00 pm – 10:00 pm – Kapha
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  10:00 pm – 2:00 am - Pitta
 2:00 am – 6:00 am – Vata
DINACHARYA:
Dinacharya is a concept in ayurvedic medicine that looks at cycles of nature and
bases daily activities around these cycles.
Ayurveda contents that, these routines help establish balance and understanding daily
cycles are useful for promoting for health.

1. Rise and shine(ब्राह्भे भुहूते उष्त्तष्ठे त ्)

According to Dinacharya, it is important to wake up before the sun rises. The time
between 4:30 – 5:00 am is considered to be an ideal time to wake up. This pre- dawn time
is when the Vata dosha is dominant, and the energy present in the environment will make
it easy to wake up. Moreover, it is that time of the day when there is a certain amount of
peace and freshness that is necessary for the body and soul. Before getting out of bed one
should say a prayer since it will induce positive energy into mind and soul.

2. Rinse(भुख प्रऺारन)

Rinse face with cold water to become alert for the coming day. You should also
perform ‗Jalneti‘ a technique prescribed by Ayurveda, which involves cleaning your
sinus, nasal passage and mouth with the help of a tea pot like vessel called neti pot.

3. Cleansing of your senses(प्रऺारनं दह ऩाण्मोस्च ऩाद्मो: शुपिकायणभ र भाराश्रभ हयं वैशम

चऺुष्म….)

To enhance all your senses in the morning, your sense organs should be cleaned
thoroughly. Wash your hands, legs with warm water,eyes with rose water and ears with
sesame oil. Brush your teeth and clean your tongue to enhance your taste buds and to
stimulate digestive responses.

4. Drink warm water(उष: जर ऩान)

Though most people consume caffeine in the morning, Ayurveda recommends the
consumption of warm water. It enhances peristalsis and also flushes the kidney of any
harmful toxins and free radicals.

5. Evacuation(गुदा दद भरभागिनाभ शौचं काष्तत फरप्रदभ।)

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 Evacuation is one of the most important pillars of health according to Ayurveda. If
this does not occur regularly, or is delayed, it slows down digestion and causes
constipation. This in turn forms harmful toxins in the body that can give rise to chronic
diseases.

6.Oil massage(अभ्मंगभ आचये ननत्मं स जया श्रभ वातहा ..), (a.h.su 2/7)

Foot massage,( ऩाद अभ्मंगस्तु तत स्थैमि ननद्रा दृष्िी प्रसादकृत । ) (a.sm. su. 3/59), (bha.pr
5/63-64) Head massage.( अभ्मंग शशशरतो भूधनि न सकर इष्तद्रम तऩािक। )

Massaging your body, foot and head with essential oils daily will keep your body
moisturised and will prevent your tissues from getting dry. This ensures that there is good
blood circulation in your body for a calmer and healthier nervous system.

7. Exercise(दोषऺमो अष्ग्न वपृ िस्च व्मामभादऩ

ु जामते।) (bha.pr. 5/47-48)

This can be done in any form, be it Yoga( ex. Surya Namaskar or walking, jogging).
Exercise will remove stagnation and fat from your body and will strengthen your
muscles.

8. Bath(दीऩनं वष्ृ मभ आमुष्मं स्नानं ऊजाि फर प्रदभ।) (a.h.su 2/16)

Bathing will remove excess oil from the surface of your skin and will make you feel
fresh and energized to take on the tasks for the day.
9. Meditation:
Meditation will help you concentrate , by maintaining a balance between your mind,
body and soul. It will also calm your nervous system and will make you feel peaceful and
steady.
10. Unwind:
After finishing the day‘s work, it is important to unwind and relax your body. Shut
your eyes, lie down, light some scented candles and listen to soulful music. This will not
only make you feel at peace, but will also release all the stress and tension from your
body. Another effective way of relaxing after a day‘s hard work is spending time with
loved ones.

11. Aachar Rasaysana (सत्मवाददनभ अक्रोधं…)(cha.chi.1/4/30-35) &

Sadvritta: (cha.su. 8/30-31)

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 Various code of conducts given by different aacharyas which brings towards
spirituality and also helpful for achiving Dharma, Artha, kaam, Moksha. Good conduct
maintains positive health devoid of all diseases,and lives for hundred years.
Benefits of Dinacharya:
1. Connection with nature
This Ayurveda daily routine helps you connect with nature by making you conscious
of your natural surroundings. In fact, it ensures that you live in harmony by aligning your
body with the rhythm of nature.
2. Prevention of diseases
It promotes a healthy lifestyle since it strengthens your immunity and protects you
from diseases.
3. Release of stress
Meditating and massaging yourself with essential oils, releases all the stress and
tension from your body and mind.
4. Digestion and absorption
By following a pattern of meal timings and by regulating the amount of food being
eaten, it helps your body to digest and absorb the nutrients from food effectively.
5. Discipline
It also helps in maintaining a certain discipline in the mind and body which is
beneficial in several other aspects of life.
6. Peace
Meditating and absorbing the positive vibes in your surroundings helps you achieve a
peaceful state of mind.
7. Happiness
Following Dinacharya every day, removes all the stress and worries in your life. This,
in turn, brings you happiness.
8. Longevity
It ensures a healthy lifestyle and promotes longevity.
DIET FOR GERIATRIC WOMAN

आयोग्मं बोजन आधीनं। (ka. Khi. 5/7)

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 Health is dependent on food. In old age there is Agni mandya & most of persons do
improper food intake . One should consume condusive food in right quality, at right time
to maintain health.
Specially woman who are in peri menopause, climacteric phase , menopause or Post
menopause period must include Soya bean, Protien rich diet , Fruts, dry fruits, Green
leafy vegitables etc.
In ayurveda Anna varga, drava varg, Dugdha vrga, etc given. So One should follow
pathapathya accordingly.
YOGASANA & PRANAYAMAA:

मोगस्तु चचत्त वष्ृ त्त ननयोध । (pa. yo. Su. 1 / 2)

Yoga is the process on gaining control over the mind.

मभ ननमभ आसन प्राणामाभ प्रत्माहाय धायणा ध्मान सभाधी अष्ि अंगानन l (Yo. Su. 2/30)

Astang yoga is multi objective Antarang and Bahirang practice of yoga .which
connects soul to God . And improve Punarjanma.

***

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 ROLE OF STHANIKA CHIKITSA IN GERIATRIC WOMEN-
YONI ABHYANGA AND PICHU IN FIRST DEGREE UTERINE
PROLAPSE –A CASE STUDY
Dr. Aswini S
Dr.Madhu M
1Preliminary MS scholar, Department of
Prasuti Tantra evum Striroga,
Sri Dharmasthala Manjunatheshwara
College of Ayurveda and Hospital, Hassan
2Associate professor, Department of
Prasuti Tantra evum Striroga,
Sri Dharmasthala Manjunatheshwara
College of Ayurveda and Hospital, Hassan

ABSTRACT:
INTRODUCTION:
Geriatric problems are much concern for medical professionals, in this current
scenario.Old age should be regarded as a normal, inevitable biological phenomenon but,
there will be a lot of physical and psychological variations in them. Genital Prolapse of
various degrees, non specific vaginitis, Vaginal atropy, Estrogen deficiency, infections,
cervical erosions etc are some of the most commonly facing physical conditions. In
Ayurveda, Acharya Charaka classified Stree according age, where in above 60years is
considered as vriddha. Vata being predominant in this age, causes many Yoni vyapat.
Prasramsini, Mahayoni, Kaphajayonivyapath, Sushka, Phalini/Andini are common.
Rasayana & Sthanika chikitsa mentioned in Ayurveda effectively prevent and manage
such diseases.
AIMS AND OBJECTIVES: The main objective of this is to assess the efficacy of
Ayurveda medicines in Prasramsini yonivyāpat; that is yoni abhyanga and pichu in first
degree uterine prolapse.
MATERIALS AND METHODS: Subject diagnosed with Prasramsini yonivyapath who
had consulted in Prasuthi Tantra and Stree roga OPD of Sri Dharmasthala
Manjunatheswara College of Ayurveda and Hospital, Hassan. Sthanika abhyanga and
yonipichu was done for the subject.
DISCUSSION: Sthanika chikitsa has showed significant improvement in the complaints
and improved the conditions of the patient.

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CONCLUSION: The Yoni abhyanga with Dhanwantara taila and yoni pichu with
Changeryadi ghrita caused improvement in tonicity of abdominal and perineal muscle
KEY WORDS: Geriatrics, Vrudha, Yonivyapat, yoniabhyanga, yoni pichu,dhanwantara
taila, changeryadi ghrita.
INTRODUCTION
Uterine prolapse is a very common condition with which the patient usually reports to
the gynecologists. Laxity of vaginal canal and uterine descent are much common
conditions. When we compare with modern science, , the basic treatment principles of
both Ayurveda and modern science remains same, both medical sciences gives emphasis
on re positioning of prolapsed part but, modern science has given more stress upon
surgical correction of prolapse1. When the prolapse of 1st or 2nd degree then the
conservative line of treatment which is told in Ayurvedic classics seems to be more
beneficial, cost effective and more over it gives mental relief to the patient from the fear
of surgery2. This paper is to show the efficacy of Ayurvedic basic treatment principle in
managment of Prasramsini yoni. Dhanwantara taila is used for yoni abhyanga as it is
balavardhaka and helps to improve the stability of vaginal walls and changeryadighrita
for yoni pichu which is explained for gudabramsha chikitsa is used.
AIMS AND OBJECTIVES
To show the efficacy of Ayurveda treatment in Prasramsini yonivyāpat, Yoni
Abhyanga with Dhanwantara taila and Yoni Pichu with Changeryadi ghrita .
CASE REPORT
A 50 year old female Hindu patient, visited to the OPD of Department of Prasooti
Tantra and Stree Roga of SDMCAH, HASSAN on 24th January 2021 with complaints of
feeling of something coming down in vagina since 1year, and since 6 months increased
frequency of micturition, Passing drops of urine on coughing or sneezing with mild
burning micturition. Later she developed with difficulty in holding urine urge for even 2
minutes sand disturbed sleep.
PREVIOUS HISTORY: N/K/C/O DM/ HTN/ hypo-hyperthyroidism or any other major
medical or surgical history.
FAMILY HISTORY:
Nothing relevant to the condition.
PERSONAL HISTORY
BP : 130/80 mmhg

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 Pulse : 76 bpm
Respiratory Rate : 17 / min
PICCLE: Absent
Built : Moderate
Nourishment : Moderate
MENSTRUAL / OBSTETRIC HISTORY:
Menarche at - 13 yrs of age
Menstrual cycle – attained menopause 5 years back.
Married life – 30 years
O/H – P2 L2 A0D0
P1- Male 28 years FTND, P2 - Male 25 years FTND, difficult labour with prolonged
second stage.
Tubectomy done 25 years back
SYSTEMIC EXAMINATION
• CVS: S1 S2 Normal
• CNS: Well oriented, conscious.
• RS: normal vesicular breathing, no added sounds
• P/A- Soft, non tender
• P/S- vagina normal, cervix healthy and normal size, white discharge+
• P/V- External os felt 2.5cm below the level of ischial spines ,but still remained
inside the vagina. On coughing - External os felt 4cm below the level of ischial
spines but still remained inside the vagina. Dribbling of urine observed on
coughing.
• B/L Breast- symmetrical , soft , no lymph nodes/mass detected.
INTERVENTION
• -minutes Yoni
pichu with Chāngeryādi Ghrita kept for 3-hours.
OBSERVATION
24/1/21- 30/1/21 1st course of treatment –

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 o Micturition frequency had reduced to 6-7 times and can hold urine for 5minutes.
o Complaints of passing drops of urine on coughing, sneezing had reduced.
o Relief from burning micturition.
o C/o something coming down in vagina reduced slightly .
4/3/21-10/3/21-2nd course of treatment –
o Micturition frequency and complaints of passing drops of urine on coughing,
sneezing reduced
o Relief with the c/o something coming down in vagina (60%)
o Patient could hold urine for 10-15 minutes .
DISCUSSION
In post-menopausal age due to estrogen deficiency and atrophic changes there is
increased laxity of vaginal canal and laxity in the ligaments causing uterine descent. This
post menopausal age is considered as vata predominent age associated with mamasa
shaithilya with increased chances of garbhashaya bhramsha3. Mithya āchāra, praduśta
ārtava, bījaduśti, and daiva are considered as sāmānya nidāna for all yonivyāpat and
dukha prasava4. Prasramsini yoni vyapad is pitta dosha predominant yoni vyapad
mentioned by Acharya Sushrut; and having features of syandate, kshobita and
dusprasuscha. Madhava Nidan has considered sramsate instead of syandate5.
Commenting on it madhukosha tika says sramsati as swasthanatccavate nissarati iti i.e.
the yoni has decended from its actual position6.
So we opted for sthanika chikitsa here, it will give a faster result as we are giving
treatment directly to the affected part. Vagina is a mucous tissue and readily absorbs the
especially in pichu dharan, where pichu is kept for aamutrakaal or for 3 hours so the
action of the drug is for a longer duration where it remains in contact with the vaginal
wall. Potential for systemic delivery through vagina was explored due to its large surface
area, high vascularity and permeability.the drugs having of vata and pitta shamaka
property was selected. Dhanwantara taila is balavardhaka and vatashamaka in action and
changeryadi ghrita explained in guda bramsha chikitsa is used for yoni pichu.
CONCLUSION
The yoni abhyanga with Dhanwantara taila and yoni pichu with changeryadi grita
caused improvement in tonicity of abdominal and perinial muscle . It also helped to
relieving all symptoms related to urinary system .

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REFERENCES
1. Parmar Meena, Parmar Gaurav. Probable Mode of Action of Sthanika Chikitisa
(Local Treatment) in Yonivyapada - An Ayurvedic Insight. Int. J. Ayur. Pharma
Research. 2014;2(7):25-31
2. Naveen & Sunita : Ayurvedic management of Prasramsini Yonivyāpat – A case
study AAMJ 2016; 3: 732 – 736
3. AN OBSERVATIONAL STUDY OF STHANIK CHIKITSA IN PRASRAMSINI
YONI VYAPAD GAYAN NAIK Ayurlog: National Journal of Research in
Ayurved Science-2014; 2(4): 1-8
4. Agnivesha, Charaka Samhita ,Ayurveda Dipika Commentary by Chakrapanidatta,
edited by Vaidya YadavjiTrikamji Acharya, Chaukhamba Surbharati Prakashan,
Varanasi, Reprinted – 2011, Chikitsa Sthana 30th Chapter, Verse-8; Pp-738, Pg -
634 (Teeka)
5. Sushrut Samhita, dalhan tika, edited by Vaidya Jadavji Trikamji Acharya,
published by Chaukhamba Surbharati Prakashan, Varanasi, uttartantra, chapter 38,
shlok no 13, pg no 564
6. Madhavnidanam, of madhavkara, with Madhukosha Sanskrit commentary,revised
and edited by, prof Yadunandan Upadhyaya,part 2, published by Chaukhamba
Sanskrit sansthan,Varanasi,chapter 62,shlok no 6, pg no 357

***

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 RASAYANAS FOR GERIATRIC WOMEN
Role of Rasayana Therapy in Geriatric women care: A Review
Dr. Bhrunali P. Gharpure
Dr. Bhagyashri M. Khot
1)PG Scholar, 2)Guide & Associate Professor,
Streeroga-Prasutitantra Department,
Govt. Ayurvedic College, Osmanabad
E-mail Id- bpgharpure@gmail.com
Mob. No. - 8087125795

ABSTRACT
Geriatrics is the branch of medicine that focuses on health promotion, prevention,
diagnosis & treatment of disease and disability in older people. In Ayurveda Acharya
Sushruta explained Vruddha avastha (Old age) of life stage. According to Sushruta
Vardhkya Avastha is swabhava (physiological). Women attains Rajonivutti (menopause)
during this Vruddha avastha. This period is associated with manifestation of ageing
process in women. Ageing is a process of physical, mental, emotional & social changes
in multidimensional aspect. These physical and psychological changes are generally
occur due to disturbed Vata Dosha & Dhatukshaya. During these degenerative changes
women affected more as compared to men. And this can be restrained to some extent
with the help of Rasayana Chikitsa.
Rasayana Chikitsa is a unique therapeutic method to minimize the intensity of
problems occuring during this degenerative phase of life. Rasayana is an Ayurvedic
Rejuvenation Therapy. These drugs provide optimum nourishment to the Rasadi Dhatus.
Rasayana formulations along with proper balanced diet, Yoga, Pranayam, Sadvrutta can
be helpful for menopausal symptoms.
Key words:- Rasayana, Geriatrics, Rajonivrutti , Jara, menopause.
INTRODUCTION
Geriatrics is the branch which concerned with the prevention and treatment of
diseases in older people. Geriatrics branch supports research aimed at improving health,
function and quality of life of older persons. India has acquired the label of ―an ageing
nation‖ with 7.7% of population of India is more than 60 years old(1). Government of
India adopted ‗National Policy on Older Persons‘ in January,1999. The policy defines
‗senior citizen‘ or ‗elderly‘ as a person who is age of 60 years or above(2). In Ayurveda,
the term ‗Jara‘ is used to denote old age people.

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 Elderly people are highly prone to physical and mental health issues. Specially
female are more sensitive than male. So psychological problems such as dementia,
depression, anxiety, insomnia, Alzheimer‘s disease, etc. are more commonly found in
female. As menopause occurs around 50‘s of life, female undergo several changes in
their body in response to lower levels of oestrogen, progesterone, FSH & LH. They show
typical symptoms of menopause as hot flushes, vaginal dryness, night sweats,
palpitations, cardiovascular disease, osteoporosis, loss of libido, etc.
In Vrudhha Avastha, Vata Dosha is more prominent with it‘s Laghu & Ruksha Guna
which results in reduction of Dhatus i.e. Dhatukshaya; which further results in
Updhatukshaya. This vitiated Vata Dosha also disturbed the other Sharir as well as
Manas Dosha leading to various physical as well as psychological diseases. In geriatric
women it is better to balanced aggravated Doshas or underlying factors, so that the
intensity of these disease will be far less or can be negligible. Ayurveda is a Holistic
Science which has got the potential for prevention of disease by health promotion.
Ayurveda mostly focus on Ahar (diet), Vihar (lifestyle modification), & Aushadhi
(medicine) Chikitsa. Ayurveda describe Rasayana Chikitsa to minimize symptoms
associated with Vrudhha Awastha. According to Acharya Charaka, people who undergo
Rasayana therapy obtain longevity and freedom from disease.
Classification of Rasayana Chikitsa based on effects(3) :-
1) Kamya Rasayana – it is used to attain desirable specific benefits such as long life,
wealth, great intelligence, etc.
2) Naimittika Rasayana – It is a therapy used to treat a particular disease.
3) Ajasrikam Rasayana – It is adviced to follow daily and person is habituated to
these substances.
Before use of Rasayana therapy Shodhana Karma (body purification) is indicated.
Haritaki, Saindhava, Amalaki, Gud, Vacha, Vidanga, Haridra, Pippali, Suntha powder are
described in Charaka Samhita for Virechana(4). This purification is to remove toxins &
prepare the body for receiving the Rasayana formulations. After proper evacuation of
bowel person shall follow proper Sansarjana Krama. After this procedure suitable
Rasayana formulations can be used.
According to acharya Charaka benefits of Rasayana are Dirghamayu (increase
longevity of life), Smruti (good memory), Medha (intellect), Aarogya (proper health),
Tarun Vaya (youthfullness), Prabha (excellent luster), Varna (excellent complexion),
Swara (excellent voice), Deha Indriya Balam Param (strength of body and sense organs is
increased).

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 Perfection in deliberation, respectability & brilliance are also achieved by Rasayana
therapy (5). Women can achieve blissful health by practising Rasayana therapy.
MATERIAL
Some Rasayana described in Aurveda for Geriatric People :-
1)Ahar Rasayana – Milk, Ghee
Daily intake of milk and ghee gives best effect of Rasayana. As Vata Dosha is more
dominant in older women Abhyantar Snehan (internal body oleation) is very
important. Ghee is a good source of Omega 3 Fatty acids. Milk is a good source of
Vitamin D and Calcium which is most important to maintain bone strength, preserve
muscle strength and prevent osteoporosis. Also a balanced vegetarian diet is the most
important aspect of the preventive management of menopausal syndrome. Black
grams, Bengal grams are good source of phytoestrogen.
2)Achar Rasayana – Person who is being truthful, free from anger, calm, relaxed, soft
spoken, loving, compassionate, practicing meditation, Bramhacharya, cleanliness and
proper diet- sleep achieves the benefits similar to Rasayana. It is basically related to
lifestyle modification by following Dincharya, Ratricharya & Rutucharya. It significantly
influence psychological & spiritual wellbeing of a woman.
3)The probable mode of action of Rasayana therapy as per contemporary science is as
follows(6)-
1. Antioxidant action – Amalaki
2. Immunomodulatory action – Guduchi
3. Haematopoietic action – Amalaki, Bhringraj, Mandura, Lauha Bhasma
4. Adaptogenic action – Ashwagandha, Shatavari
5. Antiaging action – Amalaki, Bala, Ashwagandha
6. Anabolic action – Vidarikanda
7. Nutritive action – Ksheera, Ghrita
8. Neuroprotective action – Ashwagandha, Swarna Bhasma, Rajat Bhasma
4)Amalkyadi Rasayana – Kewal Amalaka Rasayana, Amalaka Ghrita, Amalaka
Awaleha, Amalaka Churna, Apara Amalakawaleha are described in Samhitas.
Amalaki is Tridoshghna Dravya (Balance Vata, Pitta & Kapha). It comes under
Vayasthapana Gana (anti ageing & rejuvenate). Amalaki is the highest source of heat
stable Vitamin C, source of polyphenols and supports digestion, metabolism, elimination
and normal liver function. It is excellent for vision, hair and skin complexion.
5)Medhya Rasayana –

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 1. Juice of Mandukparni (Centella Asiatica)
2. Juice of Guduchi (Tinospora Cordifolia) with its root and flower
3. Powder of Yashtimadhu (Glycorrhiza Glabra) with milk
4. Paste of Shankhpushpi (Convolvulus Prostrates)
These Rasayana enhances intellectual & memory functions. These drugs used in
Dementia. These herbs are effective in life promoting, disease alleviating, promoters of
strength, Agni, complexion, Voice, etc.
6)Shatavaryadi Rasayana – Shatavari contain Phyto estrogenic compound which is
more important in postmenopausal women. It shows anti-inflammatory, antioxidant,
carminative, estrogenic action. It is classified as an adaptogen and helps in normalising
stress and anxiety.
7)Chyavanprasha – It is a powerful immunity booster formulation rich in Vitamin C and
antioxidants. It shows rejuvenate, anti viral, anti bacterial, anti fungal properties. It not
only repair or regenerate tissue but also protect the body against tissue damage and hence
reduces the ageing process in tissues of heart, lungs, liver and skin. The presence of
antioxidants protects the body against free radical damage and maintain a balanced ratio
of Calcium in the bones.
8)Brahma Rasayana – It is cognitive enhancer and memory booster; and good for
conditions like insomnia, anxiety. It prevent detrimental toxins from damaging brain cells
and preserve brain cells from degeneration. It prevents deterioration of cognitive
functions in people who are suffering from Alzheimer‘s Disease, Parkinson‘s disease and
other neurological disorders.
DISCUSSION
Ayurveda gives importance to the Geriatric care, as it is one of the branch of
Ashtanaga Ayurveda. Jara Chikitsa has a good scope as a preventive tool. Rasayana is a
specialized type of treatment having impact on Dhatus, Agni and Strotas of the body.
This lead to overall improvement in the formation and maintenance of the living tissues.
It helps in the prevention of ageing, improving of physical and mental strength &
enhances resistance against diseases. It provide essential nutrients at all levels from
macro to micro cellular level.
CONCLUSION
The prime aim of Ayurveda is to maintain the health of a healthy individual and cure
the disease. So to maintain the healthy state of body one should follow the Swasthvrutta
principles. Rasayana therapies are analysed by our different Acharyas. Therefore person

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desire of having long life, vitality and happiness should practise Rasayana therapy with
complete devotion.
REFERENCES
1. Ingale G., Nath A., Greriatric Health in India: Concerns and Solutions, Indian J
Community Med. 2008 Oct; 33(4):214-218, DOI: 10.4103/0970-0218.43225.
2. http://mospi.nic.in/sites/default/file/publication-reports/elderly-in-india.pdf
3. Sushrita Samhita with Nibandha Sangraha commentary by Dalhanacharya, Reprint
ed., Chaukhamba Sanskrit Prakashana, Varanasi,2012:498.
4. Acharya Vidyadhara Shukla, Tripathi R.D., Rasayanadhyay, Charaka Smhita,
Chikitsasthana 1/1/25, Chaukhamba Sanskrit Pratishthan, Delhi, reprinted 2013,
Vol.2, pg.8.
5. Acharya Vidyadhara Shukla, Tripathi R.D., Rasayanadhyay, Charaka Smhita,
Chikitsasthana 1/1/7, Chaukhamba Sanskrit Pratishthan, Delhi, reprinted 2013,
Vol.2, pg.5.
6. Mishra et. al., Role of Rasayana in Geriatric Care – A Review, Journal of
Ayurveda and Integrated Medical Sciences, May-June 2016, Vol. 1, Issue 1, pg.
53-54.

***

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 LIFESTYLE PROTOCOL FOR GERIATRIC WOMEN –―THE
BETTER WAY TO GROW OLD‖
Dr. Dharmista Pate
2nd year PG Scholar, Department of Prasuti Tantra
and Stree Roga, Sri college of Ayurvedic Science
and Research Institute, Bengaluru, Karnataka
Dr. Rachana H V
Associate Professor Department of Prasuti Tantra
and Stree Roga, Sri college of Ayurvedic Science
and Research Institute, Bengaluru, Karnataka.

ABTRACT
The desire to live is common to all living creatures evolved on this grateful planet, the
Earth but Man, is a step ahead in the sense, desires not only to live but to live a long,
happy and disease free. Ageing is a process of physical, psychological and social change
in multidimensional aspects moreover in women menopause bring several changes in the
body and mind due to decline in the amount of estrogen and progesterone being produced
by the body.
In Ayurveda ageing is considered are dhatukshaya janya avastha. Rajonivrittti as a
diseased condition is not described separately in the classics but it is mentioned as a part
of jara avastha in women. In menopause Lifestyle plays an important role and healthy
lifestyle changes can have an enormous impact on conditions which improve the immune
system and the endocrine system. A customized lifestyle modification strategy is
therefore an essential component in a woman‘s approach to ameliorating the symptoms of
menopause. Hence the lifestyle protocol are elaborated in this paper which includes
Dinacharya with Rasayana chikitsa based on the prakruti of the individual.
Keywords: geriatric, menopausal women, Ayurveda, Jara avastha, Dinacharya,
Rasayana, vyadhi pratyneeka chikitsa.
INTRODUCTION
Ageing is a lifelong process, which begins before we are born and continues
throughout life. The functional capacity of our biological systems (e.g. muscular strength,
cardiovascular performance, respiratory capacity) increases during the first years of life,
reaches its peak in early adulthood and naturally declines thereafter. The slope of decline
is largely determined by external factors throughout the life course.Ageing women make
up a significant proportion of the world's population and their numbers are growing. The
menopause trasition is a major health milestone for women with influences that extend
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far beyond reproduction , in addition to the symptoms that accompany menopause ,
concomitant, biological, physiological, behavioural and social changes shapes women‘s
midlife and future. Many women lack concrete information about what is taking place &
what are their options regarding a proper diet, nutritional supplements & exercise and
simple knowledge & preparation through Ayurveda that can enable one to embrace it and
move on with grace.
AIMS AND OBJECTIVE
Maintenance of health in old age by following life style protocol for avoidance of
disease
Rajonivritti
Rajonivritti is not described separately as a pathological condition or severe
health problem in Ayurvedic classics. The ancient acharyas termed it as a normal
physiology.The term 'Rajonivritti'is made up of two different words viz. "Rajah" and
"Nivritti"
As Sushruta mentioned that menopause deals with JarapakvaAvastha of the body.1
Acharyas termed it as a normal physiology occurring at the age near about 50 years
due to Vata predominance and Dhatukshaya
According to Ayurveda, 45-55 years of age are a critical decade. They provide the
foundation on which subsequent health is established. Degree of concern in this decade
and consequent life style changes determine the grace of future life and its probability of
being without the burden of chronic health problems
Lifestyle Factors associated with Early Menopause:
 Poor nutrition & Poverty
 Smoking increases risk of early menopause
 Alcohol consumption may contribute to an early entering into the phase of
menopause
 Medical treatments such as chemotherapy & radiation can initiate menopause
earlier than usual
 Stress, stain & mental tension leads to early menopause2
Signs & Symptoms of Menopause:
Estrogen levels are rapidly decline, causing symptoms to appear suddenly, more
severely and last longer. Several visible symptoms are:
 Age between 40-50

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  Irregular periods for 12 months
 Suffering from common symptoms including hot flashes, headache, weight gain,
depression, insomnia, mood swings, fuzzy thinking or fatigue3.
Lifesyle protocol for Prevention of menopausal symptoms
Prevention include some important principles of Dinacharya in the daily routine
Anjana: Souvira Anjana has been advised daily, it helps in maintaining the health eye
and vision.
Abhayanga:Ushna Abhayanga in sheeta Ritu and Sheeta Abhayanga in Ushna Ritu,
strengthens the body, repairs the regenerates tissue, very good in pacifying Vata, relieves
tiredness and many more. Shiro Abhyanga Beneficial for hair, Nourishes sense organs,
improves sleep. Padabhyanga Strengthens legs & feet, Relieves from senselessness,
stiffness, cracks, contraction etc. improves vision and improves sleep.
Nasya: Pratimarsha Nasya has been advised to use daily, usually Anu Tail is used for this
purpose. pacifies the Vata Dosha & gives unctuousness to head & neck region, so it
prevents mainly the degenerative disorders of brain & sense organs.
SnehaGandusa: Sneha Gandusha - Prevents Vataja disorders of mouth, cracking of lips,
dryness of mouth, Swarbheda (loss of voice), etc.
Vyayama: Any kind of activity which brings up tiredness in the body is Vyayama. It
promotes Overall health & functioning, strength, digestive power, Body mass & solidity,
lightness, reduces fat etc.4

VRIDHA VATA DOSHA PITTA DOSHA KAPHA DOSHA

AVASTHA IN PREDOMINANT PREDOMINANT PREDOMINANT
STREE
LAKSHANA Nervousness, Prone to Hot temper, Weight gain, lethargy, fluid
anxiety, pain, mood anger, irritability, retention, laziness, depression,
swings, vaginal feeling hot, hot lacking motivation, slow
dryness, loss of skin flashes, night sweats, digestion
tone, feeling cold,
heavy periods,
irregular periods,
excessive bleeding,
insomnia, mild hot
flashes, urinary tract
constipation, infections, skin rashes
palpitation, bloating and acne
and joint pain

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 AHARA Cereals:jai (oats), Cereals: Yava Cereals:Yava (barley), corn,
shali and shastika (barley), jai (Oats), china (Indian millet), shali and
rice, godhuma shali and shastika shastika rice , All legumes
(wheat), mung in (rice), godhuma especially mung, lentils &
less quantity (green (wheat), all legumes beans
gram), urad (black except masha (black Vegetables: All katu
gram) Vegetables: gram), kulattha (horse (pungent) & tikta (bitter)
shatavari gram) vegetables, shatavari
(asparagus), Vegetables:madhur (asparagus), ajmoda (celery),
garjanaka (carrots), (sweet) & tikta vartaka (eggplant), rasona
trapusa (ripen (bitter) vegetables, (garlic), chaulai (amaranthus),
cucumber), rasona shatavari (asparagus), changeri (Indian sorrel),
(garlic), palandu trapusa (cucumber), shalmali flowers (Salmalia
(onion), moolaka ajmoda (celery),leafy malabarica) palandu (onions),
(radish), kushmandi greens, chatraka kushmandi (pumpkin), alabu
(pumpkin), ajmoda (mushrooms), okra, (white gourd), karela (bitter
(celery), vrantaka kalaya (peas), patola gourd), patola (pointed gourd)
(eggplant), patola (pointed gourd),
(pointed gourd), makoya (solamun
nenua (sponge nigrum), kakdi (snake
gourd), changeri cucumber), karela
(Indian sorrel) (bitter guard)
VIHARA Abhayana with Tila Go to bed at 10 pm Get up early (6am), Mustard
taila, Mahanaryana Abhyang with oil recommended for massage.
taila Shiro pichu Majisthadi taili, tila
with Brahmi taila, taila Shiro dhara
ksheerabala taila

SHAMANA AshwagandhaRasay Kumari swarasa, Triphala churna, Shilajatu

AUSHADHI ana Lasuna Chanadanasava rasayana, vidanga Rasayana,
ksheerapaka, Usirasava, punaravamandura, Trikatu,
Shatavarichurna, panchatiktakaghita,
Brahmi vati

Lifestyle protocol in vridha Avastha

Role of Panchakarma Chikitsa
Panchakarma (―five therapeutic actions‖) chikitsa (―treatment‖) are physical therapies
that thoroughly cleanse and purify the physical and mental impurities from the body and
mind. As there is natural vitiation of vata dosha with advancing age it is
important to avoid the provocative causes of Vata dosha as a preventive measure,
snehan Karma (oleation therapy) is recommended treatment for Vata- vitiation; Basti
therapy is considered as prime among all the therapeutic measures, especially for
management of Vata disorders. Matra Basti with various medicated oils such as Sukumar
Ghrita, Dhanvantari Tail etc. can be used as per indications.

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 For symptoms occurring due to transition from madhayamavasth (pitta dominant
phase) to vradhhavastha (vata dominant), use of Ghrita can be recommended. Ghrita is
Vata-pitta shamaka (pacifying), Balya (strengthening), Agnivardhaka (promoting
digestion), Madhura, Saumya (agreeable), Sheeta-Virya (cooling in effect), Shulahara
(pain relieving), JwarAhara (antipyretic), Vrishya (aphrodisiac) and Vayasthapaka (age
stabilizer)5 . Thus, it not only pacifies Vata and Pitta but also improves the general
condition of the body and acts as a rejuvenator of the body. Ghrita is Yogavahi6.
Virechana is best for agni Deepti and elimination of vitiated pitta thereby correcting rasa
and Rakta Dhatu
Rasayan Chikitsa- (rejuvenation therapy), a unique concept of Ayurveda, it affords a
comprehensive physiologic and metabolic restoration for aging. Rasayana chikitsa is
mainly used for maintaining the health of healthy individuals although it can be used for
diseased also. The drugs which act at the level of rasa dhatu such as Draksha (Vitis
vinifera Linn.), milk, Shatavari (Asparagus racemosus), Salparni (Desmodium
gangeticum) etc. they act by enriching the nutritional value of the circulating plasma
help in correcting the Dhatukshaya.The drugs such as Pippali (Piper Longum Linn.),
Haritaki (Terminalia chebula), Citraka (Plumbago zylenica), etc. This group of drugs
improves the digestion, absorption and metabolism, and has some anabolic effect. Acting
at the level of Srotamsi (the microcirculatory channels carrying nutrition to the tissues)
are the drugs such as Guggulu (Commiphora mukul), Pippali (Piper longum Linn.),
Rasona (Allium cepa), etc. These Rasayana act at the cellular level helps in cellular
metabolism leading to improved tissue health and their quality7
CONCLUSION
Health problems at menopause represent imbalances in the body that were already in
growing in the body and diet plays a key role in balancing hormones during
premenopause and in menopause. The lifestyle modification along with Panchakarma and
Rasayana chikitsa not only reduce the menopausal symptoms but can also effectively
address the aging and allied problems. It can improve the quality of life as well as life
expectancy of aging female population. Although menopausal syndrome is not mentioned
as a disease in Ayurvedic literature but todays growing population of suffering female
prompts us to look for effective and safer alternatives as it is the responsibility of the
physician to identify the nature, sign and symptoms of presenting ailment and treat it
accordingly.

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REFERENCES
1. Sushruta Samhita of Sushrutawith Nidandhasangraha Commentary.Varanasi:
Chaukhambha Surbharati Pralashan. Revised edition, 2012;p351
2. D.C. Datta, textbook of gynaecology, ―Menopause‖, edited by Hiralal Konar, Fifth
edition, New central book agency(p) LTD Kolkata publication, 2008: p. 55-58
3. Howkins & Bourne (2005), Shaw's a Textbook of Gynecology. Menopause,
Reprinted, edit., Published by ELSEVIER, Pp. 56-67
4. Sastri K, Chaturvedi G, editors. Sarirasthan. Varanasi: Chaukhamba Bharti
Academy; 1998. Agnivesha, Charak Samhita, Vidyotini; p. 129. Dinacharya
5. Dr. Anant Ram Sharma, edi. Sushrut Samhita edited with Susrutavimarsini
Hindi commentary, Sutra Sthan. 96. Vol. 45. Varanasi: Chaukhambha Surbharati
Prakashan; p. 366.39
6. Acharya YT, editor. Charaka, Charaka Samhita, with Chakrpaanidatta; Ayurved
Dipika commentary. 1st ed. Varanasi, Uttar Pradesh, India: Chaukhambha
Orientalia; 1984. p.166
7. K. K. Dwivedi, M. Paul, P.B. Behere and R.H. Singh. The concept of Aging in
Ayurveda Ancient Science of Life, Vol No. XIV Nos. 3 & 4, January – April
1993, Pages 377 – 387

***

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 AN AYURVED APPROACH TO GYNAECOLOGICAL DISORDERS
IN GERIATRIC WOMEN
Dr. Divya Prakash Pawar
BAMS, MS (Gynaecology And Obstetrics)
DYT [Diploma In Yoga Teacher (मोग शशशशका) ]
PGDEMS (Post Graduate Diploma in Emergency Medical Services)
DDN (Diploma In Diet And Nutrition)
MDPK (Master Diploma In Panchakarma)
Email – divi.pawar94@gmail.com

INTRODUCTION –
Dr. Ignatz Natcher An Austrian Physician Coined The Word Geriatrics In 1909.
However, It Was In 1935 That A British Doctor Marjory Warren; Working In USA First
Developed The Practical Concept Of Geriatric Rehabilitation. With Her Initiation, The
Elderly Patients Were Gradually Taken Over By Teaching Hospitals. [1] Familiarity
With Acute Geriatric Gynaecologic Issues Is Crucial To Providing Satisfactory Health
Care For These Patients With Complaints Relating To Incontinence, Pelvic Floor
Dysfunction, And Other Gynaecologic Conditions Like Malignancy, Urinary Tract
Infection, Incontinence, Pelvic Organ Prolapse.

ते व्मापऩनोपऩ रृतनाभ्मोयधोभध्मोध्विसंश्रमा: ।

वमोहोयापऩबक्
ु तानां तेऽततभध्मापऩगा: क्रभात ् ॥ (अ.रृ.स.ु 1/7)

The Tridosha Are Present All Over The Body, But Their Presence Is Especially Seen
In Particular Parts. On Division Of The Body Into Three Parts, Kapha Dosha, Between
Chest, dominates The Top Part Up to Chest And Umbilicus Is Dominated By Pitta,
Below Umbilicus Part Is Dominated By Vata.
GERIATRICS IN AYURVEDA
The Term ‗Geriatrics‘ Gets Its Derivation From Greek Words, ‗Geri‘ Meaning Old
Age And ‗Latrics‘ Means Care And Is Concerned With The Care And Health Of Elderly.
It Resembles To The Sanskrit Word 'Geeryadi' Meaning Degenerated. In Ayurveda,
Acharya Charaka [2] Considered Old Age Above 60 Years Of Age While Acharya
Sushruta Considers It Above 70 Years Of Age [3]. Here Occurs Continuous Kshinta
(Decrease) In Dhatus, Indriya (Senses), Bala–Virya (Strength And Potential), Utsaah

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(Excitement In Life) Etc And Also That Elderly Get Prone To Various Diseases [4].
However, He Also Accepts That Beginning Of This Kshinta Occurs After The Age Of 40
Years Only According To Acharya Sharangdhar, Loss Of Medha Also Begins After
Fourth Decade Of Life. Vata Dosha Is The Most Important Factor In The
Pathophysiology Of Ageing And Related Disorders Because Of Its Natural Predominance
At That Stage Of Life [5].
SOME GYNAECOLOGICAL DISORDERS ARE AS FOLLOW –
STHANAVICYUTA, VIVRTA AND SAMVRITA YONIROGAS

पऩग्धष्स्वतनां तथा मोऩनं स्वथथतां थथामेत्ऩुन्ु ।

पऩना नाभमेष्स्वभां संवत

ृ ां वधवमेत ् नु्।

प्रवेशमेऩन:सत
ृ ां च ऩववत
ृ ां ययवतवमे ।

मोऩनु् थथानावत्ृ ता ऩह शल्मबूता भता ष्स्वमा: ।।

(च० सं० ऩच० ३०).

The Displaced (Prolapsed) Yoni Should Be Replaced After Giving Oleation And
Sudation. The Jihma Yoni (Crooked, Tortuous Or Bent) Should Be Straightened By
Benting It Downwards Or Upwards, Samvrtayoni (Due To Constriction, The Orifice
Becoming Either Pinhole Or Very Narrow) Should Be Dilated With The Help Of Fingers,
The Yoni Protubering Outside Should Be Inserted By Gently Pressing With Hand.
Balataila, Mushakataila, Laghuphalaghrita (Orally And Tampon), Shatapaki Shirishtaila
Sukumartaila, Vataharataila, Suramanda Pichu Are Effective In Pain, Roughness,
Stiffness, Displacement, And Anaesthesia Of Vagina.
PRASRAMSINI YONIVYAPAT (UTERINE PROLAPSE)
Uterine Prolapse Is One Among Such Disease Which Is Mostly A Resultant Of
Difficult Labour And Improper Postnatal Care. The Phalini Yoni Vyapad, Andini Yoni
Vyapad, Prasramsini Yoni Vyapad, And Mahayoni All These Explain The Prolapsed
Condition According To The Stage And Part Prolapsed Out. Initial Degrees Of Uterine
Prolapse Can Be Corelated To Prasramsini Yoni Narrated In Ayurvedic Classics. Our
Acharyas Were Well Aware Of Pelvic Organ Prolapse During Those Days Only, And
They Have Also Told The Conservative Line Of Management For The Same. Here

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 Treatment Can Be Obtained With Satavari Ksheerapaka And Chandraprabha Vati
Sevana And Bala Taila Abyanga Ksheera Sweda Of Yonipradesha Followed By Bala
Taila / Mushaka Taila Yoni Pichudharana. Veshwar Pinda Should Be Kept In Vagina; All
These Gives Strength To Uterus In 1st And 2nd Degree Uterine Prolapse.
SHUSHKA YONI

शुष्का नष्िातववा कऩथता । (शा.सं.वव. 7/78 आढभल्र पऩका)

Post Menopause, Which Is Another Cause Of Amenorrhoea And Oestrogen

Deficiency Ultimately Leading To Vaginal Dryness Where Treatment Should Be

तैरभुत्तयफष्स्वनेष्त्म जीवनीमऩसिं तैरं मोज्मभ ् । (च.ऩच.30/102)

Uttarbasti Or Tampon With Taila Made Up Of Jivaniya Group Of Drugs.

RAJONIVRITTI (MENOPAUSE)

तद्वपव ्ि द्वाशात ् कारे वतवभानभसक

ृ न: । जयाक्वशयीयां माऩत तचाशत: ऺमभ ॥
(स.ु शा.३/१ १ )

Sushruta Mentioned 50years As Age Of Rajonivrutti. When Body Is Fully In Grip Of

Senility. Arundatta States Age Mentioned Above Is A Probable Age And Not Fixed One
It May Have Some Variations In This Regard. Treatment protocol is as follow;
1.Shodhana Chikitsa (Bio-Cleansing Therapies) / Other Therapeutic Procedures Followed
By Shamana Chikitsa (Palliative Therapy) Should Be Advocated.
a) Snehana: Gentle Massage With Medicated Oils Such As:
1. Mahanarayana Taila
2. Ksheerabala Taila
3. Mahamasha Taila
4. Bala Taila
b) Internal Snehana (Internal Oleation) With Medicated Ghrita
Sukumara Ghrta, Or Mahtriphala Ghrita,Or Dadimadi Ghrita Etc 50 Ml With 2 – 3
Gm Saindhava Lavana Daily For 3-7 Days Before Panchakarma
c) Shirodhara With Yashtimadhu Kashaya & Milk 45 Minutes Daily For 15 Days
d) Takra Dhara 45 Minutes Daily For 15 Days
e) Matra Vasti With Dhanvantara Taila / Sukumara Ghrta 50 Ml Daily For 15 Days
2. Drug Therapy [TABLE NO. 1 – DRUG THERAPY]
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 Name Dose Vehicle Duration
Shatavari 1-3gm Water / Milk 15 Days
Amalaki 1-3gm Water / Milk 15 Days
Madhuyashti 1-3gm Water / Milk 15 Days
Ashvagandha 3gm Milk 15 Days
For Fragile Bones
Asthishrinkhala 1 – 3 Gm Water 15 Days
Kukkutand Tvak 250 Mg Milk / Water 15 Days
For Excessive Bleeding
Pushyanuga Churna 1-3 Gm Rice Water 15 Days
Chandraprabha Vati 1.5 Gm Water 15 Days
Lodhrasava 10-20 Ml Water 15 Days
Ashok Rishta 10-20 Ml Water 15 Days
Sukumara Ghrita 10-15ml Warm Milk/Warm 15 Days
Dadimadi Ghrita 20-30 Ml Warm Water 3 - 7 Days
Saptasaram Kashayam 10-15 Ml WW Empty Stomach 7-15days
For Hot Flushes / Night Sweats/ Burning Sensation
Pravala Pishti 250- 500mg Water / Honey / Milk 15 Days
Mukta Pishti 250-500 Mg Water / Honey / Milk 15 Days
Chandanasava 15-30 Ml Water 15 Days
Usheerasava 15-30 Ml Water 15 Days
Kamadudha Rasa 125- 250mg Water / Honey / Milk 15 Days
Dhanvantara Taila 60 Ml Matra Basti 15 Days
For Debility/ Anaemia
Ashvagandharishta 15-30 Ml Water 15 Days
Shatavari Guda 6 Gm Milk 15 Days
Lohasava 15-30 Ml Water 15 Days
LaghuMalini Vasant 250mg Honey / Milk 7 Days
Rasa
For Insomnial Mood Swings
Manasamitravataka 125 Mg Milk 15 Days
Brahmi Vati 125-250 Mg Milk 15 Days
Brahma Rasayana 10gm TDS Milk 15 Days
All Above Oral Medicines May Be Used Initially 2 Times In A Day After Meal For
15 Days Followed By Condition Of Patient And Physician's Direction

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OSTEOPOROSIS –
Osteoporosis Is A Bone Disease Characterized By A Decrease In Bone Mass And
Micro‒Architectural Alterations. This Would Lead To A Bone With Less Tensile
Strength And Significantly More Susceptibility To Fracture With Less Force. In
Ayurveda It Can Be Correlated With The Asthi Kshaya On The Basis Of
Pathophysiology And Symptoms. Where Vata Dosha Vitiation Leads To Slow
Degeneration Of Bones. For Management Dhatubrinhana Chikitsa, Shaman Chikitsa And
Rasayana Is Given. Ajajibhasma, Shatavari Kalpa, Praval Pishti, Ashwagandharishta,
Dashamularishta Are Used In Osteoporosis.
RASAYANA THERAPY –

यसामनं तु तत ् ऻेमभ नमयाव्माधीनाशनभ ् ॥ (शायं गधय)

विभामु: स्भऩ
ृ त भेधाभायोग्मं तरु वम: ।

प्रबापवपवयौमव हे ष्स्वमफरं यभ ् ॥

वाष्स्वस्वदद पप्रऩत कास्वततव रबते ना ।

राबोमो ऩह शशानां यसापऩनां यसामनभ ् ॥ (च.ऩच.1/7)

Rasayana (Rasa = Nutrition + Ayana = Circulation And Promotion) Especially Deals

With The Science Of Nutrition, Geriatric Care And Rejuvenation. The Strength Of
Ayurveda In The Context Of Geriatric Care Is Rasayana Therapy. Rasayana Stands As
An Answer In Preventing Premature Ageing And To Solve The Problems Due To
Ageing; It Also Ensures Healthful Longevity Including Mental Health And Resistance
Against Various Geriatric Dis-Ease Conditions.
[TABLE NO. 2 – RASAYANA DRUGS]
Age Yrs Bio-Values Suitable Rasayana[7]
1-10 Balya Vacha, Kasmari, Svarna
11-20 Vriddhi Kasmari, Bala, Ashwagandha
21-30 Chavi Amalaki, Lauha Rasayana
31-40 Medha Shankhapuspi, Yasthimadhu, Ashwagandha,
Guduchi
41-50 Tvaka Bhringaraja, Somaraji, Priyala,Haridra
51-60 Drishti Triphala Ghrita, Saptamrta Lauha, Kataka
61-70 Shukra Kapikacchu, Ashwagandha, Krishna Musali, Milk,
Ghrita.

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ROLE OF MEDHYA RASAYANA –
The Ayurvedic Classics And Yogic Texts De-Scribe A Set Of Rejuvenative Measures
To Impart Biological Sustenance Of The Bodily Tis-Sues, i.e. The Dhatus. Medhya
Rasayans Are New Class Of Neuronutrients With Cognition And Memory Ashwagandha
Is An Established Antistress And Adoptogen Besides Its Efficacy In Augmenting Neuro-
Regeneration. Enhancing, Anti-Aging, And Neuro Regenerative Effect [8]. Brahmi Is
Now Used As A Memory Enhancer And Mandukaparni Is Used In The Care Of Mental
Retardation.
ROLE OF PANCHAKARMA IN GERIATRIC CARE
In Ayurveda Panchkarma Have Its Own Five Bio-Purificatory Processes With
Rejuvenates Activity. The Schedule In The Elderly Should Consist Of Medicated Mas-
Sage, Sudation, Kayaseka, Pindasweda, Shirodhara And Brimhana Basti Suitably
Planned For Each Individual. Such A Package Could Appropriately Considered 'Geriatric
Panchakarma.
ROLE OF YOGA IN GERIATRIC
Among This Group Is Chronic Inflammatory And Degenerative Conditions Such As
Arthritis, Diabetes Osteoporosis, Alzheimer‘s Disease, Depression, Psychiatric Disorders,
Parkinson‘s Disease And Age Related Urinary Problems Following Forms Of Yogic
Exercises And Pranayama Were Practices Daily For 45-60 Mins
1) Omkar
2) Sukshama Yoga
3) Suryanamaskara
4) Sukhasana
5) Marjariasana
6) ½ Mastyendrasn
7) Salabhasana
8) PavanMuktasan
9) Shavasana 10)Anulonvilom 11)Kapalbhati 12)Bhramari
CONCLUSION –
Increased Life Expectancy, Rapid Urbanization, And Lifestyle Changes Have Led To
An Emergence Of Varied Problems For The Elderly In India. Therefore, Geriatric Health
Care Must Be Made A Part Of The Primary Health Care Services. Geriatric Woman
Suffer From Any Diseases Like Menopause, Post-Menopausal Bleeding, Uterine
Prolapse, Osteoporosis Etc. In Ayurvedic Texts And A Separate Medical Discipline
Called Rasayana Tantra Was Developed Which Described A Variety Of Methods And
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Measures To Promote Healthy Longevity. Undoubtedly, It Is The Strength Of Ayurveda
In The Context Of Geriatric Care. It Is The Demand Of The Hour To Develop An
Effective Holistic Protocol For Geriatric Care By Combining Rasayana, Panchkarma,
Dietetics, Ayurvedic Medicines And Lifestyle And Yoga. The Ayurveda- Based Package
Of Geriatric Care May Consist Of Use Of Dashvidha Pariksha, Sadvritta, Swasthvritta,
Satvika Diet, Yoga, Meditation, Geriatric Panchkarma And Rasayana Therapy.
REFERENCES –
1) Barton A, Mulley G.History of the development of geriatric medicine in the UK.
Postgraduate Med J. 2003;79:229-34.
2) Agnivesha, Charak Samhita, Pt Kashinath Pandey and Dr.Gorakhnath Chaturvedi,
Savimarshavidhyotini Hindi Commentary, Vol.I, Reprint: 2011, Chaukhamba
Bharati Academy, Varanasi, Vimaan Sthan 8/56
3) Sushruta, Sushruta Samhita, Kaviraj Ambika Dutt Shastri, Ayurveda Tatva
Sandipika, Hindivyakhyaviagyanik vimarsha-Tippani sahita, Pratham bhaga,
Reprint year: 2010, Chaukhamba Sanskrit Sansthan, Varanasi, Sushrut Sutra
Sthan- 35/35
4) Sushruta, Sushruta Samhita, Kaviraj Ambika Dutt Shastri, Ayurveda Tatva
Sandipika, Hindivyakhyaviagyanik vimarsha-Tippani sahita, Pratham bhaga,
Reprint year: 2010, Chaukhamba Sanskrit Sansthan, Varanasi, Sushrut Sutra
Sthan- 35/36
5) Sushrut, Sushrut, Edited with AyurvedTatvaSandipika, by Kaviraj Dr Ambika
Dutta Shastri, Chaukhamba Sanskrit Sansthan, Varanasi, Sutra Sthan – 35/38
6) Sushruta, Sushruta Samhita Sharira Sthan- 3/9, Kaviraj Ambika Dutt Shastri,
Ayurveda Tatva Sandipika, Hindivyakhyaviagyanik vimarsha-Tippani sahita,
Pratham bhaga, Reprint year: 2010, Chaukhamba Sanskrit Sansthan, Varanasi
7) Shri Satya Narayan Shastri (part 2) Charaka Samhita elaborated Vidhyotini Hindi
commentary Chikitsa Sthan, Rasayana-pratham paad- Ab- hayaamalakiya;
Chapter 1 Paad 1 verse 8; Varanasi Chaukhambha Bharty academy 2013. Page 5
8) Pandit Sharangdharacharya, Sharangdhar-Samhita, ‗Dipika‘ Hindi Commentry,
Uttarakhanda, Purva Khanda 6/19, Edited by Dr.Bramhanand Tripathi,
Chaukhamba Surbharti Prakashan, Varanasi, 2013:54.

***

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 IDEAL LIFESTYLE FOR GERIATRIC WOMEN
Ideal Lifestyle for Geriatric Women According to Ayurveda - A Review
Dr.Shrikant Atmaram Dighe
Dr. Bhagyashri Mahavir Khot
M.S.Scholar.
M.S. Ph.D. Professor & Guide
Dept. of Prasuti Tantra and Stree Roga, Government Ayurvedic College, Osmanabad
Address- Government Ayurveda College, Tuljapur Road, Madhuban, Osmanabad 413501.
Mail ID- digheshreekant@gmail.com
Mobile No. 9970664247

ABSTRACT-
Geriatrics is nothing but medical care for older adults; that is both male and female
older adults. Grossly, geriatric age group is starts from at the age of 60 years. Geriatric
woman suffers more than geriatric man. Because just before geriatrics, woman got
menopause, due to which there is hormonal disturbance along with anatomical changes
are seen in woman. In Ayurveda geriatric age may be correlated with Jara-avastha or
Vruddha-avastha. Age group more than 50 years old consider as jara or vruddha. In
jaravastha there is dhatukshaya in female body which leads to vitiation of Vata dosha. In
today‘s medical science there are very few and limited treatment options are available for
geriatric age group problem in women, but Ayurveda science having very effective and
useful planes to deal geriatric women problems. Ayurveda having its own holistic
approach for treating geriatric women problems. Rasayan chikitsa after proper
Panchakarma treatment along with lifestyle modification related to diet and day to day
activities plays a key role in geriatric women. Even though without any medicine, only
lifestyle modifications also found useful in it. Diet fulfils daily requirements of the body
and nourishes bodily dhatus. Which ultimately results into saptadhatuposhana and
prevention of vitiation of vata dosha. While daily activities such as Abhyanga (Body
massage), Vyayama (Exercise), Snana (Bath), Sadvritta palana (To follow proper rules
and regulations) all these are mentioned under the heading of Dinacharya by ancient
acharyas; plays an important role in improvement of geriatric condition of women. In this
view, it is important to focus on lifestyle modification by Ayurveda in geriatric women;
which gives better relief to geriatric women from geriatric problems as well as from
menopausal problems.
KEY WORDS- Geriatrics, Jara- Vruddha avastha, Diet, Dinacharya, Lifestyle.

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INTRODUCTION-
Geriatrics refers to medical care of old or elderly peoples. Our country facing
demographic transition with an ageing population. Due to reduced mortality, reduced
fertility and increase life expectancy this transition consist of increase number of old age
peoples. People above age of 60 years are included in elderly. [1] Geriatric age group
peoples suffer from large number of medical, social, psychological and economic
problems, creating huge burden on country. Women with geriatrics problems are more
than half of geriatric population. So it is very much important to focus on women
geriatric problems. The basic aim of Ayurveda is, ―Swasthasya swasthya rakshanam
aturasya vikara prashamanam.‖ [2] That literally means that ayurvedic science believes
not only in curing the disease but also in prevention of disease. And for disease
prevention Ayurveda having its own norms, which comes under Ahara (Diet), Vihara
(activities), Achara Rasayana (Rules or regulations e.g. Sadvritta Palana). All these
norms collectively gives the way of ideal lifestyle, in order to prevent and cure different
geriatric problems in women. Let‘s discuss these pillars of healthy and ideal lifestyle in
geriatric women.
Ideal Ahara (Diet)-
Food or diet which are advisable to consume on daily basis, enlisted by acharya Charaka
under the heading of Nitya Sevaniya Dravyas[3] are as follows-
1] Shashtik Shali- A kind of rice maturing in 60 days
2] Godhuma- Wheat- Rich in Carbohydrate
3] Yava- Hordeum Vulgare Linn.
4] Mudga- Phaseolus mungo Linn.- Rich in iron and pottassium
5] Saindhava- Rock salt
6] Amalaki- Emblia officinalis- Vayasthaapan- Rich in Vitamin C
7] Antariksha jala- Rain water
8] Ghrita- Ghee- Rich in Vitamin A, D, E, K.
9] Go-Dugdha- Cow milk- Rich in calcium- Prevents osteoporosis in postmenopausal
women
10] Madhu- Honey- source of energy in old age
11] Jangala Mamsa- Meat of animals dwelling in acrid climate

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 All above diet are rich in carbohydrate, proteins, vitamins, minerals, amino acids and
other body nutrients. In geriatric women there is deficiency of such an essential nutrients.
This deficiency s fulfilled by above diet. Also according to Ayurveda in Jara avastha
there is Saptdhakukshaya and Vataprakopa in geriatric women. Above diet is
saptadhatuvardhaka and tridoshahara in nature which is useful in jara or vrudhha avastha.
Ideal Vihara (Daily Activities)- [4]
Daily activities are mentioned in Dinacharya and Ritucharya by different ancient
acharyas, geriatric women should follow these ideal guidelines as follows-
1] Wake up early in the morning on Brhama Muhurta (5 am) - This period is of Vata
dosha and in jaraavstha there is vitiation of vata, hence by early wake up prevents
vata vitiation.
2] Shaucha Vidhi (Defecation) - After defecation mala are excreted out of human
body, as a result there is increase in life (Ayuvruddhi)
3] Anjana, Navana, Gandusha, Dhoom, Tambool- All these activities are
Doshashamaka, Vyadhihara and useful in old age.
4] Abhyanga (Body massage with medicated oil) - By abhyanga vata dosha get
normalized and hence this activity useful in jara avastha.
5] Exercise and Yoga- Proper exercise and yogic posture gives strength to abdominal
muscles also improves blood circulation of geriatric women and prevents many
geriatric and postmenopausal diseases.
6] Regular bath- It is vrushya and ayushyakara. Prevents many diseases which are
caused by unhygienic conditions in old age women.
7] Avoid Smoking, Alcohol- All bad habits should be avoided by geriatric women in
order to prevent hypertension and other cardiovascular diseases.
8] Proper and adequate sleep should be taken
9] Avoid Divaswap and Ratraujagaranam – Diwaswapa causes vitiation of Kapha
dosha while ratrau jagaranam causes vitiation of Vata dosha. So avoid these
things.
10] Clean genital organs regularly to avoid infections.
11] High fiber diet to avoid constipation and other bowel disturbances.
12] Drink sufficient amount of water.

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Achara Rasayana (Behavioral Pattern)-
During old age or postmenopausal age women suffering from many psychological
disorders such as anxiety, depression, psychosis, Alzheimer‘s disease etc. To avoid such
diseases every geriatric women should follow following achara rasayana-
1] Avoid Dashvidh papa karma [4]- Hinsa, Steya, Anyathakama, Paishunya, Parush,
Anrut, Sambhinalapa, Vyapada, Abhidhya, Drugviparyaya are 10 papa karma;
everyone should not perform these activities. Avoidance of these helps to prevent
psychological as well as physical diseases.
2] Give respect to beloved teachers, seniors, old doctors, king, and holy things [4]
3] Daivavyapashraya
• Mangala, Bali, Homa-Havana, Swastivachana
• By doing such a procedures geriatric woman gets mental stability and this will
help to keep away from psychiatric diseases.
4] Satvavajaya- [5]
• Satvavajaya means to have control over the mind and thus abstaining from things
that are not good for health
CONCLUSION-
Geriatric period in women is above 60 years. It is the postmenopausal period and
hence women face different physiological as well as psychological problems. To deal
with these problems lifestyle told by ancient ayurvedic acharyas; is very much effective
and useful. Ahara, Vihara and Achara Rasayana these are important factors of lifestyle
told by Ayurveda. When geriatric woman follows this ideal lifestyle then she will remain
disease free. So ideal lifestyle is very much important.
REFERENCES-
1] Khan S, Itrat M. Current Issues in Geriatric Health Care in India- A Review. J
Comm Med Health Care 2016; 1 (1): 1003-6.
2] Yadavji Trikamji, editor, Commentary: Vidyotini Hindi Commentary of Acharya
Kasinath Shastri and Gorakhnath Chaturvedi on Charaka Samhita of charaka,
Sutra Sthana, Chapter 30, verse no. 26, Chawkhambha Bharati Academy; 1996.
3] Yadavji Trikamji, editor, Commentary: Vidyotini Hindi Commentary of Acharya
Kasinath Shastri and Gorakhnath Chaturvedi on Charaka Samhita of charaka,
Sutra Sthana, Chapter 5, verse no. 12, Chawkhambha Bharati Academy; 1996.

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4] Vagbhata, Ashtanga Hridaya, Vidyotini Hindi commentary of Kaviraj Atrideva
Gupta, Sutra Sthana, Chapter 2, verse no. 1- 6, 8, 16-18, 21-22, 24-26
Chawkhambha Prakashan, Varanasi 2009.
5] Yadavji Trikamji, editor, Commentary: Vidyotini Hindi Commentary of Acharya
Kasinath Shastri and Gorakhnath Chaturvedi on Charaka Samhita of charaka,
Sutra Sthana, Chapter 11, verse no. 54, Chawkhambha Bharati Academy; 1996.

***

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 ―Management of Muhurmuhu Garbha Srava (Recurrent abortion) in
Elderly Gravida with Swarna Malini Vasanta Rasa- Observational
Clinical study‖
Dr Sindhu Umesh
Assistant Professor, Dept. of
PTSR, S.D.M.I.A.H,Bangalore

I. INTRODUCTION
Achievement of a progeny is considered to be sacred and equivalent for performing a
Yagna. Progeny is regarded a s the abode of Purusharthas. But there are various infertility
factors which render the couple childless. According to the Indian Society of Assisted
Reproduction, infertility currently affects about 10 to 14 percent of the Indian population,
with higher rates in urban areas where one out of six couples is impacted. Nearly 27.5
million couples actively trying to conceive suffer from infertility in India Recurrent
pregnancy loss (RPL) Recurrent Abortion (RA), also referred to as recurrent miscarriage
or habitual abortion, is defined as 2 or more consecutive pregnancy losses prior to 20
weeks from the last menstrual period. Based on the incidence of sporadic pregnancy loss,
the incidence of recurrent pregnancy loss should be approximately 1 in 300 pregnancies.
However, epidemiologic studies have revealed that 1% to 2% of women experience
recurrent pregnancy loss and more in Elderly women 4‗Garbhasrava‘ is one of the types
of Shat prakara Vandhyatva according to Harita
Acharya Bhava Mishra describes Muhurmuhu Garbha srava which can be correlated to
Recurrent Abortion / Habitual Abortion
The ancient text Rasa Yoga Sagara carries reference pertaining to the use of Swarna
Malini Vasanta in disorder afflicting ‗Garbhini‘
II. AIMS AND OBJECTIVES
AIM
To Elicit the mode of Action of Svarna Malini Vasanta
To assess the role of Swarna Malini Vasanta in the management and maintenance of
pregnancy in patients with history of Recurrent Abortion
III. MATERIALS AND METHODS
• 20 patients with h/o 2 or more abortions in their 1st trimester were taken for the
study

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Inclusion criteria:
 Pregnant patients beyond the age of 35 years
 H/o 2 or more abortions in 1st trimister of pregnancy
 Patients with h/o abortions treated with standard protocol of treatment of abortion
Exclusion criteria:
 H/o Consanguineous marriage
 Rh incompatibility
 Patients with systemic illness - DM, HTn, TB, thyroid dysfunction
 Seminal abnormalities in male partner
 Congenital uterine anomalies - Biconuate , septate uterus
 Cervical incompetence
 Genetic factors causing recurrent abortions
History was recorded and clinical examinations were performed thoroughly according to
the study protocol.
• Investigations:
Hb%
Blood group and Rh Factor
Blood glucose levels
USG
TC, DC, ESR
TORCH Test
Hormonal assay
Immunological tests when required
Intervention:
• The selected patients were adviced to take Swarna Malini Vasanta, one tablet, with
warm water twice daily- early in the morning , empty stomach and at night after
food; from time of conception till full term.
• Pathya - Apathya
Follow up study- Regular ANC
• Assessment Criteria: Overall assessment :

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 Age in years Patients

35-36 7

37-38 9

39-40 3

41-42 1

Occupation –
Occupation No of patients

House wives 12

Employees 08

Dietary habits -

Diet Patients

Vegetarian 9

Mixed 11

History of live births-

Live Births No of patients

Present 06

Absent 04

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Family history of abortions -
FHA Patients

Present 07

Absent 13

Abortion at same gestational age –

ASGA No of patients

Present 14

Absent 06

History of number of abortions -

No. of Abortions Patients

2 09

3 05

4 04

5 01

8 01

Gestational age of abortions -

Weeks No. of abortions

6 05

7 10

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 8 22

9 10

10 15

Prakruthi-
Prakruthi No. of patients

Vata 07

Pitta 09

Kapha 04

Patients having history of various clinical presentations on enrollment to study

Diagnosis No. of patients

TORCH infection 03

Immune complex 02

PCOD 06

Idiopathic cause 09

V.RESULTS
•Table 1:Overall Assessment
Results No. of Patients % Patients

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Major improvement 12 60%
(Full term delivery)

Moderate 4 20%
improvement
(Pre term delivery)

Minor improvement 2 10%

(Abortion beyond
threat period)

No improvement 2 10%
(Abortion at threat
period)

Table 3: Success rate recorded following treatment with SMV

Results % patients

% of live births 80%

% of abortions 20%

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VI. DISCUSSION
• On disease
• Muhurmuhu Garbhasrava mentioned by Bhava Prakasha, can be directly correlated
with the recurrent Abortion. Yoni Vyapat causing Muhurmuhu Garbhasrava are
Asrija and Putaghni (Pittala Yoni Vyapat). Jataharini causing Muhurmuhu
Garbhasravava are, Andaghni, Durdhara, Kaalaratri and Mohini. In the Present Study
Pittala Yoni Vyapats leading to Muhumuhu Garbha Srava is considered.
• On the drug .
• Vasanta Kalpa formulation renowned for rejuvenation effect comprises 8
formulations of Vasanta Malati Rasa. The ashtama Yoga (8th formulation) of
―Vasanta Malati Rasa‖ is termed as ―Swarna Malini Vasanta‖ acc to Rasa Yoga
sagara
―Vasanta Malati Rasa‖ – 8 – ―Swarna Malini Vasanta‖
- Rasa Yoga Sagara. (2108- 2114).
 The Phala Shruti says, ―…….balagrahe GARBHAYUTASU SHASTAH…‖ -
R.Y.S. 2112
 meaning indicated in ailments of Garbhini, here refering to - Shoola in
Garbhashaya , kati, vankshana , basti, Parshva , shroni and yoni mukha , Rakta
darshana / Pushpa darshana , Asrikdara , Anaha ,Mutrasangha , which are the
lakshanas of Garbha srava.
•On Observation :
- 14 patients having abortion of same gestational age – indicates that causes were
identical in all abortions

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 - Patients with pitta prakruti showed high incidence of miscarriage , which goes
according to fundamentals ascribed in treatment of garbhasrava
High incidence of abortion in 8th week points to the fact that , Critical period when
various organs are layed out in fetus, Transfer of functions to placenta
- Maximum of 9 patients with unexplained reasons - 40 – 60% of abortions are
unexplained
• Main action of Swarna Malini Vasanta
Ingredients of Swarna Malini Vasanta classified according to the Karmukata:
Pitahara Dravyas Rasayana Dipana Bhutaghna Manasadoshahara
Dravyas pachana Dravyas Dravyas

Swarna Swarna Swarna Swarna Swarna

Pravala Darada Maricha Pravala Abhraka
Gorochana Pippali Pippali Mukta Gorochana
Abhraka Kasturi Naga Nimbu
Mukta Gorochana Vanga
Navanita

* All drugs possess *Also are *Tikshna *Graha *Hrudya Dravyas

Shita Virya Visha Hara and Dosha
Lekhana

• Probable mode of action of Drug

Drug Pathology Disease

Pittahara, Shita virya Sub clinical TORCH / Bacterial

Dravyas infections infections

Rasayana , Vishahara Immune Complex APA

Dravyas ACA

Dipana - pachana Endocrine LPD

malfunction PCOS

Bhutaghna , Idiopathic Causes

Graha doshahara

Manasadoshahara, Causes
Hrudya* Psychological

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* ―Soumanasyam Garbhadharananam‖ – Ca. Sam
 Action of colloidal gold
 Colloidal gold, nanoparticles in specific, is a proved antioxidant and a potent
immunomodulator.
 Stabilizes emotions and helps to combat mental stress
 It has a balancing and a harmonising effect on all levels of body, mind and spirit.
 DISCUSSION On Results
 On Results
 Encouraging results were seen in cases of Immune complex , infection and
idiopathic as causes of abortions leading to BOH , than hormonal imbalance
leading to abortion.
 The approach towards the treatment of the hormonal imbalance is probably by
Dipana -pachana , Dhatvagni Vardhaka Dravyas rather than pittahara dravyas.
VII. CONCLUSION
 Svarna Malini Vasanta proved to be effective in abortions of 1st trimister
essentially due to immune complex , infections and idiopathic causes leading to
BOH
 The study should be conducted on a large sample size to confirm the effect of the
drug.

***

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 Management of Menopause and associated aging problems through
Ayurveda – Finding a safe and effective Treatment
Dr. Smita Mallikarjun Patil
Dr. Veena Ajay Patil
P.G. Scholar Department of Prasuti tantra and
StreeRoga, Government Ayurvedic College Osmanabad,
Email – smitapatil062@gmail.com, Mob – 7406359404.
Guide, Professor and HOD, Department of Prasuti tantra and
StreeRoga, Government Ayurvedic College Osmanabad,
Email – drveenapatil810@gmail.com

ABSTRACT: As the age advances function of most organs and systems tends to decline,
and there is a wide individual variability and need precise assessment. The climacteric is
an important period in women‘s life where loss of ovarian follicular activity is seen
which is characterized biologically by decline in fertility, endocrinologically by
alteration of gonadotropins and steroid hormone in body and clinically by alteration in
menstrual cycle, etc entering into menopause she experiences variety of psychosomatic
symptoms such as Depression, Forgetfulness Irritability, Insomnia, Anxiety, Hot flushes,
Night sweats, urinary symptoms, Joint pains, skin & hair problems. Since many years,
Hormonal Replacement Therapy (HRT) by using oestrogen alone or in combination with
progestins has been the therapy of choice for the relief of menopausal symptoms. Even
though they provide a temporary relief in symptoms they have many limitations, risks of
venous thromboembolic disease, hampered lipid profile and also risk of breast and
endometrial cancer. Hence, there is need for safe alternatives. In Ayurvedic classics,
menopause can be studied under the concepts of Jaravaydhi, Rajonivrutti, lakshanas
under dhatukshayja and vatavruddhi. Main Treatment principle will be Rasayana chikitsa
and vatashamana, it can be achieved by using various ayurvedic herbal and mineral
preparations, panchkarma and stahnika chikitsa. Which can be judiciously implemented
to alleviate menopausal as well as associated aging problems.
Key words – Rajonivrutti, Ayurveda, Menopause, Rasayana, Hormone.
INTRODUCTION: ―Menopause is Permanent cessation of Menstruation at the end of
reproductive life of a woman due to loss of Ovarian follicular activity‖. Its Natural
Process associated with unavoidable manifestations of aging process. Management of
menopause involves management of age-related changes, its ill effects and symptoms
occurring due to failing follicular activity. Women experiences variety of psychosomatic
symptoms such as Depression, Forgetfulness Irritability, Insomnia, Loss of concentration,

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Anxiety, Hot flushes, Night sweats, urinary symptoms, Joint pains, skin & hair problems.
In modern science, Hormone Replacement Therapy (HRT) is the only alternative for this
condition by which one can get some results in combating the disease, but it has a wider
range complication like vaginal bleeding, risk of breast cancer, endometrial cancer, gall
bladder diseases, venous thromboembolic disease, etc and this therapy is not much
effective in the psychological manifestations where use of Sedative, Hypnotics and
Anxiolytic drugs done, which may lead to side effects like drowsiness, impaired motor
functions, allergic reactions, drug dependence etc. So, there is need to find effective and
safe alternatives. In Ayurvedic classics, menopause can be studied under the concepts of
Jaravaydhi, Rajonivrutti, its lakshanas under dhatukshayja and vatavruddhi. Main
Treatment principle will be Rasayana chikitsa and vatashamana, it can be achieved by
using various ayurvedic herbal and mineral preparations, panchkarma and stahnika
chikitsa. Which can be judiciously implemented to alleviate menopausal as well as
associated aging problems.
MATERIALS AND METHODS: Ayurvedic Samhitas, Ayurvedic and modern text
books, websites, published articles, research works.
DISCUSSION:
Menopause: Permanent cessation of Menstruation at the end of reproductive life.[1] Age:
Ranges from 45 to 55 Years. Cause: Genetically predetermined condition. Not related to
number of pregnancies, race, height, weight, age of menarche etc.
Pathophysiology [2]: Depletion of ovarian follicular activity impaired folliculogenesis
Fall in Sr. Estrsdiol No endometrial growth Amenorrhoea.
Menopausal Symptoms: 1. Vasomotor Symptoms – Hot flushes, profuse sweating,
palpitation 2. Osteoporosis & Fractures. 3. Genitourinary – Dryness, infections,
leucorrhoea. 4. Sexual dysfunction 5. CVS- Vascular endothelial diseases 6. CNS-
Dementia 7. Psychological Changes - Depression, Forgetfulness, Irritability, Anxiety.
Management: [3] -Preventive – Preventing Surgical, Radiation Menopause Counselling –
Removing fear, anxiety of natural phenomenon and reassuring the patient.
-Treatment - Hormonal (HRT) – Principal hormone is ‗ESTROGEN‘. It can be used
either single (ideal in hysterectomized woman) or with Progestins (in intact uterus). In
many forms like oral, implants, Gel, creams and intrauterine devices. Depending upon the
cause we are using, we should use them for short period and with minimum dose. After
the withdrawal, the symptoms reappear, patient may become drug dependent, and also
develops the risks of breast cancer, endometrial cancer, hampered liver and gall bladder
function, altered lipid profile, thromboembolic diseases. And also, not much useful in

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psychological symptoms where the use of Sedative, Hypnotics and Anxiolytic drugs
done, which may lead to various side effects like drowsiness, impaired motor functions,
loss of memory, allergic reactions, drug dependence etc. Hence there is need for an
alternative medicine which helps to manage condition and also not having any side
effects. Efforts are made to find out the answer in Ayurveda.
Rajonivritti: [4] Not directly mentioned in Samhita, Rajonivritti occurring in Jarapakva
Shareer can be comparable to the present-day studies showing the mean age of
menopause With advancing age there is gradual diminution in the qualities of Dosha,
Dhatu, Mala, Agni.
Nidana – It is considered as a swabhava bala pravritta vyadhi, which occurs during
jarawastha. some specific factors also can be considered as the causative factors such as _
1. Kala – Vaya avastha 2. Swabhava - Swabhava of body to degrade every moment.
2. Vayu – apana and vyana vayus are responsible for Raja utpatti, vitiation-
rajonivrutti
3. Dhatukshaya - advancement of age-Dhatus deteriorates, Upadhatu artava -
rajonivrutti.
4. Karma – Woman living with Mithya achara and vihara get Rajonivritti earlier.
5. Abhighata - to the artavavaha srotas, can be considered as the surgical menopause.
Lakshanas: [5] The Jaravastha and Rajonivrittijanya avastha, both are naturally occurring
conditions, mainly represent kshayavastha. Moreover, the symptoms of Jaravastha,
observed in Rajonivrittijanya avastha This similarity found as_ Dhatu Indriya Guna,
Karma Kshaya, Balakshaya, Vigyana Hani, Grahana Dharana Smarana Medha hani,
Slatha Sandhyasthi, Twak Purushya, Vali.
Management: Two main components which need to be addressed as advancing
age, its allied changes and menopausal symptoms.
Preventive measures – Attaining Dhatusamya in body by Observing Dincharya
Ritucharya, Swasthavritta, Ahara Vidhi Visheshayatanam regular utilization of Rasayana,
Vaajikarana , Achara Rasayana, all these helps to prevent Akalaj Rajonivrutti.
Curative measures – Principles of treatment are, Vata dosha hara, Rasayana chikitsa,
Shodhan-Shamana aoushadhis and Ashwasana chikitsa. As there is natural vitiation of
vata dosha with advancing age avoid the provocative causes of Vata dosha. Use of
Snehana, Abhyanga, with vatahara balya oil, internally medicated ghrita, Basti is prime
for management of Vata disorders, and is Ardhchikitsa. Yapana basti, Tikta Dravya
Ghrita and Kshira basti. We can also use Shirodhara, Shiropichu, can be used. Sthanika
Chikitsa–Pariseka, Yonipicu, Utterbasti can be used.

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Rasayana Therapy – Rasayana, provide optimum quality of the bodily tissues which
provides both mental and physical health. Long life, good memory, disease free, luster,
complexion, voice, strength of body and sense, all these are obtained by Rasayana. Thus,
it helps to overcome Dhatukshayaja Lakshanas.
Shamana Dravyas [6] – Vayasthapak, Jeevaneeya Aushadha, Balya Aushadha, Medhya
Dravyas, These drugs having properties of immunomodulatory, antioxidant, anti-
inflammatory, antiaging, antidepressant and neuroprotective actions. We should also use
Satvavajaya chikitsa i.e.counselling and reassuring the patient.
CONCLUSION: Menopause is Permanent cessation of Menstruation at the end of
reproductive life of a woman, it can be compared Rajonivritti occurring in Jarapakva
Shareera. Eventhough HRT is having some benefits, it cannot be used for long duration
and having many side effects. By using Vatashamana, Rasayana, Vaysthapana,
Panchkarama, Sthanik Chikitsa explained in Ayurveda we can treat the menopausal
symptoms effectively without any or nil side effects.
REFERENCES:
1. Dutta.D.C. Textbook of Gynaecology, 6th edition, new delhi, Jaypee brothers‘
medical publishers, November 2013, Page.no. 57.
2. Howkins and Bourne, Shaw‘s Textbook of Gynaecology, edited by Sunrsh kumar,
et al, 17th edition, Elsevier RELX India Limited, page no. 87.
3. Dutta.D.C. Textbook of Gynaecology, 6th edition, newdelhi, Jaypee brothers
medical publishers, November 2013, Page.no. 60.
4. V.N.K.Usha, Textbook of Gynaecology Streeroga-Vijnan, chaukumba pratisthana,
Delhi, Reprint edition 2016, page.no 53.
5. Sushruta, Kaviraj Ambikadattashastri , sushruta samhita with ayurved tattva
sandipana hindi commentary, part1, sharirasthana 03/09, chaukumba publications,
Varanasi, reprint edition 2014, page.no.27.

***

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 HERBS USED IN GERIATRIC WOMAN
Dr. Swati S. Andhale and
Dr. Vijaykumar Nawale
1 -PG Scholar , Dept . of prasuti Tantra and Striroga .
SMBT Ayurved college & hospital , Dhamangaon, Maharashtra ,
india.2- Associate professor ,Dept. of prasuti tantra and striroga,
SMBT Ayurved college & hospital , Dhamangaon, Maharashtra , india.
E-MAIL ID- andhaleswati95@gmail.com
MOB NO-8381067321S

ABSTRACT
Geriatric problems are of much concern for medical professionals in the present-day
scenario. Ayurvedic herbs are always better than allopathic medicines. these herbs are
classified in classical Ayurvedic texts as rasayana .The Rasayana is a specified type of
treatment that leads to an overall improvement in the formation & maintenance of the
living tissues & helps in the prevention of ageing improving of resistance against
diseases. Bodily strength & process of improving mental faculties ,A lot of clinical &
experimental work is done to investigate these properties of Ayurveda herbs .This shows
that these herbs have the properties to slow down the natural process of ageing & can
successfully manage the common geriatric problems.
Keywords: Ayurvedic Herbs, Geriatric problems , Rasayana
INTRODUCTION :
Ageing is a natural process . old age should be regarded as a normal , inevitable
biological Phenomenon . This process can not be reversed . We can only prevent and
delay this process. The study of the physical and psychological changes Which are
incidental to old age is called gerontology . Discoveries in medical science and important
social condition during the past few decades have increased the life span of man. Many
people in the developed countries are living up to the age of 70 years and over. In India
,3.8% of the people are over 65 years of age .The age structure of population in the
developed countries has so evolved that the number of old people is continually on the
increase. These trends are appearing in all countries where medical and social services
are well developed and the standard of living is high .Normal metabolic activities alter in
old age; therefore ,response of drugs to various body system also gets altered .More toxic
and adverse effect of allopathic medicines is reported in old age Ayurvedic herbs are
more safe and effective in old age as these are natural to the human body. Ayurvedic

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herbs also have the property to slow down the natural process of ageing . these herbs are
much useful in the management of common problems of old age.
COMMON PROBEMS IN OLD AGE :
1- Senile Cataract 7- High blood pressure
2- Nerve deafness 8- chronic bronchitis
3- Bony changes affecting mobility 9- asthma
4- Failure of special senses 10- cancer
5- Changes in mental outlook
6- atherosclerosis
GERIATRIC IN AYURVEDA
In Ayurveda there is a concept of jaraawstha ( ageing) , the last phase of the life span
is very commonly known as Vardakas. . According to Ayurveda, ageing (Jara) is a
natural phenomenon like that of hunger, thirst, sleep and death [1]. Sushruta has grouped
them under the heading of Swabhava Pravritta Vyadhies. Acharya Dalhana has
commented over this concept that these diseases occur due to the power of nature while
Acharya Chakrapani has commented that nature of a particular individual depends upon
the invisible factor‘s heredity carries out in that particular race in which he or she is born.
It is classified as Kalaja Jara and Akalaja Jara. Akalaja Jara is a process in which the
ageing process starts before the natural time of onset and the manifestation of the
symptoms s is severe. In Ayurveda, treatment and prevention of Akalaja Jara and Kalaj
Jara are clearly mentioned in the chapter named Rasayana Adhyayan Prankamiyama
Rasayanpadam. The branch of Ayurveda called Rasayanatantra deals with the measures
to stay youthful achieve prolonged life, intellect, stamina, strength and to eradicate
diseases.
SPECIFIC HERBS FOR TREATING VARIOUS DISORDERS
Various Ayurvedic herbs are successfully used in common problems of old age.
Various experimental and clinical works on different modules are also done for
evaluations of their effect. These herbs are effective in various disorders occurring in old
age. Some of them are as follows.
Bronchial Asthma
Bronchial Asthma is a disease of airways that is characterized by increased
responsiveness of the tracheobronchial tree to a multiplicity of stimuli. The single drugs
useful in this condition are Sirisa (Albezia lebbeck), Haridra (Curcuma longa), Bharngi

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(Clerodendrum serratum), Kantakari (Solanum xanthocarpum), Brihati (Solanum
indicum), Vibhitakphal (Terminalia bellirica), Yashtimadhu (Glycyrrhiza glabra), Tulsi
(Oscimum sanctum), Vasa (Adhatoda vasica), etc.
Experimental study on Haridra (Curcuma longa) showed anti-inflammatory,
antibacterial, antihistaminic properties. Its ether extract of reduced the histamine content
of the rat skin to about 50%. Curcumin, isolated from rhizomes was found to inhibit the
carrageenin-induced oedema in rats as well as in mice [2].
Experimental study on Puskarmool (Ingula racemose) showed bronchodilator
properties on isolated trachea. It possessed antihistaminic as well as anti-5 HT activity
suggesting its use on bronchial asthma [3].
A study on Yashtimadhu showed its immunomodulator, antioxidant, and antitussive
properties [4].
Experimental study on Tulsi (Oscimum sanctum) showed antihistaminic property. The
alcoholic extract of leaves was found to protect guinea pigs against histamine and Acacia
Arabica-induced asthma.
Cardiac Problems
Single Ayurvedic herbs like Arjuna (Terminalia arjuna), Pushkaramula (Ingula
racemose),Guggul (Commiphora mukul) and Lasuna (Allium sativum) are recommended.
Light and vegetarian diet such as rice, Mung (green gram), Patla (Trithianes dioica),
Amla (Emblica officinalis), Draksha (Vitis Vinifera), fruits, etc., should be consumed
daily.
Study on Arjuna (Terminalia arjuna) showed that it induces a dose-dependent decrease
in blood pressure and heart rate and inhibits carotid occlusion response without affecting
the pressure responses. It was also demonstrated that the hypotensive and bradycardic
effects were mainly of central origin.
Study on Lasuna (Allium sativum) showed its anti-inflammatory, anti-oxidant, free
radicals scavenging, hypoglycemic and hypercholesteremia effect [5].
Study on Draksha (Vitis vinifera) showed that it has nutritious, demulcent, antioxidant,
and hepatoprotective properties [6]
Various Diseases of Rheumatoid Spectrum
The commonly used herbs for various diseases of rheumatic spectrum are Guggul
(Commiphora mukul), Rasna (Pulchra lanceolata Oliver and herein), Eranda (Ricinus
communis), Bhalla taka (Anacardium occidentale L.), Chopachini (Smilax china Linn.),

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Gourakshaganja (Aarav lanate), Shunthi (Zingiber officinalis), Kupilu (Strychnos
nuxvomica L.), Nirgundi (Vitex negundo) and Asvagandha (Withania somnifera (L.)
Dunal). The Panchakarma procedures like Patrapinda Swedan, Shalishastic Pindasveda,
massage, etc., are useful in these conditions
Study on Ashwagandha (Withania sominifera) showed its immunomodulatory
adaptogenic and anticarcinogenic effect.
Study on Shatavari showed its nutritive tonic and immunomodulatory properties [7].
Study on Guggul (Commiphora mukul) showed significant anti-inflammatory activity in
rat paw oedema produced by carrageenin [8]
Shunthi (zingiber officinalis) has aromatic, corninative, digestive, stimulant
hypolipidemic, and hypoglycemic effect [9]
Liver Disorders
Liver protective herbs like Katuki (Picrorrhiza kurroa), Bhumyamlaki (Phyllanthus
niruri), and Rohitaka (Tecoma undulata), Bhringaraja (Eclipta alba), etc., are used.
Study on Katuki (Picrorhiza kurroa) showed that it has hepatoprotective, antioxidant and
adaptogenic properties [10].
Alcoholic extract of Rohitaka (Tecoma undulata) dissolved in propylene glycol
administered in a dose of 25 mg/kg, i.e. exhibited decreased collagen content of liver and
increase in body weight in chlorpromazine damage (0.25 mg/gm, i.e.) in rats. The
alcoholic extract produced decrease in alkaline phosphates value in rats against CCl4
induced liver cirrhosis [11]
Hypertension
Hypertension is defined as a systolic pressure > 140 mmHg and/or diastolic blood
pressure > 90 mmHg. The causes of the disease are hereditary and faulty life style. In
essential hypertension the exact cause is not known. For the treatment of hypertension,
herbs like Sarpagandha (Rauwolfia serpentina), Katuki (Picrorrhiza kurroa), Brahmi
(Bacopa monnieri), Shankapushpi (Convolvulus pluricaulis), Chandana (Santalum
album), Bhringaraja (Eclipta alba), Lasuna (Allium sativum), Punarnava (Boerhaavia
diffusa), etc.
Lipid Disorders
Lipid disorders are due to improper liver function and due to vitiation of medovaha
srotas. The main causes of these are excessive use of alcohol, excessive day sleeping,
lack of exercise, various disorders of other body organs. Herbs like Dalchini

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(Cinnamomum zeylanicum), Triphala (Amalaki (Emblica officinalis), Haritaki
(Terminalia chebula) and Vibhitak (Terminalia bellirica)), Guggul (Commiphora mukul),
Sunthi (Zingiber officinalis), Pippali (Piper longum), Marica (Piper nigrum), Guggul
(Commiphora mukul), Vidanga (Embelia ribes), etc., are useful in lipid disorders.
Insomnia
The chief causes of sleeplessness are various psychic disorders. In Ayurveda,
insomnia is considered to be due to Vata disorders. Various diseases that lead to
emaciation and depletion of tissues, excessive exercises, faulty uses of Panchakarma
procedures, are the main causes of insomnia. Brihman, Santarpan, whole body massage,
and use of Vatahar drugs are the main treatment for insomnia. Herbs like Sarpagandha
(Rauwolfia serpentina), Asvagandha (Withania somnifera (L.)), Shankhpushpi
(Convolvulus pluricaulis), Brahmi (Bacopa monnieri), and Jatamansi are useful in this
condition.
CONCLUSIONS
Ayurveda has great potential to prevent and treat the diseases of old age. Rasayana
can prevent and slow down the natural process of ageing and also effectively manage the
diseases of old age. A lot of Ayurvedic herbs and compound preparations come under
Rasayana. These herbs are much popular in the society. One of the examples is
Chayvanprash that is famous all over the world for its antioxidant, anti-ageing and
therapeutic properties. Ayurvedic herbs can be used for geriatrics problems with greater
efficacy and safety in the present era.
REFERENCES
1. Suzutan, Suzutan Samira Sutras than Vedopattiyamadhyay 1/33 Zambia (Ed.) Dot
Shastri,14th 1 st End., Vol. 1, Chaukhambha Sanskrit Sansthan, Varanasi. 2003;
6p
2. Arora RB, et al. Chemical, Pharmacological and Toxicological studies of Curcuma
longa (Turmeric). II Indo Soviet Sym. Chem. Nat. Products including Pharmocol.
1970; 133p.
3. Singh N, et al. Experimental evaluation of antiasthma tic potentialities of I.
Racemose (Pushkarmul). Quart. J. Crude Drug Res. 1980; 18(2): 89–96p.
4. Daswani BR, et al. Study of immunomodulatory activity of Yashtimadhu
(Glycyrrhiza glabra). National convention on current Trends in Herbal drugs &
Annual Conference of Indian Society of Pharmacology, Herb– The Natural
Alternative, Gandhinagar, Gujarat, India. 2003; P.A–15, January 17– 18.

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5. Bhakuni DS, et al. Screening of Indian plants for biological activity, part–II.
Indian J. Exptl. Biol. 1969; 7: 250p.
6. . Facino RM. Free radicals scavenging action and antienzyme activities of pro–
cynanidines from vitis vinifera: A mechanism of these capillary protective action.
Frankel & Meyer Pharm–Biol. 1994; 36 (suppl): 14–20p.
7. Devasagayam K, Saini B. Indian med. plants. Ind. Jour. of Exp. Biology–Vol10
(6): 639–55p.
8. Gujral ML, et al. Anti–arthritic and anti– inflammatory activity of Gum Guggulu
(Balsamodendron mukul Hook). Indian J. Physiol. Pharmacol. 1960; 4: 267p
9. Fuhrman. Hypolipidemic and antiatherosclerotic effect of Zingiber in cholesterol
fed rabbits. Journal of Nutrition. 2000; V/30/ (5): 1124–31p
10. Pandey VN, Chaturvedi GN. Effect of alcoholic extract of Kutaki (Picrorhiza
kurroa) on experimentally induced abnormalities in the liver. Indian J. Res. Indian
Med. 1968; 3(1), 25p.
11. Pandey VN. Evaluation of the effects of indigenous drugs – Kutaki, Kakamachi,
Kasani and Rohitaka against experimentally induced chlorpromazine damage in
albino rats. J. Res. Ayur. Siddha. 1980; (1): 77–105p.

***

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 Ayurvedic management of Senile Vaginitis – A Case Report
Anagha s
Madhu M
Final year PG Scholar, Department of
Prasuti Tantra and Stree Roga, SDM College
of Ayurveda and Hospital, Hassan
Associate Professor, Department of Prasuti Tantra and
Stree Roga, SDM College of Ayurveda and Hospital, Hassan

Abstract
Introduction
Senile vaginitis is the most common disease we come across in OPD‘s among the
geriatric women. It is characterized by variable degrees of discomfort, dryness, soreness,
itching in the vulva. Senile vaginitis is estimated to be present in approximately 45% of
the postmenopausal women. The main causative factor is the decrease in the Serum
oestrogen level after menopause and advancing age. It has potential negative effects on
quality of life and can lead to various secondary diseases like urinary tract infection, etc.
as the local treatments targeting the affected part will give better results. Here an effort is
made to carry out this protocol in the management of senile vaginitis with easily available
medicines.
Materials and methods
Subject aged 60 years who approached Prasuti Tantra and Stree Roga OPD of Sri
Dharmasthala Manjunatheshwara College of Ayurveda and Hospital, Hassan with
complaints of burning sensation, dryness in the genital tract associated with generalized
body weakness was admitted for Sthanika Chikitsa i.e., Yoni Prakshalana, Yoni
Abhyanga and Yoni Pichu along with internal medicines.
Result
After the course of treatment, follow up was done and remarkable changes in the
symptoms were noticed.
Discussion
Sthanika chikitsa has showed significant improvement in the complaints and the
symptomatic treatment with appropriate internal medicines also helped in improving the
general health of the subject.
Keywords Senile vaginitis, post menopausal women, sthanika chikitsa

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Introduction
Vaginitis occurring in the post menopausal women is considered as senile vaginitis.
Due to the deficiency of oestrogen in this period the vaginal defense is lost. Vaginal
mucosa is thin and is more susceptible to infection and trauma. There may be
desquamation of the vaginal epithelium which may lead to formation of adhesions and
bands between the walls. It is characterized by symptoms like Yellowish or blood stained
vaginal discharge and itching, varying degrees of Discomfort, dryness, soreness in the
vulva and Dyspareunia. [1] Most of the time patients will approach when the condition
get worsened. Treatment should be aimed at improving the general health of the patient
and Symptomatic treatment should be done. In modern science treatment like oestrogen
supplementation is given. This helps in improving the vaginal epithelium, raises glycogen
content, and lowers vaginal pH.[2] these treatments are having a negative effect on the
body on long term use and chances of recuurence. Ayurveda is having positive impact on
generating a well being in the patient and to an extent prevent diseases from recurring.
Keeping this in mind treatment was carried out in the subject. The number of people aged
65 or older is projected to grow from an estimated 524 million in 2010 to nearly 1.5
billion in 2050, [3] with most of the increase in developing countries including India. The
ageing related diseases also is on the rise so inorder to tackle this problem and bringing
about healthy and strong citizens even in their geriatric period of life measures should be
taken from the pre menopausal age itself. And as senile vaginitis is the most common
disorder we come across in this particular age group this particular study was carried out.
Case report
A 60 year old lady approached to the OPD of Sri Dharmasthala Manjunatheshwara
College of Ayurveda and Hospital, Hassan with complaints of burning sensation, dryness
in the external genital tract associated with mild generalized weakness since 1 week.
Detailed history was taken and local examination was done. Pap smear was done and
subject was given internal medicines like Guduchyadi kashaya 60ml bd before food,
Chandraprabha vati 1bd after food and Manoll syrup 15ml BD after food for 1 week. And
subject was advised to come for review after 1 week with the Pap smear report. As Pap
smear was negative for intra epithelial lesion and her generalized body weakness got
reduced and slight relief from her other symptoms she was advised to get admitted for
further management. During this time period the subject was given Chitrakadi vati 1 TID
before food and Panchakola Phanta 50ml BD before food for 3 days for Deepana and
Pachana. Later she was given Achasnehapana with Shatavaryadi Ghritham in an
increasing dose starting from 30 ml upto 120ml for 4 days in empty stomach. She was
given Sarvanga Abhyanga with Ksheera bala taila followed by ushna jala snana for 3

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days. On 3rd day she was given Virechana medicine i.e., Trivrut lehya 30gm. A total of
11 vegas were there. After giving Samsarjana karma for next 3 days she was started with
Sthanika Chikitsa like Yoni Prakshalana with Panchavalkala Kwatha, Yoni abhyanga and
Yoni pichu with Ksheera Bala Taila for 7 days twice daily was done. On discharge the
subject was advised Indukantham Kashaya 60ml BD before food, Chandraprabha vati
1BD after food and Manoll syrup 15ml BD after food for 15 days. She was also given
Triphala choorna for external washing. Subject was followed up after 15 days and there
was significant improvement in her symptoms. Later she was given Vidaryadi Ghritha
5gm BD before food for 1 month. On the next follow up her main complaints like
dryness, burning sensation and generalized weakness got relieved.
Personal history
Table no. 1 personal history

Marital life 40 years

Appetie Reduced
Bowel Regular, hard stools
Micturition Regular
Sleep Disturbed
Addiction Coffee 5-6 times / day

Menstrual history
Menopause attained 5 years back.
Obstetric history
P3 L3 A0
LCB - FTND, 30 years back
Local examination
Table no. 2 local examination
PV Anteverted/uterus atrophic/free fornices
PS Cervix healthy, atrophic, dryness were noted
in vagina

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Management
Table no. 3 management

Day Medicine/procedure Dose Duration

Day 1 to day 7 Guduchyadi kashaya 60ml BD BF 7 days
Chandraprabha vati 1BD AF
Manoll syrup 15ml BD AF
Day 8 to day 10 Chitrakadi vati 1 tid BF 3 days
Panchakola phanta 50ml BD BF
Day 11 to day 14 Achasnehapana with 30ml-120 ml 4 days
shatavaryadi ghritha
Day 15-day 17 Sarvanga abhyanga 3 days
with ksheera bala taila
followed by ushna jala
snana
Day 17 Virechana with trivrut 30gm 1 day
lehya
Day 18-day 20 Samsarjana karma 3 days
Day 21-day 27 Stanika chikitsa 7 days
Yoni prakshalana with QS
Panchavalkala kashaya
Yoni abhyanga, yoni
pichu with Ksheera
bala taila
Discharge Panchavalkala kashaya QS
medicine choorna for local
washing 15 days
Indukantha kashaya 60ml BD BF
Chandraprabha vati 1BD AF
Manoll syrup 15ml BD AF
1st follow up Vidaryadi ghritha 5gm BD BF 30 days

Discussion
Considering the Ayurvedic aspect of senile vaginits, it can be correlated with Shushka
Yoni Vyapat which is having features like Yoni Shosha as explained by Acharya
Vaghbhata. It is mainly occurring due to Vata dushti and reduction in the Drava bhava in
the yoni as explained arunadatta commentary. Burning sensation associated with this can

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be due to pitta dosha and body weakness due to vitiation of vata and kapha. Treatment
aiming at normalizing these doshas was carried out. The medicines like guduchyadi
kashayam having ingredients like guduchi, padmaka, rakta chandana etc helps in bringing
normalcy in pitta dosha which to an extent helped in reducing the burning sensation
experienced by the subject. Manoll syrup containing ingredients like ashwagandha,
amalaki, etc helped in improving the general health condition. Chandraprabha vati is also
strengthening and can be given any pathology related to pelvic organs. Chithrakadi vati
and Panchakola phanta helps in increasing the agni and pachana of the doshas and it
helps in the easy digestion of ghritha which was given next. Shatavaryadi ghritha with its
main content shatavari having phyto oestrogens helped in bringing about reducing the
dryness in the vagina by its oestrogenic action. Ksheera bala taila used for sarvanga
abhyanga as well as sthanika abhyanga and pichu helps in promoting the bala and
reducing dryness and burning sensation in the vagina by its direct action on the affected
part. Virechana with trivrut lehya for removing the aggravated pitta dosha from the body
as virechana is the main line of treatment for alleviating pitta dosha. Panchavalkala
kashaya yoni prakshalana helped in alleviating the aggravate vata and pitta dosha by
acting locally. Follow up medicines like indukantha kashaya[4] having ingredients like
dashamula, daru , etc which are immune modulatory and improved the bala of the
subject. Vidaryadi ghritha with contents like vidari, punarnava, panchanguli, etc helped
in promoting the general health of the subject and providing the vitality. The general line
of treatment mentioned is shodhana, shaman and sthanika chikitsa which was
successfully carried out in the subject and helped in normalizing the vitiated doshas and
imparting strength in the subject.
Conclusion
The disease senile vaginitis one of the common conditions in post menopausal women
is being treated with readily available medicines has helped in reducing the symptoms.
Sthanika chikitsa with its direct action on affected part as the medicines will get directly
absorbed through the vaginal walls played an important role in improving the condition.
Further studies can be carried out by stressing on sthanika chikitsa in treating such
conditions.
Reference
1. Dutta d. c. Textbook of Gynecology. 6th ed. New Delhi; Jaypee Brothers Medical
Publishers (p) Ltd; 2013.p.165.
2. Dutta d. c. Textbook of Gynecology. 6th ed. New Delhi; Jaypee Brothers Medical
Publishers (p) Ltd; 2013.p.166.
3. http://www.who.int/topics/ageing/en

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 4. K.V.Krishnan Vaidyan, S.Gopala Pillai.Sahasrayogam.32nd ed. Mullakkal;
Vidyarambham Publishers; October 2013.p322.
Conflict of interest: none

***

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 GYNECOLOGICAL DISORDER IN GERIATRIC WOMEN
Dr.Bhagyashree Satpathy
Dr.Asokan.V
P.G Scholar, Guide&Professor, Department of
Prasuti Tantra and StreeRoga, Parul Institute of Ayurved,
ParulUniversity,P.O. Limda, Ta. Waghodia- 391760Vadodara,Gujarat.
e-mail id – satpathybhagyashree92@gmail.com
Mobile No- 9348062527

ABSTRACT
Geriatric gynecology deals with gynecological pathologies encountered in
postmenopausal women aged 65 years and above. The rate of increase in number of
postmenopausal women is substantially faster in developing than developed world. The
age-related geriatric problems have emerged significantly with enhanced longevity of
life. These are attributed to the physiological changes seen in reproductive organs due to
their altered hormonal mileu. The various gynecological disorders peculiar to ageing are
pelvic organ prolapse, postmenopausal bleeding, gynaecological malignancies, urinary
incontinence, genital tract infections, vulvovaginal disorders. The spectrum of
gynecological disorders in India differ from those in developed world as there are no
screening programs for early detection and hardly any dedicated geriatric units. The
purpose of the present study is to assess the various types of gynecological problems
faced by older women in India and to emphasize the need of promoting screening
programs for early detection and treatment of cancers and establishment of geriatric units
to meet the special need of this subset of population.
Key words- Geriatric, Gynecological Disorders.
INTRODUCTION
The word geriatric was coined by Dr. Ignatz Natcher an Austran physicianin 1909.
Geriatric gynecological problems have not received adequate attention in India. Geriatric
gynecology deals with gynecological pathologies encountered in postmenopausal women
aged 65 years and above. These are attributed to the physiological changes seen in
reproductive organs due to their altered hormonal mileu. The various gynecological
disorders peculiar to ageing are pelvic organ prolapse, postmenopausal bleeding,
gynaecological malignancies, urinary incontinence, genital tract infections, vulvovaginal
disorders.
In Ayurveda, geriatric mainly deals with Jara Avastha.Indian ancient lifestyles-
Ayurveda is having this branch as Rasayana Chikitsa for ages. Ayurveda understood this

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in totally offering wholistic remedies emphasising on proper lifestyles. Ancient science
also describes many disorders of geriatric women like- Garbhashay bhransha,
Yonibhransha, Rajanivrutti Janya Lakshanas/ Rajanivrutti Janya Vikara, Mutrakruchra,
Kaphaja Yonivyapad, Mahayoni.This phase of life is commonly associated with Vata
and Kapha Vruddhi and Pitta Kshaya a phenomenon which seems to be responsible for
most of the physical and psychological ailments in women.
NEED OF STUDY
Modern system of medicine stresses on Hormone Replacement Therapy with estrogen
related hormones which finaly ends up with operative procedures to fight these
gynecological disorders but educated society as awhole dreads continued use of these sex
hormones due to there onccogenic potensial.Terefore thereis always a need to find out a
cost effective safe methode to fight geriatric related ailments of women.
Ayurveda has potential to bridge this gap and provide effective therapeutics as it has
sufficient understanding of symptomatology to provide outcome.
MATERIALS AND METHODS
Different Ayurvedic classical books, research papers and journals were referred to
fulfill this part,it comprises subsection dealing with Ayuevedic management of geriatric
ailments in women.
AIMS AND OBJECTIVES
1) To study the critical review of Ayurvedic and modern literature on gynecological
disorders in geriatric women.
2) To study the aetiopathogenesis , clinical features and management acc to
Ayurveda literature.
Prasramsini yonivyapad( Pelvic Organ Prolapse)/ Yonibhransha (uterine prolapse)
It is a disease in which uterus descends out of vagina or experiences downward
displacement of uterus or any pelvic organ. Which is categorised as Complete or
Incomplete prolapse. The condistion is graded by its severity that is 1st grade , 2nd grade
and and 3rd grade, 4th grade. More severe cases need surgery, but in early stages
,exercise may help like kegel‘s exercise , preventing constipation, lifting heavy loads etc.
According to Ayurveda, here Vata Dosha is always vitiated. During geriatric phase
also there is Vata Vrudhi. Here the role of Apana Vayu is to regulate the process of
excretion mainly all pelvic organs of excretion depend on quality of Apan vayu,if this
Vata Dosha is vitiated,it may exert downward force and can dislodge the organ gradually.

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Management
Principle of management
Medicine with the properties of Grahi (which means to retain the organs at its own
place giving strength to support muscles and ligaments of uterus.) And controlling Saman
and APANA vayu and aids in the process of digestion and metabolism and helps in
releasing the prssure and stress on the pelvic floor muscles in the normal state and
ultimately from descend of pelvic organ /uterus.
ACC TO ACHARYA SUSHRUTA- Abhyanga with Ghrita,Oushadha siddha Ksheera
Swedana, replacing Yoni by hand, Yoni Purana with vesavara Pinda and bandaged. It
should be removed as pateint urges for micturion.
ACC TO BHAISHAJYA RATNAVALI- Traivrt Sneha and Swedana.
Acc to Chkradatta- Mushaka Mamsa prepared with Tila Taila can be used.
POST MENOPAUSAL SYNDROME ( RAJANIVRUTTI JANYA LAKSHANA)
It si stage in a women‘s life which is that the women looses her ability to ovulate.,
meaning that the women stops being frertile. This stage occursafter 50 years of age and is
characterised by presenting a series of symptoms, which include the disappearance of
menstruation, night sweats, overweight, emotional instability, hot flishes,dry skin etc.
Acc to Ayurveda it I because of alteration of doshas.
Vata Dosha Menopause: Symptoms –Nervousness, anxiety, pain, mood swings, vaginal
dryness, loss of skin tone, feeling cold, irregular periods, insomnia, mild hot flashes,
constipation, palpitation, bloating and joint pain.
Treatment
Diet - increase warm food and drinks. Take regular meals and use spices, fennel and
cumin. Decrease –caffeine and other stimulants, refined sugar cold drinks, cucumber,
organic food, use spices and cumin and fennel. Avoid hot spicy foods, hot drinks and
alcohol, no eating late at night.
Life Style- Early bed-time, oil massage, using almond and olive oil, meditation, yoga,
regular exercise like walking.
Herbs- Anti vata herbs include ashwagandha, arjuna, astragalus, cardamom, comfrey
root, garlic, ginseng, guggul, hawthorn berries, sandalwood and zizphus.

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Pitta – type menopause Symptoms- Prone to Hot temper, anger, irritability, feeling hot,
hot flashes, night sweats, heavy periods, excessive bleeding, urinary tract infections, skin
rashes and acne
Treatment:
Diet- Increase cooling foods, water intake, sweet juicy fruits (grapes pears, plums,
mango, melons, apples), yellow squash cucumber, organic foods Avoid hot spicy food,
hot drinks and alcohol, no eating late at night
Life style: Go to bed at 10 pm, oil massage using coconut and sesame oil, use meditation
& other techniques to reduce anger. Exercise & exposure to sun are limited.3
Herbs- Use Anti-Pitta Herbs: Aloe vera, arjuna, barberry, golden seed, saffron,
sandalwood, shatavari.
Kapha type Menopause:
Symptoms- Weight gain, lethargy, fluid retention, laziness, depression, lacking
motivation, slow digestion Treatment- Prefer light, dry & warm food, consume fruits,
whole grown vegetables, use spices such as black pepper, turmeric & ginger. Avoid –
Meat, cheese, sugar, cold foods & drinks. Life style- Get up early (6am), Mustard oil
recommended for massage. Herbs-Use Anti-Kapha Herbs: Bay berry, caynne, guggulu,
mustard.
KAPHAJA YONIVYAPAT( VULVO VAGINITIS)
It is the inflammation of the vagina characterized by itching, vaginal discharge, and
pain .Vaginitis is associated with irritation and infection of the vulva due to its proximity
to the vagina . a healthy vagina produces normal secretions to cleanse and regulate itself
same as saliva secrets in the mouth. Vaginitis occurs when changing in the normal
balance of vaginal bacteria or an infection.
CLASSIFICATION
 Bacterial vaginosis
 Trichomoniasis
 Candida albicans
 Vaginal atrophy
 Non infectious vaginitis
Acc to AYURVEDA Kapaha Dosha gets vitiated due to excessive consumption of
abhshyandi substances reaches reproductive system and causes Pichila, Kandu,

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Sheeta,Srava, Alpa vedana in vagina, is known as Kaphaj Yonivyapad or Vaginitis
Aggravated Kaphs and low level of Agni is the cause of Kaphaj Yoni Vyapat.
Which is classified underfour categories;
1. Inflammatory disease
2. Dysfunctional Uterine Disease
3. Sterility and Habitual abortions
4. Anatomical Defects.
MANAGEMENT
Diet- Consume fresh vegetables, butter guard , red amaranthas
Apathya- Avoid pickles, fermented, deep fried, spicy, bakery food items, avoid
excessive consumption of milkproducts, Viruddha Ahara- combinations like fruit with
milk, milk with fish, curd with milk.
Internal Medications- Ashokarishta, Lodhrasava,Aragwadharishta, Pushyanug Churnsa,
Chandraprava Vati, Arogyavardhini Vati, Triphala Guggulu, Nimbadi Guggulu.
External Therapies- Panchavalkala Kashaya, Panchatiktakam Kashaya, Mahaman
jishthadi Kashaya,Aragwadha Patra Kashaya, Triphala Kashaya.
Single drugs- Haridra, Aragwadha,Guduchi, Nimba , Karanja ,Amalakietc.
CONCLUSION
Health problems in geriatric represent imbalances in the body that were already in
growing in the body and diet plays a key role in balancing hormones during this phase of
life in women. Eat a varied diet high in fruit, vegetables, whole grains and dried beans. It
is a rich source of phyto estrogen. Variety and moderation are important because just as
too much estrogen is unhealthy after menopause, too much phyto estrogen may also be
dangerous. Ayurveda describes that these stubborn symptoms are due to the built up
wastes and toxins, referred to as ―ama‖ in the body tissue. In this case traditional
Ayurvedic detoxification programme ―panchakarma‖ may be needed to clear the body‘s
channels and gain relief. Lifestyle management also plays a significant role in the time of
menopause. Menopause symptoms are Nature‘s wake up call to paying more sincere
attention to one‘s health
REFERENCES
1. 1.Gayan Naik, An Observational study of sthanikchikitsa in Prasramsini
Yonivyapad, Ayurlog: National Journal of Research in Ayurved Science.
2015;2(3). ISSN: 2320-7329

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2. Mansa Devi,.Jaysheela M. Goni, Prasramsini Yonivyapat WSR. To Uterine
Prolapse A Case Study, European Journal of Pharmaceutical And Medical
Research, 2019,6(3)ISSN:2394-3211
3. KumarP,MalhotraN. Jeffcott‘s Principle of Gynecology.7th edition.New delhi :
(India) Jaypee brother‘s medical publishers (p) ltd; 2008;275-85
4. Keisha A Jones, MD and Oz Harmanli, MD, Pessary Use in Pelvic organ prolapse
and urinary incontinence, Tufts University School of medicine , Baystate Medical
Center, Department of Obstetrics and Gynecology, division of Urogynecology and
Pelvic Reconstructive surgery, Springfield, MA. PMID: 20508777,
5. Ayurvediya prasuti tantra evum streeroga, prof. P.V. Tiwari, vol.2, Chaukhambha
Orientalia, Edition 2012;57,58,88
6. LaviAgrawal,IndirasingValvi,Comparative Study of Perineal Laxity and
YoniVyapadas, International Journal of Health Sciences and Research;2018(5)
ISSN: 2249-9571
7. Sushruta Samhita Ayurvedtatvasandipika, Kaviraj Dr. Ambikadutta shastri part 2,
Chaukhambha Sanskrit Sansthan Edition: 2014;205:211
8. A Comprehensive treatise on striroga gynaecology written and Illustred by Dr.
Hemalatha Kapoorchand, Chaukhambha vishvabharti academy, Edition
2018;282:283
9. MadhavaNidana, Acharya VijayrakshitKanthdatta‗MadhukoshavyakhyaVibhushit
a‘,Sarasvati Publication Ahmedabad, 2003-2004 Edition; 514
10. Yogaratnakar, Hindi Commentary, Dr.Indradev Tripathi, Dr. Dyashankar Tripathi,
Chowkhamba Krishnadas Academy Varanasi, Edition: 2007;(809):815
11. Howkins & Bourne (2005), Shaw's a Textbook of Gynecology. Menopause,
Reprinted, edit., Published by ELSEVIER, Pp. 56-67 2.
12. Charak: Charak samhita with Ayurveda dipika commentary of chakrapanidatta,
chaukhamba, Sanskrit sansthan 5th edition, Varansi
13. Vagbhata – Asthanga Hridya with the commentary sarvangasundra of Arunadatta
and Ayurvedasyma o fHemadri, choukhamba orientlia, Varansi

***

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 PSYCHOLOGICAL PROBLEMS IN GERIATRIC WOMEN
AN AYURVEDIC REVIEW

Dr.Diksha Shrikant Kesur

B.A.M.S. M.S. (Prasutitantra and Streeroga)
G.A.C. Osmanabad
Mob. No. 8999449350
E-mail: dikshakesur@gmail.com

ABSTRACT-
Geriatrics is a branch of medical science concerned with the diagnosis, treatment and
prevention of disease in elderly people and the problems specific to ageing. In India, the
population of elderly people is growing exponentially and among them women are larger
in number (52% >60 years and 55% >80 years age groups). Women go through many
physical and psychological changes during their lifespan. The most affected aspect
among many other factors is the ―Psychological‖ aspect. Even in this modern era, India
still remains a male dominant society, which highly affects mental health of women.
About 15% of adults aged 60 and above suffer from a mental disorder and elderly women
are more prone to develop psychological problems than men. The commonly seen
psychological disorders are Insomnia, Depression, Anxiety, Dementia, Alzheimer‘s
disease, etc. Along with physical and mental health, emotional health of elderly women is
very important. Because of many hormonal changes, as in menopausal stage, taking care
of their mental health becomes utmost important. Ayurveda can prove to be a ray of hope
in such situations as it provides a holistic approach for elderly women to overcome the
psychological problems at this age.
KEYWORDS: Geriatric women, Psychological problems, Ayurveda
INTRODUCTION:
Ageing is the sequential or progressive change in an organism that leads to an
increased risk of debility, disease and death. Senescence consists of these manifestations
of the ageing. India is now labelled as the ―Ageing Nation‖ and this exponential rise in
elderly population is due to impressive gains that society has made in terms of increased
life expectancy. With the rise in elderly population, the demand for holistic care tends to
grow. Census 1991 showed the elderly female population (29.4 million) outnumbered
elderly males (27.3 million). The NSO Report said this trend has strengthened in the last
two decades. The elderly female population is now projected to rise to 100.9 million in

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2031, while elderly male population may rise to 92.9 million. Indian women face many
difficulties in their day to day life making them more vulnerable to psychological and
systemic disorders because physical health affects mental health and vice versa. Mental
health of geriatric women is often masked underneath their physical health, including
hormonal changes. So special emphasis should be given on improving mental health
status of elderly women. Commonly seen psychological disorders in this age are anxiety
and depression while the cognitive functions majorly affected are attention and memory.
Elderly women are twice more prone than men to develop Psychological problems and
paranoid disorders. Thus,for the geriatric women to have a strong emotional and
immunological status, Ayurvedic Geriatric Care can play a wonderful role. Many
Ayurvedic herbs and compound preparations are useful to improve cognitive functions,
reduce chronic stress, cure insomnia and have good results on other disorders like
Alzheimer‘s disease, Parkinsonism, etc.
CONCEPT OF AGEING IN AYURVEDA-
In Ayurveda, the term ―Jara‖ is used to denote old age. Division of life span is given
by Acharya Sharangdhar which can be applicable to both men and women. The
distribution of old age, specific loss from the body at that particular age and which
Rasayan can be used for these changes is described.
Table: Age related degenerations and accordingly preventable rasayanas

Sr. No. Decades Age-related bio- Restorative Rasayanas

(yrs.) losses
(Loss of….)
1 51-60 Vision (Drishti) Triphala,
Jyotishmati,Shatavari
2 61-70 Virility (Shukra) Kapikacchu, Ashwagandha
3 71-80 Strength (Vikram) Bala, Shilajeet,
Ashwagandha
4 81-90 Cognitive power Brahmi, Mandukparni
5 91-100 Locomotive ability Bala, Ashwagandha

All these degenerative processes lead to many psychological and emotional changes in
women. The changes in body, impairment in various systems of body can be hard for
some women to accept. These physical changes lead to mood changes, which if not
treated or looked upon in time can lead to serious psychological disorders.
The restorative rasayanas can be helpful in keeping the severe changes in check.
Rasayan especially deals with the science of nutrition, geriatric care and rejuvenation.

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Less the effects of degenerative process, less stress will be faced by the women while
coping up with old age.
PSYCHOLOGICAL PROBLEMS IN GERIATRIC WOMEN-
1.DEPRESSION:
Its is a common psychological disorder seen in elderly women which is characterised
by sadness, loss of interest, pleasure, poor appetite, low energy and poor concentration.
Difficult situations like chronic medical problems or death of spouse can lead to
depression. ―Avasada‖ is the term used for depression in Ayurveda. Medicines like
Saraswatarista, Ashwagandharista, etc along with practicing pranayam can help in mood
elevation in depressed elderly women.
2.ANXIETY:
Common fears about ageing can lead to anxiety. Many older women are afraid of
being victimized, being dependant on others, being left alone and death. Various
hormonal and health changes bring in anxiety. Anxiety is denoted as ―Udvega‖ and
Brahmi vati, Smrutisagar rasa Ashwagandha churna along with Suryanamaskar etc. can
help in reducing anxiety.
3.INSOMNIA:
Insomnia is difficulty in sleeping or maintaining sleep which leads to adequate or
poor quality of sleep. It is one of the most common sleep disorders in elderly women.
Chronic insomnia can lead to anxiety, depression, severe fatigue and lack of
concentration. Ayurveda has classified it under Vatananatmaja vikara as ‗Nidranasha‘. In
such cases, lifestyle changes like Madhur rasa aahara sevan, warm bath, consumption of
buffalo milk at bedtime can be helpful. Certain medicines which help in improving
quality of sleep are- Sarpagandha vati, Manasmitra vatak, Brahmi ghrita, Syrup
Shankhapushpi.
4.MENOPAUSAL SYNDROME-
Menopause is the natural cessation of a woman‘s menstrual cycle leading to a
hormone deficient state that occurs at the age of 45-55 years. Several studies have shown
that depression and anxiety are the most common psychiatric symptoms in women with
symptomatic menopausal transition. It might be a risk factor for subsequent clinical
depressive and anxiety disorders. Withdrawal of hormones may cause a change in the
serotonin level- which is a ‗happy hormone‘ and thus these mood disorders are
aggravated in elderly women. To cope up with this state, we can use herbs containing
phytoestrogens like Shatavari, Ashoka, Yashtimadhu, Ashwagandha, Vidari, Tila,

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Methika, Rasona, etc. These phytoestrogens bing to estrogen receptors, thus producing
estrogenic effect and help in alleviating symptoms of menopausal transition. Other
Ayurvedic formulations like Shatavari kalpa, Ashwagandharista, Chandraprabhavati can
be useful.
5.SENILE DEMENTIA AND ALZHEIMER‘S DISEASE-
Dementia is characterised by progressive impaired cognitive function affecting an
individual‘s ability to maintain normal social or occupational function. Higher mental
functions are affected first in the process in dementia. In later stages the affected places
are disoriented in time, place and person. Alzheimer‘s disease is the leading cause of
dementia. Recent studies have shown that Medhya Rasayan can help in improving
cognition and memory and has neuro-regenerative effect. Brahmi is now established as a
memory enhancer and has therapeutic role in management of senile dementia.
RASAYANA THERAPY:
Keeping in mind the above psychological problems certain rasayanas can be helpful.
 Anti-Ageing remedies:
Amalki, Ashwagandha, Guduchi, Brahmi, Chyavanprasha
 Single herb Rasayana:
Ashwagandha, Shatavari, Mandukparni, Shakhapushpi, Yashtimadhu, Guduchi,
Amalaki, Pippali, Haritki, Bhallataka
 Compound Formulations:
Brahma rasayana, Amalaki rasayana, Vasantkusumakar rasa, Makardhwaj, Shilajit vati,
Saraswatarista, Ashwagandhadi lehya.
CONCLUSION:
Ageing is a biological phenomenon and with increased longevity, the age-related
psychological disorders are increased in elderly people in 21st century and among them,
women are more in number. It is necessary to throw light on mental status of elderly
women. Their problems and needs should be understood and steps should be taken
accordingly to help them overcome their psychological problems. It can be done with
help of proper counselling, Ayurvedic medicines and meditation.
REFERENCES:
1. Sarangadhara Samhita, Chaukhamba, Varanasi, Sa.S.Purvardha 6/19.
2. Chaudhari K. Murthy ARV (2014) Effect of rasayan on mental health- a review
study. International Journal of Ayurveda and Alternative medicine 2:1-7.

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3. Garima and Kamini Diman: Psychological problems of geriatric women: A beacon
of hope in Ayurveda. International Ayurvedic Medical Journal:Volume 7, Issue 9,
September- 2019.
4. Amit Kumar Rai, Geriatric: A ray of hope in Ayurveda- World Journal of
pharmaceutical research, Volume 3, Issue 9,335-351.

***

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 Sthanik chikitsa (local treatment) in management of postmenopausal
problems
Dr. Umesh Rameshchand Lunawat
Ph.D. Scholar, Department of Streerog & Prasutitantra,
Dr. D.Y.Patil
College of Ayurved and Research Centre, Pimpri,
Dr. D.Y.Patil
Vidyapeeth Pune, Maharashtra, India. And Asso. Professor and Head,
PTSR department, Jupiter ayurved medical college, Nagpur.
Emai: umesh.lunavat@gmail.com
Dr. Jayashree Patil
Guide and H.O.D., Department of Streerog & Prasutitantra,
Dr. Aarifa Shaikh
Asso. Professor, SGR Ayurved College, Solapur, Maharashtra, India
Email: aarifashaikh2685@gmail.com

Abstract:
Though India is the largest country with youth population, the percentage of cohort of
elder population increases since last decade due to increased life expectancy and standard
medical facilities. Elder women outnumber more than elder men due to gender difference
in life expectancy. Geriatric syndromes means cohort of health issues related to old age.
Women during her perimenopausal and postmenopausal age suffers from many health
issues like atrophic vaginits, genital prolapse, pshychological problems, dementia, sleep
disorders, urinary incontinence and increased risk for cardiovascular and cerebrovascular
diseases. Health professional have to formulate protocol for proper care and medical
facility to elder women. Many local therapies are indicated for management of issues of
old age. In ayurveda along with rasayan chikitsa(rejuvenating treatment) many local
therapies are mentioned which can be used for management of geriatric syndromes.
Murdhnitail, hrudbasti, yonipichu, yoniparishek, yonidhawan, yonilep, yonipuran,
yonilep, yonivarti, yoniabhyang, uttarbasti can be advised as per need of geriatric issue
with appropriate ayurvedic formulations.
Keywords: Geriatric women, geriatric syndrome, sthanik chikitsa, menopause
1. Introduction
As per the latest UN report, India has the world‘s largest youth population despite
having a smaller population than China. Every third person in an Indian city today is
youth, and thus India is said to be youngest country in world.(i) Though, youth
populations contributes a major portion of population, the cohort of elder peoples also
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increasing since last few years as a result of increase in life expectancy, quality medical
facilities and reduction in fertility rates. Most of world‘s aging women are living in
developing countries. In India, Life expectancy for males is 70.4 years and for females
71.8 years.(ii) Gender difference in life expectancy implies that the population of elder
women is more than older men. As a population of elder women increases, the health
professionals have to be ready to provide adequate and special medical facility to health
problems of such cohort.
Elder women have to face many general and reproductive health problems. Many
countries, facing new challenges and burden on health cost associated with health issues
of elder population. Health sector tries to formulate new policies and guidelines for care
of elder cohort of population.
Data on health status of postmenopausal women is not much available for developing
countries. As compare to elder men, the rate of certain chronic diseases such as
osteoporosis, arthritis, diabetes, hypertension is significantly higher in elder women.
About one third of life span will be spent during the period of estrogen deprivation stage
with long term symptomatic and metabolic complications. Though menopause is
physiological stage of female life, she has to face many local health concerns like uro-
genital atrophy, sexual dysfunctions and systemic concerns related to cardiovascular
system, cerebrovascular system, psychological problems, osteoporosis and fractures.
Problems of postmenopausal women can collectively term as geriatric syndrome.
Postemopausal symptoms management includes use of non hormonal and hormonal
medicines, which can be given by systemic or local route.
Table 1: Health problems of elder women in postmenopausal age: (iii)
Systemic Health concerns Local Health Concerns
Related to Urogenital system Related to other system
Anxiety Dysparunia Hot Flushes
Insomnia Vaginal dryness Thinning and wrinkling of skin
Irritability Atrophic vaginitis Thinning of Hairs
Insomnia Decreased sexual desire Malignancies – Breast
Depression Dysuria
Dementia, Alzheimer disease Recurrent urinary infection
Mood swing Urinary incontinence
Osteoporosis and fracture Genital Prolapse
Cardiovascular diseases like Infections, STIs
strokes, IHD, CAD
Atherosclerosis Malignancies – Cervical,
Endometrial, Ovarian
Cerebrovascular diseases

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 In ayurveda, rasayan chikitsa (rejuvenating treatment) is advisable for elder age
group. Many formulations are mentioned in ayurvedic literature under rasayan chapter.
Health concerns in geriatric syndromes can be managed well with ayurvedic formulations
which can be administered internally or locally. Chikitsa (treatment) can be broadly
classified as abhyantar chikitsa (internal medicine) and sthanik chikitsa (local treatment).
2.Management of health concerns of elder women
2.1 Rasayan Chikitsa (Rejuvenation treatment)
Rasayan therapy promotes healthy life by preventing disease, improves immunity,
strength, vitality, memory, intelligence and works like rejuvenation.(iv) Rasayan therapy
can be used as preventive as well as therapeutic for geriatric syndrome. Health of elder
peoples depends on their health status in earlier period of life. Adopting principles of
dincharya (principles of daily routine), rutucharya (principles as per season) and rasayan
chikitsa from younger age will be helpful for better health status in elder age.
2.2 Sthanik Chikitsa (Local route of drug administration):
Local application of ayurvedic formulation like decoction, medicated oils, ghee etc.
is as important as internal rejuvenating formulations. Local symptoms will resolve more
rapidly with local application of drug as high concentration of drug is expected to act at
target organ than internal medication. Drugs show faster and efficient action on local
organs when applied locally. Ayurveda describes many local treatments for
gynecological as well as other disorders. We can summarize such local treatment as per
problems as geriatric syndrome in women as follows:
Table 2: Sthanik chikitsa (local treatment) for various menopausal symptoms
Health Concern Local treatment Meaning
Psychological Problems Moordhnitaila :- Application of medicated oils
Sleep disorders Shiro-abhyang over head in different ways
Shirodhara
Shiropichu
Shirobasti
Cardiovascular problems Hrud-basti Medicated luke warm oil is
poured into a well made from
black gram paste over precordial
region for a specified time.
Skin dryness, thinning etc Abhyang Massage with medicated oil
Osteoporosis Basti Transrectal administration of
medicated milk, oil, ghee
Urinary Problems Uttarbasti Administration of medicated oil
or decoction through urethra

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 Genital Problems Yoni Pichu Tampon soaked in medicated oil
inserted in vagina and withheld
for specific period
Yoni Dhawan Cleansing of vaginal canal with
decoction or medicated oil
Yoni Varti Insertion of herbal pessary in
vagina
Yoni parishek Cleansing of vulval part with
decoction or medicated oil
Yoni dhupan Fumigation of perineum with
herbal medicines
Yoni Abhyang Local application of medicated
oil over vulval and vaginal
region
Yoni Lep Application of paste of herbal
drug powder over vulval or
vaginal area
Yoni Puran Filling of vaginal canal with
medicated oil / kalka (Paste of
powdered drugs)
Yoni kalka dharan Insertion of paste of herbal
powder in vaginal canal
Uttarbasti Intrauterine administration of
decoction or medicated oil

a.Psychological issues: Elder women suffer from anxiety, depression, dementia, sleep
disturbance, irritability and mood swings during peri-menopausal and postmenopausal
period. Rasayan dravyas improves memory, intelligence. Murdhnitail (application of oil
over head in different way) is the local treatment described in ayurvedic classics. Sesame
oil, oil medicated with jatamansi (Nardostachys jatamansi), Himasagar tail can be used
for this purpose. Kshirdhara (pouring a cow milk on forehead by specific method for a
specified time) (ajay kumar et al 2007, university of rajasthan), jaldhara (pouring water
on forehead by specific method for a specified time), takradhara (pouring a curd on
forehead by specific method for a specified time) (B. G. Gopinath et al RGUHS, 2003)
gives significant result for insomnia, sleep disorder and irritability.
b.Cardiac problems: Hrudbasti is the local therapy in which medicated luke warm oil is
poured into a well made from black gram paste over precordial region for a specified
time. It is said to be beneficial for cardiac disorders, atherosclerosis, coronary artery
blockages, palpitation etc. Cardiac complications are more common in elder women in

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postmenopausal period. Hrudbasti therapy can effectively used to overcome these cardiac
problems.
c.Skin and hair problems: Dryness of skin and hairs, hair fall are common problems in
elder age group. There is predominance of Vata dosha in old age which aggravates such
condition. Oleation is ideal treatment for disorders of vata dosha. Abhyang (oleation)
with medicated oils helps to take of these problems.
d.Genito-urinary problems: Repeated child birth, poor access to facilities for the repair
of birth injuries, poor hygiene, untreated genitor-urinary tract infections are common
reasons for genitor-urinary problems in elder age group women. Dysuria, urinary
incontinence is a common problem in elder woman. Along with internal medicine
uttarbasti (transurethral administration of medicated oil in urinary bladder) had
significant result for urinary problems. It helps to alleviate vata dosha. It provides
strength to bladder and urethral sphincter. Ashwagandha (Withania somnifera) tail
uttarbasti shows significant result in stress incontinence (Patil netra K et
al.AYUSHDHARA, 2020:7(suppl 1):81-84).
Genital prolapse, reproductive tract infections, atrophic vaginits, dysparunia are
common gynecological issues in elder postmenopausal women. For local application of
medication over genital tract many local therapies are mentioned while describing
treatment for gynecological disorders. Local therapies mentioned in management of
reproductive system disorder are yonipichu, yoniabhyang, yonidhawan, yonivarti,
yonilep, yonipuran, yonidhupan, yoniparishek and uttarbasti. Many ayurvedic
formulations mentioned in ayurvedic texts for used as local therapy in different ways.
Some of commonly used formulations as local therapy for genito-urinary issues are
enlisted below;
Table 3: Commonly used ayurvedic formulations for menopausal problems
Indication Local therapy Ayurvedic formulation
Atrophic vaginits Yoniabhyang Til tail (sesame oil)
Yonipichu Uttarbasti Shatapushpa tail, shatavari tail
Kashmaryadi ghrut Jeevaniyavarg siddh tail
Jeevaniyavarg siddha dugdh
Genital Prolapse Yonipichu Mushaksiddha tail Changeryadi ghrut
Yoniabhyang Chukra tail Traivrut sneha Lajjalu Churn
Yonilep Uttarbasti Traivrut sneha Vasa,Goghrut yonipuran
Yonipuran
Genital infection Yonidhawan Triphala Kashaya Panchvalkal kashaya
Yonivarti Kushtha-pippalyadi varti Pippalyadi varti
Yonipichu Shodhan tail

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 Yoniabhyang Dhatakyadi tail Jatyadi ghrut / tail
Yonikalka dharan Triphala kalka Hinstra kalka
Uttarbasti Shyama-trivrut kalka
Urinary Yonipichu Bala tail Ashwagandha tail
incontinence Uttarbasti
Cervical erosions Yonipichu Jatyadi ghrut / tail
LSIL Uttarbasti Ropan tail Apamargkshar
Ksharkarm (local
application of kshar

2.3 Local therapy as part of Menopausal Hormone Therapy (MHT)

―Menopausal hormonal therapy‖ (MHT) or ―hormonal therapy‖ (HT), previously
termed as ―hormone replacement therapy‖ (HRT) is the term used to denote management
of menopausal health issues with replacement of estrogen or estrogen with progesterone.
Primary goal of estrogen replacement is to relieve vasomotor symptoms and genito-
urinary problems like vaginal dryness, atrophic vaginitis, recurrent urinary tract infection
etc. Estrogen can be used in form of vaginal gel, vaginal rings.(v)
3.Discussion:
Geriatric syndrome can be effectively managed by internal medication described in
rasayan chikitsa (rejuvenating treatment) chapter and by local medication (sthanik
chikitsa). While describing treatment of yonivyapad (disorders of female genitals), most
of formulations are advised to administer by transvaginal route as local therapy. The
purpose behind this vaginal route may be for better efficacy of drug, more absorption and
high concentration of drug in local genital organs for better recovery and to avoid
systemic adverse effects of drug, if any.
Hormone replacement, either by systemic or vaginal route, is the primary goal for
management of menopausal symptoms. Hormone replacement by vaginal route is more
preferable than systemic due to minimal side effects. Also vaginal epithelium had higher
concentration of estrogen receptors, which facilitate fast action of estrogen.
Vaginal drug administration is a part of Topical Drug Classification System (TCS). It
is used as a route for local action of drug in cervico-vaginal region. In recent years, the
vaginal route has been rediscovered as a potential route for systemic delivery of
therapeutically important macromolecules.(vi)
Drug absorption through vagina get influenced by thickness by vaginal epithelium,
vaginal fluid volume and composition, pH of vagina and sexual arousal. The

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physicochemical properties of administered drug like molecular weight, lipophilicity,
ionization, surface charge, chemical nature also affects absorption of drug.
Supportive reasons for selecting vaginal route for drug administration are:
i. Mucosal surface with rugae provides a large surface for drug absorption.
ii. Arteries, blood vessels, lymphatic vessels are abundant in the walls of the vagina.
iii. Dense network of blood vessels in vagina made it an excellent route for drug
delivery for both systemic and local effect.
iv. Vaginal epithelium had higher concentration of estrogen receptors, which
facilitate fast action of estrogen.
v. Reduced vaginal epithelial thickness in postmenopausal women facilitates
maximum drug absorption through thin epithelium.
vi. Vaginal progesterone absorption in estrogen deficient women who were receiving
vaginal estrogen therapy was found to be increased, although prior estradiol
therapy should have caused an increase in vaginal epithelium thickenss.
vii. The absorption of progesterone was increased with increased vascularity of the
vagina.
viii. For better efficacy of drug, long term retention of drug formulation in vaginal
cavity is necessary. In different forms of local treatment modalities, the drug is
advised to retain in place for specific period of time.
ix. Ideally a vaginal drug delivery system that is intended for local effect should
distribute uniformaly throughout vaginal cavity. In yonipuran, yonilep,
yoniabhyag the drug is advised to uniformaly distribute throughout vaginal cavity.
x. Rapid drug absorption and quick onset of action can be achieved with vaginal
route.
xi. The vaginal bioavailability of smaller drug molecule is good.
xii. The bioavailability of larger drug molecules can be improved by means of
absorption enhancer or other approach.
xiii. Hepatic first pass elimination of high clearance drugs may be avoided partially.
xiv. Effective route for delivery of hormones

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4.Conclusion:
Geriatric syndrome in menopausal women can be effectively treated with rasayan
chikitsa (rejuvenating treatment). Different forms of local therapy mentioned in
ayurvedic classics which can be judiciously used for management of menopausal
syndrome as per need. Local route of drug administration has its own additional benefits
and it is as important as internal medication.
5.References:
i) https://economictimes.indiatimes.com/news/politics-and-nation/india-has-worlds-
largest-youth-population-un-report/articleshow/45190294.cms?from=mdr,
4/10/2021
ii) https://www.worldometers.info/demographics/india-demographics/ 4/10/2021
iii) D.C.Dutta, Textbook of gynaecology, New central book agency, fifth edition,2008
page 57
iv) Vidyadhar shukla, ravidatta tripathi, Charak samhita, part II, verse 7-8 chapter 1/1,
page no-5, Chaukhamba Sanskrit pratishthan, Delhi, 2004.
v) https://www.uptodate.com/contents/treatment-of-menopausal-symptoms-with-
hormone-therapy 6-10-2021
vi) Ashok vadithya et al,A review on vaginal route as a systemic drug delivery,
Critical review in pharmaceutical sciences, Issue 1: April 2012
(https://www.researchgate.net/publication/224318371_A_review_on_vaginal_rout
e_as_a_systemic_drug_delivery)

***

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 IDEAL LIFESTYLE FOR GERIATRIC WOMEN
Dr. Megha Rathore
Dr. Manjusha Karkare
PG Scholar, Dept. of Stree Roga & Prasuti Tantra,
Parul Institute of Ayurved, Parul University.
HOD, Prof., Dept. of Stree Roga & Prasuti Tantra,
Parul Institute of Ayurved, Parul University.

Abstract
Older adults are the fastest growing segment of society, experience the highest rate of
chronic diseases and conditions, and require the highest long-term care costs of all age
groups. Healthy lifestyle is considered an important tool to prevent chronic conditions
and institutionalization in older adults. Older women are more likely than men to have
chronic, or ongoing, health conditions – such as arthritis, high blood pressure, and
osteoporosis. Women are also more likely to develop multiple health problems in old age.
Older women are also more likely to have memory or other ―cognitive‖ problems, and
difficulty carrying out daily activities such as dressing, walking, or bathing without help.
There is substantial evidence from epidemiological studies among older adults that
individual lifestyle factors, including physical activity, alcohol consumption, smoking
behavior, and body weight, are associated with health and functioning. What changes
occurs in old age women, what should be eaten, what investigations or examination
should be done in older aged women, what medications should be prescribed, what do‘s
and don‘ts should be advised what care should be taken are matter of concern. The
elderly's lifestyle is affected by their mental health and can change the pattern of
communication or their presence in social activities. Most of the common diseases in
aging can be prevented by observing a healthy lifestyle. In other word by improving the
lifestyle and improving the level of personal health of the elderly, it can prevent illness
and help to improve their physical and mental health.
Keywords – older women, health, lifestyle, Care, mental health.
Introduction –
The most common gynecologic problems encountered in elderly women are
vulvovaginal inflammation, genital prolapse, postmenopausal bleeding, and alterations in
bladder function.
Geriatric gynecologic disorders generally result from variations in neuroendocrine or
musculoskeletal function. The female genitourinary tract is primarily dependent on

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circulating estrogens: the changes in genital tissues associated with aging reflect the
progressive decline in gonadal-endocrine stimulation.
How to maintain a healthy lifestyle during old age -
1. See the healthcare provider regularly - Even if you feel perfectly healthy, you
should see your provider at least once a year for a checkup.
2. Take medications, vitamins, and supplements only as directed.
3. Get screened
 Screenings for colorectal cancer:
 Diabetes check:
 Cholesterol test for high blood cholesterol levels:
 Blood pressure check
 Bone health evaluation
 Depression screening
 Hearing and vision screening
4. Dental check-up
1.5. Get vaccinated - Check with your healthcare provider to make sure you‘re getting:
o A flu shot—every year in late summer or early fall, before the flu season starts.
o Two pneumonia vaccinations: pneumococcal conjugate vaccine (PCV)13 and
pneumococcal polysaccharide vaccine (PPSV)23. Ask your healthcare provider
about when to take the two vaccines
o A tetanus shot: every 10 years
o The shingles (herpes zoster) vaccine: once after age 60 or older
6. Lower the risk of falls and fractures
ADVISES –
 Use sunscreen daily
 Quit smoking.
 Drink in moderation
 Exercise.
 Exercise for brain
Steps to Aging Well
1. Stay Physically Active for a Healthy Body and Mind
2. Stay Socially Active With Friends and Family and Within Your Community

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 3. Follow a Healthy, Well-Balanced Diet
4. Don't Neglect Yourself: Schedule Checkups and Stick to Them
5. Take All Medication as Directed by the Doctor
6. Limit Alcohol Consumption
7. Quit Smoking to Lower Your Risk of Cancer and Heart Disease
8. Get the Sleep That Your Body Needs
9. Practice Good Dental Hygiene Every Day
Warning Signs Shouldn‘t be Ignored –
 Abrupt weakness or dizziness
 Shortness of breath
 Pressure in your chest area
 Tingling or numbness, especially on just one side of your body
 Loss of balance or coordination
 Difficulty speaking or swallowing
 Excessive sweating
 Sudden vision loss or blurred vision
 Marked swelling, even when you don‘t have any recent injuries
 Rapid weight loss
 Prolonged confusion
 Wounds that never seem to heal
Benefits of Yoga in Geriatric age group –
 Yoga provides a good balance, blood stream and tissue liveliness, enhance
flexibility and core stabilization. If the person attends the Geriatric Yoga
programme regularly, many problems, which are caused by age, can be prevented
 It is possible to reload the most essential brain functions with the relaxing
characteristic of Yoga
 The person gains experience with his own existence, body and mental
performance during the sessions in Yoga practices. He learns to control his body.
He analyzes his emotional status about his problem. He gains ability to cope with
the symptoms faced
It reduces sympathetic activity with relaxing techniques. Pain, fatigue, depression and
stress decrease with relaxing response. Memory becomes retentive.
Asanas: Surya Namaskar, Pavanamuktasana, Ardha Matsyendrasana, Bhujangasana and
Shavasana.

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Pranayama: Nadisodhana, Kapalbhati, Bhramari, Neti, Bhastrika and Tratak.
Mudras: Khechari mudra removes diseases and old age problems. Dharana, Dhyana,
Swadhyaya and Iswara Pranidhana.
Rasayana
Mandukaparni, Yastimadhu, jatamansi, Brahmi Rasayana,
Ashwagandha Lehyam, Maha Triphala Ghrita, Triphala Churna,
Ashwagandha Churna, Narasimha Rasayana, Agastya Rasayana, Amalaki Rasayana,
Guggulu, Sallaki, Guduchi.
Discussion -
A healthy lifestyle is a way of life that provides, maintains, and promotes the health
and well-being of the people. On the other hand, a healthy lifestyle is a way of life that
reduces the risk of severe illness or early death, helping to enjoy more aspects of our
lives. In other word by improving the lifestyle and improving the level of personal health
of the elderly, it can prevent illness and help to improve their physical and mental health.
This should be emphasized since older women often neglect early symptoms of
gynecological diseases, some of which are potentially lethal. So regular gynecological
evaluation in older women is an intregal part of medical care.
References –
1. http://www.ncbi.nlm.nih.gov/pubmed/19876492
2. 2.http://www.heraldopenaccess.us/fulltext/Alternative-Complementary-&-
Integrative-Medicine/Geriatric-Care-in-Ayurved-Evidence-Based-Review.php
3. Ambikasdutta S (2007) Sutra Sthan 35/35, Sushruta Samhita, Chaukhamba
Sanskrita Sansthan, Varanasi, India 1: 134

***

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 Review of herbs used in geriatric women
Review of ayurvedic herbs used in geriatric women
Shriya Sunil Deo
Dr. Apoorva Sangoram
1 PG Scholar,
2 HOD and Guide, Dravyaguna Vigyan,
Tilak Ayurved Mahavidyalaya, Pune
Mobile No- 8975493581

ABSRACT-Background-Ayurveda is a science of life and longevity. According to the

Ayurveda, ageing is outcome of kala or parinama. Vata dosha is the most important
factor in the pathophysiology of ageing obviously because of its natural predominance at
that stage of life. Moreover, geriatric women face various health issues such as heart
disease, cancer, stroke, diabetes, Alzheimer‘s disease, arthritis, obesity, post-menopausal
symptoms, atrophic vaginitis etc. Ayurveda has suggested many herbs for delaying the
process of ageing and age-related diseases. Prevention and management of health
problems in geriatric women can be achieved with the use of ayurvedic herbs. Present
article has focused on enhance knowledge of Ayurvedic Herbs used in geriatric women.
Material and methods- Literature regarding herbs is reviewed from Nighantus, text
books, research articles and websites. Haritaki, Amalaki, Shatavari, Punarnava,
Shaliparni, Kumari these herbs are reviewed. Discussion and conclusion- The herbs
enumerated here are rejuvenative, carminative, digestive, liver stimulants and tissue
replenishers. So, these herbs are effective in various geriatric health issues and in
degenerative joint disorders as well as neuromuscular disorders.
Key words: Ayurveda, herbs, geriatric women, diseases, ageing, menopause.
INTRODUCTION- Aging is the process of decaying and this manifests in the form of
various degenerative changes. Although these changes are natural, they are not pleasant.
Everyone is aware that a person who has taken birth must grow and finally die, but
nobody wants to grow old and certainly no one wishes to die. It is the nature of a human
being. Ayurveda considers ageing as the swabhava of life. Hence what all is needed is to
retard the rate of aging to a limited extend and to promote healthy aging. Senior women
are at greater risk than men for many conditions and are affected differently by many
diseases that impact both sexes. There are numerous herbs in Ayurveda which can be
used in prevention and management of geriatric diseases. Main aim of present article is to
review ayurvedic herbs used in geriatric women diseases.
AIM AND OBJECTIVE- To review ayurvedic herbs used in geriatric women.

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MATERIAL AND METHODS- Literature regarding herbs is reviewed from Nighantus,
text books, research articles and websites.
As per fundamental principles of Tridosha, vata is the predominant dosha during old
age.1 It precipitates atrophy and involution of tissues and is responsible for most of the
manifestation of ageing. With the advancing age, the depleted agni leads to decrease in
the vigor and vitality with decay and atrophy due to defective metabolism. During this
period, there is gradual decline of all the dhatu, virya, indriya, ojas, bala and utsaha.
Ayurveda considers ageing as the Swabhavaja vyadhi i.e., it is inherent nature of the
living being to get old.
Following are common disorders of geriatric women.2
1. Menopausal Syndrome
2. Urinary Incontinence
3. Indigestion
4. Constipation
5. Respiratory Disorders
6. Hypertension
7. Parkinsonism
8. Senile Dementia & Alzheimer‘s disease
9. Insomnia
10. Osteoarthritis and osteoporosis
11. Diabetes Mellitus
Following herbs can be used in geriatric women diseases-

1) Haritaki -हयनत योगान ् /भरान ् इनत हयीतकी |

L. N- Terminalia chebula

हयीतकी ऩञ्चयसाऽरवणा तुवया ऩयभ ् |

रूऺोष्णा दीऩनी भेध्मा स्वादऩ

ु ाका यसामनी |

चऺुष्मा रघुयामुष्मा फंह

ृ णी चानुरोशभनी ||

शवासकासप्रभेहाशि्कुष्ठशोथोदयक्रक्रभीन ् |

वैस्वमिग्रहणीयोगपवफतधपवषभज्वयान ् ||

गुल्भाध्भानतष
ृ ाछददि दहक्काकण्डूरृदाभमान ् |

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 काभरां शर
ू भानाहं प्रीहानञ्च मकृत्तथा |

अशभयीभूिकृच्रं च भूिाघातं च नाशमेत ् ||(बा. प्र. नन.) 3

Charaka has mentioned Haritaki in Vayasthapana, mahakashaya. Since it is mentioned

in vayasthapana mahakshaya, it delays the process of ageing. It acts as rasayana,
chakshushya, dipana, hridya, medhya, vatanumolana. It elevates the bala of mansadhatu,
due to mansadhatu balavardhana it prevents dhatukshaya, balakshaya and its related vata
prakopa. It acts as indriyaprasadhak and dhatuprasadhaka, so it promotes longevity. It
strengthens muscles. It is beneficial in hridroga, prameha, udavarta and vibhanda.4

2) Amalaki- आभरते धायमनत शयीयभ ् वा यसामनगुणान ् |

L.N- Emblica Officinalis

हयीतकीसभं धािीपरं क्रकततु पवशेषत् |

यक्तपऩत्तप्रभेहघ्नं ऩयं वष्ृ मं यसामनभ ् ||

हष्तत वातं तदम्रत्वाष्त्ऩत्तं भाधुमश

ि ैत्मत् |

कपं रूऺकषामत्वात्परं धात्र्माष्स्िदोषष्जत ् ||(बा. प्र. नन.)5

Charaka states of all the rasayanas, Amalaki is referred as one of the most potent and
nourishing. Amalaki is the best among rejuvenative herbs. Its primary quality and main
therapeutic benefit is vayasthapana. It is the main ingredient of many rejuvenating
compositions like Chyavanprash, a classical ayurvedic formulation which has been used
as a tonic for the young and old for centuries. It acts as rakta vishodhaka, rakta prasadaka,
dhatu shodhaka and varnya. Due to its dhatushodhana property, it excretes the mala of
doshas and dhatus from body thus it enhances dhatubala.6 It is beneficial in prameha,
rajayakshma, pradara and netra rogas.

3) Punarnava- शयीयशच दृष्ष्िं ऩुननिवं कयोतीनत |

L. N- Boerhavia diffusa

ऩन
ु निवा शवेतभर
ू ा शोथघ्नी दीघिऩत्रिका |

किु कषामानुयसा ऩाण्डुघ्नी दीऩनी ऩया |

शोपाननरगयशरेष्भहयी व्रण्मोदयप्रणुत ् || (बा. प्र. नन.)7

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 Prameha, shotha, arsha, kasa, shwasa these are some of geriatric diseases caused due
to excessive elevation of vata dosha (vata prakopa). Punarnava prevents vata prakopa and
decaying of dhatus (dhatukshaya) by proper excretion of sharirastha mala thus it
stabilizes and strengthens dhatus. It acts as vatanulomaka, mutrala, vayasthapana and
dipana.It is beneficial in pandu, hridroga, shwasa and shopha.8

4) Shatavari- शतेन आवण

ृ ोनत इनत |
L. N- Asparagus racemosus

शतावयी गुरु् शीता नतक्ता स्वाद्वी यसामनी |

भेधाऽष्ग्नऩुष्ष्िदा ष्स्नग्धा नेत्र्मा गुल्भानतसायष्जत ् |

शुक्रस्ततमकयी फल्मा वातपऩत्तास्रशोथष्जत ् ||(बा. प्र. नन.)9

It is well known as 'Queen of herbs'. This herb referred as ayurvedic rejuvenative

tonic for the female. It stengthens the uterus. It helps to remove pathogens and other
toxins from the body.Aids in digetion and also boosts the immune system. It helps to ease
menopausal symptoms and maintain normal hormone levels within the body. It boosts
energy and strength.10 It acts as balya, hridya, medhya, rasayana, chakshushya and
dipana. It is beneficial in arsha, grahani, atisara, gulma, rakta roga, vatashonita etc.

5) Shaliparni- शारस्मेव ऩणाितमस्मा् |

L. N- Desmodium gangeticum

शाशरऩणी गुरुशछददि ज्वयशवासानतसायष्जत ् |

शोषदोषिमहयी फंह
ृ ण्मुक्ता यसामनी |

नतक्ता पवषहयी स्वाद्ु ऺतकासकृशभप्रणुत ् ||(बा. प्र. नन.)

It acts as dhatu bruhan due to madhur rasa, nourishes all dhatus and increase oja with
madhur, snigdha guna. Also, it acts as rasayana. By madhur, snigdha and guru guna it
does dhatupushti and by tikta ushna guna it does dhatwagni deepana. Moreover, Charaka
has mentioned shaliparna as shothahara. It is beneficial in jwara, prameha, hridroga, vata
vyadhi, vedana, shopha and daha.

6) Kumari- कुभायमनत क्रीडते, कुभाय क्रीडामाभ ् |

L. N- Aloe vera

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 कुभायी बेदनी शीता नतक्ता नेत्र्मा यसामनी |

भधुया फंह
ृ णी फल्मा वष्ृ मा वातपवषप्रणुत ् ||

गुल्भप्रीहमकृद्वपृ िकपज्वयहयी हये त ् |

ग्रत्मष्ग्नदग्धपवस्पोिपऩत्तयक्तत्वगाभमान ् ||(बा. प्र. नन.)

It is termed as 'Bhedini' in many nighantus because excessive intake of kumari can

cause purgation. It acts as balya, bruhan and rasayana.It is helpful in geriatric women for
anemic conditions.It is mainly beneficial in yakrit rogas, pleeha rogas and rakta rogas.
Also beneficial in jwara, udara roga, vibandha, vedana and gulma rogas.
DISCUSSION -Most of the herbs mentioned above are grouped under vayasthapak gana
of Charka Samhita. The herbs explained under this heading are mostly Madhur/Kashaya
in rasa, Madhur in vipaka and hence they do dhatuposhana. E.g., Amalaki, Shaliparni,
Punarnava etc. Also, the herbs of vayasthapana gana have rasayana property which helps
in overall nourishment of dhatu. Rasayana drugs possess strong antioxidant property.
Acharya Charka has given unique importance to vayasthapana mahakshaya for
maintaining vitality and managing ageing and its allied ill effects. Some herbs like
Shatavari and Kumari mentioned above are mainly helpful in gynecological conditions in
geriatric women. Altogether, the herbs enumerated here are rejuvenative, carminative,
digestive, liver stimulants and tissue replenishers. So, these herbs are effective in various
geriatric health issues and in degenerative joint disorders as well as neuromuscular
disorders.
CONCLUSION -Aging is a natural process; the body is decaying continuously, as
shown by its etymology, that is, Shiryate Iti Shariram. Untimely aging is wholly
preventable if the principles of Ayurveda are strictly followed. Moreover, ayurvedic
herbs have minimal adverse effects so they are best in the management of geriatric health
issues.
REFERENCES-
1. Shastri Ambikadutta Edited Sushruta Samhita of Sushruta with
Ayurvedtatvasandipika commentary. Vol. 1. Chaukhamba Sanskrit Sansthan,
Varanasi. Reprint edition Sutra Sthana, 2007; 35(38): 135
2. Amit kumar Rai, Deepshikha Rai, Geriatrics: A ray of hope through Ayurveda,
Feb 2018.

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3. Khemraj Shrikrishnadas, Bhavprakash Nighantu of Bhavamishra with hindi
commentary of Lalashaligram Vaishya and Pandit Kantinarayan Mishra, Khemraj
Shrikrishnadas Prakashan, Mumbai, Reprint 2019. Pg no. 3
4. Vd. G. A. Phadake, Vd. N. H. Joshi, Dravyagunashastram, 1960. Pg no. 327
5. Khemraj Shrikrishnadas, Bhavprakash Nighantu of Bhavamishra with hindi
commentary of Lalashaligram Vaishya and Pandit Kantinarayan Mishra, Khemraj
Shrikrishnadas Prakashan, Mumbai, Reprint 2019. Pg no. 5
6. Vd. G. A. Phadake, Vd. N. H. Joshi, Dravyagunashastram, 1960. Pg no. 149
7. Khemraj Shrikrishnadas, Bhavprakash Nighantu of Bhavamishra with hindi
commentary of Lalashaligram Vaishya and Pandit Kantinarayan Mishra, Khemraj
Shrikrishnadas Prakashan, Mumbai, Reprint 2019. Pg no. 76
8. Vd. G. A. Phadake, Vd. N. H. Joshi, Dravyagunashastram, 1960. Pg no. 252
9. Khemraj Shrikrishnadas, Bhavprakash Nighantu of Bhavamishra with hindi
commentary of Lalashaligram Vaishya and Pandit Kantinarayan Mishra, Khemraj
Shrikrishnadas Prakashan, Mumbai, Reprint 2019. Pg no. 70
10. Vd. G. A. Phadake, Vd. N. H. Joshi, Dravyagunashastram, 1960. Pg no. 341

***

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 ―ROLE OF AYURVEDA IN THE MANAGEMENT OF
MENOPAUSAL SYNDROME VS HRT‖-A REVIEW ARTICLE
Dr Tejaswini K R
Dr Shruthi M
Dr Nanda K
(1,2,3)Assistant Professor, Dept Of Prasuti Tantra & Stree Roga
JSS Ayurveda Medical College & Hospital,Mysuru-570028
Phone no-08762409110
Email-tejteju9@gmail.com

ABSTRACT:
Ayurveda terms aging as Vradhhavastha (old age) or Jirna (degeneration), signified
by Kshaya (decay). Objective of Ayurveda is to accomplish physical, mental, social and
spiritual well-being by adopting preventive and promotive approaches as well as treating
disease with a holistic approach . Menopausal syndrome does not find mention as disease
in Ayurvedic literature, the reason could be women at that time belonged to a society
which had Ayurveda as its health standard. They entered in old age as kalaja
vridhhavastha (timely aging) and Rajonivritti (menopause) occurring at about age of 50
years passed uneventful.
According to contemporary medical science, this physiological transition from
reproductive to post reproductive life is associated with decline in estrogen levels. Over
time, this decline may be experienced as a change in the skin elasticity, altered cognitive
abilities, hot flushes or flashes, night sweats, menstrual irregularities, and vaginal
dryness. Other symptoms, such as depression, nervous tension, palpitations, headaches,
insomnia, lack of energy, difficulty concentrating, and dizzy spells are also reported.
Osteoporosis is most prevalent in women over the age of 50 as the hormonal influence of
estrogen on bone health dissipates with the onset of menopause. To treat the menopause
means to relieve the discomfort and disorder due to hormone deficiency and at the same
time to ward off degenerative processes of old age or at least to mitigate their effects and
slow down their rate of advance. Hormone replacement therapy (HRT) solves only half
of the problem but to provide optimum physical and mental fitness Ayurveda is the better
option for healthy long life.
Keywords: Menopause, Rajonivritti, Dhatu kshaya, kalaja vridhhavastha.
Introduction:
In Ayurveda, Menopause condition is termed as ‗Rajonivrutti‖ (and menopausal
syndrome as Rajonivruttianubandhajavyadhies). In Ayurved, Menopausal symptom are
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regarded as imbalance of the Dosha[Vata, Pitta, Kapha] and Dhatukshya which occurs as
a natural & gradual consequence of aging. Ayurveda has excellent solution for a safe &
happy transition into menopause. Ayurveda, the science of life, advocates a holistic
treatment of Menopausal syndrome by modification of diet & life style, utilizing various
herbs and minerals and offers a reliable option to the convention treatment. Ayurvedic
treatment for menopause involves correcting hormonal imbalance with appropriate diet,
Samshamana therapy, internal detoxification (Panchakarma therapy), Rasayanthearpyand
Yoga therapy.
• Cause of Menopause1-
1. Menopause is because by the nature declining function of the ovaries.Which
gradually produces lower and lower levels the hormones oestrogen,progesterone,
and testosterone.
2. Other causes include surgery that removes both ovaries or some type of
chemotherapy
• Menopausal symptoms2-
 Hot flushes, Night sweats, Trouble sleeping /Insomnia, Joints pain, Fatigue,
Depression,Palpitation,Vaginal dryness,Mood swing, Loss of libido, Impaired
memory, Urinary incontinence
• Ayurvedic view for Menopause- In Ayurvedic classicsMenopause condition is termed
as ―Rajonivrutti& Menopausal symptoms (Rajonivruttianubandhvyadhies) The whole
term Rajonivrutti means end of Artava Pravritti or cessation of menstruation.
• Rajonivrutti Kala (Age of Menopause )
Though Rajonivrutti as a diseased condition is not described separately in the classic,
Rajonivruttikala is mentioned by almost all Aacharya without any controversy According
to Sushruta and various other references (AstangaHridayam)too 50 years is mentioned as
the age of Rajonivrutti(3,4)when the body is fully in grip of senility. In
AyurvedaMenopausal symptoms are regarded as ―imbalance of the Dosha (Vata, Pitta,
Kapha ) which occurs as a natural and gradual consequence of aging.
•Nidana of Rajonivrutti:
The specific reasons for Rajonivrutti are not described in the Ayurvedic texts. But the
most probable reasons for it to occur are:(5)
(1) Swabhava
(2) Jarapakvasharira due to kala

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 (3) Dhatukshaya
(4) Effect of dosha
(5) Vayu
(6) Abhighata
Menopausal symptoms in Ayurveda:
• (Rajoniviruttianubandhlakshan )(6)-
a) Vata dominant menopausal symptoms- Dryness in vagina, extremities get cold,
difficulty in getting sleep, mild to variable hot flushes (Invariable), anxiety, panic,
nervousness, mood swings, dry skin, palpitations,bloating and constipation
b) Pitta dominant menopausal symptoms-Angry, irritable, excess hot flushes, night
sweats, extremely heavy periods with burning sensation, skin rashes, associated
complaints such as UTI (urianry track infection).
c) Kapha dominant menopausal Symptoms-Weight gain, heavy, lethargy, depression,
lack of motivation, hormonal changes such as Thyroid malfunction, fibrocystic changes
in uterus or in the breast and excessive fluid retention .
Ayurvedic Management For MenopausalSyndrome:-
Most of the Menopause Symptoms are due the Vata aggravation followed by other
Doshic factors. The basic concept of Ayurvedicmedicine is ―Swasthsyaswast
yarakshanam and aturasyavikaraprasamanam cha‖prevention is better than cure. In the
early pre‐ menopause stage it is better to balancethe aggravated or underplaying factors,
so that the intensity of the menopause symptoms will be far less or even can be
negligible. In order to achieve this one should follow the Dosha based diet and life style
principles followed by Ayurvedic herbs on regular basis. If still symptoms persists, it
better to undergo ―Panchakarma‖(Ayurvedic detoxification),which helps in the
elimination of vitiated humours or Doshas to bring them to balanced stage, then it is
advisable to take few Ayurvedic herbs or decoction and other preparation to make the
transition more graceful.Ayurveda has excellent solution for a safe and happy transition
into menopause .
Ayurvedic Treatment for Menopausal Symptoms involves correcting Dosha
imbalance with appropriate diet, samshamana therapy, internal detoxification
(panchakarma therapy/samshodhanthearpy ), Sattvavjayachikitsa,Yogatherapy,Rasayan
therapy.

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1. Ayurvedic diet and herbs-
(a) For Vata Dominant Menopause-
Diet - Increase warm food and drinks, regular meals, and use spices such as fennel and
cumin. Decrease caffeine and other stimulants, refined sugar, cold drinks, salads.
Lifestyle - Early bedtime, oil massage using almond and olive oil, meditation, yoga,
Regular exercise like walking
Herbs- Ashwagandha (Withaniasomnifera), Arjuna (Terminaliaarjuna), Cardamom
(Elettariacardomam),Garlic (Allium sativum ),Guggul (Commiphoramukul), Sandalwood
(Santalum alba)and Zizphus (ziziphusjujube.
(b)For Pitta Dominant Menopause-
Diet - Increase cooling foods, water intake, sweet juicy fruits (grapes, pears, plums,
mango, melons, apples,) zucchini, yellow squash, cucumber, organic foods. Use spices
such as cinnamon, cardamom and fennel. Avoid hot spicy foods, hot drink , alcohol.
Lifestyle - Oil massage using coconut and sesame oil. Use Meditation and other
techniques to reduce anger, hatred and resentment. Exercise and exposure to the sun are
limited.
Herbs - Aloevera, Arjuna(Terminaliaarjuna), Amla (Emblicaoffcinalis), Saffron (crocus
sativus), Sandalwood and Use spices such as cinnamon, cardamom and fennel.
(c) For Kapha Dominant Menopause-
Diet – Prefer light, dry and warm food, Consume fruits, whole grains, legumes,
vegetables. Use spices such as black pepper, turmeric and ginger. Avoid meat, cheese,
sugar, cold foods and drinks. Weekly fasting is helpful. Most or all of the daily food
should be consumed before 6 p.m.
Lifestyle - Get up early. Mustard oil and linseed oil are often recommended for massage.
Herbs- Cinnamon, Guggul(Commiphoramukul), Mustard(Brasscianigra),Haritki
(Terminaliachebula), Nagarmotha (Cyperusrotundus).
1. Samshamana Therapy- Agnideepana, Amapachana, Anulomana, Balya ,
2. SattvavjayaChikitsa-counselling and Reassurance
3. Panchkarma therapy- Panchkarmachikitsha are physical therapies that thoroughly
cleanse and purify the physical and mental impurities from the body and mind.
The general purpose ofthePanchakarma therapies is to loosen,liquefy and remove
the vitiated substances and Doshas from their abnormal sites in peripheral tissues
via their natural pathway of elimination. More serious symptoms, such as frequent

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 hot flashes, sleep disturbance, and moderate to severe mood swings, are signs of
deeper imbalances. Ayurveda describes that these stubborn symptoms are usually
due to the build-up of wastes and toxins, referred to as "Aama," in the body's
tissues. In this case,a traditional Ayurvedic detoxification programme
"Panchakarma" may be needed to clear the body's channels and gain relief. This
internal cleansing approach is also the treatment of choice for more serious
problems such as osteoporosis and high cholesterol. Panchakarma-
Abhyanga(Massage), Mriduswedana, Shiro dhara,MriduVirechan,Basti
4. Yoga therapy
5.RasayanaTherapy7,8-Triphala:-Triphala consisting of Haritaki (Terminaliachebula),
Vibhitaki (Termanaliabelerica),Amalaki (Embelicaofficianalis), pacify all the three
Doshas& also is an excellent Vayasthapana (anti-aging agent) Ashwagandha
(Withanasomnifera)- It is a powerful antioxidant & immune modulator. It is one that
improves strength, muscle mass, relieves stress. In Menopause patient,it controls
effectively the vasomotor symptoms (Hot flushes, night sweats, palpitation) Yasthimadhu
(Glycerrhizaglabra)- It is another Rasayana drug which is prescribed for Menopause. It is
an excellent antioxidant,Immuno modulator &anti-depressant, memory enhancer. It is
described as a promoting agent for life, voice, hair, complexion, strength & libido.rugs
Classical anti-aging Formulation e.g.CHYAVAN PRASHA & BRAHM RASAYAN
• DISCUSSION
Menopause is generally defined as the cessation of menses for period of 12 months or
a period equivalent to three previous cycles or the time of cessation of ovarian function
resulting in permanent amenorrhea. During the period of menopause the women enters an
estrogen deficient phase which leads to the various symptoms. This period is generally
associated with manifestation of aging process in women. Hormone Replacement
Therapy (HRT) is the only alternative available for menopausal syndrome in modern
medicine. It also has a wide range of side effects on the body of the female. While
hormone therapy (HT) helps many women get through menopause, the treatment (like
any prescription or even non-prescription medicines) is not risk-free. Known health risks
include: An increased risk of endometrial cancer (only if you still have your uterus and
are not taking a progestin along with estrogen). Increased risk of blood clots and stroke.
Increased chance of gallbladder/gallstone problems. Increased risk of dementia if
hormone therapy is started after midlife. HT started during midlife is associated with a
reduced risk of Alzheimer‘ disease and dementia. Increased risk of breast cancer with
long-term use. Menopause is linked with Vata dosha dominated stage of life. Therefore
symptoms in menopausal phase like insomnia, anxiety, urinary symptoms, osteoporotic

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changes are due to dominance of Vata dosha. Along with that Pitta dosha symptoms like
hot flushes, irritability, etc are seen, during this phase. Degenerative changes are
explained in Ayurveda as Dhatukshaya lakshana. Sushruta Acharya has explained that
there is Shareera-shithilta in Vrudha-avastha (old age) and women attains Rajonivritti
stage at around 50 years. This age is dominated by Vatadosha, this dominant Vatadosha
affects the female body.[5] The dominant Vata dosha specially with Laghu and Ruksha
guna results in reduction in Dravata of Rasa dhatu. This further leads to Dhatukshya
starting from Rasa dhatu, further respective Updhatu kshaya takes place. Thus leading to
Artava nasha (amenorrhea). The vitiated Vata dosha also disturbs the other Sharir as well
as Manas dosha (Raja and Tama dosha) leading to various psychological disturbances.
 To combat the degenerative process of the body tissue Acharyas have described
Rasayana Chikitsa. Rasayana includes drugs which promotes longevity and
improve the quality of life and correcting Dosha imbalance with appropriate diet,
samshamana therapy, internal detoxification (panchakarma therapy/
samshodhanthearpy ), Sattvavjayachikitsa,Yogatherapy.
Conclision:
To treat the menopause means to relieve the discomfort and disorder due to hormone
deficiency and at the same time to ward off degenerative processes of old age or at least
to mitigate their effects and slow down their rate of advance. Hormone replacement
therapy (HRT) solves only half of the problem but to provide optimum physical and
mental fitness Ayurveda is the better option for healthy long life.
References:
1. D.C.Dutta,Textbook of Gynaecology 5th Edition ,Published by New Central
2. book agency ,Kolkata 2008 ,Page -55
3. D.C.Dutta,Textbook of Gynaecolog 5th Edition ,Published by New Central
4. book agency ,Kolkata 2008 ,Page -59
5. KavirajaAmbikaduttaShastri-Susrutasamhita of Maharsi –susruta Ayurveda
,Tattva-Sandinpika Hindi Commentary,Pulished by-Chaukhambha Sanskrit
Sansthan Varanasi 2010,Page -27,Su.Sarir
6. Dr.BrahmanandTripathiAstangaHrday am of Srimadvagbhata ,‖Nirmala‖ Hindi
Commentary Published by Chaukhambha Sanskrit Pratisthan Delhi ,Page -
338,A.H. Sarir
7. Dr.Mamta Rani Post graduate dept of Prasutitantra&Streeroga , Thesis ―A clinical
study on the role of ―Mensol compound ― in the management of Menopausal
Syndrome ―NIA ,Jaipur

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8. Dr. Mrs. Sushama Patwardhan, Review Artical :Graceful Menopause with
Ayurveda.
9. Sri Satya Narayana Sastri Charaka Samhita of Agnivesa,Vidyotin Hindi
Commentary, Published By Chaukhambha Bharati academy Varanasi 2009,Page-
5ch.chikitsa
10. KavirajaAmbikaduttaShastri- Susrutasamhita of Maharsi –susruta
11. Ayurveda, Tattva-Sandinpika Hindi Commentary, Pulished by-Chaukhambha
Sanskrit Sansthan Varanasi 2010, Page -6, Su.Sutra.

***

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 Role of Ayurveda in Menopause vs HRT
C.S. Divya
Karkare Manjusha
PhD Scholar, Department of Prasuti Tantra
and Stree Roga, Parul University, Gujarat
Email: divya.cs83@gmail.com
Professor, Department of Prasuti Tantra and Stre
Roga, Parul University, Gujarat
Email: mrkarkare@gmail.com

Abstract
Menopause though a physiological entity in women, hormonal changes continue long
after the FMP (Final menstrual period). This episode of dynamic neuroendocrine changes
characterized by distressing clinical symptoms such as reduced fertility, menstrual
irregularities, vasomotor symptoms, physical changes impacting skin and uro-genital
tract, skeletal and cardiovascular pathology are affecting the woman‘s day to day life. In
such situation it is customary to prescribe HRT (Hormone Replacement Therapy) by and
large. Over the last few years due to the ambiguity of the potential risks of HRT there is a
difficult situation in whether to or not to resort to HRT during menopause. Although the
approach to menopause and the symptoms appearing in the current era is contrasting due
to lifestyle changes, multitasking and stress, thus, lifestyle modifications should be the
first-line approach for women with menopausal symptoms. Ayurvedic management have
proven to be beneficial in such circumstances in easing this transitional period by giving
symptomatic support without any adverse effect on the health status of the woman.
Context: During Menopausal transition the body gives out symptoms due to the
cessation of ovarian response to Pituitary Gonadotrophin till it adjusts itself to this
oestrogen deficiency. HRT is an extrinsic hormonal therapy that tries to postpone this
transition and it is not advised for long term use. Weaning of HRT contributes to tenfold
withdrawal symptoms compared to the actual transitional symptoms of menopause itself.
Neither the natural physiology of menopause can be stopped nor the reproductive age can
be postponed. Ayurveda approaches Menopause with symptomatic therapies and
phytoestrogens that neutralises this hormonal instability naturally.
Aim: To understand the utility of Ayurveda as a prospective support system during the
transitional period of Menopause and to discuss about the intrinsic risk of HRT.
Key words: Menopause, Menopausal transition, Ayurveda, HRT

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Introduction:
Around 200 years ago only 30% of women lived through menopause where as in the
current era 90%1 will live. Rajonivritti in Ayurveda is an indicative syndrome of Jarakala
which lies in the conjuncture of later part of reproductive age and beginning of senile age.
During this period there is an exacerbation of Pitta and Vata. Healthcare community is in
a dilemma on how to curb these symptoms though physiological, hampering the routine
activities of a woman. The symptoms caused due to this shift in the hormonal interplay
caused by the hypoactivities of Ovarian hormones are more compelling in women in the
current generation than the previous generation. Women in the current epoch bears
multiple facets in home making, parenting and career which leads them to multitask
efficiently to meet all these multifaceted demands. This further adds on to mental stress.
Maintenance of peri and post-menopausal health is therefore of utmost importance to
minimize the economic impact caused due to this debilitating physiology afflicting our
ageing society.
Impact of Menopause on Women‘s health:
The cessation of menstruation at the end of fertility period around 55 years is
menopause. Menopause is one of the episodes of Climacteric. Ovarian response to
Pituitary Gonadotrophins is reduced and Ovarian function ceases leading to deficiency in
Estrogen, progestogen and androgens. Climacteric occurs due to the waning function of
ovaries, which manifests by physical and psychological changes in the body.
The climacteric symptoms may be divided into the following groups
 Vasomotor symptoms like hot flushes are thought to be due to the estrogen
withdrawal and a labile vasomotor system.
 Cardiovascular symptoms- Hypertension, Palpitation and Heart disease. The
incidence of Coronary thrombosis before menopause is shallow. Women develop
coronary heart disease (CHD) several years later than men, with a notable increase
in CHD risk during midlife,2 a period coincident with the menopause transition.
 Psychological and neurological symptoms- Changes in mood and depression are
due to anxiety of losing fertility. These symptoms are either exaggerated post
menopause or in some cases developed during the menopausal transition.
 General symptoms and physical symptoms- General symptoms like insomnia,
general weakness, fatigue, headache, vertigo, breast tenderness and skin
pigmentation are not uncommon. Gastro intestinal symptoms like loss of appetite,
indigestion and constipation are also seen frequently.

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  Physical changes seen due to the withdrawal of estrogen escorts the reduction in
collagen tissue in all the organs of the body i.e., bone, skin and Genito- urinary
systems. Some of the physical changes noticed after menopause are atrophy of
secondary sexual characters like breast regression, thinning of vulval skin and
narrowing of introitus. There is marked atrophy of internal genital organs
including uterus, ovaries and supporting ligaments of genital tract. After
menopause osteoclastic activity stops. The hypoestrogenic state leads to activation
of bone remodelling units with excess of bone resorption relative to formation in
turn paving way to Osteoporosis.
HRT in Menopause: When hormones are prescribed for climacteric symptoms, they
are prescribed in Estrogens only (Rx of choice for patients who had hysterectomy),
Estrogens and progestogens (Patients who have intact uterus), Estrogens and Androgens
(especially in symptomatic relief of patients with vasomotor symptoms)
HRT is not advisable for more than 6 months and beyond usage of 5 years3 there is
threat for Carcinoma of breast and endometrium. HRT is the only treatment modality
approved by the USA FDA but all the menopausal symptoms are not relived by HRT
alone. Many other non-approved alternative medicines like SSRIs (Selective Serotonin
Reuptake Inhibitors), Gamma-aminobutyric acid (GABA) etc are also prescribed but
either these are contraindicated in certain health conditions or some of these have
substantial side effects. Menopause is not just an oestrogen deficient state but also
exhibits a wide range of secondary health complications.
Contemporary medical systems manage these symptoms by the long-term use of
sedatives, hypnotics, and anxiolytic drugs, which may lead to various side effects like
drowsiness, impaired motor function, loss of memory, allergic reactions, non-social
behaviours, drug dependence. Considering the intensity of the side effects caused by
HRT as well as the adjuvant medications used it the management of Menopausal
symptoms it is the need of the hour to detect safe and effective Ayurvedic management
without any adverse effect in curbing the symptoms affecting the menopausal women.
Ayurvedic Approach to Menopause: In ayurvedic classics there is mentioning of a
woman‘s last epoch of life which is a junction between the last part of reproductive life
(madhyamavastha) and beginning of senile age (Vridhavastha) around the age of 50
years. It is mentioned as Rajonivrithi kala or end of menstruation. There are references of
this state as Surathothsaravarjitha (incapable of sexual indulgence), were the integrity of
dhatus are lost leading to slow degeneration of upadatus i.e. raja and stanya. There is
evident vata dosha vridhi and dhatu kshaya lakshana.

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 Symptoms like hot flushes are dealt with the help of Pita shamana dravyas for the
thermo regulation and something which are coolant in nature Eg: Vanga bhasma,
Guduchi satwa/ Kashaya, Kamadugda rasa etc. In cardiovascular symptoms Hridhya
dravyas like Arjuna and prabhakara vati are utilized. In psychological and neurological
symptoms, brain tonic / medhya aushadas like brahmi, jatamamsi are employed. For
gastro intestinal symptoms, drugs like jeeraka, jyothishmati with properties of Dipana,
Pachana and raktha shodana are used.
In the physical changes caused due to menopause utility of Pravala bhasma along with
other herbal phytoestrogen in treating calcium deficiency leading to osteoporosis are
utilized. Arjuna, jatamamsi, kukkudanda twak bhasma, yashada bhasma etc is also very
effective in osteoporosis. Drugs like Bala, Ashwagandha are great rasayana dravyas in
Dhatu poshana and nourishing the skin. Shatavari, Guduchi, Ashoka, Gokshura, musta
have proved beneficial in vaginal dryness.
Conclusion: With Ayurvedic medicines containing phytoestrogens this hormonal
imbalance can be neutralized in the most natural way and is the best way to curtail
menopause transitional symptoms. The binding affinities for oestrogen receptors by
phytoestrogen is very different from that of synthetic oestrogens4. Phytoestrogens uses
selective receptor therapy which prevents overdosing. Phytoestrogens have been
classified as natural SERMs 5(Selective oestrogen receptor modulator), and a review of
cell and animal studies of phytoestrogens reveals similarities to SERMs. Due to the
possible risk of HRT and other alternatives drugs used in allopathic practise it is
important to bring out the age-old prescriptions in Ayurveda utilized in menopausal
transitional period using the logic of the physician.
Bibliography:
1. D. Keith Edmonds, Dewhurst‘s textbook of obstetrics and Gynaecology,
Blackwell publishing, 7th edition, Reprint – 2011, Pp: 717, Page No: 479
2. https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000912#R4R
3. https://pubmed.ncbi.nlm.nih.gov/12892026/
4. https://doi.org/10.1021/jf034427b
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2587438/

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 SUKHPARUDHA 2021
HERBS USED IN GERIATRIC WOMEN
Dr. Madhura Rajendra Kadam
HOD & Guide
Dr. Jayshree Patil
Department of Prasuti Tantra and Stree Roga,
Dr. D. Y. Patil
College of Ayurveda & Research Centre Pimpri, Pune.
kmadhura90@gmail.com Mobile No- 7756090922

ABSTRACT
In Ayurveda herb is referred as a dravya. Herbs may also called as botanical products
or phytomedicines. Geriatric woman is any elderly woman. Human passion on herbal
medicine dated back to times immemorial. In Ayurveda we found that dravya that is
herbs have played major part in pharmacotherapy since the Vedic period of India. Aging
increases the prevalence of disease in women. At the menopausal age symptoms gets
started troubling woman. Geriatric is described as Vrudhavstha or Jirnavastha in
Ayurveda. It is categorized under natural & Yapya (Palliative) Disease.[1] Ayurveda has
solution of every misery of human and Aging is one of the these. So, every problem in
geriatric woman has an answer in Ayurveda.
Key words- Dravya, Vrudhavsth, Yapya, Jara, Jirnavastha
INTRODUCTION
Jara is last stage of life & is one among classification of vay. The Vriddhavastha or
Jirnavastha is the last phase of life and is represented by the decay or de- generation of
the body. Sushrutacharya has mentioned ‗Jara‘ (ageing) under ‗Swabhavabalapravritta
vyadhi‘ which is of two types Viz. Kalaja (Parirakshanakrita), appearing at proper time
even after proper protection and Akalaja (Aparirakshanakrita), appearing before proper
time due to improper care and prevention. [2]
In both conditions kalaj jara & akalj jara herbs plays important role in prevention &
management also. In Ayurveda herbs used in different forms & types to prevent the
Akalaj jara & management of Kalaj jara makes life easy & happy forever.
AIM To study the use of herbs in geriatric Women.

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OBJECTIVE
To elaborate the problems in geriatric women and its management through various herbs.
MATERIAL & METHOD
Review of literature from various Samhita and other Ayurveda literatures related to
geriatric women problems & herbs, and form of e-sources compiled.
CONCEPTUAL STUDY
Reference of Geriatric in Ayurveda as Jara chikitsa:

कामफारग्रहोध्वािङ्गशल्मदं ष्राजयावष
ृ ान ् ||

अष्िावङ्गानन तस्माहुष्शचक्रकत्सा मेषु संचश्रता ।[3]

Acharya Sushrut gives an elaborate and systemic classification of age, where he

described old age as above 70 years. [4]
Acharya Charak on the other hand mentioned old age above 60 years [5]
Reference of Herbs in Ayurveda

जगत्मेवभनौषधभ ् ।

न क्रकंचचद्पवद्मते द्रव्मं वशातनानाथिमोगमो् ।। अ. ह. सू. ९

According to Acharya Vagbhat: Every dravya in this world is a medicine. No herb or

dravya is present in this world which is not a medicine. Various permutation &
combination with various methods are always useful in some way as medicine. [6]
Fig.no. 1 -Major Problems of Geriatric Women

Menopausal
syndrome

Breast
diseases Menorrhagia

Geriatric
Women
Hair fall &
Graying of Obesity
hair

Diseases of
Constipation
Bones

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HAIR FALL & GRAYING OF HAIR-
Hair fall & graying of hair is minor disease but it affects social & mental health of
woman in this era
 Bhrngaraja (Eclipta alba), Japapushpa (Hibiscus rosa-sinosis), Amalaki (Embelica
officinalis), Triphala (Amalaki+Haritaki+ Bibhitak) are very useful as single drug
as well as in formulation of oil, tablet many more product.
 Kesya meaning a conductive to the growth of hair. Some of Kesya dravya
described Bhavprakash Nighantu are as follows: Vibhitaki (Phala) Terminalia
bellirica, Sindhuvara (panchang) Vitex negundo,Yastimadhu (Moola) Glycyrrhiza
glabra ,Gunja (Seeds) Abrus precatorious, Bakuchi (Phala) Psoralea corylifolia,
Neeli (Panchang) Indigofera tinoctera, Bhallataka (Vrint) Semicarpus anacardium,
Bhringraja (Panchang) Eclipta alba, Gambhari (Phala)Gemelina arborea [8].
BREAST DISEASES:
 Shatavri (Aspargus racimosa)- Helps in strengthening & nourishing the breast.
 Kumari (aloe vera)- Kumari has been known to curb the growth of breast &
cervical Cancer cells. Regular consumption of aloe vera helps to strengthen the
duct of breast.
 Punarnava (Boerhavia diffusa)- It helps to clear ama reduces breast tenderness.
 Methi seeds (Trigonella foenum-graecum)- It prevents the buildup of ama around
the breast tissue.
 Yashtimadhu (Glyceriza glabra)- It is powerful anticancerous & hormone
balancing properties, it also cleanses the lymphatic fluid, helping the body flush
out toxins that are bad for breast tissue.[9]
MEANOPAUSAL SYMPTOMS:
 Hot flashes are the characteristic symptom of menopause. Sudden feeling of heat
followed by profuse sweating is seen.[10]
 Estrogen deficiency produces atrophic epithelial changes in Genitourinary system.
 Shatavari (Asparagus raemosus) churn with milk reduces hot flashes, Dyspareunia
along with dysuria & also aids in reducing anxiety; encouraging libido.

Yashtimadhu (Glyceriza glabra)- When used in tea & consumed, helps to decrease
the frequency & intensity of hot flashes. It has estrogen like effect that can help
women with their transition as natural estrogen declines.[11]
 Dhanyak (Coriander sativum)-water soaked with dhanyak churn overnight called
dhanyak Him helps in trouble sleeping & night sweats.

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  In geriatric women at menopausal age Insomnia, Depression, Mood swings are
some major issues herbs like Brahmi (Bacopa monnieri), Jatamansi
(Nardostachyas jatamansi), Vacha (Acorus calamus) are very useful.
MENORRHAGIA:
Heavy bleeding per vaginally is major symptom of underlying pathology & has great
impact on woman‘s day to activity.
 Til (Sesamum indicum) churn with curd or honey is mentioned
 Guduchi (Tinospora cordifolia) - Juice of guduchi helps to reduce heavy menstrual
bleeding.
 Bala (sida cordifolia)- Bala mool paste with milk.
 Indrayav (Holarrhena antidysenterica)- Indrayav churn with sharkara with its
properties helps to detoxify the blood.
 Ashok (Saraka asoca)-Cold milk boiled with the decoction of ashoka bark is useful
in menorrhagia.[12]
OBESITY:
Obesity is defined as abnormal or excessive fat accumulation that presents risk to health.
Geriatric women with obesity have difficulties in daily activity too.
 Guggulu (Commphora mukul) - Crude guggul as well many combinations of
guggul proved as Anti-obesity & Hypolipidemic/hypocholesterolemia activity
in practice and inresrarch too.
 Guduchi (Tinospora cordifolia) Vidang (Embelia ribes), Musta(Cyperus
rotundus), Shunthi (Zingiber officinale),Amala (Embelica officinalis), Vacha
(Acorus calamus) are some herbs when used in proper dose at proper condition
gives excellent results in obesity in women.
CONSITIPATION:
Constipation is general term used to indicate hard stools, painful defecation and
feeling of bloating, abdominal discomfort or incomplete evacuation. Constipation is
similar to vibamdha described in Ayurveda
It is a troublesome problem in many of a geriatric woman‘s life.
Herbs like Erand (Ricinus Communis), Draksha (Vitis vinifera), Haritaki(Terminalia
chebula), Aragvadha (Cassia fistula), Isabgol Husk (Plantago ovata) are very useful in
day to day life with no harm to body if used in proper doses & forms.

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 Few simple measures like consumption of light and easily digestible high fibre diet
including fruits, green leafy vegetables, drinking plenty of fluids and regular exercise
helps to prevent constipation.
DISEASES OF BONES
 Osteoporosis and Fracture are common after menopause due to decline in
collagenous bone matrix resulting in osteoporotic changes.
 Bone loss increase to 5% per year.
 Shallaki (Boswellia serata)[13]& Guggulu (commiphora mukul)[14]have shown
improvement in the patients of osteoarthritis.
 Herbs like Ashwgantha( Withania somnifera) , Asthishrunkhala(Cissus
quadrangularis) helps to make bones strong.
CONCLUSION:
In conclusion it can be pointed out that, Natural Herbs & their combination is great
solution of geriatric Women‘s problems .But along with herbs in Ayurveda there are
multiple therapies, Herbo mineral preparations, lifestyle modification , daily regime
according prakruti of every woman is the forever beneficial to the woman‘s life. Here
some herbs are elaborated but there are huge number of herbs that can be useful in either
way to Geriatric women.
REFERENCES:
1. Shastri Ambikadutt, Susruta Samhita edited with Ayurveda tatva sandipika Hindi
Commentary, Sutra Sthana 24th chapter, Vyadhi-samudesheyam-adhayay,
Chaukhambha Sanskrit Sansthan, Varanasi, reprint edition; 2007
2. Susruta. Susruta samhita, Vol-I. Srikanthamurthy KR, editor. 1st ed. Varanasi:
Chaukhamba Orientalia; 2008. Sutrasthana, 24.p.177-178
3. Sarth vagbhat Ahtang Hriday by Ganesh Krishn Garde A.H Su.1/5
4. Shastri Ambikadutt, Susruta Samhita edited with Ayurveda tatva sandipika Hindi
Commentary, Sutra Sthana Vol1 Chaukhambha Sanskrit Sansthan, Varanasi,
reprint edition; 2007; 35 (35): 134
5. Caraka. Caraka Samhita (Vidyotini Hindi Commen- tary), Vol.1. Sastri KN,
Caturvedi GN, editors.1st ed. Varanasi: Caukhambha Bharati Academy; 2001.
Vimanasthana, 8.p.781-782.
6. Sarth vagbhat Ahtang Hriday by Ganesh Krishn Garde A.H Su.9/5
7. Shastri Kashinath & Gorakhnath Chaturvedi, Charaka Samhita of Agnivesha
elaborated Vidyotini Hindi commentary, Sutra Sthana 4th chapter

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 Shadvirechanshatashritya-adhyay, Chaukhambha Bharati Sansthan, Varanasi,
reprint edition; 2005. p. 98
8. Acharya Priyavrat Sharma. Dravyagun Vigyan vol 1. Revised golden jubilee-
Edition; Varanasi; Chaukhambha Bharati Academy; 2008, 312p.
9. THEHealthSite.com
10. D C Dutta‘s Textbook of gynecology including contraception Enlarged & revised
Reprint of sixth edition chapter 6
11. Ayurherb.com
12. Illustrated DRAVYGUNA VIJNANA Vol-2 By Dr. J. L. Sastry Chaukhamba
Orientalia varansi
13. Rajadhyaksha A. Chauhan et al. (2001) Open study to evaluate the efficacy
of Shallaki as an add-on therapy along with NSAID in the management of
patients with Osteoarthritis, Selected papers on evidence based Ayurvedic
drugs, CCRAS.
14. Singh B. B. et al. (2003) The effectiveness of Commiphora mukul for
Osteoarthritis of the knee - an outcome study, Altern. Ther. Health Med.
May-June 9(3): 74-79.

***

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 Role of Ayurveda in menopause vs HRT

Pooja Thakur,
PG Scholar
Vd.Sunil
Guide&HOD of PTSR Dept.
E-mail- poojathakur9455@gmail.com

ABSTRACT-
Menopause is a natural phenomenon occurs at the age of 45-55 years. After the age of
40 years, ovaries reduce their production of sex hormones. As a result, the menses as well
as other body functions are disturbed. Finally the menses cease permanently.
The physiological function of most organ systems tends to decline with age, but there
is a wide individual variability. Every person deserves precise diagnosis and assessment
of function together with individually tailored management. The climacteric is a critical
period in women‘s life where loss of ovarian follicular activity is characterized
biologically by decline in fertility, endocrinologically by alteration of hormone levels,
and clinically by variation in menstrual cycle length and experience of a variety of
symptoms. For decades, estrogen, either alone or in combination with progestins (HRT)
has been the therapy of choice.
To treat the menopause means to relieve the discomfort and disorder due to hormone
deficiency and at the same time to ward off degenerative processes of old age or at least
to mitigate their effects and slow down their rate of advance. Hormone replacement
therapy (HRT) solves only half of the problem but to provide optimum physical and
mental fitness search for the safe alternatives other than HRT are warranted.
To understand the rationale of therapy, it is important to understand the problem
according to fundamental principles of Ayurveda. It also lists the group of drugs that can
be used in aging population to alleviate menopausal as well as associated aging problems,
tailored according to the individual needs.
KEYWORDS: Menopause, Rajonivritti, Dhatu kshaya, HRT, Vayahsthapan.
INTRODUCTION :
Each phase of a women‘s life is beautiful and should be considered as gracious. Right
from the moment that she entered the world, or when she steps in adolescence which
makes her capable to be prepared to experience motherhood, or finally the transition to
menopause.
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 Natural menopause is associated with unavoidable manifestations of aging process in
women. As a person grows old, the organ function is challenged both by the diseases and
by the physiologic processes associated with ageing. Management of menopause involves
management of age related changes, its allied ill effects and menopausal symptoms
occurring due to failing follicular activity.
The word ‗Menopause‘ comes from the greek word ‗Menos‘(month) & ‗Pausis‘
(cessation). Menopause is a natural phenomenon occurs at the age of 45-55 years.
Menopause means permanent cessation of menstruation at the end of reproductive life
due to loss of ovarian follicular activity. Needless to say that this phase also marks the
end of natural fertility in a woman. Irregular periods, hot flushes, night sweats, vaginal
dryness and mood swings all these are typical symptoms of menopause. Osteoporosis,
heart disease and Alzheimer's disease (progressive loss of memory and concentration) are
the long-term hazards of menopause. The group of signs and symptoms associated with
the phase of menopause are termed as menopausal syndrome. Menopause has become an
inevitable phenomenon in a woman's life and many years are spent in the postmenopausal
phase. In this millennium, a woman perceives menopause as an opportunity to
concentrate on new activities and bring out the best in her. Consequently, treatment of
this transitional phase has now gained more importance than ever before.
MODERN VIEW OF MENOPAUSE:-
According to contemporary medical science, this physiological transition from
reproductive to post reproductive life is associated with decline in estrogen levels. Over
time, this decline may be experienced as a change in the skin elasticity, altered cognitive
abilities, hot flushes or flashes, night sweats, menstrual irregularities, and vaginal
dryness. Other symptoms, such as depression, nervous tension, palpitations, headaches,
insomnia, lack of energy, difficulty concentrating, and dizzy spells are also reported.
Osteoporosis is most prevalent in women over the age of 50 as the hormonal influence of
estrogen on bone health dissipates with the onset of menopause. The progressive changes
in bone structure, quality and density lead to pathological fractures and an increase in
morbidity and mortality among menopausal women. Osteoarthritis, the most common
articular disorder begins asymptomatically in the 2nd and 3rd decades and is extremely
common by age 70. Almost all persons by age 40 have some pathologic change in weight
bearing joint .
To treat the menopause means to relieve the discomfort and disorder due to hormone
deficiency and at the same time to ward off degenerative processes of old age or at least
to mitigate their effects and slow down their rate of advance. Hormone replacement
therapy (HRT) solves only half of the problem but to provide optimum physical and

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mental fitness search for alternatives other than HRT are warranted. To understand the
rationale of therapy, it is important to understand the problem according to fundamental
principles of Ayurveda.
AYURVEDIC CONCEPT OF MENOPAUSE:
In Ayurveda classics Menopause condition is termed as ―Rajonivrutti& Menopausal
symptoms (Rajonivruttianubandh vyadhies) the whole term Rajonivruttimeans end of
Artava Pravritti or cessation of menstruation. Rajonivrutti Kala (Age of Menopause):
Though Rajonivrutti as a diseased condition is not described separately in the classic,
Rajonivruttikala is mentioned by almost all Aacharya without any controversy.
According to Sushruta and various other references (Astanga Hridayam) to 50 years is
mentioned as the age of Rajonivrutti when the body is fully in grip of senility. In
Ayurveda Menopausal symptoms are regarded as ―imbalance of the Dosha (Vata, Pitta,
Kapha ) which occurs as a natural and gradual consequence of aging.
Ayurveda considers aging Nishpratikriya (changes cannot be resisted) and
Swabhavabal Roga (natural disease). Rajonivritti (menopause) occurring in Jarapakva
Shareer (aged body) at the age of 50 years is comparable to the present day studies
showing the mean age of menopause to be 51 years. With advancing age there is gradual
diminution in the qualities of Dosha, Dhatu, Mala, Agni and Oja.
Artava (menstrual blood) is an Upadhatu (secondary constituent), formed from Rasa
Dhatu within a month after proper metabolization of Rakta dhatu by its dhatvagni and
bhutagni. The kshaya of Rakta dhatu causes Artava kshaya due to utarottar dhatu kshaya.
Kshaya of Updhatu Artava and Shukra, manifest as cessation of menstruation and
decreased libido. Further, due to same reasons loss of Ojas (body immunity) makes
women more susceptible to illness.
Dhatukshsya leads to Vata Vitiation. With advancing age, progressive vitiation of
Vata due to its fundamental properties, This may explain various symptoms of
menopause related to degenerative changes in body such as urogenital atrophy, thinning
of the membranes of the vulva, vagina, cervix, and also of the outer urinary tract,
shrinking and loss in elasticity of all of the outer and inner genital areas and skin, breast
atrophy, decreased libido, problems reaching orgasm and dyspareunia or painful
intercourse.
Ama, formed due to mandagni (slow/hypo- function of digestive fire) causes
strotovarodh (obstruction of channels), which in turn increases Medo -dushti (disorders of
fat metabolism) and decreases the nutrient supply to subsequent Dhatus, Increased
accumulation of Meda (fat/adipose tissue) and Mamsa (flesh/muscle tissue) Dhatu can

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cause the weight gain, one of the biggest complaints associated with aging. Body weight
increases with age. Further, vitiated Vata due to kshaya of Rasa Dhatu when gets lodged
in Sandhi (joints), causes Sandhigata Vata (osteoarthritis/osteoporosis)
Although all the three Dosha (Vata, Pitta and Kapha) are always present in body, their
relative predominance changes in different conditions and ages The menopause transition
represents a period of dynamic change from middle age to old age. This transition from
Pitta dominance to Vata dominance causes most of the symptoms associated with
menopause.
MANAGEMENT PROTOCOL
Two main components which need to be addressed in women having problems during
menopause are advancing age and allied changes, and menopausal symptoms. An
intellectual adoption of the suitable treatment options which includes planned usage of
multiple variables as per individual needs is best approach for its management
Aging, though considered Nishpratikriya (changes cannot be resisted) has been dealt
scientifically in Ayurveda. Emphasizing Ayu (lifespan), its chikitsa (therapeutics) is
called as Vaya Sthapana (age stabilizing). Ayurveda Avatarana (descent of Ayurveda on
earth) has been guided by zeal of mankind to have Dirgha Hitakara and Sukhakara Ayu
(a longer healthy and happy life). It recommends the countering of aging and related
changes by use of Vayasthapak drugs (age stabilizers), to rejuvenate the aged body by
Jeevneeya drugs (vitalisers) and for allied aging problems Jarachikitsa i.e. Rasayana
Chikitsa (rejuvenating process and formulations).
For menopausal symptoms occurring due to in-equilibrium in Dosha status a wide
range of options can be used. This approach should begin with eliciting the potential
symptoms at individual level. For women who are encountering depression, which may
or may not be directly related to menopause, the treatment needs are quite different from
a woman who has no such problem but is experiencing hot flashes.
Due to this high individual variability there is need to develop guidelines that can be
tailored as per individual and not just based on risk profile and symptoms. As
demographic, life style and health related factors have considerable impact on disease
outcome, symptomatic management of menopausal symptom needs to be addressed at
individual level.
PREVENTIVE MEASURES ACCORDING TO AYURVEDA:
The most important part of therapeutics in Ayurveda is Swasthyashya Swasthya
Rakshanam (to maintain the health). Preventive measures are significantly preferred. The
first and foremost objective of chikitsa in Ayurveda is Dhatusamya (homeostasis) and is
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the most important component of preventive medicine. Observing Dincharya (daily
regimen), Ritucharya (seasonal regimen), regular removal of aggravated Dosha according
to Ritu (season) by Panchakarma are the means to keep dosha in harmony; Ahara Vidhi
Visheshayatanam (Rules of proper dietary intake), regular utilization of Rasayana
(rejuvenation therapies); are various other tools to maintain the homeostasis of the body.
Incorporated well in time at the advent of middle age it may not only prevent symptoms
related to hormonal changes affecting the body but also save from. Akalaj Vradhhavastha
(untimely degenerative changes) and other troublesome outcomes related with aging.
As there is natural vitiation of vata dosha with advancing age it is important to avoid
the provocative causes of Vata dosha as a preventive measure.
THERAPEUTIC INTERVENTION
Snehan Karma (oleation therapy) is recommended treatment for Vata- vitiation; it can
be done externally and internally. The therapy of choice for Vata vitiation is Basti
(medicated enema). Basti therapy is considered as prime among all the therapeutic
measures, especially for management of Vata disorders, and is accepted as a complete
therapeutic measure by many physicians. Yapana basti (a type of enema having palliative
property) can be recommended in general. Matra Basti with medicated oils such as
Sukumar Ghrita, Dhanvantari Tail etc. can be used. As for example Basti with Tikta
Dravya Ghrita and Kshira is recommended in Asthi kshaya .Tikta Rasa by its Deepana
(appetite stimulant)), Paachana (digestive) and Rochana (stomachic) properties increases
the Dhatvagni (metabolic stage). With increased Dhatvagni, nutrition of all seven Dhatu
is improved and thus it checks Asthi kshaya. Tikta Rasa by its Lekhana (scraping)
property helps in the weight reduction and thus supports the management of
Osteoarthritis .
Abhyanga (unctuous body massage) with various medicated oils such as
Mahanarayan Taila, Ksheerbala Tail or Masa Tails for external snehan done regularly as
daily routine to check vitiating Vata may also prove useful.
For symptoms occurring due to transition from madhayamavasth (pitta dominant
phase) to vradhhavastha (vata dominant), use of Ghrita can be recommended. Ghrita is
Vata-pitta shamaka (pacifying), Balya (strengthening), Agnivardhaka (promoting
digestion), Madhura, Saumya (agreeable), Sheeta-Virya (cooling in effect), Shulahara
(pain relieving), Jwar-hara (antipyretic), Vrishya (aphrodisiac) and Vayasthapaka (age
stabilizer). Thus, it not only pacifies Vata and Pitta but also improves the general
condition of the body and acts as a rejuvenator of the body. Ghrita is Yogavahi (special
affinity to carry and to potentiate the actions of the main drug to which it is mixed) and
thus helps in increasing bio-availability of other drugs without losing its own property.
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Medicated ghrita such as Amalak Ghrita, Shatavari ghrita, Guduchi ghrita, Chitraka
ghrita, Panchakola ghrita and Panchatikta ghrita are various medicated Ghrita
preparations suitable for menopausal women.
MEDICINAL PLANTS-
Ayurvedic literature is treasure trove of medicinal plants and herbs. Listed below are
names for treatment and management of menopausal symptoms and associated problems.
Vayasthapak Aushadha- (Age stabilizer drugs) According to Ayurvedic classification,
drugs of this group may possesses age sustaining and health promotive properties.
Jeevaneeya Aushadha- (Vitalizers/ restorative drugs) , Drugs of this group may promote
longevity and optimize all the vital constituents and functions in the body.
Balya Mahakashaya– (improving strength), the drugs of this group improve vigour and
power in body.
Rasayan Chikitsa- (rejuvenation therapy), is a unique concept of Ayurveda. It
provides a comprehensive physiologic and metabolic restoration for aging. Rasayana
chikitsa is mainly used for maintaining the health of healthy individuals although it can
be used for diseased also. The word Rasa in rasayan has multiple references; it refers to
the Rasa Dhatu in the context of Rasadi Sapta Dhatu (body tissues) and to the
pharmacodynamic properties of a drug in the context of Rasa Guna etc. Ayana means
circulation, the measures by which one is capable of getting the nourishing Rasa. Acting
through a complex and comprehensive mechanism of rasa-samvahan (circulation of
nutrient juices), dhatu, agni and srotas, it nourishes bodily tissues through micro-
nutrition, thus helping in regeneration, revival and revitalization of Dhatu. Acting at all
levels of Rasa are the drugs such as Draksha (Vitis vinifera Linn.), milk, Shatavari
(Asparagus racemosus), Salparni (Desmodium gangeticum) etc. they act by enriching the
nutritional value of the circulating plasma. Acting at the level of Agni i.e. at the level of
digestion and metabolism are the drugs such as Pippali (Piper Longum Linn.), Haritaki
(Terminalia chebula), Citraka (Plumbago zylenica), etc. they improves the digestion,
absorption and metabolism, and has some anabolic effect. Acting at the level of Srotamsi
(the microcirculatory channels carrying nutrition to the tissues) are the drugs such as
Guggulu (Commiphora mukul), Pippali (Piper Longum Linn.), Rasona (Allium cepa),
etc. These Rasayana cleans and activate the micro– circulatory channels i.e. Sroto
Shuddhi leading to improved tissue health and their quality . Appropriate applications
have potential to ward off problems related not only to aging and natural menopause but
also in menopausal symptoms induced due to surgical, medical and other reasons.
Aushadha Rasayana- Some of the Rasayan yoga (formulations) that may be helpful is

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Hartitaki Rasayan, Amalki Rasayan, Pippali Rasayan, Vidanga Rsayan, Shilajatu
Rasayan, Bhallataka Rasayana, Triphala Rasayana, Vardhman Pippali Rasayana etc.
They can be used in menopausal women for various indications.
Ahara Rasayana - To ward off problems related with agnimandya and ama
accumulation in body leading to dhatukshaya, following the directives of diet becomes
even more important in aging and women with menopausal symptoms. Aahar is
dhatuposhak and dhatu is responsible for the maintenance of compactness and strength,
dhatu reflects in the terms of Sara (absoluteness of body tissues), which makes a person
look young and beautiful . Menopausal women should refrain from Vata vitiating food.
Laghu (light) and Santarpaka (nutritive) diet is recommended. Packaged, processed,
frozen, canned food and erratic food habits should be avoided.
Achara Rasayana - Achara Rasayana (social and personal code of conduct) is
unique concept of socio- moral and behavioral therapy which is preventive in nature. It is
a non-pharmacological approach by which one can acquire the Rasayana effect
From the options presented, evaluation based on Rogi – Roga Pariksha (examination
of the patient as an individual irrespective of his disease and examination of the disease
entity/disease state) specific drug and therapeutics can be selected as per individual
needs.
Before deciding upon a treatment, the physician should minutely examine and
determine, Dushya (the Dhatu and Mala involved), Desha (the area of the body where
disease is manifested, the living place of the patient), Bala (strength of the patient), Kala
(season, how old is the disease, age of the person etc.), Anala (digestive power of the
patient), Prakriti (Body constitution), Vayas (age of the patient and disease), Satva (mind,
tolerance capacity of the patient), Satmya (The food and activities to which the patient is
accustomed to), Ahara (food habits) and Avastha (stages of the diseases) of the patient
and then only should decide the appropriate treatment.
DISCUSSION- Natural menopause is a biological process, at the transition phase of life
it brings changes that manifest as symptoms in some warranting attention, and it may
pass uneventful in most women. As this is often associated with aging, it is signified by
dhatukshya and Vata vitiation. At the dosha level, this involves transition from Pitta
dominant phase to Vata dominant phase of life; while aging and natural menopause is
distinctly different processes, the consequences of each are similar. Aging women should
embrace change of life. By understanding the bodily changes well in advance and making
gradual modifications in life style and food habits can give effective results. To prevent
or to reduce the symptoms Vayahsthapan, Vajikar, Balya, Rasayan, Vata- Pitta pacifying
drugs provide a vast range of options. For research purpose principles and philosophy of
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Ayurveda must be kept under consideration. Instead of looking for active chemical
constituents, paradigm should be on the trial of the whole drug . A condition such as
surgical menopause or premature menopause occurring due to genetic or medical reasons,
where menopause occurs before the age of 40 years and is not a part of natural aging
process, requires the need to distinguish between chronological age and endocrinal
change.
Assessment using elaborate methodology of Rogi Roga Pariksha and deciding
therapeutics based on Ayurvedic principals, suggested treatment modalities can be used
without any untoward effects for these individuals also. Further, women having
menopausal symptoms are led to believe that estrogen decline must be replaced and
medical intervention is needed. In majority of such women, the depletion of estrogen
which occurs during menopause does not need to be replaced; estrogen is only required
for women who have significant menopausal symptoms due to deficiency of the
hormones. Understanding age related changes and Doshic involvement at individual level
a timely intervention may help such individuals and prevent symptoms also.
CONCLUSION- Ayurveda and modern medicine have basic epistemological
differences. Ayurvedic wisdom and logic is more health-oriented than disease-oriented.
Started during midlife as component of preventive health care, management of
menopausal symptoms based on Ayurvedic principals can not only reduce the
menopausal symptoms but can also effectively address the aging and allied problems. It
can improve the quality of life as well as life expectancy of aging female population. It
provides wide range of treatment options in the form of single herbs, formulations,
therapeutic procedures and life style modifications, which can be utilized as per
individual needs. Single drugs given under Jeevaneeya, Vayahstapan and Balya
Mahakashaya, formulations and Rasayan Yoga, Ghrita Yoga and Achara Rasayan, Aahar
Rasayan opens new avenues for scientific researches. Although menopausal syndrome
does not find mention in Ayurvedic literature, todays growing population of suffering
female prompts us to look for effective and safer alternatives. It is not possible to name
each and every disease; it is the responsibility of the physician to identify the nature, sign
and symptoms of presenting ailment and treat it accordingly.
REFERENCES-
1. Ch. 321. 15th Edition 1987. Harrison's Principles of Internal Medicine.
2. http://en.wikipedia.org/wiki/Life_extension
3. Shastri A D, Sushrut Samhita of Maharishi Shusruta with Ayurvedatatvasandipika
Hindi commentary, Sutra Sthan, Chapter 35, Verse 36, Chaukhambha Sanskrit

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4. Atridev Gupta, Edi, 2nd edition, Charak Samhita, Viman Sthan, Chapter 8, Verse
22; ( also Sushrut Samhita, Chapter 15, Verse 22)
5. Gupta A, editor. Asthanga Hrudaya Sharira Sthana, Chapter 1, Verse 24 with
Vidyotini Hindi comm; Varanasi: Chaukhamba Sanskrit Sansthana; 1991 p. 364.
6. WHO Scientific Group. Research on the menopause in the 1990s. World Health
Organ Tech Rep Ser. 1996, 866, p. 1–107.
7. D.C.Dutta, Textbook of Gynecology 5th Edition ,Published by New Central book
agency ,Kolkata 2008 ,Page -55
8. Vagbhatt, Astang Hridaya, Sutra Sthan, Chapter 12, Verse 26-28; Astang Hridaya
Sutra Sthan, Chapter 11, Verse 26 Vagabhatt, Astang Hridaya ,Sutra Sthan,
Chapter 13, Verse 67-68
9. Agnivesha, Charak Samhita. Sutrasthana. Vol. 20. Vidyotini Hindi Commentry by
Pt. Kashinath Shastri and Dr. Gorakhanath Chaturvedi; Varanasi: Chaukhamba
Bharti Academy; 1998. p. 15.
10. Vagabhatt, Astang Sangrah, Sutra Sthan, Chapter 19, Verse 15; Vagabhatt,
Astanga Hridaya, Sutra Sthan, Chapter 11 , Verse 31; Charak Samhita, Sutra
Sthan, Chapter 28, Verse 27
11. Acharya Vaidya Jadavaji Trikamji, editor. Agnivesha, Charaka Samhita, with
commentary Chakrapanidatta; Sutra Sthan. Chapter 26, Verse 5, Chaukhabha
Sanskrita Sansthan. Vol. 28. Varanasi
12. Puri, H.S. Traditional Herbal Medicine for Modern Times, Rasayana - Ayurvedic
Herbs for Longevity and Rejuvenation. Taylor & Francis, London. 2003
13. Pandey, Dr. Gyanendra. Dravyaguna Vijnana. Varanasi India. Krishnadas
Academy, Second edition 2002
14. Atridev Gupta, (editor) (2nd edi.) Charaka. Charaka Samhita, Chikitsa Sthana,
volume2, Chapter 1, Abhayaamalakiyarasayanapada, Verse 6-7,p-51
15. Atridev Gupta, (editor) (2nd edi.) Charaka. Charaka Samhita, Sutra Sthan, Chapter
18, Versa 44-47.

***

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 Sthanik chikitsa (local treatment) in management of postmenopausal
problems
Dr. Umesh Rameshchand Lunawat
Ph.D. Scholar, Department of Streerog & Prasutitantra,
Dr. D.Y.Patil
College of Ayurved and Research Centre, Pimpri,
Dr. D.Y.Patil
Vidyapeeth Pune, Maharashtra, India. And Asso.
Professor and Head, PTSR department, Jupiter ayurved medical college, Nagpur.
Emai: umesh.lunavat@gmail.com
Dr. Jayashree Patil
Guide and H.O.D., Department of Streerog & Prasutitantra,
Dr. Aarifa Shaikh
Asso. Professor, SGR Ayurved College, Solapur, Maharashtra, India
Email: aarifashaikh2685@gmail.com

Abstract:
Though India is the largest country with youth population, the percentage of cohort of
elder population increases since last decade due to increased life expectancy and standard
medical facilities. Elder women outnumber more than elder men due to gender difference
in life expectancy. Geriatric syndromes means cohort of health issues related to old age.
Women during her perimenopausal and postmenopausal age suffers from many health
issues like atrophic vaginits, genital prolapse, pshychological problems, dementia, sleep
disorders, urinary incontinence and increased risk for cardiovascular and cerebrovascular
diseases. Health professional have to formulate protocol for proper care and medical
facility to elder women. Many local therapies are indicated for management of issues of
old age. In ayurveda along with rasayan chikitsa(rejuvenating treatment) many local
therapies are mentioned which can be used for management of geriatric syndromes.
Murdhnitail, hrudbasti, yonipichu, yoniparishek, yonidhawan, yonilep, yonipuran,
yonilep, yonivarti, yoniabhyang, uttarbasti can be advised as per need of geriatric issue
with appropriate ayurvedic formulations.
Keywords: Geriatric women, geriatric syndrome, sthanik chikitsa, menopause
1. Introduction
As per the latest UN report, India has the world‘s largest youth population despite
having a smaller population than China. Every third person in an Indian city today is
youth, and thus India is said to be youngest country in world.(i) Though, youth
populations contributes a major portion of population, the cohort of elder peoples also
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increasing since last few years as a result of increase in life expectancy, quality medical
facilities and reduction in fertility rates. Most of world‘s aging women are living in
developing countries. In India, Life expectancy for males is 70.4 years and for females
71.8 years.(ii) Gender difference in life expectancy implies that the population of elder
women is more than older men. As a population of elder women increases, the health
professionals have to be ready to provide adequate and special medical facility to health
problems of such cohort.
Elder women have to face many general and reproductive health problems. Many
countries, facing new challenges and burden on health cost associated with health issues
of elder population. Health sector tries to formulate new policies and guidelines for care
of elder cohort of population.
Data on health status of postmenopausal women is not much available for developing
countries. As compare to elder men, the rate of certain chronic diseases such as
osteoporosis, arthritis, diabetes, hypertension is significantly higher in elder women.
About one third of life span will be spent during the period of estrogen deprivation stage
with long term symptomatic and metabolic complications. Though menopause is
physiological stage of female life, she has to face many local health concerns like uro-
genital atrophy, sexual dysfunctions and systemic concerns related to cardiovascular
system, cerebrovascular system, psychological problems, osteoporosis and fractures.
Problems of postmenopausal women can collectively term as geriatric syndrome.
Postemopausal symptoms management includes use of non hormonal and hormonal
medicines, which can be given by systemic or local route.
Table 1: Health problems of elder women in postmenopausal age : (iii)
Systemic Health Local Health Concerns
concerns Related to Urogenital Related to other system
system
Anxiety Dysparunia Hot Flushes
Insomnia Vaginal dryness Thinning and wrinkling of
skin
Irritability Atrophic vaginitis Thinning of Hairs
Insomnia Decreased sexual desire Malignancies – Breast
Depression Dysuria
Dementia, Alzheimer Recurrent urinary
disease infection
Mood swing Urinary incontinence
Osteoporosis and fracture Genital Prolapse
Cardiovascular diseases Infections, STIs

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 like strokes, IHD, CAD
Atherosclerosis Malignancies – Cervical,
Endometrial, Ovarian
Cerebrovascular diseases

In ayurveda, rasayan chikitsa (rejuvenating treatment) is advisable for elder age

group. Many formulations are mentioned in ayurvedic literature under rasayan chapter.
Health concerns in geriatric syndromes can be managed well with ayurvedic formulations
which can be administered internally or locally. Chikitsa (treatment) can be broadly
classified as abhyantar chikitsa (internal medicine) and sthanik chikitsa (local treatment).
2. Management of health concerns of elder women
2.1 Rasayan Chikitsa (Rejuvenation treatment)
Rasayan therapy promotes healthy life by preventing disease, improves immunity,
strength, vitality, memory, intelligence and works like rejuvenation.(iv) Rasayan therapy
can be used as preventive as well as therapeutic for geriatric syndrome. Health of elder
peoples depends on their health status in earlier period of life. Adopting principles of
dincharya (principles of daily routine), rutucharya (principles as per season) and rasayan
chikitsa from younger age will be helpful for better health status in elder age.
2.2 Sthanik Chikitsa (Local route of drug administration):
Local application of ayurvedic formulation like decoction, medicated oils, ghee etc.
is as important as internal rejuvenating formulations. Local symptoms will resolve more
rapidly with local application of drug as high concentration of drug is expected to act at
target organ than internal medication. Drugs show faster and efficient action on local
organs when applied locally. Ayurveda describes many local treatments for
gynecological as well as other disorders. We can summarize such local treatment as per
problems as geriatric syndrome in women as follows:
Table 2: Sthanik chikitsa (local treatment) for various menopausal symptoms
Health Concern Local treatment Meaning
Psychological Moordhnitaila :- Application of medicated oils
Problems Shiro-abhyang over head in different ways
Sleep disorders Shirodhara
Shiropichu
Shirobasti
Cardiovascular Hrud-basti Medicated luke warm oil is
problems poured into a well made from

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 black gram paste over
precordial region for a specified
time.
Skin dryness, Abhyang Massage with medicated oil
thinning etc
Osteoporosis Basti Transrectal administration of
medicated milk, oil, ghee
Urinary Problems Uttarbasti Administration of medicated oil
or decoction through urethra
Genital Problems Yoni Pichu Tampon soaked in medicated
oil inserted in vagina and
withheld for specific period
Yoni Dhawan Cleansing of vaginal canal with
decoction or medicated oil
Yoni Varti Insertion of herbal pessary in
vagina
Yoni parishek Cleansing of vulval part with
decoction or medicated oil
Yoni dhupan Fumigation of perineum with
herbal medicines
Yoni Abhyang Local application of medicated
oil over vulval and vaginal
region
Yoni Lep Application of paste of herbal
drug powder over vulval or
vaginal area
Yoni Puran Filling of vaginal canal with
medicated oil / kalka (Paste of
powdered drugs)
Yoni kalka dharan Insertion of paste of herbal
powder in vaginal canal
Uttarbasti Intrauterine administration of
decoction or medicated oil

a.Psychological issues: Elder women suffer from anxiety, depression, dementia, sleep
disturbance, irritability and mood swings during peri-menopausal and postmenopausal
period. Rasayan dravyas improves memory, intelligence. Murdhnitail (application of oil
over head in different way) is the local treatment described in ayurvedic classics. Sesame
oil, oil medicated with jatamansi (Nardostachys jatamansi), Himasagar tail can be used

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for this purpose. Kshirdhara (pouring a cow milk on forehead by specific method for a
specified time) (ajay kumar et al 2007, university of rajasthan), jaldhara (pouring water
on forehead by specific method for a specified time), takradhara (pouring a curd on
forehead by specific method for a specified time) (B. G. Gopinath et al RGUHS, 2003)
gives significant result for insomnia, sleep disorder and irritability.
b. Cardiac problems: Hrudbasti is the local therapy in which medicated luke warm oil is
poured into a well made from black gram paste over precordial region for a specified
time. It is said to be beneficial for cardiac disorders, atherosclerosis, coronary artery
blockages, palpitation etc. Cardiac complications are more common in elder women in
postmenopausal period. Hrudbasti therapy can effectively used to overcome these cardiac
problems.
c.Skin and hair problems: Dryness of skin and hairs, hair fall are common problems in
elder age group. There is predominance of Vata dosha in old age which aggravates such
condition. Oleation is ideal treatment for disorders of vata dosha. Abhyang (oleation)
with medicated oils helps to take of these problems.
d.Genito-urinary problems: Repeated child birth, poor access to facilities for the repair
of birth injuries, poor hygiene, untreated genitor-urinary tract infections are common
reasons for genitor-urinary problems in elder age group women. Dysuria, urinary
incontinence is a common problem in elder woman. Along with internal medicine
uttarbasti (transurethral administration of medicated oil in urinary bladder) had
significant result for urinary problems. It helps to alleviate vata dosha. It provides
strength to bladder and urethral sphincter. Ashwagandha (Withania somnifera) tail
uttarbasti shows significant result in stress incontinence (Patil netra K et
al.AYUSHDHARA, 2020:7(suppl 1):81-84).
Genital prolapse, reproductive tract infections, atrophic vaginits, dysparunia are common
gynecological issues in elder postmenopausal women. For local application of medication
over genital tract many local therapies are mentioned while describing treatment for
gynecological disorders. Local therapies mentioned in management of reproductive
system disorder are yonipichu, yoniabhyang, yonidhawan, yonivarti, yonilep, yonipuran,
yonidhupan, yoniparishek and uttarbasti. Many ayurvedic formulations mentioned in
ayurvedic texts for used as local therapy in different ways. Some of commonly used
formulations as local therapy for genito-urinary issues are enlisted below;

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 Table 3: Commonly used ayurvedic formulations for menopausal problems
Indication Local therapy Ayurvedic formulation
Atrophic vaginits Yoniabhyang Til tail (sesame oil)
Yonipichu Shatapushpa tail, shatavari
Uttarbasti tail
Kashmaryadi ghrut
Jeevaniyavarg siddh tail
Jeevaniyavarg siddha
dugdh
Genital Prolapse Yonipichu Mushaksiddha tail
Yoniabhyang Changeryadi ghrut
Yonilep Chukra tail
Uttarbasti Traivrut sneha
Yonipuran Lajjalu Churn
Traivrut sneha
Vasa,Goghrut yonipuran
Genital infection Yonidhawan Triphala Kashaya
Yonivarti Panchvalkal kashaya
Yonipichu Kushtha-pippalyadi varti
Yoniabhyang Pippalyadi varti
Yonikalka dharan Shodhan tail
Uttarbasti Dhatakyadi tail
Jatyadi ghrut / tail
Triphala kalka
Hinstra kalka
Shyama-trivrut kalka
Urinary incontinence Yonipichu Bala tail
Uttarbasti Ashwagandha tail
Cervical erosions Yonipichu Jatyadi ghrut / tail
LSIL Uttarbasti Ropan tail
Ksharkarm (local Apamargkshar
application of kshar

2.3 Local therapy as part of Menopausal Hormone Therapy (MHT)

―Menopausal hormonal therapy‖ (MHT) or ―hormonal therapy‖ (HT), previously
termed as ―hormone replacement therapy‖ (HRT) is the term used to denote management
of menopausal health issues with replacement of estrogen or estrogen with progesterone.
Primary goal of estrogen replacement is to relieve vasomotor symptoms and genito-

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urinary problems like vaginal dryness, atrophic vaginitis, recurrent urinary tract infection
etc. Estrogen can be used in form of vaginal gel, vaginal rings.(v)
3.Discussion:
Geriatric syndrome can be effectively managed by internal medication described in
rasayan chikitsa (rejuvenating treatment) chapter and by local medication (sthanik
chikitsa). While describing treatment of yonivyapad (disorders of female genitals), most
of formulations are advised to administer by transvaginal route as local therapy. The
purpose behind this vaginal route may be for better efficacy of drug, more absorption and
high concentration of drug in local genital organs for better recovery and to avoid
systemic adverse effects of drug, if any.
Hormone replacement, either by systemic or vaginal route, is the primary goal for
management of menopausal symptoms. Hormone replacement by vaginal route is more
preferable than systemic due to minimal side effects. Also vaginal epithelium had higher
concentration of estrogen receptors, which facilitate fast action of estrogen.
Vaginal drug administration is a part of Topical Drug Classification System (TCS). It
is used as a route for local action of drug in cervico-vaginal region. In recent years, the
vaginal route has been rediscovered as a potential route for systemic delivery of
therapeutically important macromolecules. (vi)
Drug absorption through vagina get influenced by thickness by vaginal epithelium,
vaginal fluid volume and composition, pH of vagina and sexual arousal. The
physicochemical properties of administered drug like molecular weight, lipophilicity,
ionization, surface charge, chemical nature also affects absorption of drug.
Supportive reasons for selecting vaginal route for drug administration are:
i. Mucosal surface with rugae provides a large surface for drug absorption.
ii. Arteries, blood vessels, lymphatic vessels are abundant in the walls of the vagina.
iii. Dense network of blood vessels in vagina made it an excellent route for drug
delivery for both systemic and local effect.
iv. Vaginal epithelium had higher concentration of estrogen receptors, which
facilitate fast action of estrogen.
v. Reduced vaginal epithelial thickness in postmenopausal women facilitates
maximum drug absorption through thin epithelium.

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 vi. Vaginal progesterone absorption in estrogen deficient women who were receiving
vaginal estrogen therapy was found to be increased, although prior estradiol
therapy should have caused an increase in vaginal epithelium thickenss.
vii. The absorption of progesterone was increased with increased vascularity of the
vagina.
viii. For better efficacy of drug, long term retention of drug formulation in vaginal
cavity is necessary. In different forms of local treatment modalities, the drug is
advised to retain in place for specific period of time.
ix. Ideally a vaginal drug delivery system that is intended for local effect should
distribute uniformaly throughout vaginal cavity. In yonipuran, yonilep,
yoniabhyag the drug is advised to uniformaly distribute throughout vaginal cavity.
x. Rapid drug absorption and quick onset of action can be achieved with vaginal
route.
xi. The vaginal bioavailability of smaller drug molecule is good.
xii. The bioavailability of larger drug molecules can be improved by means of
absorption enhancer or other approach.
xiii. Hepatic first pass elimination of high clearance drugs may be avoided partially.
xiv. Effective route for delivery of hormones
4.Conclusion:
Geriatric syndrome in menopausal women can be effectively treated with rasayan
chikitsa (rejuvenating treatment). Different forms of local therapy mentioned in
ayurvedic classics which can be judiciously used for management of menopausal
syndrome as per need. Local route of drug administration has its own additional benefits
and it is as important as internal medication.
5.References:
i) https://economictimes.indiatimes.com/news/politics-and-nation/india-has-worlds-
largest-youth-population-un-report/articleshow/45190294.cms?from=mdr,
4/10/2021
ii) https://www.worldometers.info/demographics/india-demographics/ 4/10/2021
iii) D.C.Dutta, Textbook of gynaecology, New central book agency, fifth edition,2008
page 57

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iv) Vidyadhar shukla, ravidatta tripathi, Charak samhita, part II, verse 7-8 chapter 1/1,
page no-5, Chaukhamba Sanskrit pratishthan, Delhi, 2004.
v) https://www.uptodate.com/contents/treatment-of-menopausal-symptoms-with-
hormone-therapy 6-10-2021
vi) Ashok vadithya et al,A review on vaginal route as a systemic drug delivery,
Critical review in pharmaceutical sciences, Issue 1: April 2012
(https://www.researchgate.net/publication/224318371_A_review_on_vaginal_rout
e_as_a_systemic_drug_delivery)

***

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Importance of Rasayanas and Ayurveda Approaches for Restoring the
Health of Geriatric Women W.S.R. to the Management of Gynecological
Problems
Dr Harkiran Nehra, M.S. (Ayu).
Professor, Prasuti Tantra & Stri Roga, Sardar Patel Institute
of Medical Sciences and Research Centre, Lucknow, India.

Abstract
Ayurveda, the science of life practicing in India since ancient time and acceptance of
natural drugs is increasing day by day globally. Ayurveda‘s approach helps to cure many
health ailments, promotes general health and delay consequences of aging, etc. In this
regards it is well documented that Ayurveda provides unique modalities for geriatric care
and many natural drugs offers health benefits in gynecological issues related to the
elderly patient. Natural menopause is biological process associated with middle aged or
elderly women. The condition mainly involves Dhatukshya and Vata vitiation. In this
connection Ayurveda advocated some approaches (Vayasthapan, Vajikara, Balya and
Rasayana) for managing gynecological problems associated with elderly women. The
Rasayana and Vata- Pitta pacifying drugs mainly advised for delaying symptoms of aging
in geriatric female. These drugs are Yastimadhu, Draksha, Pippali, Haritaki, Chitraka,
Shatavari and Shaliparni, etc. Moreover Ayurveda formulations such as; Amalaki
Rasayana, Pippali Rasayana, Hartitaki Rasayana, Vidanga Rsayana, Bhallataka
Rasayana, Triphala Rasayana and Shilajatu Rasayana, etc. are also recommended for
reversing consequences of menopause in elderly women. These drugs also help to restore
general health by enriching nutritional value of the circulating plasma. The Ayurveda
Rasayana therapy acts at the level of Agni thus improves digestion and metabolic
activities which gets suppressed in elderly people. The Rasayana not only rejuvenate
whole body but also improves quality of Rasa and establishes hormonal balances,
therefore considered good for elderly female.
Key-Words: Ayurveda, Geriatric, Gynecological, Rasayana.
Introduction
Ayurveda is a medical science that routed through the knowledge of ancient
philosopher and Vedas. This science encompasses heritages of Indian culture and offers
several theories related to the disease prevention and treatment. This science deals with
physical, mental as well as spiritual health of person. Ayurveda provides different
modalities for maintaining health and curing symptoms of aging, in this regards

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Ayurveda practitioner advised specific therapy i.e. Rasayana for managing gynecological
problems associated with elderly women [1-4].
The gynecological problems are very common in current scenario due to the stressful
and disturbed pattern of life style. The elderly women suffer from many health problems
and menopause is major gynecological consequence of aging in elderly female.
Dhatukshaya is the main factor which leads degenerative changes in elderly female,
Table 1 depicts specific health problems associated with degenerative changes of
particular types of Dhatu in elderly female.
Table 1: Dhatukshaya in geriatric female:

S. No. Types of Related Health Problems/Pathological Symptoms

Dhatukshaya
1 Rasakshaya Hridravata, Shool, Shosha and Trusha
2 Raktakshaya Rajonivrutti, Twakrukshata and Sirashaithilyata
3 Mansakshaya Toda, Rukshata, Sandhi Sphutan and Sandhi vedana
4 Medokshaya Angarukshata, Shosha and Krushta
5 Ashtikshaya Asthi kshaya and Sandhi shaithilya
6 Majjakshaya Asthi soushirya, Dourbalya, Bhrama and Sandhi
Shunyatva

As depicted in above table the aging is responsible for many health issues and
Raktakshaya in elderly women can lead to symptoms of Rajonivrutti, Twakrukshata and
Sirashaithilyata. The Dhatukshaya in geriatric female is responsible for Shoola, Trusha,
Rukshata, Sandhi Sphutan, Asthi kshaya and Dourbalya, etc. Moreover geriatric female
also suffers with menopausal symptoms therefore special care is needed for restoring
health of elderly female. Ayurveda Rasayana therapy offers several health benefits for
delaying age related degenerative changes and cure post menopausal symptoms [3-5].
The health benefits of Rasayana recommended for geriatric care depicted in Table 2.
Rasayana yoga (formulations) offers health benefits for reliving menopausal symptoms
are as follows:
 Haritaki Rasayana
 Amalaki Rasayana
 Pippali Rasayana

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  Vidanga Rsayana
 Shilajatu Rasayana
 Bhallataka Rasayana
 Triphala Rasayana
Table 2: Rasayana advised for geriatric care

S. No. Rasayana Health benefits in geriatric female

1 Yastimadhu Used for voice, hair, strength and libido
2 Sankhpushpi Relieves stress and anxiety related to the aging
3 Mandukaparni Anxiolytic and psychotropic activity
4 Guduchi Restore immunity and prevent common age
related illness
5 Ahara Rasayana Prevent Agnimandya and accumulation of Ama,
imparts Dhatuposhak effects and maintain
strength.
6 Ashwagandha Balya and Vaya-Sthapana properties cures
symptoms of early aging
7 Amalaki Possess Rasayana Karma
8 Haritaki and Responsible for Dhatu Pushti
Vasa

Rasayana Benefits in Menopausal Symptoms:

 The Sheeta and Madhura Rasayana i.e.; Yastimadhu pacifies hot flushes.
 Drugs like Shatavari boost mental strength thus prevent post menopausal
depression and anxiety.
 The calming and soothing and Rasayana helps to cure insomnia and mood
swings.
 Some aphrodisiac medicines prevent vaginal dryness, loss of libido and
atrophic vaginitis associated with aging.
 Rejuvenating Rasayana resist dryness of skin and pacify palpitations.
 The drugs like Pippali and Haritaki boost digestive fire in elderly patient
thereby restore metabolic activities which ultimately strengthen Dhatus.
 Support regeneration, revival and revitalization of Dhatu, therefore delay
degenerative effects of aging related to the depletion of Dhatus in elderly
female.

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Effects of Rasayana at the level of Ojas and Tejas:
Ojas is responsible for immunity, stability and nourishment. The low level of Ojas in
elderly women increases susceptibility towards the illnesses. The physical and mental
strength get diminishes due to the lack of Ojas in case of geriatric patient. The Ayurveda
Rasayana imparts rejuvenating and nourishing effects therefore restore Ojas and
improvement in metabolic activities boost immune power thus prevents prevalence of
common illness.
Tejas is considered as refined version of Pitta, acts as positive subtle essence of Agni
and helps to restore digestive fire. It controls intelligence and enthusiasm, the process of
aging witnessed lack of enthusiasm and mental imbalances. Ayurveda Rasayana likes
Draksha, Shatavari and Chitraka, etc. improves mental function and provides energy by
improving nourishment of body therefore diminishes effects of aging. Ayurveda drugs
helps to maintain intelligence and enthusiasm thus govern functioning as like normal
level of Tejas.
Rasayana acts on levels of Rasa:
Draksha and Shaliparni strengthen Rasa by enriching nutritional value of circulating
plasma (Rasa). Therefore restore circulatory functioning in geriatric female.
Rasayana acts on levels of Agni:
Pippali and Haritaki acts at the level of Agni by improving digestion and metabolism,
in this way these drugs nourish whole body and maintain physical as well mental
strength.
Rasayana acts on levels of Srotas:
Guggulu and Rasona, etc. acts at the level of Srotamsi thus restore functioning of
microcirculatory channels of body thus maintain nutritional supply affected by
degenerative changes of aging. These Rasayana cleans micro-channels thereby imparts
Sroto Shuddhi action which is important to retain normal process of circulation.
Probable mode of action of Rasayana for Geriatric Care:
Vata Dosha and Agnimandhya mainly causes Rajonivritti and specific Gunas of
Rasayana helps to cure this problem in geriatric female as depicted in Figure 1.
The Madhura and Kashaya Rasa of Rasayana offer Medhya & nourishing effects thus
reverse effects of degenerative changes in elderly female.
Sheeta Virya of Rasayana provides calming and soothing effects thus relax mind and
cure anxiety or stress related to the menopausal symptoms.

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 Laghu Guna of Rasayana cleans micro channels of body thus regularizes circulatory
process of body.
Tridoshashamaka property of the Rasayana drugs establishes balances amongst
Doshas therefore give Vayahsthapana, Balya and Vedanasthapana, etc., properties [6-8].
Figure 1: Mechanism of Rasayana for managing Rajonivritti

Vatavriddhi and Agnimandhya

Rajonivritti

Snigdha Guna of Rasayana

Nullify Ruksha Guna of Vata Dosha

Deepana-Pachana action of Rasayana leads Dhatu Pushti

Subside symptoms of Rajonivritti

Conclusion
Ayurveda offers excellent approaches for graceful and safe transition into menopausal
phases for geriatric or middle aged female. Rasayana therapy is considered beneficial for
graceful menopause and managing health problems associated with geriatric female.
Ayurveda Rasayana reduces menopausal symptoms and effectively cures aging and allied
problems. Rasayana improves quality of life in geriatric female since these drugs offers
Jeevaneeya and Vayahstapan effects. Rasayana Yoga, Achara Rasayana and Aahara
Rasayana, etc. are effective and safer alternatives for curing health of geriatric female.

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References
1. D.C. Dutta, Textbook of Gynecology 5th Edition, Published by New Central book
agency, Kolkata 2008, Page -55.
2. Kaviraja Ambikadutta Shastri Susrutasamhita of Maharsi –susruta Ayurveda,
Tattva-Sandinpika Hindi Commentary, Pulished by- Chaukhambha Sanskrit
Sansthan Varanasi 2010, Page -27.
3. Kaviraja Ambikadutta Shastri Susrutasa mhita of Maharsi –susruta Ayurveda,
Tattva-Sandinpika Hindi Commentary, Pulished by-Chaukhambha Sanskrit
Sansthan Varanasi 2010, Page-9.
4. Kaviraja Ambikadutta Shastri Susrutasamhita of Maharsi –susruta Ayurveda,
Tattva-Sandinpika Hindi Commentary, Pulished by- Chaukhambha Sanskrit
Sansthan Varanasi 2010, Page -131.
5. Kaviraja Ambikadutta ShastriSusrutasamhita of Maharsi –susruta Ayurveda,
Tattva-Sandinpika Hindi Commentary, Pulished by- Chaukhambha Sanskrit
Sansthan Varanasi 2010, Page -6.
6. Sushruta. Sushruta Samhita, Sutra Sthana, Shonitvarnaniya Adhyaya 14/6,
Ambika Dutta Shastri, ‗Ayurveda-Tattva-Samdipika‘ Vyakhya. Reprinted 2nd ed.
Varanasi: Chaukhamba Samskrit Samsthan; 2006. p. 48.
7. Vagbhatta. Asthanga Hridaya, Sharira Sthana, 1/7, Commentary by Kaviraj
Atridev Gupta. Reprinted. Varanasi: Chaukhamba Surbharti Prakashan; 2007. p.
170.
8. Bhavamishra. Bhavaprakasha Purva Khanda 3/1. Pandit Shree B. S. Mishra. 9th
ed. Varanasi: Chaukhamba Samskrit Samsthana; 2005. p. 204.

***

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 GYNAECOLOGICAL DISORDERS IN GERIATRIC WOMEN
Name of the student Name Of Guide
Dr . Jagruti Rajendra Patil Dr .Prashant Dalvi,
PG scholar HOD,
Department of Streeroga and Prasutitantra Dept of PTSR,
R.A. Podar medical ( Ayurveda) college, RAP Medical College ,Mumbai
Mumbai
Email ID: sonalrrpatil30@gmail.com
Mobile no. 9405648451
PG Girls Hostel, R. A. Podar Hospital , Annie Besant Road, Worli , Mumbai

ABSTRACT:
Geriatric gynaecological problems have not received adequate attention in India. Even
the vaginal discharge may be indicative of underlying cervical cancer. Increase in the use
of various pesticides , exposure to radiations etc . are affecting the quality of life which
ultimately affect geriatric health. Various disorders occur particularly in this age group
right from oestrogen deficiency symptoms to cancerous growths, having variability in
their prognosis. Spectrum of gynaecological disorders, comorbidities, diagnosis and
management should have to be noticed and analysed.
The responsibility of the gynaecologist as the primary physician for geriatric patients
increases, to detect the cancer earlier and manage it to decrease morbidity and mortality.
Not only doctors but also older women need to be aware of their health issues. So it is our
duty to make them aware.
Keywords – Prolapse , malignant changes , oestrogen deficiency
Introduction

वमो मथास्थूरबेदेन त्रिपवधभ ्-फारं, भध्मं, जीणिशभनत । (च० सं० पव० ८/१ २२)[7]

वि
ृ तु ऺीमभाणधाष्त्वष्तद्रमाददगुणभ ् वरीखरनत......। ( अ.सं.शा.)
Age is briefly classified in three phases according to Ayurveda ,Bala ,madhyam ,
jeerna . The word jeerna indicates the decreased power of various systems of our body to
various conditions. As there are various changes occurring in female body according to
age and hormonal changes her body is most vulnerable to the diseases in this age which
we have to care of.
Gynaecological disorders in older women differ from those who are younger. Elderly
women experience vasomotor, urogenital, psychosomatic, psychological symptoms and

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sexual dysfunction. These urogenital changes make women vulnerable to gynaecological
morbidities. Common gynaecological problems encountered in elderly women are
vulvovaginal inflammation, genital prolapse, postmenopausal bleeding, malignancy and
alteration in bladder function. Population aging is emerging as a pre-eminent
phenomenon throughout the world. Among the aged, the women deserve special attention
because they outlive men in most societies. Nevertheless, postmenopausal and geriatric
gynaecological problems have not received adequate attention in India. There is an
obvious need of screening programme for early detection of gynaecological malignancy
to provide better geriatric services, but a paucity of data regarding gynaecological
morbidity in geriatric women hampers proper planning.
It‘s our primary responsibility that we have to detect the various life threatening disorders
in their early stage and ensure the healthy life to elderly women.
Common gynaecological problems include:
 Cervical Dysplasia.
 Menstrual Disorders.
 Pelvic Floor Prolapse.
 Pelvic Pain.
 Polycystic Ovarian Syndrome.
 Uterine Fibroids.
 Urinary Incontinence.
Causes of various gynaecological disorders in geriatric women.
1. Estrogen deficiency-As it is the most important hormone which protects the
female genitelia from various infections, abnormalities by its various actions.
After menopause deficiency of oestrogen causes atrophy of epithelial lining of
genital track making it vulnerable for various infections.
2. Obstetric History – Home deliveries ,multiple vaginal deliveries, improper care
during puerperium etc causes laxity in pelvic floor which will lead to genital
prolapse ,cystocele ,rectocele etc.
3. Decreased immunity – Due to dietary deficiency, comorbidities like
hypertension, diabetes, age related decreased immunity power will lead to various
infections of genital track or aggravate the previously presented uncovered
infections. Hence increased incidence of UTI, vaginal discharge occurs in this age.
This may lead to many metastatic changes and finally cancers.
4. Unopposed oestrogen – Endogenous source of oestrogen like tumours or PCOS
or exogenous sources like single oestrogen replacement therapy in menopause will

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 lead to endometrial hyperplasia ultimately endometrial cancer. Breast cancer also
caused by oestrogen therapy
5. Age related diseases-Many diseases are common in this particular age e.g.
endometrial cancer , ovarian cancer, breast cancer.
6. Hereditory – As menarche age ,menopausal age or pattern of a women is
generally similar to that of her mother there are increased chances of developing
the malignant disorders if she had the family history have the same
Classification of various gynaecological disorders in geriatric women.
1.According to cause
A)Due to laxity of muscles and tissues
1. Urge Incontinence
2. stress Incontinence
3. cystocele
4. rectocele
5. Uterine prolapse
B) Due to oestrogen deficiency
1. Senile Vaginitis
2. 2.Dyspareunia
3. 3.Vaginal infections
4. 4.osteoporosis
5. 5.Pruritus vulvae
C) Due to unopposed oestrogen therapy
1. 1.Endometrial Hyperplasia
2. Endometrial cancer
3. 3.Breast cancer
2 According to site
1.External Genitalia
1. Vulva – pruritus vulvar, lichen sclerosis, vulval carcinoma
2.vagina– Vaginal infections, dyspareunia, vaginal wall prolapse
3.Urinary System- Frequency of micturition, stress Incontinence, urge incontinence
recurrent UTI, retention of urine .
2.Internal genitalia

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1.Cervix- Cervical erosion
Cervical intraepithelial neoplasia
2.Uterus – Endometrial hyperplasia
Endometrial Carcinoma
Uterine prolapse
3.Ovaries – Ovarian cancer.
Diagnostic methods. Patients should have to undergo screening test of various
gynaecological disorders occurring especially in geriatric age group.
1.PAP smear test
To rule out CA – cervix
Should be done if any cervical discharge is present
2 Routine USG pelvis
In case of postmenopausal bleeding, dyspareunia to rule out endometrial
hyperplasia
3 Endometrial biopsy
Patients complaining of postmenopausal bleeding, delayed menopause and having co
morbid diseases like HTN ,DM have to be ruled out for CA endometrium
Patients having history of CA breast ,CA ovary or having family history of the above
have to be screened for CA endometrium.[4]
4 Mammography
As the risk of breast cancer increases with family history of the same or other
gynaecological cancers she have to be screened for CA breast to detect it in early case [4]
5. General investigations for vaginal discharge, swab culture, CBC , urine culture have to
be done for concerned diseases
6.Screening for hypertension, diabetes, BSL fasting-PP , lipid profile have to be checked
regularly as these are all related to each other and geriatric age.
Treatment
1.Prevention
A)Early diagnosis give the proper direction to treatment

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B)Dietary supplements, nutritional improvement will improve their immunity ultimately
life status
C) Care during reproductive age- Deliveries in hospital postpartum care, avoiding
multiple deliveries will reduce the chances of genital prolapse
Pelvic floor exercises also improve the tone of muscles and hence reduce the chances of
prolapse
2.Curative
 Proper history taking.
 According to disease
1. Frequent UTI – general antibiotics along with local oestrogen
2. Prolapse – surgical intervention
3. Cancerous growths-surgical interventions along with radio or chemo therapies
4. According to Ayurveda

वमो मथास्थर
ू बेदेन त्रिपवधभ ्-फारं, भध्मं, जीणिशभनत । (च० सं० पव० ८/१ २२) [6]

The old age starts after sixty or seventy and is dominated by the vaat dosha. So the
disorders occur in the geriatric age have the predominance of vaat Dosha.
Rajonivrutti ayu:

तद् वषािद् द्वादशादध्

ू वं मानत ऩञ्चाशत् ऺमभ ् । (सु० सं० सू० १ ४/६)[9]

Caesation of menses occurs after the age of 55 years .

Relation of shukra dhatukshaya with geriatric age:

शक्र
ु ं धैमं च्मवनं प्रीनतं दे हफरं हषं फीजाथिञ्च । (सु० सं० स०
ू १ ५/५ )[9]

As dhairya ,chyavan of other dhatus ,dehabaala ,harsha and beeja nirman are the
functions of shukra dhatu and these get reduced in vruddhavastha so there is a relation
between the geriatric age and shukrakshay.
Common gynaecological disorders according to ayurveda
1. Mahayoni

2. Stanarbud- as शुक्रवहे द्वे तमोभर

ूि ं स्तनौ वष
ृ णौ चI स.ु शा.9/12
[ 10]

Stana are moolasthana of shukravaha stratus hence after menopause vaat also affects the
moolasthan and form granthi

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Dosha -Vaat dosha
Dushya- Saptadhatu especially shukra
Treatment
Chikitsatatva for geriatric problems
1) Bruhan
2) Dhatvagnivardhan
3) Shukravardhan
4) Vaat shaman
Results and discussion:
The severity of disorders occur in geriatric women vary right from just vulval itching
to cancers of ovary , endometrium, breast. Multiparous women will show genital prolapse
more than the women having limited no. of deliveries. Women having family history of
any gynaecological cancer have higher risk of developing it.
Conclusion:
As the diseases occur in geriatric women will lead to life threatening conditions if not
detected early ,we should start to make them aware by conducting various camps so as to
reduce morbidity and mortality ultimately improving their life status
References:
1. Jonathan s. Berek , Berek & Novak‘s Gynaecology ,page no. 1233
2. Hiralal Konar, DC Datta Textbook of Gynaecology ,page no. 561
3. Hiralal Konar, DC Datta Textbook of Gynaecology ,page no.333
4. Jonathan s. Berek ,Berek & Novak‘s Gynaecology ,page no. 1350
5. Premavati Tiwari, Ayurvediya Prasutitantra evam streeroga, page no.36
6. acharya Priyavat Sharma, charak Sanhita ,Chaukhamba prakashan,viman sthan
adhyay -8, shlok-122,page no.655
7. Premavati Tiwari, Ayurvediya Prasutitantra evam streeroga ,page no.51
8. Premavati Tiwari, Ayurvediya Prasutitantra evam streeroga , page no32
9. Vaidya Datto Ballal Borkar ,Sarth Susrut Sanhita ,Page no.-55.
10. Vaidya Datto Ballal Borkar ,Sarth Susrut Sanhita ,Page no..365

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 GYNECOLOGICAL DISORDERS IN GERIATRIC WOMEN
AYURVEDIC MANAGEMENT OF GYNECOLOGICAL
DISORDERS IN GERIATRIC AGE- A REVIEW
Dr. Janabai Shrimant Sargar
Dr. Veena Ajay Patil
P.G. Scholar, (Streeroga & Prasutitantra),
Govt. Ayurved College, Osmanabad.
E-mail - sargar75janabai@gmail.com
M.S. PhD, Prof. & HOD (Streeroga & Prasutitantra),
Govt. Ayurved College, Osmanabad

Abstract
Geriatric women means elderly women or postmenopausal women and the age
considering is above 65 year gynecological disorders commonly found in geriatric
women, which are postmenopausal syndrome, postmenopausal bleeding, pelvic organ
prolapse, recurrent UTI, or cystitis, stress urinary incontinence, malignancy of genital
organ, vulvovaginal inflammation. In this age group we should take care of geriatric
women and improve the quality of life. some of the treatment modalities explained in
Ayurveda like Basti, Uttarbasti, Yonidhavan, Yonipichu etc and also Pathya-Apathya for
each condition is also mentioned. All these are very much helpful in treating the
gynecological disorders in geriatric age group.
Keywords- Geriatric women, Ayurvedic management, Sthanik Chikitsa, Gynecological
disorders
Introduction –
Geriatric gynecology deals with gynecological pathology encountered in
postmenopausal women age 65 year and above. The age related geriatric problems have
emerged significantly with enhance longevity of life.[1] Geriatric women affected many
gynecological disorders like uterine prolapse, stress urinary incontinence etc. In
Ayurveda, menopause is compared to Rajonivritti and the age of Rajonivritti is 50 year
and above, which is Vata dominant stage of life. During the time of delivery, sometimes
the women has complications like obstructed labour, prolong labour, untimely bearing
down without active stage of labour, grand multipara etc and in this condition there is
high chance of developing disorders like uterine prolapse, rectocele and cystocele at
latest stage of life. In old age there is over all facidity of muscle tissue. Hence sometimes

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there is urine incontinence leading to involuntary dribbling of micturition and this
condition may lead to symptoms like UTI, vaginitis etc.
Materials and methods –
•Postmenopausal Syndrome-
In Ayurveda, menopause compare to Rajonivritti.

‗स्वबावात ववनाशकायणवनयऩेऺाद उऩयभो ववनाश: स्वबावोऩयभ:||

[2] च. सु. १ ६/२७

Menopause age-

………………….. ‗मावत ऩंचाशत: ऺमभ‘ || [3] स.ु स.ु १ ४/६

Menopause means permanent cessation of menstruation at the end of reproductive life

due to loss of ovarian follicular activity. [4]
Symptoms-
Hot flush, Atrophic vaginitis, Loss of libido, Insomnia, Dementia, Osteoporosis,
Recurrent UTI
Ayurvedic management - As it is the period of Vata Vriddhi, therefore the selection of
treatment and Ahara should be Vatashamaka, Balya, Jeevaniya and Rasayana.
Shamana Chikitsa- Shatavari Churna + Ashwagandha Churna each 2 gm with milk
BD
Shodhana Chikitsa-
1)Yonipichu – Bala Tailam, Tila Tailam
Mode of action-
I. Vitiated Vata Dosha can be nullified
II. Prevention from fungal and bacterial infection
III. Cures postmenopausal vaginal dryness
IV. Strengthens the vaginal muscles
2)Basti –
Panchtiktaksheer Basti for Osteosporosis [5].

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 In Asthivaha Srotodushti Chikitsa Panchatikataksheer Basti and Sarpi are mentioned.
It is Rasayana for Asthi Dhatu. They rejuvenate the Dhatu, repair them, remove kha-
vaigunya and give Balya to Asthi Dhatu.
3)Nasya- Shatavari Ghrita, Bramhi Ghrita
It is phytoestrogeneic property stimulate olfactory nerve and limbic system, which is
turn stimulate hypothalamus leading to stimulations of gonadotrophin releasing neurons,
thus regularizing GnRH pulsatile secretion [6]. Intern regulate the estrogen level and
subside the symptoms of insomnia, dementia.
1) Shirodhara –
Bramhi Tailm- Calming the nervous system and balancing the neurotransmitters.
•Uterine Prolapse –
In Ayurveda Uterine prolapse correlated with Mahayoni Vyapada.

भहामोनी व्माऩद-

‗ववषभं द:ु खशय्मामां भैथन

ु ात कु वऩतोअवनर:‘||

गबाशमस्म मोनाशच भुखं ववष्िम्बमेत पवमा:‘||

भांसोत्सतना भहामोवन: ऩवावंऺणशुवरनी‘|| [7]

च. वच. ३०/३५, ३६

Downwards displacement of uterus from its normal position is called prolapse of uterus.
Symptoms-
 Feeling of something coming down per vagina, specially during coughing,
walking, Backache and Dyspareunia
 If presence of cystocele – urge of incontinence, retention of urine, painful
micturition and If presence of rectocele- constipation

Ayurvedic management of uterine prolapse- ‗सवाव्माऩत्सु भवतभातभहामोतमां ववशेषत: ||

नवह वाताह्मते मोवननााायीणां संप्रदष्ु मवत:‘ ||

[8] च. वच. ३०/ १ १ ५

Yonipichu- Bala Tailam – it is use for only first and second degree of uterine prolapse.

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 To decrease the hardness of displaced organ, For mobilization of organ, Enhancing
the strength of local ligaments and muscles.
•Stress Urinary Incontinence –
Urinary incontinace is defined as the involuntary loss of urine. It is always associated
with genital organ prolapse. In stress incontinence, There is no desired to pass small
quantity of urine during sneezing, coughing and lifting of the heavy weight
Cusative factor –
Geriatric age, multiparous women, obesity, prolapse
Symptoms- involuntary leakage of urine. Ayurvedic management of stress incontinence
Matra Basti- with Narayana oil 40 ml daily [9]
Yonidhavan – Thriphala Kwatha, Panchavalkala Kwatha Mode of action [10]
 As the name Dhavana suggests cleaning, it washes out the secretions and
discharges of vagina.
 It deals with the altered PH of vagina thus not favoring the micro-organism
invasion.
Yonipichu -Bala Tailam and Til Tailam
Shaman Chikitsa – Chandraprabha Vati 500 mg bd
Gokshur Guggulu 500mg bd
Discussion and Conclusion-
Due to recent lifestyle changes and diet, uterine prolapse, urinary incontinence etc
disease are seen more commonly in women which can be prevented by using the
principle of Jara Chikitsa, Vayasthapan Chikitsa as well as Rasayana and Vajeekaran
Chikitsa before onset of menopausal and in Yuva Avastha.
Postnatal complication of women can also be prevented by following Masanumasik
Garbhini Paricharya, Sutika Paricharya which will do proper Vatashaman and prevent
any future complication in geriatric age.
References –
1) International journal of reproduction, contraception, obstetrics and gynecology,
Sood N et al, Gynecological disorders in geriatric women regarding their
frequency, diagnosis and management in the state of Himachala Pradesh, India,
pISSN 2320- 1770, eISSN2320-1789.

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2) Charak, Vd. Joshi. Y.G., Charak Samhita with Ayurveda Dipika commentary, part
1, Sutrasthana Adhyaya 16/27, Pune, Vaidyamitra Publication, 4th edition 1014,
676.
3) Sushruta, Kaviraj Ambikadattashastri, Sushruta Samhita with Ayurveda Tattva
Sandipana hindi commentary part 1, Sootrasthana, Adhyaya 14/6, page no.45,
Varanasi, chaukumba publications, reprint edition 2014, 178.
4) Dutta. D. C. textbook of Gynecology, page no.56, 6th edition, newdelhi, Jaypee
brothers medical publishers, November 2013, 267.
5) Journal of pharmacy and biological science (IOSR-JPBS) Ujwala Rogade, Role of
Panchatikta Ksheeraghrita Basti, Panchatikta Ghrita Guggul Vati and Janubasti in
the management of Sandhigata Vata w.s.r. to Osteoarthritis, e- ISSN:2278-3008,
p-ISSN:2319-7676, volume 11.
6) International journal of pharmacy and biological science (IJPBS) Shweta Mahadev
Mahajan et.al. Role of Shatavari Ghrita Nasya in Menopausal symptoms: a review,
ISSN:2230-7605(online) (2019): ISSN:2321-3272.
7) Charak, Vd.Joshi.Y.G., Charak Samhita with Ayurveda Dipika commentary, part
1, Chikitsasthana Adhyaya 30/35,36, Pune, Vaidyamitra Publication, 4th edition
1014, 676.
8) Charak, Vd.Joshi.Y.G., Charak Samhita with Ayurveda Dipika commentary, part
1, Chikitsasthana Adhyaya 30/115, Pune, Vaidyamitra Publication, 4th edition
1014, 676.
9) Int J Ayu Pharma Chem, Patel Manish, Ayurvedic management of Incontinence of
urine in aged, vol 7, Issue 1, eISSN 2350-0204.
10) A textbook of Gynecology, according to syllabus prescribed by C.C.I.M.
Chaukhamba Sanskrit Pratisthan, N delhi, by professor of Dr. V.N.K. Usha, page
no.587, 2nd edition, professor and head, P.G. Dept. of Prasuti Tantra and
Streeroga S.

***

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 ROLE OF AYURVEDA IN MENOPAUSE VS HRT
MANAGEMENT OF MENOPAUSAL SYNDROME THROUGH
AYURVEDA
Dr. JYOTI,
Dr. MADHU M
P.G Scholar 2) Guide & Associate Professor,
Department of Prasuti Tantra and Stree Roga,
Sri Dharmasthala Manjunatheshwara College of
Ayurveda and Hospital, Hassan, Karnataka.

ABSTRACT
Menopause is a unique phenomenon and experience to women every
woman.1¬¬¬¬¬¬¬¬¬ It is the ending phase of a woman‘s monthly menstrual period and
ovulation which is defined as a time of cessation of ovarian function resulting in
permanent amenorrhea i.e., cessation of menstruation for 6 months to 1 year at
approximate age of 45 years or above.1¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬ Due to a decline in the
amount of the oestrogen and progesterone hormone which are produced by her body
causes several changes physically and mentally both.2 In Ayurveda, there is no specific
description for menopause but the word Rajonivrutti is mentioned at 50 years.
The Depletion of Ovarian follicles in menopause leading to decrease in ovarian
hormones results in manifestation of aging process in women, hot flushes, sweating,
mood changes, irritation, lack of concentration, loss of libido, forgetfulness, osteoporosis
etc.3 In Allopathic science this condition is treated by oestrogen, either alone or in
combination with progestins (HRT) but in Ayurveda, physiological system based on
balance of ―vata‖, ―pitta‖ and ―kapha‖. Rajonivrutti is predominant by vata so, there is a
significant tendency to develop more degenerative changes. So, Rasayana therapy
described by Acharyas which promotes longevity is very helpful in alleviating the vata
and associated symptoms along with Panchakarma therapies like shirodhara, shiropichu,
nasaya play a very important role in stress management, improvement in quality of life. A
detailed description of menopause is elaborated in the paper highlighting the role of
Ayurveda in abating the symptoms of menopause with a case study on successful
Ayurvedic management of menopausal syndrome.
KEYWORDS
Menopause, HRT, Rajonivrutti, Rasayana, Panchakarma

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INTRODUCTION
Menopause is defined as the permanent cessation of menses.2 However,
manifestations that occur around the time of menopause are caused by the underlying
ovarian changes. Various hormonal changes take place in the body during this phase of
life. Above 60 million women in India are above the age of 55 years. Due to increase in
life expectancy, women spend one third of their life in postmenopausal age. Age for
menopause ranges from 45-50 years.2 Incidence and prevalence rate of postmenopausal
syndrome is 78% of population, but only 19.5% of the symptomatic women take
treatment.3 Hence there is a need for definitive management during the Menopausal stage
which involves management of age-related changes to improve the quality of life of
individuals.
Depletion of primordial ovarian follicles resulting in diminished oestradiol levels.
There is 66% reduction in oestrogen.3 Gonadotropins increase as a result of the absence
of negative feedback of ovarian steroids, hence FSH (40 IU/L) increases markedly is
essential criteria for diagnosis of menopause, reflecting fall in oestrogen and LH rises
moderately.3Over time, this decline may be experienced as a change in the skin elasticity,
altered cognitive abilities, vasomotor symptoms like hot flushes, headache, dizziness,
night sweats, menstrual irregularities, dyspareunia, incontinence, valvular pruritis lack of
energy, difficulty concentrating, vaginal dryness, sleep disturbances and also influence on
carbohydrate and lipid metabolism results in increase in insulin resistance and
hyperlipidaemia, cardiovascular disease respectively.2
Its deficiency leads to increase in osteoclastic activity results in osteoporosis. There is
fall in 2-hydroxylated oestradiol which has neuroprotective action.2 Depression, mental
stress is more common in these women due to increased level of FSH and cortisol and
serotonin deficiency. 2
In modern medicine, the management of menopausal syndrome is through hormone
replacement therapy (HRT). Often there is spectacular relief from the symptoms of the
disease but there is an associated risk of serious side effects such as increased probability
of developing breast cancer, uterine cancer, venous thromboembolism, stroke, etc. HRT,
however, is not very effective in managing the psychological symptoms associated with
menopause. An effort to manage this with long-term use of sedatives, hypnotics, and
anxiolytic drugs leads to side effects like drowsiness, impaired motor function, loss of
memory, antisocial behaviour, allergic reactions, etc.
Menopausal syndrome does not find mention as disease in Ayurvedic literature,
however, the context of Menopause is depicted as ―Jara Pakva Avastha‖ of body and
Rajonivrutti.5 According to Acharya Sushruta and various other references, 50 years is
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mentioned as the age of Rajonivrutti. Rajonivrutti janya lakshan is a group of symptoms
produced by degenerative process of body tissue. Menopause involves doshas, dhatus,
srotas and manas. The clinical features would be in accordance to it and treatment should
be multi-dimensional.
Moreover, Menopause is linked with Vata dosha dominated stage of life. Anxiety,
nervousness, insomnia, depression, sabdasahisunta, dryness of skin, vagina, palpitations,
bone and joint pain are Vata dominant features. Along with that Pitta dosha symptoms
like hot flushes, irritability, mutradaha, amlodgara, short temper etc are seen, during this
phase. Excessive sleep, agnimandya, lethargy, weight gain, slugginess are due to the
dominance of kapha.5
Materials and Methods: Ayurvedic literature related to Rajonivrutti (Menopausal
Syndrome) are searched. Other research journals, papers related to Menopausal
Syndrome are also explored. Patient attending the Outdoor Patients Department of
Streeroga & Prasooti tantra, SDMCAH, was randomly incorporated into the study
irrespective of caste, religion etc.
Case Report: A 48-year-old lady came to O.P.D of PrasutiTantra and Streeroga
department of SDMCAH presented with the complaint of generalised weakness, body
ache associated with headache since3 months. For one year she has been experiencing hot
flashes, night sweats. She had complaint of low back ache, muscle and joint pain
especially knee joint, disturbed sleep, depression, anxiousness. The patient had history of
hypothyroidism and diabetes mellitus for 5 years and since then was on modern
medication. Menstrual history includes absence of menstruation for 8 years. Obstetric
history includes G3P3L3D0A0 three full term normal deliveries.
Table 1: Diagnostic focus and Assessment The patient was diagnosed as having
Menopausal syndrome by Australasian Menopause Society Symptom Score Sheet4 -

Symptoms None - 0 Mild - 1 Moderate - 2 Severe - 3

Hot flushes 3
Light headed feelings 1
Irritability 2
Depression 3
Anxiety 1
Mood changes 2
Sleeplessness 3
Unusual tiredness 3
Back ache 3

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 Joint pains 3
Muscle pains 3
New facial hair 1
Dry skin 1
Dry vagina 1
Urinary frequency 2
Headache 3
The patient attained a score of 35 which suggests that she needs treatment.
COURSE OF TREATMENT - To overcome these above mentioned features our
Acharyas mentioned Rasayana therapy, balya, vayasthapka type of drugs, Abhyanga and
shirodhara, shiropichu for Mansika chikitsa. The type of treatment depends upon the
dosha in which woman‘s menopause symptoms are manifesting. In order to reduce the
signs symptoms of Rajonivrutti some important Rasayana are used. In this, patient was
administered Shirodhara up to 20 min. with one litre of ushna jala and shiropichu with
kotambchukadi taila for 7 days and given orally ksheerabala capsules and Maha Rasnadi
Kwatha 20 ml twice daily, after food for 1 month.
1) BALA (Sida cordyfolia)- In menopause age it helps as a Rasayana as a Balya and
Bruhaniya by normalizing vata and pitta. Hence it is used in diseases which are
caused due to vitiation of vata and pitta.
2) LAHSUNA (Allium sativum) – Acc to kashyapa-its acts as Amruta and Rasayana.
Menopause is associated with an increase in oxidative stress and a decrease in some
antioxidant parameter. Consumption of garlic extracts and crude black seed may have
beneficial effect on improved balance between blood oxidants and antioxidants in
healthy menopausal women.
3) Mode of action of Shirodhara and Shiropichu-Penetration of topically applied drug
into the skin follows passive diffusion.
Effect on endocrine system-An effect of Shirodhara on hormone secretion has also been
postulated considering the effect on the hypothalamus.6
Effect on anxiety and depression-Shirodhara may have an anti-depressant effect like
Mono Amine oxidase inhibitors. Inhibition of the MAO-A decreases the deamination of
Nor-Adrenaline (NA) and to a lesser extent of 5-HT which is associated with the
antidepressant action. It may decrease anxiety by facilitating the inhibitory presynaptic
action of GABA and sedative activities in limbic system. It can be postulated that
Shirodhara has some effect on the hypothalamus, with resulting relief of most of the
psychic and somatic disorders.6

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Fig. 1: Shirodhara with ushna jala Fig. 2: Shiropichu with Kotambchukadi
taila
RESULT:
Table 2: Menopause rating scale -
Parameters Before treatment After treatment
Joint pain ++++ ++
Muscle pain +++ +
Weakness +++++ ++
Hot flushes ++ +
Anxiety and mood swing +++ +
Headache ++++ ++

DISCUSSION- Menopause is simply not an oestrogen deficiency state but it is

associated with large number of symptoms which disturbs women‘s routine life. There is
no specific description regarding clinical features of Rajonivrutti as Ayurveda considers
Rajonivrutti is a natural process of aging, signified by Vata vitiation and dhatukshya
further respective Updhatu kshaya takes place. The vitiated Vata dosha also disturbs the
other Sharir as well as Manas dosha (Raja and Tama dosha) leading to various
psychological disturbances. Thus, leading to Artava nasha (amenorrhea). Thus, modern
science mainly concentrates on tackling the physical problems of menopause, but the
psychological aspect is often neglected. Therefore, here we have made an attempt to
focus on the other side of the coin, i.e., the psychological aspects of menopause can be
well treated by Shirodhara and Shiropichu and to combat the degenerative process of the
body tissue Acharyas have described Rasayana Chikitsa. There is a great scope for
research in Ayurveda to find a cure for the management of menopause which can
improve the quality of life as well as life expectancy of aging female population with
safer aspects as compared to HRT.

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CONCLUSION- Menopause viewed as part of ageing, intricately relates the biological,
cultural and social aspects of women‘s life. Shirodhara, shiropichu and Shaman Yoga
combined is better in various psychological disturbances mainly include headache,
irritability, depression, mood swings, sleep disturbances, etc as compared to HRT. So, it
can be concluded that in women with mild to moderate symptoms of menopausal
syndrome, a Shaman Yoga along with Shirodhara and Shiropichu gives better result in
both somatic as well as psychological complaints. No any adverse effect was noted
during the study.
Therefore, it could be a safe alternative therapy of HRT. It is found to be an effective
therapy in psychological and somatic problems related with menopausal syndrome.
ACKNOWLEDGEMENT –I thank to organize of Sukhapraudha-2021, dept of PTSR
for selecting my abstract and giving me this opportunity. Dr. Madhu M (Associate
Professor) for her constant support and her confidence in me for this presentation. I thank
my guide so much.
REFERNCES:
1) International Journal of Health Sciences and Research, Review Article
Menopausal Syndrome and Its Management with Ayurveda Dr. Gati Krushna
Panda1, Dr B.C. Arya1, Dr Mahendra Kumar Sharma1, Dr Mamta Rani (Vol.8,
issue 5 May 2018).
2) Sudha Salhan, Textbook of gynaecology, Jaypee brothers, foreword Anusuya
Dass, chapter 22, Menopause, page 147
3) Jeffcoat‘s principles of gynaecology (Jaypee publications) by Pratap Kumar and
Narendra Malhotra. Chap 53 Menopause, Page no 86
4) International Journal of Herbal Medicine (IJHM) Ayurvedic management of
menopausal syndrome with Vayasthapka gana: A case report, Akhila M and Dr.
Laxmipriya Dei Department of Prasuti Tantra and Streeroga, IPGT & RA, Gujarat
Ayurveda University, Jamnagar, Gujarat, India (2019)
5) Dr. Hemalatha Kapoor Chand, A comprehensive Treatise on Stri Roga,
gynaecology, Chauhambha Vishvabharati, Varanasi, chapter 8 Rajonivrutti page
399-400.
6) An International Quarterly Journal of Research in Ayurveda, An assessment of
Manasika Bhavas in menopausal syndrome and its management, Khyati Santwani,
VD Shukla, MA Santwani, Gayatri Thaker, Department of Panchakarma and

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Manas Roga, Institute for Post Graduate Teaching and Research in Ayurveda,
Gujarat Ayurveda University, Jamnagar, India (26 feb, 2011).

***

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 A CASE STUDY ON STANA ARBUDA
Dr.K.Thilagavathi Amma
Dr. L.V. Rathnakar, M.D. (Ayu)
Dr. C. Swathi, M.S.,
Affiliation: Second year pg scholar,Dept of PTSR,
Sri Jayendra Saraswathi Ayurveda college&Hospital,Chennai.

KEYWORDS: Arbuda,Ayurveda,breast,cancer,stana.
ABSTRACT:
Backgroud :Stana arbuda is the third major killer cause of cancer death in worldwide
(WHO 1998).77% of cases occur in women over 50 years of age.The three dates in a
women life that have a major impact on breast cancer incidence are age at menarche, age
at first full term pregnancy,age at menopause. Arbuda was prevalent during vedic period
and which is a dreadful disease in 21st century.Brihat trayees mentioned about arbuda
which is considered as an equivalent of cancer. Generally Arbuda, develops very fast and
causes either destruction of local tissues or even marana. Material and methods :In this
paper,A case presentation on stana arbuda is attempted.Disscussion : Stana arbuda falls
under mamsa pradoshaja vikaras.Every cell and tissue will have it‘s own agni.The
decrease in agni is inversely proportional to the related dhatu and vice versa. In arbuda,
the decreased state of dhatwagni is resulting in the excessive growth of the
dhatus.Conclusion: Ayurveda emphasizes ―Swasthasya swaasthya rakshanam aturasya
vikara prashamanam cha‖prevention of breast cancer may be possible through rasayana.
INTRODUCTION:
Arbuda was Prevalent during vedic period and which is a dreadful disease in 21st
century. While going through literature, direct description of the word ―stana arbuda‖ as a
disease or symptom is not available, but Acharya‘s were aware about the disease in terms
of stana arbuda. Stana arbuda means the large vegetation of flesh which appears at any
quadrants of the stana,becomes slightly painful,rounded,immovable and deep seated and
which is due to the vitiation of the flesh and blood by the deranged aggravated
doshas;vata,pitta,kapha.It develops too fastly and causes either destruction of local tissues
or even marana.Stana arbuda is a mamsavriddhijanya and mamsadushtijanya shotha with
kapha and medodusti¹.Brihat and Laghu trayees mentioned about arbuda, which is
considered as an equivalent of cancer. Cancer in essence is a change in cell metabolism.
Breast cancer is that,cancer forms in the cells of breast.The unique aspect of breast
cancer, it is the most common (30%) of all cancers and is the second common cause of
cancer death in women. One out of eight obstetric – gynecologic patients is likely to

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develop breast cancer. According to WHO, In 2020 there were 2.3 million women
diagnosed with breast cancer and 6,85,000 deaths globally. At the end of 2020,there were
7.8 million women alive who were diagnosed with breast cancer in the past 5 years.The
three dates in a women life that have a major impact on breast cancer incidence are
- Age at menarche
- Age at first full term pregnancy
- Age at menopause².
Associated risk factors are never breast fed,obesity.Stana arbuda treatment can be
highly effective, especially when the disease is identified early.Treatment of stana arbuda
often consists of 1.Sodhana chikitsa, 2.Dhatwagni chikitsa, 3.Rasayana prayoga,
4.Vyadhi pratyanika chikitsa,5.Sastra chikitsa.
PATIENT INFORMATION:
A female of 60 years old came to Ayurvedic OPD with diagnosis of stage 3 breast
cancer. Soon after diagnosis,Patient was not willing to undergo chemotherapy initially
and approached our institution. She is non diabetic,non HTN and not hypothyroidism.
Attained menopause at age of 48 years and no physical and systemic illness.No tumour
history was reported.She was married but nulliparous. The palpable mass in the right
breast was neglected by patient for few months. Then it grows in size and externally
findings developed.She approached doctor and referred for CT Scan in october 2020 only
in the advanced stage.
CLINICAL FINDINGS:
atient presented with a large lump present in outer upper quadrant of the right breast.
On examination - Pain full lump,hard,heaviness present,tenderness present
and breathing difficulty.Right axillary lymph nodes are palpable. CT report findings was
stage 3 breast cancer.There was no metastasis to other organs. Right Axillary lymph
nodes were involved.
TIMELINE:
Oct 2020 : Diagnosis of stage 3 breast cancer was made.
MONTH MEDICINE DOSE FINDINGS REMARKS

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Nov 2020 1.Rasa 2 -0-2 A/F Externally wound,
To sinduram cap 20 ml -0 -20ml Pain + + +
2.Nimbamrutha + ww Hardness + +
Dec 2020
di Heaviness++
panchatikthaka Tenderness +
m kashayam
++
3.Bhallataka 0 - 1tsp – 0 A / f
ghritam Axillary lymph node
4.shatavari 1 spoon - 0 – -
churnam 1 spoon A/f palpable
Jan 2021 1.Triphala 1 -0-1 A/F Externally wound, Improved
guggulu 20 ml -0 -20ml Pain + + Hardness +
2.varanadhi + ww(ES) Heaviness+
kashayam
1 pinch with Tenderness +
3.Shodhitha satavari ch 1 +
kupilu churna spoon - 0 – 1
4.satavari spoon A/f
churnam
Axillary

lymph node -

palpable

Mar 2021 1.Rasa 2 -0-2 A/F Externally wound, Improved

To 1 pinch with
sinduram cap Pain +
May 2021
satavari ch 20
2.Shodhita Tenderness +
ml -0 -20ml +
kupilu churna Axillary lymph node
ww ES
3.Nimbamrutha -
1 spoon - 0 – 1
di palpable
spoon A / f
panchatikthaka
m kashayam
4.satavari
churnam
July 2021 1.Triphala 1 -0-1 A/F Tenderness + Improved
20 ml -0 -20ml + ww(ES)
guggulu External wound
1 pinch with
2.varanadhi healed
satavari ch 1
kashayam
spoon - 0 – 1
3.Shoditha spoon
kupilu churnam A/f
4.satavari

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 churnam

Sept 2021 1.Rasa 2 -0-2 A/F External wound Improved

1 pinch with
sinduram cap healed
satavari ch 20
2.Shodhita
ml -0 -20ml +
kupilu churnam
ww ES
3.Nimbamrutha
1 spoon - 0 – 1
di
spoon
panchatikthaka A/f
m kashayam
4.satavari
churnam
A/f External wound healed Improved
After 7th follow up the patient got much relief from all of symptoms which was there
initially.And the same medicine is going on still now.wound management was done with
Triphala kashayam prakshalanam daily and then application of jathyadi ghritam as pichu.
DIAGNOSTIC ASSESSMENT :
CT Scan – stage 3 breast cancer. Poor prognosis. Through ayurvedic medications wound
management was done, it healed and patient got good relief.
FOLLOWUP & OUTCOME :
Only upto 7th follow up patient was followed.And the treatment is going on.
PATIENT PERSPECTIVE :
Patient was educated and counselled in regarding to prognosis and limitations of
ayurvedic treatment. Informed consent was taken.

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DISCUSSION:
Pharmaceutical intervention by Ayurvedic medicine is attempted.Through this,wound
healing action in the drugs do wonders in breast cancer wounds. It improved the quality
of patient life by decreasing pain,heaviness,Tenderness, hardness. A longer life
expectancy is achieved.The possibility to diagnose cancer early then treat according to it.
CONCLUSION :
The five year survival rate of the patient can be prolonged by using Ayurvedic
regimen.Followup for another few years can be done.The phytoconstituent named
Shatavarin 4 in satavari has anticancer activity, which is given throughout the
treatment.Patient is quite happy with wound healing and reduction in symptoms.
REFERENCE :
1. Tiwari P. V.Ayurvediya Prasuti Tantra Evum Stree Roga.Part2. Second Ed.
Varanasi: Chaukhambha Orientalia;2000.
2. Longo. DL,kasper. DL,Jameson. DL,Fauci. AS,Hauser. SL,Loscalzo. J,editor‘s.
Harrisons principles of internal medicine.vol 1.18th Ed.New delhi: mc graw-
Hill;2012.
3. Sasty JLN.Introduction to oncology cancer in ayurveda,second Ed. Varanasi:
Chaukhambha orientalia;2001.

***

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 FERTILITY ISSUES IN ELDERLY WOMEN
AN AYURVEDIC APPROACH TOWARDS MANAGEMENT OF
FERTILITY ISSUES IN ELDERLY WOMEN
A CASE REPORT
Dr Kanchan Malhotra
Dr Prathima
PG Scholar, HOD and Associate Proffesor,
Department of prasuti tantra and stree roga,
SDM College of Ayurveda & Hospital, Hassan
Kanchan, mail id- kanchanmalhotra0195@gmail.com
Mobile no. - 7982873017, 7834974255

ABSTRACT
Introduction: Infertility is becoming major issue today‘s society due to declining rate
of fertility and fecundabilty with age. Fertility gradually declines in age of 30‘s,
particularly after 35. After age of 35 the quality and quantity of egg decreases causing
more abortions and chromosomal abnormalities like down‘s syndrome. In Ayurveda
there are four important factors of garbha that are ritu (fertile period, season), kshetra
(healthy reproductive organs), ambu (proper nutrient fluid), beeja (ovum or sperm).
Beejadushti in females can be correlated decrease in quality and quantity of ovum i.e.
anovulation. The fertility issues of geriatric age can be better managed by ayurvedic
protocol which help in improving quality of kshetra, ambu, beeja.
Clinical findings: A female with case of putraghani yonivyapath and apraja aged 39
years came to OPD of prasuti tantra and stree roga at SDM hospital, hassan with history
of spontaneous abortion twice at two and half month of gestation due to no fetal cardial
acctivity and was anxious to conceive since 5 years and associated with WDPV and
vulvar itching since 4 years.
Intervention: The case was treated with ayurvedic management protocol for 8 days
which included sthaniaka chikitsa for 7 days, shirodhara for 2 days, virechana done on
8th day and then shaman chikitsa followed by yoga basti.
Outcomes: With the following ayurvedic treatment protocol WDPV and vulvar itching
cured and patient conceived and given birth to child.
Conclusion: So it can be concluded that Ayurveda is effective in management of fertility
issues in elderly women.

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Keywords: Infertility, Elderly women, Sthanika chikitsa, Virechana, Shirodhara, Yoga
basti, Ayurveda.
INTRODUCTION
Infertility is defined when couples are unable to conceive after one or more year of
regular unprotected coitus. According to WHO, one in every four couples in developing
country is affected by infertility. Fertility rate in India is declining every year, current
fertility rate for India in 2021 is 2.179 births per woman, 0.95% decline from 2020.
Reproductive potential of woman decreases as she get older and fertility can be
expected 5-10 years before menopause. Now a days due to career settlement by late 30‘s,
women are getting married late. A woman best reproductive age is in her 20‘s, fertility
and chances of conception gradually declines after30‘s, particularly after 35. After the
age of 35 the quality and quantity of ovum decreases. There is declinement in quality of
chromosomes of ovum that there are more chance of getting downs syndrome in foetus
and abortions. In late age also the number of eggs start decreasing that there are more
chances of getting anovulatory cycles.
So here we will focus on management of fertility issues in elderly woman by
ayurvedic management protocol that includes shaman and shodhana chikitsa.
CASE REPORT
PRESENTING COMPLAINTS
A 39 year old female patient with marital life of 5 years had a history of spontaneous
abortion twice at two and half month of gestation due to no fetal cardial activity. After
that she has not conceived and she was having itching in vulvar region since 4 years, for
further treatment patient approached as outpatient in department of prasuti tantra and
stree roga of sri dharamasthala manjunatheshwara college of Ayurveda and hospital
Hassan, Karnataka.
CLINICAL FINDINGS
The patient had vatapittaja prakriti with amayukta jihva. The patient was having LMP
on 01/02/2020 with regular menstrual history of 5-6 days/28 days. On P/S the cervix was
hypertrophied, congestion in lower lip, nebothian cyst at 12‘o clock position and WDPV
++. P/V- NS/AV/Tenderness in left and anterior fornices.
INVESTIGATIONS
12/02/2020 PAP smear positive
for bacterial vaginosis.
Haematological investigation as on 12/02/2020

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 Haemoglobin 11.4 gm%,
total leucocyte count 4800 cells/cmm
erythrocyte 26mm/hr
sedimentation rate
fasting blood sugar 92.0 mg/dl
HIV Negative
HbsAg non reactive
VDRL non reactive

Urine analysis as on 12/02/2020

Leucocytes Negative
Glucose Negative
Protein Negative
Ph 5.0
Specific gravity 1.020

DIAGNOSTIC FOCUS AND ASSESSMENT

On the basis of patient‘s complaints like spontaneous abortion twice at two and half
month gestation can be compared with putragahni yonivyapad due to no development in
fetal cardiac activity. As patient was having excessive bleeding during first two
pregnancies which lead to miscarriage i.e. without progeny as she was having problem in
conceiving, thus can be compared to apraja yonivyapad. As patient was having itching in
vulvar region associated white discharge can be compared with kaphaja yonivyapad and
finding of hypertrophied cervix and congestion on lower lip of cervix can be compared to
karnini yonivyapad. For fertility issue patient was assessed by studying of follicular size
on 2/07/2020.
THERAPEUTICAL INTERVENTION
Patient was admitted to in patient department of prasuti tantra and stree roga for
management with ayurvedic protocol.
Treatment protocol
S.no. Internal medication Duration
1. Deepana pachana with 11/02/2020 –
Chitrakadi vati (500 mg) 2tab tid (before 12/02/2020
food)
+
Shunthi jala 50 ml tid (before food)
2. Snehapana with phala ghrita 13/02/2020 –
30ml - 1st day 16/02/2020
60ml – 2nd day

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 90ml – 3rd day
120ml – 4th day
External medication
1. Shirodhara with dashmoola kashaya 11/02/2020 –
12/02/2020
2. Yoni prakshalana with nimbadi kwatha 11/02/2020 –
followed by yoni pichu of doorva ghrita 17/02/2020
3. Savanga abhyanga with brihat saindhava 17/02/2020 –
taila followed by bashpa sweda and 18/02/2020
ushna jala snana
4. Virechana with trivrith lehya 100 gms + On 18/02/2020
draksha kashaya

2. Patient was discharged on 18/02/2020 and was instructed to follow Samsarjana karma
from 18/02/2020 – 21/02/2020.
3. Shamana chikitsa to be followed at home :
4. Patient came to opd on 9/06/2020, on 3rd day of LMP. Patient was advised shaman
chikitsa and was advised for follicular study for next cycle.
a) tab pushpadhanwa rasa 2 tab – 0 – 2 tab
b) phala ghrita 5 gms – 0 – 0
5. Patient was admitted on 2/07/2020 – 6/07/2020in patient department for administration
for yoga basti

Day 1st 2nd 3rd 4th 5th

Type of basti A N N N A
A A A

FOLLOW UP AND OUTCOMES

On 18/02/2020 patient got 10 virechana vegas and type of shuddhi was avara.
On 29/12/2020 patient came to OPD with history of amenorrhea since 1 month, LMP was
17/11/2020. Patient UPT was positive and then regularly followe for ANC. Patient
underwent LSCS and given birth to a healthy male baby on 22/07/2021 at 2:45 pm.
DISCUSSION
Vata by virtue of its properties responsible for proliferation and division of cells
(granulosa and theca cells) especially Apana Vayu is responsible for ovulation. Pitta is
associated with its conversion power like conversion of androgens to estrogen in Graffian

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follicle maturity of follicle by its paka karma. Kapha stands as a building and nutrition
factor. It binds all the cells together and gives nutrition for growth and development of
the cells.
The shodhana therapy in Ayurveda help in removal of toxic elements from body and
bring all the vitiated doshas in equilibrium.
Deepana and pachana chiktsa
Chitrakadi vati because of its laghu, ruksha guna and katu, tikta rasa it subsides kapha
and by ushna virya and tikshna, snigadha guna it counteracts vata. Both chitrakadi vati
and shunthi jala helps in pachana of ama.
Virechana
As patient was diagnosed with putraghani yonivyapad in which due to dushta shonita
(ovum) there is recurrent destruction of foetus. To balance vitiated pitta dosha virechana
is best treatment as it helps in improving quality of ovum.
Sthanika chikitsa
The bacterial vaginosis can be compared with kaphaja yonivyapad. The nimbadi
kwatha has vrana shodhana property, krimighana (antimicrobial, antifungal,
antibacterial), shoshana (absorbent), samgrahi (ceases secretion), kledaghana (ceases
harmful infection) and tridoshashamaka properties which helped in reducing white
discharge and itching in patient. Doorva ghrita has raktastambhaka, krimighana,
kaphapittashamaka, vrana ropana, anti-inflammatory, antiproliferative properties which
helped in reducing congestion of lower lip of cervix in patient.
Shirodhara
Dashamoola kashaya shirodhara helps in reducing stress in patient. Having no
children had psychological impact on mind of patient, which get reduced after shirodhara.
It also helps in improving HPO axis.
Yoga basti
As apana vayu is mainly responsible for process of ovulation, conception and for
vitiated vata dosha basti is indicated as best treatment.
Shamana chikitsa
Pushpashanva rasa, capsule ashwagandha, phala ghrita are administered with the aim
of formation and improvement in quality of ovum and process of ovulation.

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CONCLUSION
Due to vitiation of tridoshas in elder female of age more than 35 there is less chance
of conception, more chance of abortions, poor quality and less formation of ovum. So, by
following proper ayurvedic treatment protocol these issues managed, cured and reduced.

***

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 FERTILITY ISSUES IN ELDERLY WOMEN

ABSTRACT:
Background: In the present age many women are career oriented and are marrying
late. More importance is given to profession than family life. This is giving rise to issues
related to fertility and proliferation of assisted reproductive technologies. As the age
increases women are more prone to metabolic diseases like Diabetes Mellitus,
Hypertension.
If Garbhadhana vidhi is properly followed various fertility issues can be prevented.
Aims & Objecives:
To explore fertility issues in elderly women and the various possible treatment
modalities in Ayurveda.
Result:
By following Ayurvedic treatment we can deliver a healthy progeny devoid of severe
complications.
Conclusion:
Vata dosha is the pradhana dosha in PRAUDHA AVASTHA. Ayurvedic treatment
which improves the fertility and reduces the vata will help an elderly female to deliver a
healthy off spring.
Keywords: Female infertility, Shodhana Chikitsa, Shamana Chikitsa, Vandhyatva.
Introduction:
Infertility is defined as a failure to conceive within one or more years of regular
unprotected coitus. Fecundability is defined as the probability of achieving a pregnancy
within one menstrual cycle. In a healthy couple it is 20% (1). Fecundability is highly age
related, thus Infertility evaluation at 6 months (instead of 1 year) should be performed in
any women older than 40years and according to some experts in women older than 35 (2).
Female Infertility according to Ayurveda is called as Vandhyatvam. Charaka
mentions about Vandhyatva in sharira sthana and chikitsa sthana as: 1. Vandhyatva 2.
Apraja 3. Sapraja.And Harita mentions 6 types in thrithiya sthana, 48th chapter. 1.
Dhatukshaya 2. Kakavandhya 3. Anapathya 4. Garbhasravi 5. Mrtavatsa 6. Balakshaya
In these, Garbhasravi – Repeated Abortions Mrtavatsa – Still birth can be taken as
fertility issues in elderly women (3).

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FACTORS INVOLVED IN ELDERLY WOMEN: (4)
(a) Ovarian Factors: As the age increases, the number of eggs gets decreased; if at all
present the remaining eggs are more likely to have abnormal chromosomes. Premature
ovarian failure is cessation of menstrual periods due to failure of the ovaries before age
40, also known as early menopause.
(b) Quality of Eggs: The quality of the egg changes as the age increases. Miscarriages
happen as the numbers of remaining eggs dwindle in number. An important change n egg
quality is the frequency of genetic abnormalities called an Euploidy. As a women gets
older, more and more of her eggs have either too or few chromosomes. So, Down
syndrome is more common in elderly women.
1 in 1480: At age 20
1 in 940: At age 30
1 in 353: At age 35
1 in 85: At age 40
1 in 35: At age 45
(c) Quantity of Eggs: Ovarian Reserve is a term that is used to determine the capacity of
the ovary to provide egg cells that are capable of fertilization resulting in a healthy and
successful progeny. The decrease in quantity of eggs containing follicles in the ovaries
called Loss of Ovarian Reserve. Women begin to lose ovarian reserve before they
become infertile and before they stop regular periods. Women with poor ovarian reserve
have lower chance of becoming pregnant. Scientific reports states that Ovarian Reserve
declines progressively with increasing age, optimal fertility is accepted to be between 20
and 30 years old. Ovarian Reserve Test (ORT) provides an indirect estimate of a
woman‘s remaining follicular pool. The levels of Basal Follicular Stimulating Hormone
(FSH), Anti-Mullerian Hormone (AMH), Inhibin B, Basal Estradiol, Ovarian Volume are
estimated.
(d) Menstrual cycle: The regular cycle will be seen till early 30s and it may become
shorter after 40 years.
(e) Metabolic Diseases: Pregnant women with advanced micro vascular disease such as,
Hypertension, Nephropathy, and Retinopathy have a 25% risk of preterm delivery as a
result of worsening maternal condition or pre-eclampsia.

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 Gestational Diabetes Mellitus affects 3% of pregnancies. Preconception glucose
control may reduce the rate of complications to as low as that seen in the general
population.
Risk Factors for HTN Disorders: (5)
Risk factor Risk ratio
Age >40 3
Chronic HTN 10
Diabetes Mellitus 2
Twin Gestation 4
(f) Other diseases in elderly women which impact fertility: Fibroids, Endometriosis, PID.
RISK FACTORS IN ELDERLY PREGNANT WOMEN:
Miscarriages, Still birth, Repeated Abortions, Preterm birth.
MODERN INTERVENTION:
1. ART - Assisted Reproductive Technology [IVF, ICSI, GIFT, ZIFT]
2. Artificial Insemination [IUI]
The success rate of IVF IS ONLY 30% - 35% and in younger women it is 40% in young
women below age 35.
In case of IUI only 15% of success is seen and it varies from study to study from 8% -
20%.
AYURVEDIC INTERVENTION: (6)
Acharyas have mentioned Vrddha stree or Praudha as anarhas for Maithunam. Vata
Dosha is predominant in prauda and yoni rogas which implies vatahara chikitsa can be
used in treating the fertility issues in elderly women. According to Bhela, Vandhyatva
occurs due to various vata rogas and yoni rogas. The aggravated vata expels the Shukra
from the uterus, destroys the raja[ovum], thus the women become infertile. Due to
sheetatva of Garbhashaya and Sushkatva of Indriya[Penis] infertility occurs. All the
factors are due to vata which we could see in Praudha which hinders the conception and
gives rise to complications in delivery.
The main chikitsa to be done is Vasti karma as it is the pradhana shodhana karma for
vata dosha. Brhmana dravyas, ahara, oushadhi should be given to compensate the loss of
bala and dhathu, as Praudha will have a decline in it.

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 Vasti is the best among all kinds of therapies because it provides the body with quick
nutrition and mitigates the abnormal vata. It makes the Garbhashaya healthy, even the
sterile women can conceive. Bhela adds on to it that Niruha Vasti acts like nectar in
treating Vandhyatva, by curing vata dosha, rajo dosha leading to conception. While
Charaka opines Anuvasana vasti is effective. Sushruta says Yapana vasti acts as both
Shodhana and Snehana. On the whole Vasti plays a vital role in Vandhyatva and other
complications of elderly pregnant women. All poorva karma like sneha svedam and other
procedures like vamana virechanam should be done. Acharyas have mentioned so many
types of vasti , few examples have been given below:
A.Narayana Taila vasti [Also used for nasyam, abyangam, panam]
B.Bala Taila Vasti[Mooda Garbha]
C.Lashuna Taila Vasti
D.Shatapushpa Taila Vasti
E.Shathapaka Taila Vasti
F.Traivrta sneha Vasti
G.Shathavaryadi Vasti
H.Guduchyadi Vasti
After shodhana karma laghu ahara and dravyas like lashuna, karkati moolam,
dvibrhati,ksheeram, mamsam should be taken. Katu, amla, lavana, ushna, vidahi dravyas
to be avoided. Shodhana karma regulates and restores the normal physiological function
and relieves the obstruction. It is only in a shuddha garbhashaya achieved after shodhana
treatment, conception occurs as a result of union of shukra and artava along with descent
of jiva.
SHAMANA OUSHADHIS
Phala ghrtam, Phala Kalyanaka ghrtam, Sheetakalyanaka ghrtam, Jeevaniya ghrtam,
Lashuna ghrtam, Lakshmanadi ghrtam, Kumarakalpadruma ghrtam(Preterm birth).
Maharasnadi Kashyam (Sharangadhara Samhita)
Dasamoola Arishtam
The above said medicines help in mitigating vata dosha, ghrtam acts as rasayana ,
strengthens the uterus and helps in Sukkha prasava in Praudha.

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HOME REMEDIES
1. Oral intake of vata shunga collected in pushya nakshatra in shukla paksha with
water during rtukala
2. Vasa moola one karsha taken with tila tailam one kudava in early morning and diet
intake of milk and rice in the evening.
3. Oral intake of kalka made from tender fruits of karpasa with milk during menstrual
phase.
CONCLUSION:
In this modern world, elderly primigravida is common. Modern treatments are heavy
to bear the expense by the patient with least success ratio. Our Ayurveda emphasises in
prevention rather than curing by strictly following our Dinacharya and Rtucharya. Elderly
conception can be maintained and delivered gracefully with the help of Ayurvedic
Shodhana Karma and Shamana Oushadhis. Rasayana and Vajikarana chikitsa helps in
maintaining the Garbha in elderly women.
REFERENCES:
1. Hiralal Konar, editor.D.C.Dutta‘s Textbook of Gynecology.7th ed. New
Delhi..Jaypee Brothers;2016. Chapter – 17, pg: 186.
2. John O.Schorge et al, editors. Williams Gynecology.1st ed.China: Mc Graw-
Hill;2008. Chapter – 19, pg: 426
3. Tewari.P.V. Ayurvediya Prasuti Tantra Evam Stri Rogam, Part – 2. 2nd ed.
Varanasi..Chaukhambha Orientalia;2000. Chapter -5
4. www.ReproductiveFacts.org & www.acog.org/womens-health
5. John P.Cloherty, Eric C, Eichenwald, Ann R.Stark, editors. Manual of Neonatal
Care. 6th ed. New Delhi.. Wolters Kluwer(India)Pvt.Ltd;2008. Chapter – 24, pg: 9.
6. Hemalatha Kapoorchand. Stri Roga,1st ed. Varanasi..Chaukhambha Vishva
Bharati; 2018.

***

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 FERTILITY ISSUES IN ELDERLY WOMEN EFFECTIVE
AYURVEDIC MANAGEMENT OF INFERTILITY DUE TO LOW
AMH IN ELDERLY WOMEN- CASE STUDY
Dr. Maheshwari Danappagoudar
Dr. Savita S Patil
PG Scholar, Dept of Prasuti Tanra and Stree Roga,
Professor and HOD of Dept. of Prasuti Tantra & Stree Roga
Sri Sri college of Ayurvedic Science and Research
Institute, Bengaluru, Karnataka.
Mail ID : malipatiljayaprakash@gmail.com

ABSTRACT
Pregnancy or the motherhood beyond the edge of reproductive age is referred as
Pregnancy in ―Elder gravida‖. In the developing and developed countries age of marriage
and their by child bearing are relatively late in life. Chances of pregnancy for healthy
couples in their 20s and early 30s is around 1 in 4 women, 40s around 1 in 10women.
Generally reproductive potential decreases as women get older and fertility can be
expected to end 5 to 10 years before menopause. Age is the single biggest factor affecting
a women‘s chance to conceive and to have a healthy baby.
Risk of pregnancy complications increases with age. The risk of miscarriage and
chromosomal abnormalities in the fetus increases from the age of 35. Complications such
as GDM, Placenta previa, Caesarian section and still birth are common among older
women than younger women.
According to Ayurveda, Infertility primarily refers to the biological inability of
women to contribute to conception and also who is unable to carry pregnancy to full
term. Ayurvedic management gives a new hope in women by strengthening body‘s own
self healing and balancing mechanism and rely on intervention by any outside or foreign
substance to replace or correct the hormones in the body.
Case study: A patient named Akanksha aged 38 years diagnosed as Infertility with low
AMH value treated with Virecana followed by Matrabasti and shaman chikitsa.
Key words: Infertility, AMH, Virechana and matrabasti.
INTRODUCTION:
Infertility is a condition which leads to physical, psychological & social detriments to
the couples .Even though so much advanced techniques are there in ART (Assisted
reproductive technique), the success rate of IVF techniques depends largely on the

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ovarian response during retrieval, which reflects on the ovarian reserve, which will come
to know from blood level of AMH.
AMH is released from the granulose cells of preantral and antral follicles, then it rele
ased into the circulation, it is best endocrine marker for assessing ovarian reserve of
elderly women.. Uncertainty in the ART procedure outcome can be minimized to a
greater extent. This case report of low AMH resembles to Dhatu kshyajanya vandyatwa.
the role of the effective ayurvedic protocol to improve the AMH level to a satisfactory
level to have a better response to ovarian stimulation for IVF has to be validated.
CASE REPORT :
The reported case is 38 years old married, non smoking, non alcoholic with secondary
infertility (P1 L1 A0) since 3 years with low AMH and low USG showed endometrial
thickness of 7.33 mm. She received to IUI treatment and one IVF which were
unsuccessful. Her family history was negative for any premature ovarian or low AMH.
Her personal history reviled regular bowel habit and sound sleep. Her appetite was
apparently normal and the Tung was un coated. She attend menarche at 14 years ,
menstrual cycle with the gap of 28 to 40 days . obstetrics history P1 A0 L1. First delivery
was 4 years back, pregnancy was uneventful and delivered through cesarean section.
Her bloodpressure (BP) 110/70 mmhg, pulse rate 86 bpm and body mass index 22
kg/m2. She Pitta Kapha prakruti with madyama satwa and madyama kosta. In view of
symptoms of irregular ministration with low AMH diagnosed as datu kshya janya
vandyatwa.
THERAPEUTIC FOCUS AND ASSESSMENT:
Patient was given which Deepana pachana followed by Virechana (sneha pana with
phala gurhta). Matra basti with shata pushpi taila. Samana chikitsa done for two
months with Shatapushpa Shatavari churna 1tsp BD with Phala grita (before food),
Pushpa dhanwa vati 1BD (after food), and Kushmanda avaleha 1tsp BD.
FOLLOW-UP AND OUTCOME:
After two months followup done in the OPD with reassessment AMH value showed
significant improvement.
DISCUSSION :
Over the past few decades in modern medical field , Hormonal therapy, IUI, IVF,
embryo transfer, gametes intra fallopian transfer are developed but with high expensive
& minimal success rate.

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AYURVEDIC APPROACH
Ayurveda supports the body by strengthening body‘s own self healing mechanism. It
doesn‘t rely on outside substance to fulfill the hormone level.
MODE OF ACTION
Basti dravya enters entric nervous system. These signals stimulate endogenous opoids
present in GIT mainly b endorphins. Regulates hormone.
CONCLUSION :
 Infertility itself doesn‘t stand alone. It is the result of some other disease so the
herbs used in the treatment are directed towards the underlying cause.
 Ayurvedic treatment gives a new hope in elderly women with depleted ovarian
reserve. In Charaka samhita, there is a effective, holistic and wide range of
treatment modality for infertility based on Ayurvedic principles. The treatment of
Infertility comprises of administration of panchakarma therapies, rasayana and
vajikarana dravya
 Shatavari is a best herbal drug for low AMH, hence it‘s called ―Pushpa prajakari‖.
 Rutu, Kshetra, Ambu and Beeja are the prime requisites for Garbha. Beeja is most
essential among them.
 • All the Tridosa play important role in the process of gametogenesis, Vata
is responsibe for Proliferation & division of cells, Pitta does formation of
hormones by conversion/ paka, kapha helps for (growth & proper nourishment
oocyte.
 Apart from this following pathya plays a vital role in the prevention and cure of
diesese. Dietary management involves strict compliance and adherence to foods
that incease Oja. This is important to regulate the ovulation and enhances
fertilization.
REFERENCES:
1. Dutta D C. Textbook of Gynecology. Edition 8, New Delhi: Jaypee Brothers;
2020.p.28-31.
2. Dutta D C. Textbook of Gynecology. Edition 8, New Delhi: Jaypee Brothers;
2020.p.156-164.
3. Kapoorchand Hemalatha, Cmprahensive treatise on Prasuti tantra, Chaukambha
Bharati academy; 2020.p.68-70.
4. Dewailly D, Andersen CY, Balen A, Broekmans F, Dilavarni, Fanchin R, The
physiology & clinical utility of Anti mullerian hormone in women, Human
Reproduction update2014 May-jun; (pubmed PMID :24430863)
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5. Devet A, Laven JS, de Jong FH, Themmen AP, Fauser BC, Antimullerian
hormone serum level: a putative marker for ovarian aging . Fertility and sterility.
2002 feb; (pubmed PMID: 11821097).
6. Steiner AZ, Pritchard D, Stanczyk FZ, Kesner JS, Meadows JW, Herring
AH,Baird DD, Association between biomarkers of ovarian reserve and infertility
Among older women of Reproductive age. JAMA 2017 OCT10; ( Pubmed
PMID:29049585)

***

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 STHANIKA CHIKITSA IN GERIATRIC WOMEN
A CLINICAL APPROACH FOR THE MANAGEMENT OF SUSHKA
YONI THROUGH STHANIKA CHIKITSA IN RAJONIVRTTI‖- A
CASE STUDY
Dr. Meghana.M. N
2nd year PG Scholar, Dept. of PTSR, Sri Sri College
of Ayurvedic Science and Research Institute, Bengaluru, Karnataka.
Dr. Rachana H.V,
Associate professor, Dept. Of PTSR, Sri Sri College
of Ayurvedic Science and Research Institute, Bengaluru, Karnataka.

ABSTRACT
Menopause is an unavoidable condition in every women life and they wish to have it
with ease. Vaginal dryness is the symptom of genitourinary syndrome during menopause,
which is often associated with irritation, pain and loss of libido. Our Acharya‘s explained
as Rajonivritti. During this phase the sushkata in the yoni is mainly due to involvement of
vata dosha. Here the Vata hara line of treatment is applied through. Sthanika chikitsa,
which plays a major role and more advantageous in stree roga as the treatment is given
directly to the affected area. Sthanika chikitsa like Abhyanga, Nadi sweda and yoni pichu
which was given for the following case in Rajonivrtti.
Case study: A Patient aged 49 years old female came to OPD with a complaint of
dryness in vagina with irritation associated with pain on and off since 1 years and her
symptoms were increased since 3-4 days. She attained menopause 2 years back.
Treatments like Abhyanga with ksheera bala taila followed by Nadi sweda with
Ashwagandha ksheera paka and yoni pichu with Ashwagandha ghrita was given for 7
days and had a fruitful outcome.
Key words: Menopause, Sushka yoni vyapath, Sthanika chikitsa.
INTRODUCTION
Permanent cessation of menstruation at the end of reproductive life due to loss of
ovarian follicular activity which defines the menopause and the age ranges between 45-
55 years. The depletion and resistant of follicles to pituitary gonadotropins leads to
impairment in folliculogenesis with diminishing estradiol production. The fall in the
estradiol level affects different physiological, psychological, different organs and system
and marked changes can be seen in ovaries, fallopian tubes, uterus, menstrual changes,
vagina, vulva, Breast fat, bladder and urethra, loss of muscle tone and in Adrenals. The

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vagina becomes narrow and vaginal epithelial becomes thin and rugae patterns and no
glycogen, due to marked estrogen deficiency leads to vaginal dryness and atrophy. Age
of Rajonivritti explained as 50 years and also it depends on the nutritional status of
women.
AIMS AND OBJECTIVE
To evaluate the effect of Sthanika chikitsa in dryness and pain in vagina.
METHODOLOGY
SINGLE CASE STUDY-The present case study is successful Ayurvedic management of
a case of Sushka yoni since 1 year. A 49-year-old female patient came to OPD of sri sri
college of Ayurvedic science science and research hospital, Banglore.
HISTORY OF PRESENT ILLNESS:It is a Single case study. A Patient aged 49 years
attained menopause 2 years back , with the complaint of dryness in vagina with
irritation associated with pain on and off since 1 years and symptoms were increased
since 3-4 days and approached to OPD of Prasuti tantra and stree roga, Sri sri college of
Ayurveda science and research .for the above condition the patient was underwent
Sthanika Abhyanga with ksheera bala taila Sthanika nadi sweda with Ashwagandha
ksheera paka and yoni pichu with Ashwagandha ghrita followed by oral medications.
MENSTRUAL EXAMINATION INVESTIGATIONS
HISTORY Regular FINDING Hb – 12gm /dl
MENOPAUSE Neck- NAD RBS- 98mg/dl
ATTAINED: 2 years Breast – NAD USG Abdomen – Normal
back p/A- NAD study
MARITAL P/S- NAD Urine R/M - Normal
HISTORY: Married P/V-NAD
OBS HISTORY:
P2L2A0D0

TREATMENT PLAN

SL.NO STHANIKA CHIKITSA DURATION

1 Sthanika abhyanga 7 days
2 Sthanika nadi sweda 7 days
3 Yoni pichu 7 days
4 Shatavari granules 2tsp -0-2tsp with milk
5 Ksheera bala taila External Application X
7days

PATHYA APATHYA
Shatapushpa, nuts, milk, Hot and spicy food, caffeine, day

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 amalaki, egg white, soybean, sleep, irregular meal, awake at
peanuts, whole grains, yoga and night, oily foods, cold drinks.
pranayama

PAIN ASSESSMENT

Vaso Analog scale

Before Treatment- 6
After Treatment 1

RESULT
The single case study demonstrates that Sthanika chikitsa with vata and pitta hara
dravyas helps to decrease the symptoms of menopause Like dryness in vagina. No
adverse effect and complications are seen and the dryness of vagina is reduced
DISCUSSION
The dryness in vagina which is one of the common symptom during menopause due
to estrogen depletion and during the age of menopause there will be increase in vata .and
also disturbance in the vaginal flora. Snehana and swedana is a best line of treatment for
vata vyadi explained as a purva karma for panchakarma by all Acharyas. Abhyanga with
ksheera bala taila – murchita tila taila and bala which are vata shamaka and in the form of
taila it helps to allivates vata.. Ashwagandha Ksheera paka nadi sweda is a type of
snigdha sweda and does vata shamana. Yoni pichu which maintain the vaginal pH and
flora and also strengthens the walls of vagina and reduces the chances of infection.
Ashwagandha ghrita which acts as vata shamaka and ghrita which is considered as best
sneha, absorb quickly due to its lipophilic action. The medication remains for long time
in vagina through easy absorption of drugs through mucosa and sub mucosa. which the
action of drugs take place followed by the oral intake of shatavari granules with milk acts
as rasayana and help to maintain health and external application of ksheera Bala taila
relives pain and improve the condition.
CONCLUSION
The unavoidable condition in every women life want to land with ease. the ayurveda
management through Sthanika chikitsa and rasayana therapy helps to improve the
menopausal conditions instead of hormonal replacement therapy and the Sthanika
chikitsa also helps to improve the condition in a short period of time without any adverse

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and systemic effect, had a fruitful outcome in case of Suskha yoni and thus improve the
quality of life in menopausal women.
REFERENCES
1. Dutta DC. Text book of obstetrics.9th ed. New Delhi, London, Panama: Jaypee
Brothers Medical Publishers;2019. Ch.14, Operative obstetrics; New Delhi,
London, panama: Jaypee brothers Medical Publishers;
2. Acharya Agnivesa, Caraka Samhita, English Translation by Ram Karan Sharma,
Bhagwan Dash, Ch. chi 30/ver32-33, Varanasi; Chowkhamba Krishnadas
Academy
3. Acharya Sushrutha, Sushrutha Samhitha, Acharya Jadavji Trikamji Narayan Ram
Acharya, Sutra sthana.Ch.4, Varanasi: Chaukhambha Orientalia.
4. Acharya Vrddhajivaka, Kashyapa samhitha, P.V. Tewari, Reprint 2018,
Ch.4/ver70 Varanasi: Chaukhambha Visvabharati Oriental publisher.
5. Kashayapa samhitha Jathisutriadyaya 4/70
6. Teva p, sharma k, prakash h. mode of action of sthanik chikitsa in commonly used
in stree roga.
7. Meena p, gaurav p. probable mode of action of sthanika chikitsa (local treatment)
in yonivyapada–an ayurvedic insight. int. j. ayur. pharma research. 2014;2(7):25-
31.
8. Buhrman S. Ayurvedic approaches to women‘s health. Protocol J Botanic Med.
1996;1(4):2-7

***

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 GRACEFUL AGEING IN STREE
Dr. Nanda K O
Assistant Professor, Department of Prasuti Tantra & Stree Roga
JSS Ayurveda Medical College & Hospital, Mysuru – 570028
Phone No – 08970322532
Email – nandako89@gmail.com

Ageing is an inevitable part of growing older. A progressive generalized impairment

of action resulting in loss of adoptive response and increasing risk of age related diseases
and disabilities. It is the process of deterioration.
Ageing brings about physiological, psychological and immunological changes and
nutritional status. It is necessary to give care which help to achieve the health purposeful
and peaceful independent living.
The other causes includes stress, emotional factors play very important role. Now a
day‘s nuclear family is common. The society is witnessing a gradual but definite
withering of the Joint family system as a result of which a section of the family, primarily
the ageing process are exposed to emotional neglect and lack of physical support. They
are facing number of problems ranging from absence of ensured and sufficient income to
support themselves and their dependence to ill-health, social insecurity, loss of social role
and recognition to non-availability of opportunities for creative use and free time.
To combat the science of ageing includes regular exercises, quit smoking, manage
stress, good diet, enough rest, drink plenty of water, regular health check up.
Ayurveda considered jara i.e., ageing is one among the swabhavaja vyadhi. The
lakshanas like decrease of sharira dhatu, rasa, rakta, indriya bala, virya, purushartha,
parakrama, grahana, dharana, smarana, vachana and vignyana shakthi are inevitable.
The treatment and management are clearly mentioned in ayurveda which includes
preventive and conservative methods like : -
 Rasayana-Vajikarana These two are comes under Ashtanga Ayurveda. The
dravyas enhances physical, mental, immune health to prolong healthy life.
Rejuvenating formulations have a rich anti-oxidation resource potential to retard
the progressive process of oxidation in cells
 Therapeutic procedures Abhyanga, Shodhana
 Ekamulika aushadhas includes vayastahpana, jivaniya , balya, medhaayushkara
ojovardhaka dravyas
 Ahara – Hitahara, Pathyahara and also following the ahara sevana karma

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  Vihara - Dinacharya, Rutucharya, Gramya dharma , Vyayama, Yoga &
Pranayama
 Vichara - Sadvrutta, achara rasayana, satvavajaya chikitsa.
Ageing is emerging as one of the major social challenge hence there is need to pay
greater attention, promoting holistic policies and programs to this vulnerable segment of
society. It is the duty of government, local bodies, voluntary organizations, home for the
aged and the young people to look after the aged persons to make their life comfortable,
meaningful and enjoyable one.
―Growing old happens in mind, but reshaping of ageing process is within our
control.‖
Key words: Ageing, Jara, Rasayana-Vajikarana, Pancakarma, Ahara, Vihara, Vichara
INTRODUCTION
Ayurveda being oldest and traditional system of medicine and medication based on
experience and observation thus Ayurveda called as Holistic Science. Ayurveda
maintains health by maintaining equilibrium with nature between individual‘s body,
mind, and spirit. Mainly concentrates on prevention of the disease and encourages the
maintainence of health. Ayurveda enables us to create balance of body, mind and
conciousess. To prevent disease and to promote health of an individual Achrayas
explained Rasayana and Vajeekarana. The word Rasayana comprise of two words Rasa
and Ayana ie Rasa-nutrition and Ayana-path or way1. Rasayana is a Sanskrit word
literally meaning path of essence. Main aim of Rasayana is to enrich or to nourish the
Saptadhatus. Rasayana concentrates mainly promoting the health of an individual and
curing the disease of an individual2. There are many quotations said by our Acharyas
regarding Rasayana:
 Labhopayi Shastanam Rasadinam rasayanam ie which nourishes the rasadi
dhatus3
 Yat Jaravyadhividhwamsi bhesajam tat rasayanam ie not only cures the disease
but also deals jara (Geriatrics) chikitsa4.
 Rasayana tantram nama vayasthapanam ayumedhabalakaram rogarashamanam
samartham cha ie Rasayanatantra is one which does the Vayasthapanam
(youthfulness), medhya (intelligence), Balakara (promotes strength) and also
capable of curing the disease5.

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IMPORTANCE OF SHODHANA:
Rasayana is not beneficial to who has not undergone Shodhana (purificatory therapy);
it will be waste just as dyeing dirty clothes does not make the colour shine bright. After
ascertained that the koshta is shuddha, he should be administered Rasayana therapy
according to vaya, prakriti and satmya6. Rasayana yields benefits in Young age and
Middle age persons.
Classification of Rasayana
1) Mode of action :
a) Samshodhana
b) Samshamana
2) Mode of administration
a) Kutipraveshika
b) Vatatapik
3) Purpose of administration
a) Kamya: Prana kamya, Medha kamya and Sri kamya
b) Naimittika : it is vyadhinimittaja
c) Ajasrika : Ksheera Ghrita abhyasa
4) Based on Achara Rasayana
a) Aahara rasayana
b) Achara rasayana
c) Dravya rasayana
5) According to Bhesaja bheda
a) Dravyabhuta
b) Aadravyabhuta
BENEFITS OF RASAYANA7
Sthapaka (stabilizes) Vardhaka (enhances) Aprapthapaka
(endows)
Vayasthapaka Ayu (longevity) Arogya (health)
(youthfulness)
Smriti (memory) Taruna (young)
Bala (strength) Prabha (complexion)

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 Medha (intelligence) Swara (voice)
Varna (colour)
Deha indriya bala
(strength of body
and sensory organs)
Vaksiddhi(clearness
of voice)
Kanti (lusture)

PROBABLE MODE OF ACTION OF RASAYANA

JARA IN STREE -
An individual is expected to stay healthy and have long life. Women attain
menopause 40s or 50s, it is a natural biological process which marks the ageing in
women during this time she experience both physical, mental and hormonal changes,
where she needs extra care and concern to overcome the complaints and complications
related to menopause.
Ageing is an inevitable part of growing older. A progressive generalized impairment
of action resulting in loss of adoptive response and increasing risk of age related diseases
and disabilities.
Ageing brings about changes in physiological, psychological and immunological and
nutritional status in every individual. It is necessary to give care which help to achieve
purposeful and peaceful independent quality living.
BIOLOGICAL EFFECTS OF RASAYANA DRAVYAS:
MULTIDIMENSIONAL APPROACH:

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  Imuno modulatory effects- Immuno competent, Immuno stimulany,
Humoralimmunity, Immunopotentiating
 Antioxidant
 Antiageing effects
 Anabolic effects
 Nootropic effects
CONCLUSION
Rasayana is a procedure of Protective, Nutritive and Homeostasis of body, mind and
senses. The purpose of Rasayana is to obtain strength, immunity, ojas, and vitality and
strengthen the senses. Rasayna brings about regeneration, revival and revitalization of the
bodily tissues or dhatus. Rasayana is a standard treatment influences the bodily elements
like Dhatu, Agni and Srotas.
An individual is expected to stay healthy and have long life. Ageing is an inevitable
part of growing older. A progressive generalized impairment of action resulting in loss of
adoptive response and increasing risk of age related diseases and disabilities. Ageing
brings about changes in physiological, psychological and immunological and nutritional
status in every individual.By following ayurvedic principles like Ahara, Vihara, Vichara,
Rasayana, Vaajikarana and Sthanika Chikitsa especially for Jara Stree will achieve
purposeful and peaceful independent living. ―Growing old happens in mind, but
reshaping of ageing process is within our control.‖
REFERENCES
1. Waman Apte. Sanskrit-Hindi Shabdakosha. Reprint. New Delhi: Anil Prakashan;
2007. Rasayana. p. 94.
2. Acharya Vidyadhar Shukla. CarakaSamhita of Agnivesa. Reprint. New Delhi.
Varanasi: Chaukhamba Sanskrit Pratishthan; 2010. p.5
3. Acharya Vidyadhar Shukla. CarakaSamhita of Agnivesa. Reprint. New Delhi.
Varanasi: Chaukhamba Sanskrit Pratishthan; 2010. p.5
4. Anakkleelil.S. Gopala Pillai, Shargadhara Samhita by Sharghadhar.Poorvakhanda.
Reprint. Varanasi: Chaukambha Orientalia;2011.p.418
5. Aharya JT. SusrutaSamhita of Susruta with NibandhaSangraha Commentary of Sri
Dalhanacharya and NyayachandrikaPanjika of Sri Gayadasacharya. Reprint.
Varanasi: Chaukambha Sanskrit Sansthan; 2009.p.498.
6. Aharya JT. SusrutaSamhita of Susruta with NibandhaSangraha Commentary of Sri
Dalhanacharya and NyayachandrikaPanjika of Sri Gayadasacharya. Reprint.
Varanasi: Chaukambha Sanskrit Sansthan; 2009.p.498.

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7. Aharya JT. SusrutaSamhita of Susruta with NibandhaSangraha Commentary of Sri
Dalhanacharya and NyayachandrikaPanjika of Sri Gayadasacharya. Reprint.
Varanasi: Chaukambha Sanskrit Sansthan; 2009.p.498.
8. Aharya JT. SusrutaSamhita of Susruta with NibandhaSangraha Commentary of Sri
Dalhanacharya and NyayachandrikaPanjika of Sri Gayadasacharya. Reprint.
Varanasi: Chaukambha Sanskrit Sansthan; 2009.p.498.
9. Acharya YT. CarakaSamhita with Ayurveda Deepika Commentary of
Chakrapanidatta. Reprintt. Varanasi: Chaukambha publication; 2011. p.82.
10. Susruta, Susruta Samhita, NibandhasangrahaCommentary by Sri Dalhanacharya,
edited by Vaidya Yadavji Trikamji Acharya, Reprint. Varanasi: Chaukambha
Orientalia,-2015. P.
11. Acharya YT. CarakaSamhita with Ayurveda Deepika Commentary of
Chakrapanidatta. Reprintt. Varanasi: Chaukambha publication; 2011. p.82.

***

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 AN ARTICLE ON GYNAECOLOGICAL DISORDERS IN
GERIATRIC WOMEN
Dr.Nidhi Sharma
Dr. Asokan V
1st Year P.G Scholar, Department of Prasuti Tantra
Evum Stri Roga, Parul Institute of Ayurved,
Parul University, Vadodara (Gujarat) - India,
Professor of Prasuti Tantra and Stri Roga Department,
Parul Institute of Ayurved, Parul University, Vadodara (Gujarat)

ABSTRACT:
The Indian society which was pyramidal till 20th century, has become rectangular
today and morbidity related to geriatric gynaecological problems is on the rise. Common
gynaecological problems encountered in elderly women are vulvovaginal inflammation,
genital prolapse, postmenopausal bleeding, malignancy and alteration in bladder function.
Pelvic organ prolapse and genital malignancy are the major gynaecological disorders
above 60 years in women. Post menopausal bleeding is the commonest complaint.
Ovarian and endometrial cancer are showing a rising trend in the women above 60 years.
The risk of developing Gynecological tumor is highest in geriatric women.Women over
the age of 65 have a higher risk of developing cancer of the uterus (two fold), ovaries
(three fold) and Cervix (10% increased risk). Postmenopausal and geriatric
gynaecological problems have not received adequate attention in India. There is an
obvious need of screening programme for early detection of gynecological malignancy to
provide better geriatric services. The Geriatric care can best be summed up by the slogan
of the British Geriatric society ―Adding Life to Years‖.
Key Words: Geriatric women, Gynaecological Disorders, Genital Malignancy, Ovarian
and Endometrial Cancer.
INTRODUCTION:
The word Geriatrics was coined by Dr. Ignatz Natcher an Austrian physician in 1909.
Regular gynecologic evaluation in older women is an integral part of medical care, just as
it is for women of reproductive age. Geriatric gynaecology deals with gynaecological
pathology encountered in postmenopausal women at and above 60 years of age with an
intention of early diagnosis and management. A major challenge for the world in the 21st
century is the ageing of its population. The age-related geriatric problems have emerged
significantly with enhanced longevity of life. These are attributed to the physiological
changes seen in reproductive organs due to their altered hormonal mileu. The unique

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features of geriatric illnesses arechronicity and heterogeneity, greater severity and slow or
sometimes no recovery. The various gynaecological disorders peculiar to ageing are
pelvic organ prolapse, postmenopausal bleeding, gynaecological malignancies, urinary
incontinence, genital tract infections, vulvovaginal disorders.
Vulvovaginal inflammation:
Vulvovaginitis is an inflammation or infection of the vulva and vagina. It‘s a common
condition that affects women and girls of all ages. It has a variety of causes. Other names
for this condition are vulvitis and vaginitis.Bacterial vulvovaginitis affects near 30 %
trusted 2017 case sheet indicates that vaginal candidiasis (yeast infection) is the second
most prevalent vaginal infection
Genital Prolapse:
Uterine prolapse occurs when pelvic floor muscles and ligaments stretch and weaken
and no longer provide enough support for the uterus. As a result, the uterus slips down
into or protrudes out of the vagina. Uterine prolapse can occur in women of any age. But
it often affects postmenopausal women who've had one or more vaginal deliveries.Mild
uterine prolapse usually doesn't require treatment. But if uterine prolapse makes you
uncomfortable or disrupts your normal life, you might benefit from treatment.
Post Menopausal Bleeding:
Endometrial atrophy, uterine fibroids, and endometrial cancer are common causes of
postmenopausal vaginal bleeding. About 10% of cases are due to endometrial cancer.
Uterine fibroids are benign tumors made of muscle cells and other tissues located in and
around the wall of the uterus. Women with fibroids do not always have symptoms, but
some experience vaginal bleeding between periods, pain during sex, and lower back pain.
Genital Malignancy :
Vulvar Cancer , Vaginal Cancer , Cervical Cancer , Womb Cancer , Fallopian Cancer ,
Ovarian Cancer.
Female genital cancers are an important cause of death in women. Numerous types of
vaginal and vulvar cancer are seen in clinical practice, with main symptoms being vaginal
bleeding, discharge, pruritis, local pain, and the presence of a mass. The diagnosis and
identification of the exact tumor type rest on clinical criteria, findings obtained from
imaging studies, and a properly obtained biopsy.

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Discussion :
The low literacy rate, lack of awareness of screening programmes and lack of health
education, the non availability of medical facility, most of the women visit to hospitals
only when symptomatic. Most of the patients deny to have pap smear or any other
screening test. Overall gynecological conditions may become less frequent to elderly
women once they are menopausal naturally or after major gynecological surgery, such as
hysterectomy. Post menopausal bleeding is the most alarming and caused apprehension.
Thorough evaluation is done always focusing to exclude malignancy. In urogenital
disorders UTI and other infections like candida vaginitis, trichomonas and mixed
infections are common because of lack of estrogen and change in vaginal pH and other
medical disorders. Incomplete and ineffective voiding of urine causes urinary stasis
causing UTI. Vaginitis and UTI are common urogenital infections, for which candida
vaginitis is the commonest cause. In older women, vaginal pH changes owing to lack of
oestrogen and predisposes to candida vaginitis. Ineffective voiding and incomplete
bladder emptying leads to urinary stasis and colonisation by pathologic bacteria resulting
in UTI. UTI was the sole source of infection in 10% of febrile older women.
Conclusion
Changing demographics rise the problem of providing gynecological care for these
elderly women. The responsibility of the gynecologist as the primary physician for
geriatric patients increases, to detect the cancer earlier and manage it to decrease
morbidity and mortality. There should be increased screening programmes for cancer
making this available for all the women at all stages and at all levels. There should be
establishment of geriatric units to improvise on the health of women over 60 years to give
them quality of life. Old age should be a boon and not a curse to our mothers and elderly
women.
References
1. Census of India 2001. Available from: http://www.censusindia.
gov.in/Census_Data_2001/India_at_glance/broad.aspx. Accessed 2 October 2009.
2. Kohli HS, Bhaskaran MC, Muthukumar T, Thennarasu K, Sud K, Jha V, et al.
3. Treatment-related acute renal failure in the elderly: a hospital-based prospective
study. Nephrol Dial Transplant., 2000;15: 212-7.
4. Bartman B.A., Weiss K.B. Women‘s primary care in the United States: A study of
practice variation among physician specialties. J. Womens Health, 1993; 2: 261–
268.
5. Schmittdiel J., Selby J.V., Grumbach K., Quesenberry C.P., Jr. Women‘s provider

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6. preferences for basic gynecology care in a large health maintenance organization.
J. Womens Health Gend. Based Med., 1999; 8: 825–833.
7. Chen T.J., Chou L.F., Hwang S.J. Patterns of ambulatory care utilization in
8. Taiwan. BMC Health Serv. Res., 2006;
9. Nicholson W.K., Ellison S.A., Grason H., Powe N.R. Patterns of ambulatory
10. care use for gynecologic conditions: A national study. Amer. J. Obstet.
11. Gynecol., 2001; 184: 523–530.
12. Health Promotion Administration, Ministry of Health and Welfare, Taiwan.
13. Accessed on 11 April 2014; Available online: http://www.hpa.gov.tw/English/C
14. lassShow.aspx?No=201312110001.
15. Gredmark T, Kvint S, Havel G, Mattsson L. Histopathological findings in women
16. with postmenopausal bleeding. BJOG,1995; 102: 133-6.

***

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 THE EFFECT OF VAYASTHAPANA GANA KSHEERABASTI IN
GENITO URINARY SYNDROME OF MENOPAUSE ALONG WITH
DIFFUSE EPISCLERITIS - A CASE REPORT
Dr. Rachana Yadav
Laxmipriya Dei
Phd Scholar, Department of PTSR, ITRA, Jamnagar
Professor & Head, Department of PTSR, ITRA, Jamnagar

ABSTRACT-
Background- GSM describes the multiple changes occurring in the external genitalia,
pelvic floor tissues, bladder and urethra, and the sexual function and libido, caused by
hypo-oestrogenism during the menopause transition and post menopause. Episcleritis is
inflammation of the thin, loose, highly vascular connective tissue layer that lies between
the conjunctiva and sclera, its incidence is less than 1/1000 and most cases are found to
be idiopathic. It presents with acute onset of redness, lacrimation and photophobia.
Episcleritis mentioned in modern ophthalmology can be understood as Sirajala in
ayurvedic classics. Case report- A 55 years postmenopausal women with the complain of
painful burning micturition, constipation, white discharge p/v with itching since 7 days &
one eye red since one month came to PTSR OPD, ITRA. Menopause had occurred 7
years back. Patient was given trikatu choorna for 3 days followed by Vayasthapana gana
ksheerabasti 450ml for 8 days in apana kaal between 4-5pm & Vayasthapana gana
choorna 5gm bd ksheerapaka before meal for one month. Panchavalakal, nimba choorna
for vaginal wash, & chandraprabaha vati 2tab bd with luke warm water for 15 days.
Patient got relief in constipation and gas formation after ksheerabasti. Vaginal wash and
chandraprabha vati gave relief in burning micturition, white discharge. After 4th day of
ksheerabasti patient got relief in redness in eye which was concerned as autoimmune
disorder by modern consultant. Conclusion- Hence showing sarvadaihik effect of
ksheerabasti.
KEYWORD- Episcleritis, Sirajala, Ksheerabasti, Vulvo-vaginal atrophy, Sukhapraudha
Corresponding Author-
Dr. Rachana Yadav
Phd Scholar, Department of PTSR, ITRA, Jamnagar
Postal Address- Fifth floor, Department of PTSR,
New Institute Building, ITRA, Jamnagar- 361008

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Email id- cdrachana16@gmail.com
Mobile no- 8160409836
Introduction
GSM (Genitourinary syndrome of menopause) includes wide spectrum of
vulvovaginal symptoms and urinary troubles replacing the term vulvovaginal atrophy
(VVA). It is a silent epidemic condition affecting 50-60% postmenopausal women.
Estrogen withdrawal causes thinning, narrowing, tissue loss & reduced blood supply in
vulvo-vaginal area, which results GSM. GSM causes burning in vagina, dyspareunia,
urinary urgency, repeated UTI. Dyspareunia affects all the domain of sexual function and
deteriorates the quality of life. Anatomical modification related to GSM includes-
thinning of vaginal mucosa, mucosal dryness, atrophy of elastic and collagen tissue with
reduced blood supply. Menopause results altered appearance and function of smooth
muscle cells, increased density of connective tissue and fewer blood vessels, an increase
of vaginal pH, which is an index of poor vaginal epithelium maturation, indicates
estrogen deficiency and it results chronic VVA or GSM1. There is also changes in
vaginal flora associated with the loss of superficial cells, glycogen, and lactobacilli result
in increased pH and the increased potential for vaginal and urinary tract infection and
inflammation. Decreased in vaginal blood flow and lubrication often result in dryness and
dyspareunia2. The reduced blood supply and less elasticity make the vagina prone to
petechial, injury and pain.
Vitiated Apana Vata and Rasa Dushti causes constipation and flatulence, burning
micturition, itching vagina, dyspareunia. Vitiated Vyana Vata and Rasa Dushti cause
vaginal dryness involving Artavavaha Strotas. Vitiated Vata and Mamsa Dushti cause
atrophic vaginitis involving Artavavaha Strotas. All these together lead to genitourinary
symptoms3,4.
Episcleritis is benign recurrent inflammation of the episclera, involving the overlying
tenon‘s capsule but not the underlying sclera5. As a rule, episcleritis presents with acute
onset of redness, lacrimation and photophobia. Generally, it is painless with minor eye
tenderness. It commonly affects a single quadrant in one eye as opposed to scleritis that
may involve more than one quadrant. The above presented disease can be compared with
Sirajala a rakthaja (vitiated by blood) chedhana (excision) sadhya (curable) vyadhi
(disease) described under suklagata netra roga (diseases of the sclera) in ayurveda2.The
signs and symptoms of sirajala are jalabha (network of vessels), Katina sira Mahan
(tough raised vessels) 6.

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Case report
A 55 year old postmenopausal lady came to O.P.D of Prasutitantra and Streeroga
department of ITRA Jamnagar. Since one year she was experiencing hot flashes, night
sweats and increased sweating. She had complaint of flatulence, constipation, white
discharge p/v with itching, tiredness since 7 days. She felt poor memory, increased anger,
headache, disturbed sleep, depression, anxiousness for last one year. She was having
decreased sexual desire, pain during coitus and vaginal dryness. Since 7 days she
presented with decreased amount of micturition and burning sensation during micturition.
Since one month she was having redness in her one eye for which she took modern
medicine but not relieved. The symptoms were severe enough to disturb the quality of her
life and for the above said complaints she consulted gynaecologist.
Her past menstrual history revealed that she had menarche at the age of 14 years,
having regular cycles, with 2-3 days duration and moderate amount of bleeding. Her last
menstrual period was on 16/8/2013. Her obstetric history was gravida 3; Parity 3;
Abortion 0; Living 3.
Her personal history revealed she had reduced appetite, constipated bowel, disturbed
sleep, decreased frequency and burning micturition.
Clinical findings
Her vital signs revealed afebrile, having blood pressure 130/70 mm Hg, heart rate-
72/minute and respiratory rate-14/minute. She was of Kapha Pitta prakriti with
Madhyama satwa. Her pelvic examination showed no signs of redness, swelling,
cystocele and rectocele on inspection. P/S finding showed vagina dry, pinkish pale,
cervix firm, and round, with mild whitish discharge. P/V finding showed uterus
anteverted, cervix firm mobile with no tenderness on movement, fornix clear.
Red eye was diagnosed as diffuse episcleritis but it was not relieved by modern
medications.
Diagnostic focus and Assessment
The patient was diagnosed as having Menopausal syndrome by Australasian
Menopause Society Symptom Score Sheet. The patient attained a score of 49 which
suggests that she needs treatment. Table 1: Australasian Menopause Society Symptom
Score Sheet
Investigations
Hb- 11gm%, ESR- 90mm/hr, Urine R/M- pus cells—18-20/hpf

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 USG findings were- Uterus- AV Normal size, ET 3mm, Atrophic ovary, mild
adenomyosis, and small fibroid.
Therapeutic intervention
The patient was given Deepana pachana with Trikatu churna with warm water for
three days. Then she was given Ksheerapaka Basti of Vayasthapana Gana Choorna 7 for
8 days in apana kaal 4-5pm. Fine powder of Vayasthapana Gana (total 30gm) was boiled
with 15 parts of Ksheera (450 ml) and 15 parts of water (450ml) until only milk part
remains8. Thus obtained Ksheera Paka is filtered and used for Basti procedure.
Vayasthapana gana choorna 5gm bd ksheerapaka pan before meal for one month.
Panchavalakal, nimba choorna for vaginal wash, & chandraprabaha vati 2tab bd with luke
warm water for 15 days.
Outcome
It was observed that after eight days of basti, the patient got marked relief of hot
flashes, micturition problems, bloatedness, gas trouble, disturbed sleep and emotional
disturbances. After two months of treatment, patient got better relief of almost all
symptoms except for sexual problems, weight gain and vaginal dryness. Patient got relief
in constipation and gas formation after ksheerabasti. Ksheerabasti, oral, vaginal wash and
chandraprabha vati gave relief in burning micturition, white discharge with itching. After
4th day of ksheerabasti patient got relief in redness in eye which was concerned as
autoimmune disorder by modern consultant. She felt good appetite, regular bowel,
wellness of mind and body.
Discussion
Ayurveda describes Rajonivritti as the end of Artava pravritti. This occurs in
jarapakwa sareera and may get manifested from the age of 50. In Jaraparipakwa sareera,
there will be degradation in the formation of Artava which is the Upadathu of rasa due to
Applenana 9. There will be gradual depletion of dhatus, upadhatus and ultimately ojas.
Ras-rakta dhatu kshaya causes kshaya of nagapushpa and Bahya pushpa resulting in
Rajonivritti. Rasayana (Rejuvenation therapy) delays the degenerative process of our
body may be useful in the management of Menopausal Syndrome. Drugs mentioned
under Vayasthapana Gana have the property of rasayana, vyadhi nasanam, medhya,
balya, jeevaneeya, dhatu pushti Kara. Most of the drugs have Tikta, Madhura and
Kashaya rasa and having Madhura Vipaka. Tikta, Kashaya rasa are Pittashamak and also
subside Kapha dosha. Madhura rasa having soothing effect promotes strength and pacify
Pitta and Vata Dosha. So, Vayasthapana Gana choorna works as Tridosha Shamaka and
reduce the Rajonivritti janya lakshanas by balancing Tridosha. Most of the drugs having
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Dipana, Pachana property which improves the status of Agni in this patient. Amalaki,
Shatavari, Jatamansi, Mandukparni, Guduchi, Shalparni and Punarnava have Hridya
property; Amalaki, Shatavari, Jatamansi, Mandukparni, Haritaki, Jivanti have Medhya
property. The drug Punarnava, Mandukparni, Shatavari and Aparajita helps to reduce
psychological symptoms of patient. Researches shown that Aparajita induces feeling of
calm and peace promotes good sleep and relieves anxiety and mental fatigue10.
Researches shown that the drug Punarnava possess antistress, adaptogenic,
immunomodulatory, antibacterial activity11. Punarnava, Jivanti and Shatavari have
Mutrala Properties which reduced bladder problems. Punarnava, Amalaki and Guduchi
normalized the blood pressure of the patient. Vasomotor symptoms of the patient is
mainly improved by phytoestrogenic activity of Shatavari12 and due to Seeta virya of
Amalaki, Jeevanti, Mandukaparni, Shatavari; dahasamani property of Guduchi. The
physical symptoms of patient were improved mainly by Vata pacifying action of Rasna;
anti-inflammatory action of Guduchi, Sthira and Punarnava. The increased physical and
mental well-being of the patient may be due to the rejuvenative action of Abhaya and
Aamalaki. Majority of the drugs of Vayasthapana Gana has been investigated in modern
pharmacology for its antioxidant, free radical scavenging, cytoprotective,
immunomodulatory, adaptogenic, antifungal, anti-inflammatory, anti-aging,
neuroprotective properties by which it reduces genito urinary syndrome of Menopause
13. Basti is the most important treatment for vata, drugs given in basti form has specific
target action and quick absorption. Ksheera is jeevaneeya, medhya, rasayana, brimhana,
especially pitta samana and in form of basti maximum absorption would be ensured.
Owing to this properties of vasti, the patient felt marked improvement the patient got
marked relief of hot flashes, joint pain micturition problems, bloatedness, gas trouble,
disturbed sleep and emotional disturbances.
As described by Aacharyas, shuklagata roga have rakta dushti and affects sira. In
Sirajala, kapha is the sthanika dosha i.e. ashraya and rakta is in prakopa awastha i. e.
ashrayi. According to ashraya-ashrayi chikitsa principle, the treatment should be kapha-
rakta shamaka. Moreover it also has features of netra aamavastha like- raga, shopha,
gharsha, shoola, ashru etc. therefore aama pachana treatment should also be added.
vayasthapana ksheerapaka basti by its saravadaihika effect and vata pitta shamaka
property pacifies rakata dushti resulting in relief in redness and pain in eye.
chandraprabha vati acts as catalyst for other herbal ingredients to deliver swift therapeutic
action.

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Conclusion
Menopausal syndrome having genito urinary symptoms can be successfully managed
with Vayasthapana Gana Ksheerapaka Basti, orally with Vayasthapana gana churna.
Vayasthapana Gana Ksheerapaka Basti and oral Vayasthapana gana churna also help in
treatment of diffuse episcleritis.
Acknowledgement
IPGT and RA, Gujarat Ayurved University, Jamnagar, supported the study.
References
1. Pudney J, Quayle AJ, Anderson DJ. Immunological microenvironments in the
human vagina
2. and cervix: mediators of cellular immunity are concentrated in the cervical
transformation
3. zone. Biol Reprod 2005;73: 1253-1263.
4. White HD, Yeaman GR, Givan AL, Wira CR. Mucosal immunity in the human
female
5. reproductive tract: cytotoxic T lymphocyte function in the cervix and vagina of
6. premenopausal and postmenopausal women. Am J Repro Immunol 1997;37:30-
38.
7. Baranwal Vandana, Dwivedi Manjari. Oestrogenic activity of jayanti and vansa-
An
8. experimental study. IAMJ. 2014; 2(1)
9. Misra D.N et al; A Clinical Trial to Evaluate the Efficacy of M-3119 in
Menopausal
10. Syndrome, Volume V, Obs. and Gynae. Today. 2000, p.749
11. Salama A, Elsheikh A, Alweis R is this a worrisome red eye? Episcleritis in the
primary care
12. setting J Community Hosp Intern Med Perspect. 2018; 8(1):46-48.Published 2018
Feb 6
13. Murthy Srikantha K R. Illustrated Shushruta Samhita.Varanasi: Chaukhamba
Orientalia;
14. 2010.
15. Sharma PV. Charaka Samhita of Charaka, Sutra sthana. Second edition,
Chaukamba Sanskrit
16. series,Varanasi, 2008.

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17. Yadavji Trikamji Acharya. Dravyagunavijnanam. Second edition, Uttarardha
Parobhasha
18. Khanda, Mumbai, 2008, 33-34.
19. Ambika Dutt Sashtri (Editor). Commentary: Ayurveda Tatva Sandeepika on
Sushruta
20. Samitha of Susruta, Sutrasthana, Chowkhambha Sanskrit Series, Varanasi, 2010.
21. https.//pdfs.semanticscholar.org.>
22. https.//www.ijpsdr.com 2010.
23. 12 https://www.researchgate.net article available at www.ijpba.info
24. 13 https.//www.iamj.in/posts/images/upload/692 700.pdf
Table 1. Australasian Menopause Society Symptom Score Sheet
Symptoms None-0 Mild-1 Moderate-2 Severe-3
Hot Flashes 3
Light headed feelings 1
Irritability 3
Depression 3
Unloved feelings 3
Anxiety 3
Mood changes 3
Sleeplessness 3
Unusual tiredness 3
Backache 3
Joint pains 3
Muscle pains 2
New facial hair 0
Dry skin 2
Crawling feelings under skin 2
Less sexual feelings 3
Dry vagina 3
Uncomfortable intercourse 3
Urinary frequency 3
Headache 3

Before ksheerabasti After ksheerabasti

***
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 ROLE OF SHATAVARI AND ASHWAGANDHA IN THE
IMPROVEMENT OF GERIATRIC WOMEN HEALTH -A REVIEW
ARTICLE
Dr Raneesha Thahira
Dr Prathima
Post graduate scholar, Department of prasuti tantra&striroga,
Sri Dharmasthala Manjunatheshwara college of Ayurveda
and Hospital, Hassan- 573201,Karnataka,India
HOD and Associate professor, Department of prasuti tantra & str roga ,
Sri Dharmasthala Manjunatheshwara college of Ayurveda
and Hospital, Hassan-573201,Karnataka,India

ABSTRACT
Introduction Ageing is the accumulation of changes in a person over time.Geriatric
care has to address two fold problems,firstly the basic anti-aging care to retard the rate of
physiological ageing and secondly the medical management of diseases specifically
occurring in old age.Vriddavastha is the period after 60 or 70 years of age.This stage of
life becomes very crucial as degenerative change occurs to dhatus, indriya, bala, veerya,
utsaha, paurusha, parakrama,grahana.dharana,smarana,vachana. Disease and disability of
older women are very closely related to the loss of female sex hormones after
menopause. HRT (hormonal replacement therapy) is the conventional treatment practiced
for it. Ayurveda has a focused branch of medicine called rasayana,which deals with
diseases as well as problems related with ageing. Rasayana chikitsa in Ayurveda are
having similar effect in comparsion to hormonal replacement therapy. Shatavari and
Ashwagandha are selected for this purpose,as both of them are known for their anabolic
potentials(rasayana)and phytoestrogenic proeprties.An anabolic rasayana tends to give
dhatuposhana leading to the proper nourishment of all the dhatus by enhancing nutrition
and qualities of all dhatus.Shatavari and ashwagandha are said to be good source of
phytoestrogens and are recommended for all three doshas vitiation.Aims and
objectives:The purpose of this review is to evaluate and explore the pharmacolog ical and
phytoestrogenic activities of shatavari and ashwagandha in geriatric women health.
Materials and methods: Literatures such as Brihattrayee,Nighantu modern text books
written in 21st century and recent journals were critically reviewed to explore safety and
efficacy of pharmacological and phytoestrogenic activity of shatavari and ashwagandha
in geriatric women health. Discussion: Shatavari is the main rejuvenative tonic for the
female,having gunas like balya,vayasthapana,rasayana ,medhya and agnivardhaka
properties which help to reduce the dhatukshaya laskhanas also reduce manasika

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laskhanas when given orally.Ashwagandha due to its vayasthapana and balya
properties,directly acts as rasayana causing dhatu pushti and manasa tarpana.Further it
supports sound sleep, has anti-stress effect,improves degenerative changes,also affects
elements of the central nervous system and the immune system Conclusion:Thus an
attempt to highlight the role of shatavari and ashwagandha in the improvement of
geriatric women health through its pharmacological and phytoestrogenic properties.Key
words:geriatrics, shatavari, ashwagandha, rasayana pharmacology,phytoestrogen.
Introduction: Aging is essentially a physiological phenomenon which results because of
overwhelming of inherent evolutionary processes by the involutionary changes occurring
in the mind-body system.Geriatric care has to address two fold problems, firstly the basic
anti-aging care to retard the rate of physiological ageing and secondly the medical
management of diseases specifically occurring in old age such as
osteoporosis,obesity,hypertension diabetes,Alzheimersdisease,degenerative arthritis.
Disease and disability of older women are very closely related to the loss of female sex
hormones after menopause. In Ayurveda geriatrics is considered as jarapakwa avastha
and in women it can be considered as postmenopausal phase or rajonivrutti. Rajoni
vrutthijanya laskhanas are produced as a result of dhatukshaya in the body(1).In this stage
majority of women encounter problems like hot flushes, nightsweats, palpitations,
insomnia, anxiety irritability,vaginal dryness,vaginal and cervical atrophy.A common
practice to relieve menopausal symptoms is to administer hormone replacement
therapy,which is not free from adverse effects,therefore women are turning to natural
medicine in an attempt to have a safe alternative to synthetic steroidal hormones.
Shatavari and ashwagandha being known sources of phytoestrogens can be effective in
reducing adverse menopausal symptoms
Ayurveda has a focused branch of medicine called rasayana, which deals with
diseases as well as problems related with ageing.Shatavari and Ashwagandha are selected
for this purpose,as both of them are known for their anabolic potentials(rasayana) and
phytoestrogenic properties.An anabolic rasayana tends to give dhatuposhana leading to
the proper nourishment of all the dhatus by enhancing nutrition and qualities of all
dhatus.
India is abundantly enriched with a good sort of herbs having therapeutic worth.
Shatavari is most commonly used ayurvedic herb.Asparagus racemosus (family-
Asparagaceae) traditionally known as SHATAVARI means ―who possesses a hundred
husbands or acceptable to many, indicates that this herb is highly effective in problems
related with female reproductive system,main rejuvenative tonic for the
female(2).ASHWAGANDHA (Withania somnifera,family-solanaceae)used as a broad

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spectrum remedy in india for centuries.ashwagandha is categorized as an anti-
inflammatory, antioxidant herbal suppliment Therapeutic implications for cancerous
tumors as well as neurodegenerative diseases documented,classified as an adaptogen
,which indicates its ability to regulate physiological processes and there by stabilize the
body‘s response to stress.(9)
MATERIALS AND METHODS : Literatures such as Brihattrayee,Nighantu ,modern
text books written in 21st century and recent journals were critically reviewed to explore
safety and efficacy of pharmacological and phytoestrogenic activity of shatavari and
ashwagandha in geriatric women health.
RESULT AND DISCUSSION:
ACTIVE CONSTITUENTS OF SHATAVARI :The major constituents of Asparagus
racemosus are steroidal saponins(shatavri 1)which are present in roots .Shatavarin Ⅳ is a
glycoside of sarsasapogenin having two molecules of rhamnose and one molecule of
glucose.other active compounds such as quercetin,rutin,,hyperosid are found in flowers
and fruits.while diosgenin ,querticin -3 glucuronid present in leaves .also contains
vitamins A,B1,B2,C,E Mg,P.Ca,Fe and folic acid .other primary constituents are
asparagin,arginine tyrosine flavonoids,resin,tannin. (4)
PHARMACOLOGICAL ACTIONS OF SHATAVARI RELATED TO
GERIATRIC WOMEN HEALTH :A racemosus is also suggested for its soothening
agent upon systemic dryness which is part of natural aging process. Asparagus root
possesses aphrodisiac,anti-carcinogic ,anti-proliferative,cardio protective ,anti -bacterial
,anti-fungal,anti -oxidant,anti-depressant,hepatoprotective,immunomodulant,anti -
inflammatory,anti -diabetic ,anti- spasmodic,diuretic,anti-septic properties(5).Useful for
menopause,leucorrhea and has the capacity to balance pH in the cervical area.It endores
positive emotions that calming fresh sensitivity and the sizzling emotions such as
irritability,anger,jelousy,resentment, and hatred. also helps with pain, restless
sleep,disturbing dreams,in those having weak emotional and physical heart.
PHYTOESTROGENIC ACTIVITY OF SHATAVARI : Shatavari is mainly known
for its phytoestrogenic properties Phytoestrogens exhibit structural similarity and mimic
the effect of naturally occurring estrogen compounds in the body The majority of
phytoestrogens belong to a large group of phenolic compounds known as
flavonoids,isoflavones,prenylated flavonoids are estrogens with the most potent
estrogenic activity .They promote growth differentiation,and physiological functions,of
the female genital tract,pituitary,breast and several other organs.Phytoestrogenic
compounds are capable of binding to the estradiol(E2) receptors (E2R).In silico research

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has suggested that shatavari derived phytoestrogen including rutin, kaempferol, genistein,
quercetin bind to E2R with greater affinity than a selelctive estrogen receptor modulator
control,Bazedoxifene. (6) The potential for estrogen like effects of shatavari
supplimentaion has implications for both muscle and bone health after menopause.In the
presence of excess of estrogens in the body, phytoestrogens may have antiestrogenic
effect by occupying some estrogen receptors various formulations containing shatavari
have shown their effectiveness in alleviating the symptoms in and postmenopausal
period and in hysterectomised patients.
AYURVEDIC REVIEW: Shatavari secures the honour of a rasayana in Ayurveda
which means herbal medication encouraging regular health by boosting cellular
endurance.Charaka samhitha and ashtanaga hridaya are the two main texts on ayurvedic
medicines ,lists shatavari as part of the formulas to treat disorders affecting women,s
health. Charaka describe the gana of shatavari as balya and vayasthapana,also in
bhavaprakasha Nighantu its properties are balya,medhya,agnivardhaka properties which

Rasa Madhura,tikta
Guna Guru,snigdha
Vipaka Madhura
Virya Sita

help to reduce dhatukshaya laskhanas .Rasa panchaka of shatavari mentioned in table no

1below
Shatavari has vatapittahara properties,helps to relive symptoms caused due to vata
and pitta Shatavari is the having gunas like balya,vayasthapana rasayana,medhya and
agnivardhaka properties which help to reduce the dhatukshaya laskhanas also reduce
manasika laskhanas when given orally. Shatavari has a long term use in Ayurveda for
increasing satwa(healing energy) inside the body. It also increases ojas, acts on sapta
dhatus.(7) An anabolic rasayana tends to give dhatuposhana leading to the proper
nourishment of all the dhatus by enhancing nutrition and qualities of all dhatus
Other uses: vrushya,kshayapaha,pushtida,chakshushya.pittasrahara,gulmahara,
shophahara, kshataskheenahara,retodoshahara.
FORMULATIONS: shatavari gritha,shatavri taila,shatavri kwatha,mahanarayana
taila,shatavri guda,shatavri churtna ,shatavari mandura.
ASHWAGANDHA: ACTIVE CONSTITUENTS :It include alkaloids
(isopelletierine,anaferine,cuseohygrine),etc steroidal lactones and saponins.sitoindosides
and acylsteryl glucosides in ashwagandha are anti stress agents.Active principles of

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ashwagandha for instance the sitoindosides Ⅵ-X and withaferin-A have been shown to
have anti-stress activity.(8)
PHARMACOLOGICAL ACTIONS OF ASHWAGANDHA RELATED TO
GERIATRIC WOMEN HEALTH :Anxiety is one of the prominent features of post-
menopausal women because of sudden withdrawl of sex hormones i.e estrogen and
progesterone.Ashwagandha is one of the medhya rasayana but also acts as anxiolytic
drug,helps to reduce anxiety level in post menopausal women and hence improve the
quality of life .Ashwagandha known for its ability to support especially brain function
and nervous system,adrenal and sexual functions,helping relief stress and promoting
feeling of calmness and relaxation.its also known for its neuroprotective,thyroid
modulating ,anti-tumor,anti-inflammatory properties.it may help protect the heart and
brain damag ,reduce adrenal insufficiency,support memory and promote nerve cell
regenerations,maintains normal blood sugar and cholesterol levels,improves
sleep,increases muscle strength and support immune system.It improves level of sex
hormones by reducing cortisol levels. ashwagandha supports healthy levels of luteinizing
hormone which triggers development of the corpus lutuem out of which progesterone is
made .(10)
PHYTOESTROGENIC PROPERTIES OF ASHWAGANDHA :Ashwagandha
beneficial in normalizing oestrogen and reducing hot flushes,mood fluctuations,sleep
issues,irritability and anxiety.it prevents loss of bone mineral density and help normalize
follicle stimulating hormonewhich increases the risk of postmenopausal osteoporosis (10)
AYURVEDIC REVIEW : Among the ayurvedic rasayana herbs ,Ashwagandha holds
the most prominent place.it is known as ―sattvic kapha rasayana‖herb .
Rasa Tikta,kashaya
Guna Laghu,snigdha
Virya Ushna
Vipaka Madhura

Due to madhura rasa and snigdha guna present in ashwagandha hels to increase from
rasadhatu to shukra dhatu. tikta rasa does agni deepana karma. therefore dhatu gets
nourishes and enhanced. ashwagandha helps to increase prithvi and jala mahabhoota
amsha present in dhatu which results in increase of mamsa dhatu. Mamsa dhatu helps to
provide nourishment to body and helps in brahmana karma.Its having kaphavatahara
properties.Ashwagandha due to its vayasthapana and balya properties,directly acts as
rasayana causing dhatupushti and manasa tarpana. (11)

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Other actions:kantivardhaka,Kasahara,krimigna,shophhahara,kanughna
FORMULATIONS: Ashwagandhadya gritha,ashwagandhadya kwatha,Ashwagandha
rasayana,AShwagandhadi lehya,Balashwagandhadi taila.
CONCLUSIONS : Ayurveda and modern medicine have basic epistemological
differences.Ayurvedic wisdom and logic is more health -oriented than disease oriented.in
modern view,A common practice to relieve menopausal symptoms is to administer
hormone replacement therapy,which is not free from adverse effects,therefore women are
turning to natural medicine in an attempt to have a safe alternative to synthetic steroidal
hormones. Rasayana chikitsa in Ayurveda are having similar effect in comparsion to
hormonal replacement therapy in modern view.Hence both of these drugs are selected
having rasayana and phytoestrogenic proeprties.Shatavari and ashwagandha have shown
highly significant result in treating symptoms postmenopausal symptoms like
hotflushes,night sweats,palpitations insomnia,anxiety irritability.Shatavari and
ashwagandha are the important medicinal plants having traditional importance as it is
used in the indigenous system of medicines like Ayurveda,sidda and unani.Clearly,more
research is needed to define the effect of phytoestrogens from shatavari and ashwagandha
and characterizing formulations and /or isolated phytoestrogens is imperative. Further
more drugs having similar gunas needs to be explored.
REFERENCES:
1. Mishra, amrita, & shelare, R.V (2018),AN AYURVEDIC AND
CONTEMPORARY OVERVIEW OF MENOPAUSE;A CONCEPTUAL
APPROACH .international journal of Ayurveda and pharma research ,6(2)
2. sharma,komal &Bhatnagar,maheep (2011) asparagus racemosus (shatavari):a
versatile female tonic ,international journal of pharmaceutical and biological
archieves 2.855-863
3. singh N,Bhalla M,de jager ,An over view on ashwagandha :a rasayana
(rejuvenator) of Ayurveda.Afr J tradit compliment altern med ,2011;8(% suppl)
4. Mishra,jai and verma,Navneet (2017)ASPARAGUS RACEMOSUS ;CHEMICAL
CONSTITUENTS AND PHARMACOLOGICAL ACTIVITIES -A REVIEW
.Europian journal of biomedical AND pharmaceutical sciences .207
5. Mishra,jai and verma,Navneet (2017)ASPARAGUS RACEMOSUS ;CHEMICAL
CONSTITUENTS AND PHARMACOLOGICAL ACTIVITIES -A REVIEW
.Europian journal of biomedical AND pharmaceutical sciences .207
6. Shatavari supplementation in postmenopausal women improves handgrip strength
_ A randomized control trials -Mary f.o leary,sarah R.

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7. Hegde L Prakash,a text book of dravyaguna-chaukambha Sanskrit samsthan-
edi,reprint 2017.pg 773
8. singh N,Bhalla M,de jager ,An over view on ashwagandha :a rasayana
(rejuvenator) of Ayurveda.Afr J tradit compliment altern med ,2011;8(% suppl)
9. singh N,Bhalla M,de jager ,An over view on ashwagandha :a rasayana
(rejuvenator) of Ayurveda.Afr J tradit compliment altern med ,2011;8(% suppl)
10. http://www.ncbi,nlm.nih.gov/pubmed/19633611
11. Hegde L Prakash,a text book of dravyaguna-chaukambha Sanskrit samsthan-
edi,reprint 2017.pg 93

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 RASAYANA CHIKITSA IN GERIATRIC WOMEN CARE
Dr.Adrija P
Dr.G.Ramadevi
2nd yearPG scholar,Dept.of Prasuthi tantra and stree roga,SDMCA Udupi.
2Professor &HOD, Dept.of Prasuthi tantra and stree roga,SDMCA Udupi.

INTRODUCTION
Ayurveda means the science of life which consists of 8 branches. Jarachikitsa is the
7th branch of ayurveda which explains about rasayana chikitsa .The term rasayana
consists of two words rasa and ayana ,rasa means taste or essence or flavor or juice etc
.Ayana means a path or to increase or to circulate.The rasayana will increase and promote
the circulation of vital essence all over the body causes the nourishment of uttarottara
dhathu with good quality and quantity.According to sushrutha, rasayana tantra means
which endows vayasthapana-imparts longevity, age sustainer,rogapaharan through
enriching the immunity. [1]
―Menopause is just puberty‘s evil older sister‖. Geriatric women are passing through
various process of the body like-premenopause-peri menopause menopause &
postmenopause. Perimenopause is the beginning of the next phase of a reproductive
women where she faces irregular menstruations, sweaty nights, sleepy mornings etc. That
will continue upto 4-8 yrs till she attains menopause. Menopause is defined as permanent
cessation of menstruation at the end of reproductive life due to the loss of ovarian
follicular activity. It is the point of time when last and final menstruation occurs.
Post-menopause is the last phase of a women‘s life counting from her puberty
.because from there on wards the hormones will not have any major shifts as such
previously happened in her life. Geriatric women are currently passing through this phase
, where the estrogens lowered their activity and other functions of the body where highly
effected due to that.
Aim and objectives
 To study about physiological changes in geriatric women
 To study the role of rasayana chikitsa in geriatric women care
MATERIALS AND METHODS
Literary references are collected from Charaka samhitha, Susrutha samhitha,
Ashtanga hrudaya and various other ayurvedic samhithas and books of modern medical
science.

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Physiological changes in geriatric women
Geriatric women are who attained menopause and going through a postmenopausal
stage of their life. During the menopausal transition, estrogen levels decline and levels of
FSH and LH increase. The menopausal transition is characterized by variable cycle
lengths and missed menses, whereas the postmenopausal period is marked by
amenorrhea. The menopausal transition begins with variability in menstrual cycle length
accompanied by rising FSH levels and ends with the final menstrual period.Menopause is
defined retrospectively as the time of the final menstrual period, followed by 12 months
of amenorrhea.

effects on
brain stem
causes
effects on insomnia
Hypothalam Aging of
us causes neurons
hotflashes incresed increased
Estrogen stress cortisol
in brain
effects on decreased
Amygdala energy
causes production decreased
moodswings in brain estrogen
effects on
Hippocamp
us causes
Memory loss

Post-menopause describes the period following the final menses. The major
consequences of menopause are related primarily to estrogen deficiency. It is very
difficult to distinguish the consequences of estrogen deficiency from those of aging, as
aging and menopause are inextricably linked.Many symptoms are found related to
postmenopausal syndrome: Hot flushes, irritability, mood swings, insomnia, dry vagina,
difficulty concentrating, mental confusion, stress incontinence, urge incontinence,
osteoporotic symptoms, depression, headache etc.The deficiency of estrogen decreases
the energy of brain and causes the above psychological symptoms and increases the stress
.Deficiency of estrogen in cardiovascular system can leads to risk of myocardial
infraction ,in urogenital mucosa it causes dry vagina , urge incontinence &in bones it can
cause osteoporosis. More changes happens in central nervous system than the other

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systems. So the geriatric care in women care should be focused on the neuro protective as
well as balancing of the other systemic changes. [2]
Discussion
 Rasayana chikitsa
Rasayana chikitsa is the heart of jara chikitsa.It is the best way to prevent diseases.The
benefits are focused on attaining strength (balya) life giving (jeevaneeya), deerghamayu,
medha, smruthi,kanthi,pranathi,vaaksidhi,bulk promoting(brumhaniya) and stabilizing
the aging process (vayasthapana).It maintains the equilibrium of dosha ,dhatu,mala which
brings health. [3]
 Probable mode of action
Rasayana may act at three levels of biosystem to promote nutrition such as -
1. At the level of Agni by promoting the digestion and metabolism.
2. At the level of Srotasa by promoting the microcirculation and tissue perfusion.
3. At the level of Rasa itself by acting as direct nutrition.
• According to Allopathic mode of action rasayana have anti oxidative action which
postulates the age associated oxidative reductions ,immunomodulatory actions,
Antiaging effect,Adaptogenic effect, Neuroprotective action, Hemopoietic action
&Anabolic actions [4]
 Rasayana used in geriatric care
RITHU RASAYANA RASAYANA YOGAS SINGLE DRUGS ACHARA
RASAYANA
 In vasanta- ghrita preparation with aragwadhadi gana+ vastsaki gana
 In Varsha- vidaryadi gana+rasnadi kalka- ghrita sevana [5]
 Chyavana prasha
 Brahma rasayana
 Narasimha rasayana
 Dhatri rasayana
 Vidangadi rasayana
 Ashwagandha
 Amalaki
 Satavari
 Vidari
 Gokshura

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  Bala
 Mandukaparni
 Guduchi
 Yashtimadhu
 Shankhupushpi
 Brahmi

Rasayanas should be used only after the shodhana of the patient otherwise it will to
diseases.Agni of the patient should be well enough to digest the rasayanas other wise
should be continued with deepana pachana chikitsa.Alongwith this achaara rasayana
should be followed. [6]
Geriatric women are very prone to disease and always with minimal psychological
issues due to their postmenopausal phase.Rasayanas are the best remedy to them because
it reaches upto the subtle level of mind through the sapnjavaha srothas and nourishes the
further .Most of the preparations have phytoestrogens ,antioxidants ,immunomodulators
etc are can be recommended instead of hormone replacement therapy in geriatric women.
Conclusion
Aging is not a disease ,it‘s a natural process of life. Geriatic people are faced with
numerous challenges- physiologically & psychologically.Geriatric women needs special
care to balance their hormonal changes which is fulfilled by Rasayana chikitsa by which
body tissues attain its best capacity to perform their systemic activities.Research studies
shown- Hormonal replacement therapy can manage menopausal symptoms it can also
leads to breast tenderness, low back pain, vaginal bleeding, mood changes.If properly
implemented, rasayana chikitsa can give a better result instead of hormonal replacement
therapy.
Reference
1. Susruta, Susruta Samhita, Edited with Ayurveda-Tattva-Sandipika by Kaviraja
Ambika Dutta Shastri, Chaukambha Sanskrit Sansthan, Varanasi, Reprint 2007.
Part I, Sarbopghat Samni Rasayan Adhaya page 120.
2. D.C. Duttas. Textbook of Gynaecology, 6th ed. 2008.pageno 60
3. Caraka Samhita of Agnivesa, Revised by Caraka and Drdhabal with elaborated
vidyotini Hindi commentary by Pt. Sastri Kasinatha & Chaturvedi Gorakhanatha,
edited by Pt. Rajeswara Datta Sastri, Chaukhambha Bharti Academy, Varanasi,
Reprint 2007. Part I, Rasayana Adhay Prathum Paad page no 499.

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4. Elements of Rasayan therapy in Ayurveda,prof. Sharma Ajay kumar, Sri Satguru
publication ,Delhi, First edition 2005,page no. xv
5. Paradkar H.S. Rasayan Vidhi Adhyaya. In A.M.Kunte & K.R. Navare (Eds),
Ashtanga samgraha.Varanasi:Chaukhamba Publications, 2009; 923–939.
6. Caraka Samhita of Agnivesa, Revised by Caraka and Drdhabal with elaborated
vidyotini Hindi commentary by Pt. Sastri Kasinatha & Chaturvedi Gorakhanatha,
edited by Pt. Rajeswara Datta Sastri, Chaukhambha Bharti Academy, Varanasi,
Reprint 2007. Part IV, Rasayana Adhay Prathum Paad page 501

***

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 MANAGEMENT OF PSYCHOLOGICAL PROBLEMS IN
GERIATRIC WOMEN WITH MURDHNI TAILA
Dr Reshma. E,
Dr Madhu.M
PG Scholar, Department of Prasuti Tantra and
Stree Roga, SDM College of Ayurveda and Hospital,
Hassan, PIN 573201, Email- drreshmaayu@gmail.com
Associate Professor, Department of Prasuti
Tantra and Stree Roga, SDM College of Ayurveda
and Hospital Hassan, PIN 573201,
Mob-8970167939,
Email- drmadhu.ayu@gmail.com

INTRODUCTION
Geriatrics is emerging as a major medical speciality all over the world. The world
population of elderly is increasing across the world. Old age women population are
affected with physical, psychological, emotional and social challenges in their life. The
most common psychological symptoms are anxiety, depression, and sleep disorders1. In
Ayurveda, geriatrics is considered as jarapakwa avastha and in women it is considered as
post-menopausal phase or Rajonivrutti. Vata predominant diseases are most common in
this stage. The factors for Vatavriddhi in old age are due to Vriddhavastha, Dhatukshaya,
Rukshata, Shosha, etc. There is no direct reference available regarding lakshanas of
Rajonivritti in the Ayurvedic classics. Snehana is the best management for vatashamana
in jarapakwa avastha. Murdha is one among the trimarma of the body and considered as
uttamanga which is the seat of prana. Murdha taila is considered ideal for relieving
psychological problems by vatashamana by nourishing the shirapradesha.
MATERIALS AND METHODS
The study was done by collecting literature regarding the descriptions available for
the management of psychological problems in geriatric women with murdhni taila.
PSYCHOLOGICAL PROBLEMS IN GERIATRIC WOMEN
The most common psychological disorders in post-menopausal age group are
dementia, depression, insomnia, anxiety, mood swings, anxiety, irritability etc which are
mainly due to vata dosha. Manasika doshas (Raja and Tama) are also responsible for this.
Dementia (smritinasha) is characterized by progressive loss of memory and other
cognitive domains, affecting an individual‘s ability to maintain normal social or
occupational function. It has physical, psychological, social and economic impacts.

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Currently more than 55 million people live with dementia worldwide. The rate of
incidence of dementia and Alzheimer‘s disease are higher for women than for men2.
Depression (mano- avasada) is a common mental disorder in elderly and contributes to
significant psychological and social distress, physical disability and higher mortality. It is
characterized by sadness, loss of interest, pleasure, feeling of guilt, or low self-worth,
disturbed sleep, poor appetite, low energy, and poor concentration. Anxiety is one of the
most common symptoms seen in the elderly. It is a psychological and physiological state
characterised by cognitive, somatic, emotional and behavioural components. Anxiety
disorders occur more often in women. Insomnia is the most common sleep disorder in
elderly, it comes under vataja nanatmaja vikara and called Anidra or Nidranasha. The
incidence of insomnia in women is 1.3 times greater than in men3.
MURDHNI TAILA
Murdhni Taila or Moordha Taila is a type of Bahya Snehana procedure on the shiras
in which medicines remains in contact with the scalp for a fixed duration of time.
Murdha Taila is also practiced as a part of Dinacharya.
Types of Moordha Taila4 –
Moordha Taila or Murdhni Taila is of 4 types –
1.SHIRO ABHYANGA –
Application of oil on shiras followed by massage is shiro abhyanga. Shiro abhyanga is
specially indicated in roukshya, kandu mala etc. Daily application of shiro abhyanga
specially indicated in jara, srama and vatavikaras.
2.SHIRO SEKA / SHIRO DHARA –
Shiro dhara or seka or prisheka is a procedure in which different forms of medicated
liquids is poured in stream over the head for a fixed duration of time (usually 35-45
minutes or 60 minutes). Shirodhara is an effective procedure for head related diseases in
a prophylactic and curative way. It is very effective in cases of insomnia, anxiety and
depression. Acharya vagbhata prescribed parisheka for conditions of arumshika,
shirasthoda, daha etc which are the common conditions seen in elderly women.
Ksheeradhara, Snehadhara, Dhanyamladhara, Kashaya dhara, Takra Dhara, Lala dhar,
Kashaya dhara are the different variations of parisheka.
3.SHIRO PICHU –
The Pichu is kept in shiras for a fixed duration of time (usually 1-2 hours to 1⁄4 to 1⁄2
a day). Shiro Pichu is used to treat many diseases occurring due to Shiro abhihata,
Pakshaghata, Anidra, Shiro rukshata ,kesha shatana sputana and dhoopana.

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4.SHIRO BASTI –
Shirobasti is specially indicated in conditions of prasupthi, ardita, nidranaasa, timira
and other daruna shirorogas.
Among the above four Shiro Pichu is the most effective and beneficial procedure.
DISCUSSION
This paper is to highlight the role of murdhni taila in the management of
psychological problems in geriatric women. Proper use of murddhni taila will cure all
types of vataja shirorogas, results in indriyaprasada, and provide swara-hanu-
moordhabala
RESULT
Tarpana or Snehana type of treatment is the preferred treatment in psychological
problems such as dementia, depression, insomnia, anxiety, mood swings, anxiety etc
which are more common in post-menopausal women. For promoting health, preventing
disease and managing chronic illness murdha taila is very important. So, it is considered
as ideal for relieving psychological problems in geriatric women.
REFERENCES
1. https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults
2. https://www.who.int/news-room/fact-sheets/detail/dementia
3. Curr Geriatr Rep.Author manuscript; available in PMC 2020Dec11
4. Ashtanga hridaya, sutrasthana, Gandushadi vidhi adhyaya, sloka no.23-26

***

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 ROLE OF AYURVEDA IN MENOPAUSE VS HRT
AN AYURVEDIC VS CONTEMPORARY OVERVIEW OF
MENOPAUSE
Dr. Sapna Raghunath Rathod
Dr. Veena A. Patil
P.G. Scholar, Guide & Professor, Department of
Prasuti Tantra and StreeeRoga , Government Ayurved College Osmanabad
Email Id- sapnarathod726@gmail.com
Mob no – 7770034767

ABSTRACT
Menopause is said to be universal reproductive phenomenon. This phase of life is
more vulnerable for women as long with ageing she suffers from inevitable scars of
menopause. Menopause means permanent cessation of menstruation at the end of
reproductive life due to loss of ovarian follicular activity. In Ayurveda menopause
condition is termed as ― Rajonivrutti‖. Rajonivrutti janya lakshana is a group of
symptoms produced by degenerative changes in the body. Degenerative changes are
explained in Ayurveda as Dhatukshaya lakshana. Vata dosha dominance is seen in the
later stage of life. Hormone Replacement Therapy (HRT) is the only alternative available
for menopausal syndrome in modern medicine. It also has a wide range of side effects on
the body of female. But in Ayurveda to combat the degenerative process of the body
tissue, Acharyas have describe Rasayana Chikitsa. Ayurveda has excellent solution for a
safe and happy transition into menopause. Ayurveda, the science of life, advocates a
holistic treatment of menopausal syndrome by modification of diet and lifestyle, utilizing
various herbs and minerals and offers a reliable option to the convention treatment.
Ayurvedic treatment for menopause involves correcting hormonal imbalance with
appropriate diet, Samshamana therapy, internal detoxification (Panchakarma therapy),
Rasayana therapy and Yoga therapy.
KEYWORDS – Menopause, Rajonivrutti, Ayurveda, HRT
INTRODUCTION
Menopause is a natural phenomenon occurs at the age of 45-55 years. Menopause
means permanent cessation of menstruation at the end of reproductive life due to loss of
ovarian follicular activity[1]. Various symptoms seen in menopausal phase which
includes vasomotor symptoms like hot flushes, night sweats, headache, insomnia,
dizziness etc. Psychological symptoms include mood swings, anxiety, depression

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irritability etc other symptoms include loss of libido, dyspareunia, osteoporotic changes
as well as cardiovascular changes. Being an alarming problem, it needs an effective and
safe treatment. In modern science, Hormone Replacement Therapy ( HRT) is one and
only alternative for this health hazard by which one can get spectacular achievement in
combating the disease, but it has a wider range of secondary health complications like
vaginal bleeding, breast cancer, endometrial cancer, gallbladder diseases etc. on the other
hand this therapy is not much effective in the psychological manifestations of this stage.
In Ayurveda, this phenomenon taken in a different way and not as a serious health
problem. As Acharya Sushruta mentioned menopause deals with ―Jara Pakva Avastha‖ of
the body. The ancient Acharyas termed it as a normal physiology occurring at the age
near about 50 years is mentioned as age of Rajonivrutti[2], due to Vata predominance and
Dhatukshaya.. Rajonivrutti janya lakshana is a group of symptoms produced by
degenerative process of body tissue. Degenerative changes are explained in Ayurveda as
Dhatukshaya lakshana. To combat the degenerative process of the body tissue Acharyas
have described Rasayana chikitsa. Rasayana includes drugs which promotes longevity
and improve quality of life Rasayana therapy can be used in the management of
menopausal syndrome.
Modern view of Menopause
Menopause is defined as permanent cessation of ovarian function resulting in
permanent amenorrhoea.
Menopausal Symptoms - Vasomotor symptoms like hot flushes, night sweats, headache,
insomnia, dizziness etc. Psychological symptoms include mood swings, anxiety,
depression irritability etc other symptoms include loss of libido, dyspareunia,
osteoporotic changes as well as cardiovascular changes.
Management of Menopausal Syndrome –
1)Counseling
2)HRT( Hormone replacement therapy) – HRT has a wider range of secondary health
complications like vaginal bleeding, breast cancer, endometrial cancer, gallbladder
diseases etc. on the other hand this therapy is not much effective in the psychological
manifestations of menopausal syndrome.
Potential Health Risks of HRT & side effects of HRT

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 Potential Realth Risks of HRT Side Effects of HRT
Endometrial cancer Oestrogen related: vaginal bleeding,
Endometrial hyperplasia increased cervical mucus, Nausea,
Breast cancer Vomiting, Fluid retention, Weight
Gall bladder disease gain
Thrombophlebitis Progesterone related: symptoms like
PMS, Anxiety, Irritability,
Depression, Sleep disturbance
Other: Itching, Headache, loss of hairs
etc.

Ayurrvedic view for Menopause-

In Ayurvedic classics menopause condition is termed as Rajonivrttti & Menopausal
symptoms (Rajonivrutti janya lakshana). Women attains Rajonivrutti stage at around 50
years. This age is dominated by Vatadosha, affects the female body [3] . The dominant
Vata dosha specially with Laghu and Ruksha guna results in reduction in Dravata of Rasa
dhatu. This further leads to Dhatukshaya starting from Rasa dhatu , further respective
Updhatu kshaya takes place. Thus leading to Artava nasha (amenorrhoea). The vitiated
Vata dosha also disturbs the other Sharir as well as Manas Dosha Raja and
Tama dosha) leading to various psychological disturbances. Basic of Ayurvedic
Therapy in Menopause-
Sushruta contributed ageing and diseases as the cause for the menopause. According
to jararogchikita sutra rasayana is the only way to combat symptoms associated with jara.
Rasayana Therapy -
Literarily the term Rasayana refers to the means of obtaining the optimum
nourishment to the Rasadi Dhatus. Thus, the Rasayana is a specialized type of treatment
influencing the Dhatus, Agnis and Strotas of the body leading to an overall improvement
in the formation and maintenance of the living tissues and helps in the prevention of
ageing, improving of resistance against diseases, bodily strength and process of
improving mental faculties. In Ayurveda for menopausal syndrome we used drugs which
are Vatapitashamak, Rasayana, Hrudya,Ojovardhaka, Vatanulomak, Deepaniya, Balya,
Medhya and Brimhana are the drug of choice. Many of the Rasayana herbs are capable of
strengthening the immune system; e.g. Shatavari, Ashwagandha, Amalaki, Bala,
Yashtimadhu, Dashmool, Rason, Guggul. Rasayan drugs which specially influence
Medha and promotes mental competence. Such rasayana are called Medhya rasayana.
Acharya Charaka has described four Medhya rasayana namely Shankhapushpi,
Madukparni, Guduchi and Yashtimadhu. [4] helps to reduce psychological symptoms.

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Preparations like Ashwagandha ghrita, Shatavari gharita, Bhramhi ghrita, Rason
kshirpak, Saraswatarishta, Chyawanprash can be used for menopausal syndrome
Shatavari – Shatavari contains natural phytoestrogens and so can be used as an
alternative to synthetic HRT, gently and naturally rebalancing estrogen levels.
Samshamana therapy- Agnideepana, Amapachana, Anulomana, Balya. Panchakarma
therapy – Snehana, Swedana, Shrirodhara, Nasya, Pichu, Basti
Yoga therapy-Yoga and Pranayama can be beneficial in reliveing stress and other
psychological symptoms as well as imporove muscle tone.
Sattvavajaya Chikitsa – Counseling and reassurance regarding stress management and
develop positive approach towards menopause can be helpful.
CONCLUSION – Nowadays, symptoms related to menopause are becoming a major
problem for which a safe and effective line of treatment is necessary. Hormone
Replacement Therapy (HRT) is the only alternative available for menopausal
syndrome in modern medicine. It also has a wide range of side effects on the body of
female. On the other hand this therapy is not much effective in the psychological
manifestations of this stage. In Ayurveda special branch of Rasayana is explained which
is life promoting and deals with aging problems., to improve health as well as longevity.
menopausal symptoms generally occur due to disturbed Vata dosha. Dhatukshaya is
responsible for Vata vruddhi and vitiated Vata dosha affects various systems in women‘s
body. From the above theory we can conclude that various Aurvedic drugs having
properties of Rasayana, Vata shamana along with Panchakarma, Sadvritta, Yoga can be
helpful in management of menopausal syndrome as alternative to HRT.
REFERENCES
1. D.C. Dutta, Textbook of Gynaecology 5thEdition, Published by New Central book
agency, Kolkata 2008, page- 55
2. Kaviraj Ambika Dutta Shastri edited with Ayurveda Tattva Sandeepika, Sushruta
Samhita hindi commentary Chaukhambha Sanskrit Sansthan, Varanasi-
publication reprint 2007
3. Vidyadhar Shukla, Ravidutt tripathi, Charaka Samhita, Delhi, Chaukhambha
Sanskrit Pratisthana, 2006, p203
4. Vidyadhar Shukla, Ravidutt tripathi, Charaka Samhita, Delhi, Chaukhambha
Sanskrit Pratisthana, 2006, p39

***
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 ROLE OF STHANIKA CHIKITSA IN POST MENOPAUSAL
WOMEN CARE
Dr.Shilpa J
PG Scholar ,Department of Prasutitantra Evam Stree
Roga,Sri Kalabyraveshwara Swamy Ayurvedic
Medical College Hospital and Research Centre,Bengaluru
Dr.Anupama V
HOD and Professor,Department of Prasutitantra
Evam Stree Roga,Sri Kalabyraveshwara Swamy Ayurvedic
Medical College Hospital and Research Centre,Bengaluru

ABSTRACT
Geriatrics focuses on the healthcare of the elderly people. In Ayurveda the age of a
women is classified into different epochs , among which Vriddhavastha can be correlated
with Geriatric Age group.Vriddha avastha coincides with Menopause,during which the
predominant Dosha is Vata.Hence there are more chances of Vatika disorders,like
rukshata in the yoni pradesha causing vaginal discomfort,itching(Yoni
kandu),Dyspareunia(Yoni shoola,Yoni sparshasahatwa) and recurrent vaginitis(Yoni
srava).Another major complaint during this period is Shitilata of Yoni pradesha causing
Urge incontinence ,stress incontinence etc.which later leads to increased frequency of
micturition and recurrent urinary tract infections .There are also increased chances for
Genital prolapsed because the supporting structure becomes weak and lax as the age
advances.
Ayurveda has given different modes of treatment for these gynaecological issues like
shodhana chikitsa ,Shamana chikitsa and sthanika chikitsa, Where Sthanika chikitsa like
Yoni dhavana, Yoni-pichu, Yoni-dhoopan, Yonilepana, Yoni-purana etc can be used as
preventive as well as curative therapy to prevent discomfort due to Rukshata as well
condition like Mahayoni due to Yoni Shitilata . Each sthanika Chikitsa has its own
importance and shows marvellous results when applied with proper indications, strict
aseptic precautions and extreme carefulness. These Sthanika Chikitsa are considered as
effective therapy for disease management ,and also provides the advantages of being
inexpensive and easy to use. This paper highlights Sthanika Chikitsa as preventive as
well as curative measure in Geriatrics.
KEYWORDS: Geriatrics,Sthanika Chikitsa,Menopause,Vriddhavastha,Yoni Rukshata,
Yoni Shitilata

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INTRODUCTION
Ayurveda is the branch of science which gives equal importance for prevention and
cure, Post menopausal time can be correlated with Vriddhavastha. Since Vata is
predominant Dosha during this period,all measures by which Vata can be controlled
should be adopted. Yoni Rukshata and Yoni shitilata are the two underlying cause for all
gynaecological problems during this period.Yoni rukshata leads to vaginal discomfort,
itching(Yoni kandu),Dyspareunia(Yoni shoola,Yoni sparshasahatwa) and recurrent
vaginitis(Yoni srava).Yoni shitilata leads to Urge incontinence ,stress incontinence
etc.which later leads to increased frequency of micturition and recurrent urinary tract
infections .There are also increased chances for Genital prolapse due to this shaithlya.
Sthanika chikitsa which is appropriate to the condition with right medicine gives
marvellous results in these gynaecological conditions.These Sthanika chikitsa should be
performed according to the prescribed procedure under strict aseptic precautions
OBJECTIVES
 To study about different sthanika chikitsa used in Post menopausal women.
 To study mode of action of sthanika chikitsa used in Post menopausal women
MATERIALS AND METHODS
This is a conceptual type of study.Textual materials are used for study from which
various references have been collected. Ayurvedic classical texts,online journals,research
papers,articles from pubmed etc are reffered for this study.
STHANIKA CHIKITSA IN POST MENOPAUSAL WOMEN

सवित: सुपवशुिमा: शेषं कभि पवधीमते|

फस्त्मभ्मग़ ऩरयषेकभ ् प्ररेऩ पऩचु धायणभ ्|| (A.S.U.39/53)

1)YONI DHAVANA
Yoni dhawana is the procedure of cleaning Yoni and Apathyamarga with kwatha or
any other drava dravya
Prakshala Dravyas having Tikta Kashaya Rasa and Laghu Ruksha is selected,so their
action is Vrana Shodhana, Ropana, Srava kleda shoshana, Kandughna ,Krimighna,
Sothahara and Vedana sthapana.
DIESEASE CONDITION DHAVANA DRAVA DRAVYA
Yoni paicchilya Triphala kwatha, Panchavalakala kwatha
Yoni kleda Triphala kwatha, Pancha valakala kwatha
Yoni sheetalata Dasamoola kwatha

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 Yoni kandu Kashaya of Guduchi,Triphala and Danti

2)YONI PICHU
Vaginal tampoon made of cotton and gauze soaked in Taila/Ghrutha/Kashaya is
termed as Pichu, when placed in yoni it is called Yoni pichu .Vesha vara is a modified
form of pichu indicated in Mahayoni

पऩचु तैरं पऩचुना तुरकेन तैरं वातहय द्रव्म क्वाथ शसि मोननषु धायमेत ्।

(सु.सं.उ. 37/27, डल्ह.िी

Sneha in pichu does the brimhana of Garbhashaya and Yoni.Vatasamaka property of

the drugs helps in correcting Apana vayu
DIESEASE CONDITION PICHU DRAVYA
Yoni rukshata Guluchyadi taila
Yoni karkashata Bala taila,Dhatakyadi taila
Yoni shoola Saindhava taila,Dhatakyadi taila
Prasramsini Phala grita pichu
Mahayoni Changeryadi ghrta pichu,Veshavara

3)YONI PURANA
Yoni poorana is the filling of Yoni with either Taila,kalka ,Pinda,Churna etc made
into compact mass and inserted into Yoni.It is usually done when large quantity of drug
is required to be retained at the site of action.
Sneha poorana is Balya in action,thus Strengthens Yoni. Kalka and choorna dharana
which is mainly of thikta-kashaya rasa pradhana acts as Ropana,sravahara,kledahara.
DIESEASE CONDITION PURANA DRAVYAS
Vataja Yoni vyapat Himsra kalka
Yoni shula Lasuna,Grhadhuma,Visala,Vayuvidanga,Kantakari
Yoni kandu BruhatiPhala+DwiHaridra kalka
Yoni sparshasahtwa
Mahayoni Vasa of Risha and Varaha processed with madhura
gana dravyas

4)YONI LEPANA
Medicines in the form of Kalka applied externally in Yoni is called as Yoni lepana.

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 Lepa is Vatahara hence relieves Yoni shoola. Tikta –Kashaya Rasa pradhana of the
lepa acts as Vrana shodhaka , Vrana ropaka and Sophahara
DIESEASE LEPANA DRAVYA
CONDITION
Yoni Gadikarana • Palashabeeja,Udumbara,tila taila,Madhu
• Makandha phala,Madhu,Karpooram
Yoni Shula Lasuna,Grihadhooma,Visala,Vayuvidanga,Kantakari

5)YONI DHOOPANA
Fumigation of Yoni with Oushada yuktha Dhuma is called Yoni Dhupana
Site of Dhoopana- Bahya Yoni
Dhoopa is Sroto shodaka , Kaphagna,Kledagna and Srava sthambaka
DIESEASE CONDITION DHOOPANA DRAVYAS
Yoni Sparshasahatwa Daruharidra,Brihati phala
Yoni kandu Haridra,Dviharidra,Brihatiphala
Sweta pradara Sarala,Guggulu,Yava with Ghrita
Katu matsyaka with taila

DISCUSSION
The action of sthanika chikitsa is mainly by the absorption of drugs across the vaginal
mucosa.Vaginal drug delivery offers many advantages over the Oral route of
administration by ,the avoidance of hepatic first pass metabolism,avoidance of enzymatic
deactivation in GIT,large permeation area and rich vasularisation.Drugs administered via
the vaginal route are absorbed through-Transcellularly via concentration dependent
diffusion through the cells.Paracellularly mediated by tight junctions.Vesicular or
receptor mediated transport. The drugs used in Sthanika Chikitsa acts by exerting its
antiseptic, antimicrobial,antifungal,anti inflammatory and analgesic action.
CONCLUSION
Sthanika Chikitsa are cost effective,safe,effective with almost no side effects.This can
be a boon to Stree roga when the Vaidya apply this therapy in practice logically and
carefully under strict aseptic precautions.Sthanika Chikitsa holds its own importance and
shows tremendous results when applied with proper indications ,strict aseptic precautions
and extreme carefulness.

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REFERENCES
1) Susrutha Samhitha, English translation with Dalhana‘s commentary ,Edited and
translated by Priyavat Sharma, Chaukambha Visvabharati, Oriental Publishers&
Distributors, Varanasi,Shareer Sthana, 2nd chapterSukra sonitha dushti sareera
2) Vagbhata‘sAshtanga Hrdayam, Transalated by Prof.K.R.Srikantha Murthy,
Chowkhamba Krishnadas Academy,Varanasi,Uttaratantra,34 th chapterGuhyaroga
pratishedha
3) Agnivesa‘s Caraka Samhitha Volume IV, By Dr.Ram Karan Sharma,Vaidya
Bhagwan Dash
on Cakrapani dutta‘s Ayurveda dipika ,Choukhamba Sanskrit Series Office,Varanasi
Reprint 2009,Chikitsa sthana , 30 th chapterYoni roga chikitsa
4) Jeffcoate‘s Principles of Gynaecology,edited by Dr.Pratap Kumar,Dr. Narendra
Malhotra,Jaypee brothers medical publishers
5) Ashtanga Sangraha of Vaghbata, Translated by Prof.K.R.Srikantha Murthy,
Chaukambha Orientalia Varanasi.,Uttara tantra 39 th chapter

***

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 ROLE OF AYURVEDA IN MENOPAUSE VS HRT
ROLE OF AYURVEDA IN MENOPAUSE VS HRT
- A REVIEW
Dr. Shital Laxman Surjuse
Dr. Umesh K. Agawane
PG Scholar, Guide & Assistant Professor
Dept. of Prasutitantra and Streeroga, Govt.
Ayurved College, Osmanabad
Email- shital.surjuse@gmail.com
Mobile No. 8087143839

Abstract -
Menopause is a physiological ageing change that occurs in women's life. It is
permanent cessation of menstruation at the end of reproductive life due to loss of ovarian
follicular activity. During menopausal stage in women's body there is imbalance between
hypothalamic-pituitary-ovarian axis, these can leads to hypoestrogenic state. Due to low
estrogen sign and symptoms like hot flushes, irregular or stoppage of menstruation,
insomnia, irritability etc. seen. In modern science to overcome these symptoms &
complications hormone replacement therapy is given like hormonal tablet, hormonal
patches, hormonal creams & gel etc. But HRT has wide range of side effects such as
endometrial cancer, breast cancer etc. which seen in long term therapy.
In Ayurveda we can correlate menopause as a dhatukshaya avastha or rajonivrutti.
Aacharya Sushruta described this avastha under the heading of parihani. In Ayurveda
various therapies were described like Nasya, Shirodhara, yonipichu etc. under
panchakarma chikitsa. Rasayana chikitsa, herbal medicines and yoga also described by
different aacharya for dhatukshaya avastha. Through Ayurveda we can correct the
hormonal imbalance by above management. These treatment reduces the physical &
psychological symptoms without any side effects. So Ayurveda plays important role in
management of menopause.
Keywords: Menopause, HRT, Rajonivrutti, Ayurveda
Introduction –
Menopause is a physiological ageing change that occurs in women‘s life. It is defined
as permanent cessation of menstruation at the end of reproductive life due to loss of
ovarian follicular activity. To confirm that menopause has set in it will take about 12
months of amenorrhea. The age of menopause is between 45 – 55 yrs. [1] During

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menopausal stage in women‘s body there is imbalance between hypothalamic-pituitary-
ovarian axis which leads to hormonal imbalance that produces several signs and
symptoms. This signs and symptoms are due to hypoestrogenic state.
During this stage of menopause women may faces symptoms like hot flushes, night
sweating, irregular or stoppage of menstruation, palpitation, fatigue, vaginal dryness, loss
of libido and psychological symptoms like anxiety, depression, insomnia, mood swings,
irritability, inability to concentrate etc. Women also faces some condition like
osteoporosis, urogenital atrophy and dementia etc. [2]
In Ayurveda the context of menopause is depicted as Rajonivrutti and jarapakva
avastha of body. Aacharya sushruta described 4 stages of madhyama avastha i.e.
Vruddhi, Yauvan, Sampurnata, Parihani. Out of which menopause comes in 4th stage i.e.
parihani stage which start at the age of 40 years and end at 70 years. [3] Where parihani
means gradual degenerative changes of body (Dhatukshaya) occurs. Aacharya sushruta
also described 50 years is the age of menopause (Rajonivrutti). In this stage there is
predominance of vata dosha and menopausal symptoms are due to vata vruddhi and
dhatukshaya. It is transitional phase where pitta phase is converted into vata phase.
As menopausal symptoms cause physical and psychological symptoms which will
affect routine of women. So we need to manage the menopausal symptoms. In modern
science management is done by counselling, multivitamins and hormone replacement
therapy. But it has wide range of side effects such as endometrial cancer, venous
thromboembolic disease etc.
Ayurveda plays an important role to pacify the rajonivrutti lakshanas by means of
various procedure of panchakarma, rasayana chikitsa, various herbal drugs &
formulations which already mentioned in Ayurveda. They are effective and don‘t have
side effects.
HRT in Menopause –
HRT is hormone replacement therapy is a medication containing the hormone that
women‘s body stop producing after menopause.
There are 2 types of hormones used in HRT for menopause
 Estrogen
 Progesterone
HRT may involve either taking both of these (combined HRT) or just estrogen (estrogen
only HRT)

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HRT available in the form of hormonal tablets, hormonal patches, hormonal creams,
hormonal gels, hormonal implants etc.
Benefits of HRT -
It help to relieve most of the menopausal symptoms like hot flushes, night sweating,
vaginal dryness, dry skin, insomnia etc.
It also prevents osteoporosis and cardiovascular disease.
It is used in premature menopause and it helps to reduce the risk of developing
diabetes.
Side effects of HRT –
As we see HRT has benefits in menopause but it has wide range of side effects after
taking long term therapy as mentioned before. It may develops side effects like
endometrial cancer, breast cancer, venous thromboembolic disease, coronary artery
disease and cholecystitis etc. [4]
Role of Ayurveda in Menopause –
As we see HRT has benefits as well as wide range of side effects. So we need to look
for alternative management for menopause which having lesser or no side effects.
Ayurveda offers the alternative treatment for menopause.
In menopause there is a degenerative changes occurs in body, so to combat this
degenerative changes aacharya described Rasayana chikitsa. Ayurvedic management
involve correcting the dosha imbalance with healthy diet, shamana chikitsa, panchakarma
therapy, satvavajaya chikitsa, rasayana chikitsa and yoga therapy.
Discussion – Ayurvedic Management
A] Shamana chikitsa – It involve he agnideepana, aamapachana, anulomana, balya and
medhya drugs. Which improve the dhatuposhana in tern reduces the dhatukshaya
lakshanas, balya drugs strengthen the body. Medhya drugs helps to reduce the
psychological symptoms. Also the majority of symptoms are due to vata predominance
so we can use madhur rasatmaka and ushna, snigdha, guru gunatmaka dravyas to balance
the vata dosha. Following drugs we should use in this-
E.g. Shatavari, Ashwagandha, Bala, Dashamoola, Amalaki, Arjuna, Rasona, Guggulu,
Yashtimadhu and Medhya Dravyas like Bramhi, Shankhapushpi, Guduchi,
Mandukaparni etc.
1] Shatavari – it is balya, vayasthapana, medhya and agnideepana. It contains
phytoestrogen so it can be used as alternative to HRT.

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2] Amalaki – it contain highest amount of stable vitamin c. it is powerful antioxidant,
cytoprotective nature and immune modulatory action which promote anti-aging action.
3] Formulations – Bramhi Vati, Shatavari Ghrita, Saraswatarishta etc.
B] Rasayana chikitsa – It helps to obtaining the optimum amount of nourishment to the
rasadi dhatu also helps to improve dhatu, agni and srotasa. It decreases the ageing process
and increases the longevity of life, it also increases the mental as well as physical
strength. It helps in preservation of youthfulness. According to Aacharya Charaka it
produces long life lasting memory, talent, youth and luster. [5] Following are some
examples of rasayanas –
Examples –
1] Ekal dravya rasayana - Amalaki, Ashwagandha, Guduchi, Bramhi, Shankhapushpi,
Yashtimadhu, Haritaki, Bhallataka, Mandukaparni etc.
2] Formulations – Chyavanprasha, Brahma Rasayana, triphala rasayana, Amalaki
Rasayana, Medhya Rasayana (Shankhapushpi, Mandukaparni, Guduchi, Yashtimadhu)
etc.
C] Panchakarma therapy – Panchakarma helps to loosen, liquefy and remove vitiated
doshas from their abnormal site in peripheral tissue via their natural pathway of
elimination and cause balance of doshas (shakha to koshtha). Hence the symptoms of
menopause caused due to vitiated doshas get relieved.
1. Snehana – it helps to treat the vata dosha imbalance. It is also considered as
jarahara (decreases the ageing process) e.g. Bala taila.
2. Shirodhara – It reduces the vata dosha. Warm oil pouring on forehead improve
blood circulation to brain and hypothalamus, hence activate the HPO axis and help
in hormonal imbalance. It also cause vasodilation so relieve symptom like hot
flushes. It has tranquillizing effect due to continuous flow of oil on forehead. It
increases the dhi and smriti (memory and retaining power). Hence it helps in
psychological symptoms. E.g. jatamansi taila, bramhi taila, shatavari taila, takra
dhara.
3. Nasya – Nasa is considered as gateway of shira. So sheha given through nasya
reach to shirogata marma and spread to the mastishka and help to remove vitiated
doshas. [6] As shira is considered as sthana of mana, so it will act on manovaha
srotasa and relieve manasik lakshanas. E.g. anu taila, shatavari ghrita,
panchendriyavardhan taila.

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 4. Yonipichu – It soften the vaginal canal. So help in vaginal dryness. E.g.
shatadhauta ghrita, shatavari ghrita/ taila, bala taila
5. Basti – It is considered as best treatment of vata dosha. It is also useful in
dhatukshaya avastha and helps to overcome osteoporosis. E.g. anuvasana basti -
bala ashwagandhadi taila, also other basti like panchatiktaksheer basti, majja basti.
D] Satvavajaya chikitsa – counselling and reassurance to patients helps to reduce the
psychological symptom.
E] Yoga therapy – yoga, exercise, pranayama, and meditation helps to relieve
psychological symptoms as anxiety, stress, depression etc. it also helps to improve agni
and dhatuposhana.
Conclusion –
Menopause is a natural biological process in women‘s life. Only few women
experiences menopausal symptoms which affects day to day life. To relieve this
symptoms modern science has HRT but it has side effects. Through Ayurveda we can
relieve this menopausal symptoms easily without any side effects. So Ayurveda helps
well than HRT to combat the symptoms.
References -
1. D. C. Dutta, textbook of gynaecology including contraception, edited by Hiralal
Konar, Jaypee Brother Medical Publisher (P) Ltd., 8: 46
2. D. C. Dutta, textbook of gynaecology including contraception, edited by Hiralal
Konar, Jaypee Brother Medical Publisher (P) Ltd., 8: 48-49
3. Kaviraj Ambikadatta Shastri, Sushruta Samhita (hindi commentary). Sutrasthana
chapter 35, shloka no 39, Varanasi; Chaukhamba Sanskrit prakashan, 2012; 10:27
4. D. C. Dutta, textbook of gynaecology including contraception, edited by Hiralal
Konar, Jaypee Brother Medical Publisher (P) Ltd., 8: 46
5. Sri Satya Narayan Sastri Charaka Samhita of Agnivesha, vidyotin hindi
commentary, published by Chaukhamba bharati academy Varanasi 2009, page -5
cha. Chikitsa
6. Vagbhata ashtang hridayam, sartha vagbhata, by Ganesh Garde, anmol prakashan,
Pune, sutrasthana chapter 20, verse 1, page 85

***
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STHANIKA CHIKITSA IN THE GERIATRIC WOMEN SUFFERING
FROM DYSPAREUNIA – A CASE STUDY
Dr Shravani P
Dr Savita S Patil
Professor, Head of the Department,
Department of Prasuti Tantra & Stree Roga,
Sri Sri College of Ayurvedic Science and Research
Institution, Bengaluru, Karnataka.
Mail ID – Shravani.rao96@gmail.com
Contact number – 9148039070

ABSTRACT - The etiological factor of Yoni Vyapat are mainly due to the vitiation of
Doshas, among which Paripluta Yoni Vyapat is due to the vitiation of Vata Dosha, which
can be correlated to Dyspareunia. Dyspareunia means the coital act is difficult and or
painful. There are different etiology depending upon the site of pain, out of which Vagina
Atrophy prevalence of 67.5% associated with vaginal dryness – 62%, itching 40%. For
the better and fruitful result Sthanika Chikitsa (local therapies) has been enumerated as an
important part of Yoni vyapad chikitsa, which includes Yoni Parisheka (cleansing of
vagina), Yoni Abhyanga (massaging of vagina with medicated oil), Yoni Pralepa
(semisolid drug applied on the vaginal wall), Yoni Pichudharana (medicated soaked
tampon place in vagina).
CASE STUDY – A female aged 49 years, approached OPD complaining of painful
coitus along with dryness and itching of vagina, which increased after her menopause.
The condition was treated with Sthanika chikitsa followed by internal medications.
KEYWORDS – Paripluta, Dyspareunia, Vaginal Atrophy, Sthanika Chikitsa.
•INTRODUCTION: Dyspareunia means that the coital act is difficult and or painful. It
is the most common sexual dysfunction1. Based on the clinical symptom of excessive
external and internal pain during intercourse, this condition can be co related to
Paripluta Yoni Vyapat which is explained by Acharya Sushrutha under Vataja Yoni
Vyapat2. As Yoni is considered as the sthana of Apana Vayu, Sthanika Chikitsa helps in
relieving the symptoms
•CONCEPTUAL VIEW: Acharya Sushrutha has explained Vimshati Yoni Vyapat, of
which he has explained Paripluta Yoni Vyapat under Vataja Yoni vyapat, and Acharya
Madhava and Bhava prakasha also explained Paripluta under Vataja condition. The
cardinal feature include Graamya- dharma – ruja (Pain during intercourse) &
Bahyabhyantra vata vedana (Excessive external and internal pain)1. Similarly in the

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contemporary science, the etiological causes of Dyspareunia depends upon the site of
pain – Superficial, Vaginal, Deep2.
SUPERFICIAL VAGINAL DEEP
SUPERFICIAL VAGINAL DEEP

Narrow introits Vaginitis Endometriosis

Tough hymen Vaginal septum Chronic cervicitis

Bartholin‘s gland cysts Tender scar Chronic PID

Tender perineal scar Secondary vaginal Retroverted uterus

atresia
Vulvar infection Tumor Prolapsed ovary in POD
Urethral pathology VAGINAL
ATROPHY
(Menopause)
Vulvar vestibulitis
syndrome

Menopause is a Natural transition from reproductive phase to non-reproductive phase

in a women‘s life. It occurs with stoppage of menstruation (amenorrhea) for twelve
consecutive months. It sets the stage for aging and accelerates the process of non-
communicable diseases. Worldwide the age of menopause is in between 45 and 55 years.
Due to increased life expectancy, especially in affluent society, about one-third of life
span will be spent during the period of estrogen deficiency stage with long term
symptomatic and metabolic complications3.
MANAGEMENT: Treatment depends upon the cause. In infective lesions it has to be
treated with antibiotics, in Tender scar it has to be excised similarly in Vaginal Atrophy
in post-menopausal condition HRT is extremely effective option. There are certain
indications, contra indications for HRT along with certain side effects.
Side effect of HRT4 –
 Estrogen related: Vaginal bleeding, Increased cervical mucus, Nausea, Vomiting,
Fluid retention, Weight gain
 Progesterone related: Symptoms like PMS, Anxiety, Irritability, Depression, Sleep
disturbances.
 Others: Itching, Headache, Coronal changes, Loss of hair etc.

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 In our Classics, there is no direct reference for the management of Paripluta Yoni
Yvapat, but as it is explained under Vataja Yoni Vyapat, the same line of management
can be adopted in treating the condition5-

―वातातािमा् पऩचुं दद्माद्मोनौ च प्रणमेत्तत्| वातातािनां च मोनीनां सेकाभ्मङ्गपऩचुक्रक्रमा्||

उष्णा् ष्स्नग्धा् प्रकतिव्मास्तैरानन स्नेहनानन च| दहंस्राकल्कं तु वाताताि कोष्णभभ्मज्म धायमे ||‖

(C. CHI. 30/61 -62)

Here, while explaining the sutra they have given importance of sthanika chikitsa such as
Yoni Picchu, Yoni Seka , Yoni Abhyanga , Yoni Kalka dharana.
STHANIKA CHIKITSA6:

―सवित् सुपवशुिामा् शेषं कभि पवधीमते। फस्त्मभ्मङ्गऩरयषेकप्ररेऩपऩचुधायणभ ्॥‖

(A.S.U 39/53)
Sthanika chikitsa has been enumerated as an important part of Yoni Vyapad Chikitsa,
such as Basti (inserting the medicated oil inside the uterus), Yoni Parisheka (cleansing of
vagina), Yoni Abhyanga (massaging of vagina with medicated oil), Yoni Pralepa
(semisolid drug applied on the vaginal wall), Yoni Pichudharana (medicated soaked
tampon placed in vagina).
BENEFITS OF STHANIKA CHIKITSA 7:
 Avoidance of hepatic first – pass effect, thus prevention of hepatic toxicity
 Easy to administer and possible self-insertion and removal.
 Fast acting on the local region and on reproductive system
 Protection of drug against gastrointestinal enzymes
 Avoidance of parenteral route associated inconvenience
PROBABLE MODE OF ACTION7:
 Anatomist has described that epithelium consist as many as 40 distinct layers. The
rogue Of the epithelium create an involute surface and results in a large surface
area that covers 360cm, this large surface area allows the trans-epithelial
absorption of medications via the Vaginal route.
 The post Fornix has rich blood supply so actively absorption of drug.
 In oral rout some medicine‘s active ingredient metabolized in liver and degrades
as a result the Effect of drug reduced.

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  The presence of dense network of blood vessels has made the vagina an excellent
route of drug delivery for both systemic and local effects.
 Blood leaving the vagina enters the peripheral circulation via a rich venous
plexus, which empties primarily into the internal iliac veins.
 Vaginal permeability is much greater to lipophilic drug than to hydrophilic drug.
However, it is generally accepted that low molecular weight lipophilic drugs
are likely to be absorbed more than large molecular weight lipophilic or
hydrophilic drugs.
CASE REPORT:
• Patient details :
A Female aged 49years, from Hosadurga, Chitradurga. Occupation: House wife
Religion: Hindu, Socio-economic status: Middle class, marital status: Married
• Case history:
Complaints of painful coitus along with dryness and itching of vagina since 3-4 years,
which increased since 2 years after attaining menopause.
Also complaints of blackish flakes on scratching since 3 months
• Menstrual history:
Menarche: 15years
Menstrual history : 4-5days
(Before menopause) 26-28days (Regular)
Menopause - 47years (Attained naturally).
• Obstetric history:
Married life: 27 yrs.
P1L2A1DO:
L2– LSCS – Twin pregnancy (1998),
A1 – MTP (7Week of pregnancy) (2005)
Coital history: Once in 3-4 months, Dyspareunia - ++
Surgical history: B/L Tubectomy done on 2005
•Examination:
GENERAL EXAMINATION

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 Temp -97.2 F Pulse -86bpm
BP -130/80 mm Hg.
SYSTEMIC EXAMINATION
CNS- Properly oriented to time, place and person, HMF intact
CVS- S1, S2 heard, No murmurs
RS- NVBS+, No added sound
LOCAL EXAMINATION
BREAST EXAMINATION: B/L Symmetry, No tenderness, No palpable mass, No
discharge from the nipple.
P/A EXAMINATION: Soft, non-tender. No organomegaly, BS +
P/S EXAMINATION: Cervix – Healthy, Cystocele+
P/V EXAMINATION: Uterus anteverted Normal size.
•INVESTIGATIONS:
Hb-13.1gm %, Platelets -2.8 lakhs /cumm, RBS-108 mg/dl.
PAP Smear- Negative for intra epithelial lesion or malignancy
Urine routine and microscopy: Pus cell- 4-5, Epi cells- 5-6
USG – Nothing abnormal detected.
TREATMENT:
STHANIKA CHIKITSA:
Yoni Abhyanga with Ksheera bala taila
Yoni Picchu with Guduchyadi taila
X 14 days.
INTERNAL MEDICATION:
 Aloes Compound 2-0-2 (After food)
 Dhanwantaram vati 2-0-2 (After food)
 Dashamoolarista 4tsp -0-4tsp with equal water (After food)
 Shatavari kalpa 0-0-1tsp (Bed time)
 Dhatupostik churna 1tsp-0-0 with a glass of milk (Empty stomach)
X 1month

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FOLLOW UP - Previous complaints of Vaginal dryness and flakes on itching reduced –
60%, Dyspareunia reduced – 50%
DISCUSSION:
 As Yoni is Ashrayi for Apana Vayu, and the Paripluta is a Vataja Yoni Vyapat,
tackling Vayu is the considered as first line of treatment and thus Sthanika
Chikitsa plays a very important role.
 Pichu provide muscle strength,
 Stretchability & tissues nourishment,
 Yoni abhyanga helps in strengthen the muscles of vagina & providing
nourishment to the local region
 Ksheera bala taila

―फरा-कषाम-कल्काभ्मां तैरं ऺीय-सभं ऩचेत ् ।

सहस्र-शत-ऩाकं तद् वातासग

ृ ्-वात-योग-नुत ्

यसामनं भुख्म-तभभ ् इष्तद्रमाणां प्रसादनभ ् ।

जीवनं फंह
ृ णं स्वमं शुक्रासग
ृ ्-दोष-नाशनभ ् ॥―
(A.H.C. 22/45-46)
Guduchyadi Taila

गुडूची किुका नतक्ता स्वादऩ

ु ाका यसामनी |

संग्रादहणी कषामोष्णा रघ्वी फल्माऽष्ग्नदीऩनी |

दोषिमाभतड्
ृ दाहभेहकासांशच ऩाण्डुताभ ् ||

काभराकुष्ठवातास्रज्वयकृशभवभीतहये त ् |

प्रभेहशवासकासाशि्कृच्ररृद्रोगवातनुत ्‖

(B.P.N Guduchyadi varga)

CONCLUSION:
Our Acharyas was very clear about the Mode of action of Sthanika Chikitsa, and has
explained different types of Sthanika chiktsa for the management of maximum

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reproductive disorders, with a specific purpose i.e. strengthening, nourishing, and
regenerate new tissues.
REFERENCES:
1. Dutta D C. Textbook of Gynecology. Edition 7, New Delhi: Jaypee Brothers;
2019. p.470.
2. Usha V N K. Streeroga Vignana. Delhi: Chaukambha Sanskrit pratishtana; 2016.
p.201.
3. Dutta D C. Textbook of Gynecology. Edition 7, New Delhi: Jaypee Brothers;
2019. p.46.
4. https://wjpr.s3.ap-south-1.amazonaws.com/article_issue/1456747514.pdf
5. Usha V N K. Streeroga Vignana. Delhi: Chaukambha Sanskrit pratishtana; 2016.
p.186.
6. Usha V N K. Streeroga Vignana. Delhi: Chaukambha Sanskrit pratishtana; 2016.
p.585.
7. https://ayushdhara.in/index.php/ayushdhara/article/view/576/529/

***

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 Herbs used in geriatric women
Review of ayurvedic herbs used in geriatric women
Vd. Shriya Sunil Deo
Dr. Apoorva Sangoram
PG Scholar, 2 HOD and Guide, Dravyaguna Vigyan,
Tilak Ayurved Mahavidyalaya, Pune
Mobile No- 8975493581

ABSRACT-Background-Ayurveda is a science of life and longevity. According to the

Ayurveda, ageing is outcome of kala or parinama. Vata dosha is the most important
factor in the pathophysiology of ageing obviously because of its natural predominance at
that stage of life. Moreover, geriatric women face various health issues such as heart
disease, cancer, stroke, diabetes, Alzheimer‘s disease, arthritis, obesity, post-menopausal
symptoms, atrophic vaginitis etc. Ayurveda has suggested many herbs for delaying the
process of ageing and age-related diseases. Prevention and management of health
problems in geriatric women can be achieved with the use of ayurvedic herbs. Present
article has focused on enhance knowledge of Ayurvedic Herbs used in geriatric women.
Material and methods- Literature regarding herbs is reviewed from Nighantus, text
books, research articles and websites. Haritaki, Amalaki, Shatavari, Punarnava,
Shaliparni, Kumari these herbs are reviewed. Discussion and conclusion- The herbs
enumerated here are rejuvenative, carminative, digestive, liver stimulants and tissue
replenishers. So, these herbs are effective in various geriatric health issues and in
degenerative joint disorders as well as neuromuscular disorders.
Key words: Ayurveda, herbs, geriatric women, diseases, ageing, menopause.
INTRODUCTION- Aging is the process of decaying and this manifests in the form of
various degenerative changes. Although these changes are natural, they are not pleasant.
Everyone is aware that a person who has taken birth must grow and finally die, but
nobody wants to grow old and certainly no one wishes to die. It is the nature of a human
being. Ayurveda considers ageing as the swabhava of life. Hence what all is needed is to
retard the rate of aging to a limited extend and to promote healthy aging. Senior women
are at greater risk than men for many conditions and are affected differently by many
diseases that impact both sexes. There are numerous herbs in Ayurveda which can be
used in prevention and management of geriatric diseases. Main aim of present article is to
review ayurvedic herbs used in geriatric women diseases.
AIM AND OBJECTIVE- To review ayurvedic herbs used in geriatric women.

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MATERIAL AND METHODS- Literature regarding herbs is reviewed from Nighantus,
text books, research articles and websites.
Acharya Sushruta gives an elaborate and systemic classification of age, where he
described old age as above 70 years.1 Acharya Charaka on the other hand mentioned old
age above 60 years.2As per fundamental principles of tridosha, vata is the predominant
dosha during old age.3 It precipitates atrophy and involution of tissues and is responsible
for most of the manifestation of ageing. With the advancing age, the depleted agni leads
to decrease in the vigor and vitality with decay and atrophy due to defective metabolism.
During this period, there is gradual decline of all the dhatu, virya, indriya, ojas, bala and
utsaha. Ayurveda considers ageing as the swabhavaja vyadhi i.e., it is inherent nature of
the living being to get old. Following are common disorders of geriatric women.4
1. Menopausal Syndrome
2. Urinary Incontinence
3. Indigestion
4. Constipation
5. Respiratory Disorders
6. Hypertension
7. Parkinsonism
8. Senile Dementia & Alzheimer‘s disease
9. Insomnia
10. Osteoarthritis and osteoporosis
11. Diabetes Mellitus

Herb Rasa Vipaka Virya Doshaghnata

Haritaki Lavanvarjit Madhur Ushna Tridoshaghna

pancharas

Amalaki Amlapradhan Madhur Sheeta Tridoshghna

pancharas

Punarnava Madhur, Tikta, Madhur Ushna Kaphapittasha

Kashaya mak

Shatavari Madhur, Tikta Madhur Sheeta Vatapittasham

ak

Shaliparni Madhur, Tikta Madhur Ushna Tridoshghna

Kumari Katu, Tikta Katu Sheeta Kaphaghna

Table 1. List of herbs used in geriatric care in women

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1) Haritaki - हयनत योगान ् /भरान ् इनत हयीतकी |

L. N- Terminalia chebula

हयीतकी ऩञ्चयसाऽरवणा तुवया ऩयभ ् |

रूऺोष्णा दीऩनी भेध्मा स्वादऩ

ु ाका यसामनी |

चऺुष्मा रघुयामुष्मा फंह

ृ णी चानुरोशभनी ||

शवासकासप्रभेहाशि्कुष्ठशोथोदयक्रक्रभीन ् |

वैस्वमिग्रहणीयोगपवफतधपवषभज्वयान ् ||

गुल्भाध्भानतष
ृ ाछददि दहक्काकण्डूरृदाभमान ् |

काभरां शूरभानाहं प्रीहानञ्च मकृत्तथा |

अशभयीभि
ू कृच्रं च भूिाघातं च नाशमेत ् ||(बा. प्र. नन. ह.19-22) 5

Charaka has mentioned Haritaki in vayasthapana mahakashaya. Since it is mentioned

in vayasthapana mahakshaya, it delays the process of ageing. It acts as rasayana,
chakshushya, dipana, hridya, medhya, vatanumolana. It elevates the bala of mansadhatu,
due to mansadhatu balavardhana it prevents dhatukshaya, balakshaya and its related vata
prakopa. It acts as indriyaprasadhak and dhatuprasadhaka, so it promotes longevity. It
strengthens muscles. It is beneficial in hridroga, prameha, udavarta and vibhanda.6

2) Amalaki- आभरते धायमनत शयीयभ ् वा यसामनगुणान ् |

L.N- Emblica Officinalis

हयीतकीसभं धािीपरं क्रकततु पवशेषत् |

यक्तपऩत्तप्रभेहघ्नं ऩयं वष्ृ मं यसामनभ ् ||

हष्तत वातं तदम्रत्वाष्त्ऩत्तं भाधुमश

ि ैत्मत् |

कपं रूऺकषामत्वात्परं धात्र्माष्स्िदोषष्जत ् ||(बा. प्र. नन.ह.39,40)7

Charaka states of all the rasayanas, Amalaki is referred as one of the most potent and
nourishing. Amalaki is the best among rejuvenative herbs. Its primary quality and main
therapeutic benefit is vayasthapana. It is the main ingredient of many rejuvenating

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compositions like Chyavanprash, a classical ayurvedic formulation which has been used
as a tonic for the young and old for centuries. It acts as rakta vishodhaka, rakta prasadaka,
dhatu shodhaka and varnya. Due to its dhatushodhana property, it excretes the mala of
doshas and dhatus from body thus it enhances dhatubala.6 It is beneficial in prameha,
rajayakshma, pradara and netra rogas.8

3) Punarnava- शयीयशच दृष्ष्िं ऩन

ु निवं कयोतीनत |

L. N- Boerhavia diffusa

ऩुननिवा शवेतभूरा शोथघ्नी दीघिऩत्रिका |

किु कषामानुयसा ऩाण्डुघ्नी दीऩनी ऩया |

शोपाननरगयशरेष्भहयी व्रण्मोदयप्रणुत ् ||(बा.प्र.नन.गु.231)9

Prameha, shotha, arsha, kasa, shwasa these are some of geriatric diseases caused due
to excessive elevation of vata dosha (vata prakopa). Punarnava prevents vata prakopa and
decaying of dhatus (dhatukshaya) by proper excretion of sharirastha mala thus it
stabilizes and strengthens dhatus. It acts as vatanulomaka, mutrala, vayasthapana and
dipana.It is beneficial in pandu, hridroga, shwasa and shopha.10

4) Shatavari- शतेन आवण

ृ ोनत इनत |

L. N- Asparagus racemosus

शतावयी गुरु् शीता नतक्ता स्वाद्वी यसामनी |

भेधाऽष्ग्नऩुष्ष्िदा ष्स्नग्धा नेत्र्मा गुल्भानतसायष्जत ् |

शक्र
ु स्ततमकयी फल्मा वातपऩत्तास्रशोथष्जत ् ||(बा. प्र. नन.ग.ु 186)11

It is well known as 'Queen of herbs'. This herb referred as ayurvedic rejuvenative

tonic for the female. It stengthens the uterus. It helps to remove pathogens and other
toxins from the body. Aids in digetion and also boosts the immune system. It helps to
ease menopausal symptoms and maintain normal hormone levels within the body. It
boosts energy and strength.12 It acts as balya, hridya, medhya, rasayana, chakshushya
and dipana. It is beneficial in arsha, grahani, atisara, gulma, rakta roga, vatashonita etc.

5) Shaliparni- शारस्मेव ऩणाितमस्मा् |

L. N- Desmodium gangeticum

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शाशरऩणी गरु
ु शछददि ज्वयशवासानतसायष्जत ् |

शोषदोषिमहयी फंह
ृ ण्मुक्ता यसामनी |

नतक्ता पवषहयी स्वाद्ु ऺतकासकृशभप्रणुत ् ||(बा.प्र. नन.गु.31-33)13

It acts as dhatu bruhan due to madhur rasa, nourishes all dhatus and increase oja with
madhur, snigdha guna. Also, it acts as rasayana. By madhur, snigdha and guru guna it
does dhatupushti and by tikta ushna guna it does dhatwagni deepana. Moreover, Charaka
has mentioned shaliparna as shothahara. It is beneficial in jwara, prameha, hridroga, vata
vyadhi, vedana, shopha and daha.14

6) Kumari- कुभायमनत क्रीडते, कुभाय क्रीडामाभ ् |

L. N- Aloe vera

कुभायी बेदनी शीता नतक्ता नेत्र्मा यसामनी |

भधुया फंह
ृ णी फल्मा वष्ृ मा वातपवषप्रणुत ् ||

गुल्भप्रीहमकृद्वपृ िकपज्वयहयी हये त ् |

ग्रत्मष्ग्नदग्धपवस्पोिपऩत्तयक्तत्वगाभमान ् ||(बा.प्र. नन.गु.229-230)15

It is termed as 'Bhedini' in many nighantus because excessive intake of kumari can

cause purgation. It acts as balya, bruhan and rasayana.It is helpful in geriatric women for
anemic conditions. It is mainly beneficial in yakrit rogas, pleeha rogas and rakta rogas.
Also beneficial in jwara, udara roga, vibandha, vedana and gulma rogas.16
DISCUSSION -Most of the herbs mentioned above are grouped under vayasthapak gana
of Charka Samhita. The herbs explained under this heading are mostly madhur/kashaya
in rasa, madhur in vipaka and hence they do dhatuposhana. E.g., Amalaki, Shaliparni,
Punarnava etc. Also, the herbs of vayasthapana gana have rasayana property which helps
in overall nourishment of dhatu. Rasayana drugs possess strong antioxidant property.
Acharya Charka has given unique importance to vayasthapana mahakshaya for
maintaining vitality and managing ageing and its allied ill effects. Some herbs like
Shatavari and Kumari mentioned above are mainly helpful in gynecological conditions in
geriatric women. Altogether, the herbs enumerated here are rejuvenative, carminative,
digestive, liver stimulants and tissue replenishers. So, these herbs are effective in various
geriatric health issues and in degenerative joint disorders as well as neuromuscular
disorders.

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CONCLUSION -Aging is a natural process; the body is decaying continuously, as
shown by its etymology, that is, Shiryate Iti Shariram. Untimely aging is wholly
preventable if the principles of Ayurveda are strictly followed. Moreover, ayurvedic
herbs have minimal adverse effects so they are best in the management of geriatric health
issues.
REFERENCES-
1. Shastri Ambikadutta Edited Sushruta Samhita of Sushruta with
Ayurvedtatvasandipika commentary. Vol. 1. Chaukhamba Sanskrit Sansthan,
Varanasi. Reprint edition Sutra Sthana, 2007; 35(35): 134.
2. Shastri Kashinath, Chaturvedi Gorakhnath edited Charak Samhita of Agnivesha,
Revised by Charak and Dridhabala, Part I, Chaukhamba Bharati Academy,
Varanasi, Reprint Vimana Sthana, 2004; 8(122): 782.
3. Shastri Ambikadutta Edited Sushruta Samhita of Sushruta with Ayurvedtat
vasandipika commentary. Vol. 1. Chaukhamba Sanskrit Sansthan, Varanasi.
Reprint edition Sutra Sthana, 2007; 35(38): 135
4. Amit kumar Rai, Deepshikha Rai, Geriatrics: A ray of hope through Ayurveda,
Feb 2018.
5. Khemraj Shrikrishnadas, Bhavprakash Nighantu of Bhavamishra with hindi
commentary of Lalashaligram Vaishya and Pandit Kantinarayan Mishra, Khemraj
Shrikrishnadas Prakashan, Mumbai, Reprint 2019. Pg no. 3
6. Vd. G. A. Phadake, Vd. N. H. Joshi, Dravyagunashastram, 1960. Pg no. 327
7. Khemraj Shrikrishnadas, Bhavprakash Nighantu of Bhavamishra with hindi
commentary of Lalashaligram Vaishya and Pandit Kantinarayan Mishra, Khemraj
Shrikrishnadas Prakashan, Mumbai, Reprint 2019. Pg no. 5
8. Vd. G. A. Phadake, Vd. N. H. Joshi, Dravyagunashastram, 1960. Pg no. 149
9. Khemraj Shrikrishnadas, Bhavprakash Nighantu of Bhavamishra with hindi
commentary of Lalashaligram Vaishya and Pandit Kantinarayan Mishra, Khemraj
Shrikrishnadas Prakashan, Mumbai, Reprint 2019. Pg no. 76
10. Vd. G. A. Phadake, Vd. N. H. Joshi, Dravyagunashastram, 1960. Pg no. 252
11. Khemraj Shrikrishnadas, Bhavprakash Nighantu of Bhavamishra with hindi
commentary of Lalashaligram Vaishya and Pandit Kantinarayan Mishra, Khemraj
Shrikrishnadas Prakashan, Mumbai, Reprint 2019. Pg no. 70
12. Vd. G. A. Phadake, Vd. N. H. Joshi, Dravyagunashastram, 1960. Pg no. 341
13. Khemraj Shrikrishnadas, Bhavprakash Nighantu of Bhavamishra with hindi
commentary of Lalashaligram Vaishya and Pandit Kantinarayan Mishra, Khemraj
Shrikrishnadas Prakashan, Mumbai, Reprint 2019. Pg no. 53
14. Vd. G. A. Phadake, Vd. N. H. Joshi, Dravyagunashastram, 1960. Pg no. 314
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15. Khemraj Shrikrishnadas, Bhavprakash Nighantu of Bhavamishra with hindi
commentary of Lalashaligram Vaishya and Pandit Kantinarayan Mishra, Khemraj
Shrikrishnadas Prakashan, Mumbai, Reprint 2019. Pg no. 76
16. Vd. G. A. Phadake, Vd. N. H. Joshi, Dravyagunashastram, 1960. Pg no. 184

***

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 MANAGEMENT OF ATROPIC VAGINITIS BY STHANIKA
CHIKITSA – A CASE STUDY
Dr. Shruthi M
Dr. Tejaswini KR
Dr. Vidyanarayan
Assistant professor, Department of Prasuti tantra and Stree roga
Assistant professor, Department of Prasuti tantra and Stree roga
Reader . Department of Prasuti tantra and Stree roga
JSS Ayurveda Medical College, Mysuru, Karnataka
Ph.no 8762118141

ABSTARCT -
The life of a women are generally divided into infancy, puberty, reproductive age,
climatric period and elderly years. These stages accompanied by considerable hormonal
changes. In menopause woman enter an estrogen deficiency phase, which accelerates the
aging process resulting into inevitable changes like hot flushes, psychological changes,
osteoporotic changes, vaginal dryness, dysperuniea, dysurea etc. This is the age of
Rajonivrutti and the symptoms are more nearer to vata vruddhi lakshanas. Atropic
vaginitis is a condition where the lining of vagina gets drier and thinner results in itching,
burning and pain during sex and urinary system related problems also. 40%
perimenopausal woman suffers with this. Sthanika chikitsa are local treatments
mentioned in Ayurveda which plays important role in the management of many
Yonivyapadas. Sthanika chikitsas in stree roga includes Yoniprakshalana, yonipichu,
yoni abhyanga, yoni dhupana, varti, kshara karma etc. This paper will be dealing about
management of case of atropic vaginitis with the help of sthanika chikitsa.
Key words- Sthanika chikitsa, Perimenopause, Atropic vaginitis, Yonivyapad
INTRODUCTION
Health is an important factor that contributes to human well-being and economic
growth. A healthy women is a promise of a healthy family. In different phases of
woman‘s life, from puberty to post menopause health of reproductive system is important
as creation of good offspring and caring of children is highly depends on the woman's
health. Ayurveda also given prority on women reproductive health. Under the heading of
yonivyapath many reproductive system related issues in all age group are discussed
Vaginitis is a condition charecterised by infection and inflammation of vagina. There
are different types of infections based on causative organisms like bacterial , candidial ,
trichominial, monilial, gonorrheal etc1.Vaginitis in postmenopausal women is called
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atrophic vaginitis. The term is preferable to senilevaginitis. There is atrophy of the
vulvovaginal structures due to estrogen deficiency. After menopause the vaginal
defence is lost. Vaginal mucosa is thin and is more susceptible to infection and trauma.
There may be desquamation of the vaginal epithelium which may lead to formation of
adhesions and bands between the walls.2 Vulvovaginal atrophy is a silent epidemic that
affects up to 50%–60% of postmenopausal women who are suffering in silence from this
condition. Hormonal changes, especially hypoestrogenism inherent in menopause, are
characterized by a variety of symptoms. More than half of menopausal women are
concerned about the symptoms of vulvovaginal atropy, such as dryness, burning, itching,
vaginal discomfort, pain and burning when urinating, dyspareunia, and spotting during
intercourse. All these manifestations significantly reduce the quality of life and cause
discomfort in the sexual sphere3
CASE REPORT
A female patient aged 60 years attending the outpatient department, presenting with
complaint of vaginal itching with burning sensation since 1 month along with yellowish
discharge per vaginally. Itching is hampering her daily activities. She was also suffering
from burning micturition since 20 days. The complaints started gradually 3 months ago
and she had not taken any treatment for this. Now since a month the symptoms became
severe day by day. Her Personal History- Diet: Mixed, prefers fried items,dry items
Appetite: Moderate, Bowel: Constipated, Micturition: 3-4 times per day, burning
sensation, Sleep: Sound, Habits: Intake of tea, 2-3 times, Exercise: Nil
Menstrual history- She attained menopause 6 years back.
On examination-
General examination - Conscious, well oriented, BP- 130/84mmhg, Pulse- 88/m, BMI-35
Systemic examination- External genitalia – itch marks seen in labia
Per speculum examination – Vagina dryness seen with small hemorrhagic spots in
vaginal walls Cervix- Small , slight yellowish discharge seen
Per vaginal examination- Uterus – Anteverted, small, no fornices tenderness , no cervical
motion tenderness
Investigations - PAP Smear test – negative for intraepithelial lesion, Blood and Urine
routine – Normal study

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INTERVENTION
Table no .1
Procedure Drug Days of treatment
Yoni prakshalana Triphala kwatha 7days
Yoni Abhyanga Mahanarayana taila 7 days
Yoni swedana Nadi sweda 7days
Yoni pichu dharana Shtavari ghruta 7 days
Shamana Phala ghruta 30 days
Rasna erandadi kashaya 30 days

RESULTS
The following changes observed during and after treatment
Table. No 2
Day of treatment Symptoms
Vaginal itching and Burning sensation Discharge
dryness
Day 1 and 2 no change No change Slightly seen
Day 3 no change Slightly reduced Slightly seen
Day 4 Slight reduction No change No change
Day 5 &6 Slight reduction Slight reduction Reduced
Day 7 Reduced Reduced Reduced

After sthanika chikitsa and 20 days of shaman chikitsa patient came for follow up.
There was symptomic relief. On examination there was no haemorrhagic spots and rashes
seen in vagina. Yellowish discharge was absent. The internal medicines were continued
for a month of time and Pathyaharas are advised .
DISCUSSION
Importance of sthanika chikitsa
Sthanika chikitsa means local treatments that to be given through pelvic area. In
Ayurveda. Sthanika chikitsa includes Yoni dhavana, pichu dharana, dhoopana, purana,
yoni swedana, yoni varti and uttara basti. In samanya chikitsa of yonivyapath along with
shodhana and shaman sthanika chikitsas are mentioned4. The vagina provides a
promising site for local effect as well as systemic drug delivery because of its large
surface area, rich blood supply, avoidance of the first-pass effect, relatively high
permeability to many drugs5. .It bypasses portal circulation, increasing the bio
availability of the drug. Action is based on the property of drugs used in the form of taila,

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ghrita etc.diminishes the chances of infection in the genital tract as taila is yoni-
vishodhana
The symptoms of atropic vaginitis can be correlataed with vataja yonivyapath in
Ayurveda. Clinical features of vatala yonivyapth are roughness, dryness and numbness in
vagina, tingling sensation and pain. These are more close to the symptoms of atropic
vaginitis. For the treatment vatala yonivyapath, snehana, different varities of sweda and
sthanika chikitsas like parisheka, kalka dharana, pichu dharana internally vata
prashamana yogas are mentioned6
On this basis in above mentioned case we had given yoni dhavana to flush out the
discharge. Yoni abhyanga done with mahanarayana taila which helped in reduce dryness .
Yoni swedana done with nadi sweda. Snehana and swedana together very good treatment
for vata pradhana vyadhis. Pichu kept with shatavari ghruta helped in retension of drug
for long duration. Shaman aushadhis helped in vata and pitta prashamana and improving
general health.
CONCLUSION
Sthanika chikitsa with shaman aushadhis plays important role in the treatment of
atropic vaginitis.
REFERENCES
1. Dutta DC, text book of gynaecology ,5th edition,kolkatta, New central book
agency 2007,p181
2. Dutta DC, text book of gynaecology ,5th edition,kolkatta, New central book
agency 2007,p181
3. Iuliia Naumova and Camil Castelo-Branc Current treatment options for
postmenopausal vaginal atrophy International Journal of Womens Health v.10;
2018
4. Acharya JT. Charaka Samhita with Ayurveda Dipika commentary of Chakrapani
Datta. Reprint ed. Varanasi (India): Chaukambha Orientalia; 2011.p.233
5. Vinita Vijay Kale , Alok Ubgade, Vaginal Mucosa – A Promising Site for Drug
Therapy Journal of Pharmaceutical Research International, Page 983-10000, 2013
6. Acharya JT. Charaka Samhita with Ayurveda Dipika commentary of Chakrapani
Datta. Reprint ed. Varanasi (India): Chaukambha Orientalia; 2011.p.233

***
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 HERBS USED IN GERIATRIC WOMEN
Dr.Shruthi Pandith K
PG Scholar, Dravyaguna Vijnana, Karnataka Ayurveda
Medical College, Manglore, Karnataka)

ABSTRACT
Geriatrics or geriatric medicine is a specialty that focuses on health - care of elderly
people. It aims to promote health by preventing and treating diseases and disabilities in
older adults. Elderly people are vulnerable to a lot of diseases and dis-abilities, many
people face problems of loneliness also. There-fore these elderly people should be treated
with utmost care and we should concern them specially. Geriatric women are again very
special category, whom should be treated different from men, as women after menopause
already suffer from a lot of issue, they are to be considered with treatment which will
balance their hormonal imbalance issue, their calcium deficiency , weakness, and other
elderly issues. In general use, herbs are widely distributed and widespread group of
plants, excluding vegetables and other plants consumed for macronutrients, with savory
or aromatic properties that are used for flavoring and garnishing food, for medicinal
purposes, or for fragrance. Elderly people may face many difficulties so if we can use
herbs in geriatric care or geriatric medicine that will be really a boon, the strength
physically and memory power all diminish during this time, so if herbs with special
qualities which will rejuvenate and nourish their body physically and mentally and will
help to stay fit and strong and will alleviate a lot of geriatric problems. So here in this
article certain herbs which can be used in geriatrics are thrown light.
KEY WORDS: Geriatrics, Geriatric women, Elderly, Herbs, Geriatric medicine.
INTRODUCTION
Globally, the population is aging and the proportion of older people is rising. (United
Nations, Department of Economic and Social Affairs 2017). A characteristic of ageing
population is the ‗feminization‖ of ageing (WHO,2002), the female to male ratio
increase, world wide women account for 61% of those aged 80 years and above (UN,
Department of Economic and Social affairs 2017). Almost everywhere in the world
women live longer than men and are more likely to experience serious illness and have
co/multimorbidities, which adversely affect their quality of their life. Furthermore, older
women experiences increased fraility, the consequences of increased longevity. Women
around the age of 45-50 will attain their menopause , they start a lot of issues a few years
before attaining menopause. Many issues are related with calcium and vitamin D, and
other deficiencies. Ailments due to hormonal imbalance are also common.

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 Once after attaining menopause , issues due to this hormonal imbalance like hot
flushes, irritability, mood swings, insomnia, dry vagina, difficulty in concentrating,
mental confusion, stress incontinence, urge incontinence, osteoporotic symptoms,
depression. Headache, vasomotor symptoms are common. Other illness like
hypertension, diabetes, heart disease, gastric issues, bowel disorders, dementia, arthritis,
poor memory, parkinsonism, alzheimers, and other psychological illness are also
common. Obesity, metabolicsyndrome, and diabetes, cardiovascular disease , cognitive
decline, depression and cancer are the major disease of concern. An herb is a plant or
plant part used for its scent, flavor, or therapeutic properties. Herbal medicines are one
type of dietary supplement. There are a lot of herbs which act as rejuvinators, elderly
women mainly need to rejuvenate their body. So intake of these drugs will help them to
keep healthy. There are herbs which are cardiotonic, cardioprotective, hepatoprotective,
immunoboosters, some are rich source of calcium, vitamins and iron contents. If in
oldage if we wisely use these herbs all the necessary nutrients are being able to obtain.
This will help us to stay healthy and happy during oldage.
SOME OF MAIN HEALTH ISSUES FACED BY GERIATRIC WOMEN
Many symptoms occur postmenopause ,including hot flushes, weight fluctuation and
vaginal dryness. Some of these symptoms are temporary and some are permanent. Post
menopause is the period after the point when a persons menstrual cycle stops completely
. This cessation typically happens between age ages 40 and 58, according to The North
American Menopause Society (NAMS).1 The core symptoms during oldage are
vasomotor ailments, psychological issues ,metabolic disease, skin related issues, and
immunity related issues 2.
LIST OF SOME DRUGS WHICH HAS MULTI ACTIONS AND HELP TO
BATTLE GERIATRIC AILMENTS
GUDUCHI- Tinospora cordifolia
Potential medicinal properties reported by scientific research include antidiabetic,
antipyretic, antispasmodic, anti inflammatory, anti-arthritic, antioxidant, anti-allergic,
anti-stress, anti-leprotic, antimalarial, hepato-protective, immune modulatory and anti-
neoplastic activities. This plant is used abundantly in Ayurveda , belong to
menispermaceae family. According to Ayurveda Gudoochi have lot of actions in , among
them it is considered as supreme drug as Balya (health promoting, strength giving),
Rasayana (rejuvenating). Many among oldage illness and troubles can be battled if
elderly women start the habit of consuming a decoction prepared with Guduchi in a
prescribed quantity. While there are no serious or potential side effects of the herb, in
some cases it cause constipation or lower blood sugar level. The nutrient content of this
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plant are carbohydrates, proteins, fat, fibre, iron, calcium and vitamin C. Guduchi can
combat disease like thrombocytopenia, Alzheimer‘s disease, Buerger‘s disease,
hyperuricemia, gout, leprosy. So this is a sure choice of herb in geriatric women.3
ASHWAGANDHA- Withania somniferum
This plant belongs to Solanaceae family. Used in many of Ayurvedic preperations.
The medicinal properties of this plant is known from the classical period itself.
Ashwagandha has actions like Rasayana and Vajeekarana. It also do the nourishment of
seven Dhatus. It rejuvenates body, provides strength, it arrest odema, , it can be used in
chronic cough, and emaciation, it also arrest tumors. Ashwagandha can be used in
emaciation like the powder is made and it is roasted in ghee and can be consumed.
Elderly people may suffering from insomnia Ashwgandha powder boiled in milk in milk
and if consumed will help to get good sleep. Elderly people also suffer from urinary tract
infections, if consumed with milk helps to cure these ailments. It helps to strengthen the
nervous tissue also.4
BALA- Sida cordifolia
This plant belongs to family Malvaceae, there a wide variety of Bala. This plant has
many wonderful medicinal properties. The medicinal value of this palnt has been known
from the classical age itself , Ayurveda classics have a wide range of references about
this plant. Bala is best in all kind of pain. Elderly people are common to suffer from
different types of body aches. In Ayurveda Bala help to alleviate Vata Dosha , geriatric
women are prone to such Vata predominant disease, so cosuming this herb would help
greatly. It improves cardiac functioning, it promotes good sleep, It is good in piles, it
helps to get cure from rheumatic fever, odema and other related ailments. The habit of
drinking Bala Ksheera Paka will help to give good strength for geriatric women.4
PALANDU-Alium cepa
This is widely used in daily food, but the medicinal properties has been discussed in
our classics. This plant belongs to Liliaceae family. It helps to cure from cough ,cold,
allergies, and breathing difficulties. In splenomegaly daily intake of Plandu greatly
helps.It also helps to alleviate body aches. Palandu act as cardiotonic and recent
researches shows that they act ass cardiprotective. So using of Palandu also improves
strength in geriatric women.4
GOKSHURA- Tribulus terrestris
This is another herb which can be used in elderly women, these women are common
to suffer from, urinary infections, and difficulty in micturition and also pedal odema and
poor kidney function. Gokshura is having the property to give a cure from all of the
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above told ailments. Gokshura boiled in water and if consumed daily will help to cure
from aiments, powder if mixed with water and consumed will help to cure pedal odema
and it improves proper kidney functioning. So this herb can also be used in geriatric
women.4
PUNARNAVA-Boerhavia diffusa
This plant belongs to Nyctaginaceae family. This plant has been told many a times in
our classics. This plant is popularly used by many villagers as a vegetable in their daily
food. This plant has a lot of medicinal properties. There are different varities of
Punarnava. This is best in diseases of skin, kidney troubles, liver diseases, rheumatic
complaints, insomnia, fever, cough, addiction etc. If consumed daily two spoon of
Punarnava juice will help to strengthen our kidney function and liver function, It is best
in all kind of odema, The decoction of Punarnava is said to be best to cure insomnia. So if
consumed as a vegetable once or twice in a week may help to keep away from many
ailments and imparts good sleep . So this herb can be used by geriatric women.4
AMLA- Emblica officinalis
This plant belongs to Euphorbeaceae family It is called as miracle fruit. It has lots of
medicinal value. Our classics have mentioned a lot of it medicinal values. People of any
age can use Amla. It is being used internally and externally for many purposes.The
medicinal values are It is rich source in vitamin C. It rejuvenates the body, It gives
immunity, It helps to fight diabetes, In mouth ulcers which is common in oldage people
due to poor digestion and absorption Amla can be used along with cumin seeds and curd.
In breathing difficulty it can be consumed with Pippally, in hyper acidity it can be used.
In urinary obstruction and head ache it can bee used externally as application to
umbilicus and head respectively. In indigestion,, dyspepsia, diarhoea Amla can be used or
its leaf can be mixed with buttermilk and can be used. In vomiting and improving
immunity Amla can be consumed daily. In cancer vit C will help to cmbat against the
carcinogenic cells , so consuming Amla will help greatly, also it helps to prevent
artherosclerosis and act as cardioprotective, the Chyavanaprash made up of Gooseberrys
can be consumed. So people of elderly age can consume Amla in their daily food.4
OTHER HERBS
A number of other herbs are there which can be used in geriatric women they are
Shatapushpa, Jeeraka, Haridra, Durva, Dronapushpi, Brahmi, Kapikachu, Mandukaprni,
Thulasi, Amaranthus, Moringa, Isabgol, ,Kumari, Vishnukrantha, Sankhupushpi, Asoka,
Bilva etc are some among them.4

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CONCLUSION
We all know geriatric women are those are to be given care properly . They are
vulnerable to many diseases so hey should be concerned greatly. They happen to get a lot
of physical and psychological issues so they are prone to different diseases easily. Herbs
are magic remedies for many ailments, some herbs can be used as vegetable in their daily
food , but some can be consumed as medicines in prescribed doses. When used wisely
these herbs will provide them with strength and help them to battle with their geriatric
health ailments.
REFERENCES
1.[.Lindesey Todd, Medical news today, July 29, 2021]
2.[Nanette Santoro, Neil Epperson, Sarah Mathews, Menopausal Symptoms and Their
Management Endocrinol Metab Clin North Am.2015 Sep;44,(3):497-515]
3.[Prajwala B, Raghu N, Gopenath T S, Basalingappa K M, Guduchi Its Medicinal
Properties, Journal of Plant Physiology and Pathology, 2019,7:3]
4.[Raghavan Thirumulpad K, Ayurveda Vijnana Kosam, Samrat publications, 2005]

***

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COMMON AYURVEDA FORMULATIONS IN GERIATRIC WOMEN
CARE
Dr SINDHURA. K. S.
PG SCHOLAR
DEPT.OF RASA SHASTRA AND BHAISHAJYA KALPANA
K.V.G AYURVEDA MEDICAL COLLEGE AND HOSPITAL
AMBATEADKA, SULLIA, D.K. DISTRICT-574327, KARNATAKA.

ABSTRACT
Aims and objectives
To present some of the common Ayurveda formulations prescribed in geriatric
problems of women.
Need of the presentation
With advancement of time, the world population of the elderly people is increasing
significantly. As the age advances, the prevalence of illness increases and hence the life
expectancy of an individual decreases. Now a days, Geriatrics is emerging as a major
medical speciality globally. The western system of medicine has got many limitations in
improving the general health of a person, apart from providing medical management of
the diseases occurring during the later part of life. Hence Ayurveda should have an upper
hand in the management of women geriatric problems. It is a need of the hour to
highlight some of the common, economic and easily available Ayurveda formulations,viz
Dhanyaka Hima, Jeeraka Rasayana, Kukutanda Twak Bhasma, Chavanaprasha Rasayana
are the ones, which will be extremely helpful to improve the geriatric women problems in
our daily clinical practice.
Key words
Geriatric, Woman care, Ayurveda in Geriatrics, Ayurveda woman care.
INTRODUCTION
From Greek - geron meaning old man + iatreia meaning the treatment of disease. The
branch of medicine concerned with the diagnosis, treatment and prevention of disease in
older people and the problems specific to aging.
JARA/ RASAYANA CHIKITSA
Jara- Swabhavajanya Vyadhi (natural & inevitable process)
Etymologically – Jr +Ana + Tap

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 Derived from ―jrish vayohanow‖ – ―Vayah krta slata mamsadyavastha vishesha‖ –
The muscles and other tissues are loosened under the influence of aging.

यसामनततिं नाभ वम्स्थाऩनभ ् आमुभेधाफरकयं योगाऩहयण सभथं च1 ।( सु सू 1/7 )

That which arrests/ delays the aging process, which supports or improves life span
and intelligence/ cognition and which is able to cure /destroy diseases of both body and
mind.
NEED OF MEDICINES IN GERIATRIC WOMEN
With the rise in elderly population all over the world including India, it is now felt
necessary to develop newer strategies for Geriatric health care. Geriatric care has to
address two-fold problems, firstly the basic anti-aging care to retard the rate of
physiological ageing and secondly the medical management of diseases specifically
occurring in old age. Ayurveda on the other hand has got the potential for prevention of
diseases by promotion of health and management of diseases occurring in old age. It has
a focused branch called Rasayana which deals with the problems related to ageing and
methods to counter the same. Significant causes of morbidity among the elderly women
are as follows,
 MENOPAUSAL SYMPTOMS
 GARBHASHAYA DOURBALYA
 ASTHI KSHAYA
 PSYCHOLOGICAL DISTURBANCES
 BALAKSHAYA/ DHATU KSHAYA
COMMON AUSHADHA YOGAS
The Aushadha yogas commomly used in the above conditions are as follows-
•IN MENOPAUSAL SYMPTOMS LIKE- HOT FLASHES – DHANYAKA HIMA

प्रात् सशकिय् ऩेमो दहभो धातमकसम्बव् ।

अततदािहं तथा तष्ृ णां जमेत ् स्रोतो पवशोधन्2 ।। (Sha.Sam.Madyamakhanda 4/7)

Rasa- Kashaya, Tikta, Madhura Guna- Laghu, Snigdha Vipaka- Madhura,

Doshaharatva- Tridosha hara, Srotokarma –Shrotoshodhana
•GARBHASHAYA BALYA – JEERAKADI RASAYANA/ MODAKA

जीयकद्पवतमं कृष्णा सुषवी सुयशबविचा ।

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 वाभकं सैतधवं चापऩ मवऺयो मवाननका ।।

एषां चूणं घत
ृ े क्रकष्ञ्चत ् बष्ृ िवा खण्डेन भोदकं ।

कृत्वा खादे द्मथावपि मोननयोगाद्पवभुच्मते3 ।। मो. य- मोननयो प्रकयण 13-14

Agni karma – Dipana, Pachana,

Doshagnata – Kapha Vata Shmana, Vatanulomana
Karma- Shulahara, Kosta shuddhikara.
•ASTHI POSHAKA YOGA – KUKKUTANDA TWAK BHASMA4
 Rich source of calcium – CaCO3 + CaO..
 Clinically indicated in Garbhashaya related issues – menstrual disorders,
leucorrhoea, Infertility etc.
 Effective in treatment of anemia.
•FOR PSYCHOLOGICAL SUPPORT – ASHWAGANDHA CHURNA5
Rasa – Tikta, Katu, Madhura Guna – Laghu, Snigdha Verya –Ushna Vipaka -Madhura
Doshaharatva – VataKapha Hara, Pittakara .
 Anupana – Milk (Balya,Medhya,Ojasya,Vrushya,Rasayanam).
 Anti anxiety effect .
 Nadi balya.
 Increases vyaadhikshmatva.(usd extensively during covid-19 pandemic)
•RASAYANA YOGA – CHYAVANAPRASHA RASAYANA6
Agni karma – Dipana, Mala karma – malanulomana, Mutradoshahara,
Sroto karma- Sroto shodhana . Doshaharatva - Tridosha hara, Vatanulomana .

▫ जया जजिरयतो अप्मासीत ् नायीनमन नतदन - elderly person also regains their lost
complexion, beauty etc.

▫ भि
ू शुक्राशमान ् योगान ् व्मऩोहनत - corrects the problems related to pelvic organs.

▫ अङ्गवधिन in वि
ृ , फार, ऺीण etc - improve physic in elderly, children and debilitated
persons.

▫ ऩवनानुरोम्मं - Corrects (Apana) vaayu vikrti.

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▫ अष्ग्नफर, इष्तद्रमफर वपृ ि - improves digestion, physical strength, sensory organ
functioning.

▫ वणि प्रसादं - improves complexion.

DISCUSSION: Perimenopause, Menopause and Post menopause are the stages in a

womans life when her monthly period stops. This is the end of woman's reproductive age.
During post menopausal age, ovaries no longer produce high levels of hormones -
Estrogen, Progesterone and Testosterone. Together, estrogen and progesterone control
menstruation. Estrogen also influences how the body uses calcium and maintains
cholesterol levels in the blood. During this stage, menopausal symptoms such as hot
flashes, irritability, mood swings, Insomnia, Vaginal dryness, Night sweats etc may
occur. However some women continue to experience these symptoms for a decade or
longer after the menopause transition. As a result of the lower levels of estrogen,
postmenopausal women are at increased risk for a number of conditions such as
osteoporosis and heart disease. Hence we being the practitioners of Ayurveda can
effectively contribute to improve the quality of life of a postmenopausal/ geriatric woman
by minimizing her sufferings and improving her health status.
CONCLUSION
Ayuveda as a health science has got both preventive and curative roles, for which it is
known and accepted worldwide. This presentation is an effort to highlight how simple
oushadha yogas of Ayurveda can be effectively used in improving the health status of a
geriatric age woman. By considering the dosha, dushya, agni, ama etc of a post
menopausal woman, we can effectively manage her geriatric health issues with the help
of easily available, simple, effective and economical preparations. Further studies in this
regard must be conducted for the betterment of the society and the science.
REFERENCES
1. 1.Acharya Sushruta;Sushruta Samhita with Nibhandhasangraha Commentry of Sri
Dalhanaachaya and the Nyayachandrika Panjika of Sri Gayadasacharya on
Nidhana Sthana edited by Vaidya Yadavji Trikamji Acharya From the Beginning
to the 9th Adhyaya of Chikista Sthana and the rest by Narayan Ram Acharya
KAVYATIRTHA, published by Chaukamba Surbharathi Prakashana, Varanasi,
Print 2012,Sutra Sthana Verse No.1/7.
2. 2.Acharya Sharangadhara;Sharangadhara Samhita with DIPIKA Hindi
Commentary of Pandita Sharangadharacharya containing Anjananidana of

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 Maharsi Agnivesha by Dr.Brahmanand Tripathi published by Chaukamba
Surabharathi Prakashan Varanasi,Madhyama Khanda Verse No.4/7.
3. 3.Yoga Ratnakara;Commentary by Acharya Laxmipati Shastri,Published by
Chaukambha Sanskrita Series Office,Varanasi.Yoni rogaprakarana Verse. No.-13-
14
.
4. Ayurveda Sara Sangraha by Baidyanath published by Sri Baidyanath Ayurved
Bhawan pvt LTD;,Page No:116.
5. 5Acharya Bhavamishra; Bhavaprakasha Nighantu Commentary by Prof
K.C.Chunekar,Edited by Dr.G.S.Pandeya,Published by Chaukambha Bharathi
Academy,Varanasi,Guduchiyadi Varga 189-190.
6. 6.Acharya Charaka;Charaka Samhitha with Ayurveda Deepika commentary by
Chakrapanidatta edited by Yadavji Trikamji Acharya,publishd by Chaukamba
Surbharathi Prakshan,Varanasi,Reprit 2011,Chikistsa Sthana.Verse No.62-74.

***

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 RASAYANAS FOR GERIATRIC WOMEN.
AN EFFECT AND BENEFITS OF RASAYANA THERAPY IN
GERIATRIC WOMEN.
Dr. Sonu Mariam Rajan,
Dr. Rachana H. V
1st year PG scholar, 2. Associate professor, Department of
Prasuti Tantra and Stree Roga, Sri Sri College of Ayurvedic
Science and Research Institute, Bengaluru, Karnataka.

ABSTRACT:-
Every living being on the earth has to pass through the process of ageing and human
being is not different. According to Ayurveda, Rasayana is jara vyadhi nashaka
oushadha. It is an Ayurvedic rejuvenation therapy which helps in maintenance and
promotion of health. According to Caraka, people who undergo rasayana therapy obtain
longevity and freedom from disease. Rasayana therapy prevents effect of ageing and
provides longevity, improves mental and intellectual competence, preservation of
youthfulness, increased luster and glow of the skin, healthy condition of voice, excellent
potentiality of the body and the sense organs.
As women get older, they may be less likely to get regular gynecological care.
Women who are past childbearing years still need regular gynecological care, and many
conditions affecting the female reproductive system occur in the later years, after
menopause. Ayurveda classics describe a large number of rasayana drugs for geriatric
care. Popular rasayana drugs are Ashwagandha, Shatavari, Brahmi, Mandukaparni,
Aamlaki, Shankapushpi etc. Some compound formulations like Chyavanaprasha,
Aamlaki rasayana, Brahma rasayana also can be used for geriatric care. Thus by the use
of these rasayana therapy we can replenishes the vital fluids of the body, boost the ojas
and the immune system, thus keeping away from diseases and prevents against ill effects
of advanced age.
Keywords: Rasayana, Geriatrics, Chyavanaprasha, Aamlaki rasayana, Brahma rasayana,
Shatavari.
INTRODUCTION
Geriatrics – Geri (old age) + iatrics(care). It is a special division of medicine related to
the preventive and curative measures of elderly. Geriatric problems are best confronted
by preventive measures than curative ones. Ayurveda, has broad spectrum of preventive
measures for combating the ageing process. It has a focused branch called Rasayana

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which deals primarly with geriatric problems. Rasayana is the destroyers of jara and
vyadhi. Rasayana therapy prevents effect of ageing and provides longevity, improves
mental and intellectual competence, preservation of youthfulness, increased luster and
glow of the skin, excellent potentiality of the body and the sense organs. The concept of
Rasayana therapy is not a single drug treatment but it is a comprehensive and specialized
regimen capable of producing healthful longevity and improved mental faculties by
acting at the level of Rasa, Agni, and the Shrotamsi, thus enabling the organism to
procure the best qualities of different dhatus.
As women get older, they may be less likely to get regular gynecological care.
Women who are past childbearing years still need regular gynecological care, and many
conditions affecting the female reproductive system occur in the later years after
menopause. Due to increased life expectancy, specially in affluent society, about one-
third of life span will be spent during the period of estrogen deprivation stage with long
term symptomatic and metabolic complications.
ENDOCRINOLOGY IN MENOPAUSE WOMEN1
Few years prior to menopause, along with depletion of the ovarian follicles, the
follicles become resistant to pituitary gonadotropins. As a result, effective
folliculogenesis is impaired with diminished estradiol production. In the time of
menopause stage, the estrogen level in the body got decreased. This decreases the
negative feedback effect on HPO axis resulting in increase in FSH. The sustained level of
estrogen may cause endometrial hyperplasia and clinical manifestation of menstrual
abnormalities prior to menopause. Due to the physiologic aging GnRH and both FSH and
LH decline along with the decline of estrogens.
ORGAN CHANGES:- 2
Ovaries- shrink in size, become wrinkled and white.
Fallopian tube- show features of atrophy. The muscle coat become thinner.
Uterus- become smaller and the ratio between the body and the cervix reverts to the 1:1
ratio. Vagina- becomes narrower due to gradual loss of elasticity.
Vulva- shows features of atrophy.
Breast fat- reabsorbed and glands atrophy. The nipples decrease in size.
Loss of muscle tone- leads to pelvic relaxation, uterine descent and anatomic changes in
the urethra and neck of the bladder.

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PHYSICAL DISORDERS:-3
Osteoporosis and fracture- Following menopause bone loss increases to 5% per year. It
is mainly due to estrogen loss and deficient nutrition.
Cardiovascular and Cerebrovascular diseases- Oxidation of LDL and foam cell
formation cause vascular endothelial injury, cell death and smooth muscle proliferation.
All these lead to vascular atherosclerotic changes, vasoconstriction and thrombus
formation.
Dementia - Estrogen is thought to protect the function of CNS. Dementia and mainly
Alzheimer disease are more common in post-menopausal women.
Urogenital atrophy- Estrogen plays an important role to maintain the epithelium of
vagina, urinary bladder and the urethra. Estrogen deficiency produces atrophic epithelial
changes in these organs.
Hair loss and baldness- This is due to low level of estrogen with normal level of
testosterone. Sexual dysfunction- Estrogen deficiency is often associated with decreased
sexual desire.
Psychological changes- There is increased frequency of anxiety, headache, insomnia,
mood swing and inability to concentrate.
The hormone replacement therapy (HRT) is indicated in menopausal women to
overcome the short term and long term consequences of estrogen deficiency. The risks of
HRT are Endometrial cancer, Breast cancer, Venous thromboembolic disease, Coronary
heart disease, Lipid metabolism, Dementia and Alzheimer disease are increased.
Ayurvedic Role in Geriatric Disorders-
Ayurveda has 2 main objectives:-
1. To maintain the healthy state.
2. To cure the disease of individual.
3. A rasayana may act at 3 levels of biosystem to promote nutrition such as -
4. At the level of Agni by promoting the digestion and metabolism.
5. At the level of Srotasa by promoting microcirculation and tissue perfusion.
6. At the level of Rasa itself by acting as direct nutrition.
Acharya caraka has mentioned that on administration of Rasayana one attains longevity,
memory, intelligence, freedom from diseases, youthful age, excellence of lustre,
complexion and voice etc.

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BIOLOGICAL EFFECTS OF RASAYANA DRUGS:-4
The concept of Rasayana had invoked a good deal of scientific enthusiasm way back in
late 60‘s
1. Anabolic effect and promote tissue building.
2. Anti stress and adaptogenic effects. Eg:- Aswagandha and Shilajathu- it can
neutralize the negative effect of stress and restore homeostasis.
3. Immunomodulatory effect.
4. Anti oxidant effect :- it enhances the natural enzymatic defence mechanism of the
body.
5. Anti ageing effects- it could influence the secretion of a hormone DHEA the
deficiency of which is implicated in the process of ageing. Repeated stress on
every cell causes aging process.
ASWAGANDHA RASAYANA-
It is known as sattvic kapha rasayana. It could be an effective alternative that can
counter aging issues including sleep quality and mental alertness improvement. It
enhances the function of brain and improves the memory. It improves reproductive
function and cell mediated immunity. SHATAVARI RASAYANA-
It is the source of phytoestrogens. The symptoms of menopause are due to the body
experiencing a withdrawal to oestrogen, thus phytoestrogens occupy vacant receptors and
stimulate estrogenic action. Various formulas containing Shatavari have shown their
effectiveness in alleviating the symptoms in postmenopausal period and hysterectomized
patients.
AMALAKI RASAYANA-
In Ayurvedic classics, Amalaki has been mentioned as the best rasayana and
vayasthapana drug. It consists of rich of vitamin C. It is having anti oxidant and anti
ageing property. It is treating the symptoms like insomnia, constipation, digestive
weakness and anemia. It promotes intellect. SHANKAPUSHPI RASAYANA-
It is medhya, hrudya, deepana- pachana and tridosha hara. The powerful antioxidants
and flavonoids present in it improve the improve the memory capacity and reduces
mental fatigue. It is having anti stress, anti depressive and anti anxiety properties.
CHYAVANAPRASHA RASAYANA- 5
It helps in rejuvenation, enhancing immunity, prevents khalitya, palitya and wrinkling
of the skin. It is having anti oxidant and tissue regenerating capacity. It improves
intelligence and

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memory and it is beneficial for mental clarity.
BRAHMA RASAYANA-6
It improves ahara shakti and vyayama shakti and it is rich in vitamins, protein and
dietary fibre. It helps in immune modulation, body building and prevention of oxidative
damage and it is a cardiotonic. It improves metabolism, strengthen the respiratory system,
memory, strengthens the endocrine system and balances the hormonal flow.
DISCUSSION-
Rasayana therapy is thus, associated with multidimensional effects on the physiology.
It maintains positive health, perverse youth, sleep, physical as well as mental fatigue,
weakness and maintains proper balance between Vata, Pitta and Kapha. Rasayana drugs
having Madhura, Guru, Snigdha and sheeta properties act at the level of Rasa by
improving the nutritional value of the PoshakRasa which help to obtain the best qualities
of dhatus. The drugs like amalaka, aswagandha, shatavari etc helps to balance the body
natural processes and modulate the neuro endocrine immune activities. The probable
mode of action of Rasayana drugs could be through chelation of free radicals (ferrous
ions) and also as a chain breaker.
CONCLUSION-
The properties and benefits of Rasayana mentioned in the classics can be coreelated
with adaptogenic property. It helps to normalize body functions, strenghthen systems,
promote homeostasis and have a protective effect against a wide variety of cellular stress.
It is effective in improving the quality of life in geriatric women and helps in alleviating
the symptoms in post menopausal period.
REFERENCES-
1. Dutta D C. Textbook of Gynecology. Edition 6, New Delhi: Jaypee Brothers;
2013. p.57.
2. Dutta D C. Textbook of Gynecology. Edition 6, New Delhi: Jaypee Brothers;
2013. p.58.
3. Dutta D C. Textbook of Gynecology. Edition 6, New Delhi: Jaypee Brothers;
2013. p.58,59.
4. Elements of Rasayan therapy in Ayurveda, prof. Sharma Ajay Kumar, Sri Satguru
Publication,Delhi, First edition 2005, page no. 93-96.
5. Sharma P V. Charaka Samhita, Chikitsa sthana; Rasayana Chikitsa: Chapter 1
,Verse 62-74 . 14th ed. Varanasi: Chowkhambha Sanskrit Series,2007; 20.
6. Sharma P V. Charaka samhita, Chikitsa sthana; Rasayana Chikitsa: Chapter 1
,Verse 41-57. 14th ed. Varanasi: Chowkhambha Sanskrit Series,2007; 18.
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 GYNAECOLOGICAL DISORDER IN GERIATRIC WOMEN
(RASAYANA FOR GERIATRIC WOMEN)
ACTION OF MEDHYARASAYANA IN MENOPAUSAL WOMEN
Dr.K. Sribala
Dr. Kola Vijaya Kumari
M.D (Ayu) P.G. Scholar, Guide & Head of the Dept,
Professor, Department of Prasutitantra & Streeroga
Dr.N.R.S Govt Ayurvedic college,Vijayawada.
sribala.ravikanth@gmail.com
Mob: 7207377816

ABSTRACT:
Menopause is defined as ‗cessation of menstruation‘. It is a naturally occurring
phenomenon in women‘s life. According to Ayurveda, rajonivritti is mentioned as ‗jara
pakva shareeranam yati pachashatah kshayam‘. i.e it occurs at the age of or following the
age of 50 yrs. This episode of women‘s life is very troublesome with increasing incidence
of ailments (including physical and psychological). Ayurveda, the science of life
emphasis on prevention rather than cure. Therefore, there are many evidence of
mentioning Rasayana dravyas even for a healthy individual and the disease afflicted. The
term Rasayana, which is self-explanatory is the drug or compound that which nourishes
the individual at the level of physical, psychological, social, and spiritual level. The
rasayanas that are explained for dhatu poshana eventually possess action of vayasthapana
i.e., by preventing ‗jara pakva‘ of dhatus of the menopausal women. Similarly, medhya
Rasayana have effect on psychological trauma of the menopausal women. By their action
at the level of hypothalamus, it also has a regulation effect imbalanced hormonal levels
there by stress & cognition related issues of menopause women could be addresses with
the administration of medhya Rasayana.
The action of medhya Rasayana, though understood in certain level of memory,
cognition or brain related pathologies. It has its effect on regulating ―vata‖- thereby could
easily reverse the damage of nerve tissues and muscle tissue damage. In the form of
achara Rasayana, menopausal related spiritual health could also be maintained. thus, the
concept Rasayana exclusively mentioned in Ayurveda endows the best rejuvenating
measures in the menopausal women.
Keywords: Menopause, Naimittika Rasayana, Dravya, Rasayana, medhya, achara,
rejuvenation.

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Introduction:
Menopause is defined as cessation of menstruation that is amenorrhea for a period of
complete 12 months which is thus confirmed with the irreversible changes in the
hormonal and reproductive functions of female.in Ayurveda it is described as rajonivrutti
which means the end of artava pravrutti .it defines jarapakva shareeranam yati
panchashatah kshayam i.e. the degenerated, deteriorated dhatus esp. the artava.it is not a
pathology but a state of depletion where the management in Ayurveda is through
Rasayana karma which is rasa dhatu poshana and in turn preenana of its upadhathu
Artava also and all other subsequent dhatus. when it comes to menopause, the changes
are governed by H-P-O Axis, the management through medhya Rasayana is understood
to be more beneficial as it has capacity of not only reversing physical pathologies but can
also rejuvenate the body, mind, and soul effectively.
The physiology of menopause involves the ovary getting less sensitive to pituitary
gonadotrophins FSH & LH leading to drop in levels of oestrogen which gives negative
feedback effect on pituitary gland resulting increased LH, FSH levels, decreased
oestrogen levels. The term coined in Ayurveda ―jara‖-jeernam gacchati -deplete or
degenerate
Pakva -undergoing transitions and transformations.
Shareera – sheeryate that which degenerates
Indicates this state of menopause is vata bhooyishta due to dhatu kshaya.
Materials and methods:
The management of ―jara pakva shareera‖ includes correction right from its root therefore
understanding each and every clinical presentation through their bio-chemical changes is
very necessary.
hot flashes and perspiration – due to disturbed hypothalamus gland which is
responsible for thermoregulation of body.
[could be taken as dravadhathu vikara due to vitiated vata]
Vaginal dryness -due to altered PH of vaginal fluids.
[due to apreenana of rasadhathu, upadhathu artava also gets afflicted]
Insomnia – due to loss of emotional balance
Mood swings – due to fluctuating serotonin levels
anxiety & depression

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Cognitive inabilities
The decrease in levels of oestrogen causes fluctuation of serotonin causing
psychological imbalance in menopausal woman.
Here it is indicative that even vitiation of vata dosha afflicting three doshas causing
neurological diseases, cognitive disturbances in menopausal woman are considered.
As the phase of menopause is understood as not as pathology but as stage of every
woman‘s life, rather prescribing a bunch of medicine merely not makes a management
but administration of Rasayana fetches more results than that of simply treating with
compound drugs.
The Rasayana, by its action is
―Ayuhu pradanani Amaya nasanani bala agni varna svara vardhanani‖ [ch.chi.1.3/30]
*Ensures longevity of life
*Cures the ailments
*Promotes bala, agni, varna, svara.
The whole action is intended through group of medhya Rasayana in order to correct the
menopausal changes right from hypothalamic level.
―mandookaparnyaha svarasa prayojyah ksheerena yashtimadhukasya choornam
Raso guduchyastu samoola pushpyaha kalkaha prayojyaha khalu shankapushpyaha‖

[ch.chi.1/30]

Drug Part used Active principle Action intended

Mandukaparni Fresh whole plant Scopolamine Neuroprotective

juice
Prevention of amyloid
plague

Inhibits memory
impairment

Yashti madhu Kalka or churna Glycyrrhizine Circulation to CNS

Aphrodisiac

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 Guduci Kanda rasa Alkaloids lactones Cognitive enhancement by
immune stimulation

Synthesis of acetylcholine

Shankha Kalka Kaempferol Nerve tonic

Pushpi
(Beneficial in epilepsy)

Mode of action
 Action on behaviour sides being neuroprotective, brain growth promoter
 Anti-seizure activity from direct or indirect modulation of ATPase activity
 Potent antioxidant and terminate free radicals
 Anti-hypoxic property to CNS & Memory enhancing
 Supplementation of choline – antioxidant & Immunomodulatory properties
 Regulating the body‘s production of stress hormones – adrenaline & cortisol
 Neuro protective and hepatoprotective action
 Antioxidant activity by decreasing lipid peroxidation
 Anti-arthritic activity
 Sedative and hypothermic action.
Conclusion:
 Medhya Rasayana with its action by prabhava are beneficial in treating
menopausal degeneration. Medhya Rasayana act on the basis of antioxidant,
adoptogenic immunomodulatory action. Their action on modulation of biological
axis and neurotransmitters requires further analysis.

***

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BEYOND HORMONE THERAPY – THE CONCEPT OF AYURVEDA
FOR MENOPAUSE AND ITS MANAGEMENT
DR. SUDARSHAN GOPICHAND PATIL.
(PG SCHOLAR 2ND YEAR, DEPT. OF
PRASUTITANTRA AND STREE ROGA )
DR. SUNIL SADASHIV
MORE. ( HOD , PROFESSOR DEPT. OF
PRASUTITANTRA AND STREE ROGA )
SHREE SAPTASHRUNGI AYURVED
MAHAVIDYALAYA AND HOSPITAL, HIRAWADI, NASHIK.

ABSTRACT :
Menopause means permanent cessation of menstruation at the end of Reproductive
life due to loss of ovarian follicular activity. The clinical diagnosis is confirmed
following stoppage of menstruation for 12 consecutive months without any pathology.
During the period of menopause the women enters an estrogen deficient phase which
leads to various symptoms. The period is generally associated with manifestation of
aging problem in women, other symptoms include hot flushes, sweating, mood changes,
loss of libido etc. These symptoms affect the quality of life of the female.
Hormonal Therapy (HT) is the only alternative available for menopausal syndrome in
modern medicine. It also wide range of side effect on the body of the female.
In Ayurveda the concept of menopause is described as Jarapakwa avastha of body and
Rajonivrutti. Rajas means Menses and Nivrutti means Cessation or pause. Permanent
cessation of menses is Rajonivrutti (menopause). Rajonivrutti janya lakshana is a group
of symptoms produced by degenerative changes in the body. Degenerative changes are
explained in Ayurveda as Dhatukshaya lakshana. Vata dosha dominance is seen in the
later stage of life. According to Ayurveda menopause involves Dosha, Dhatu, Strotas and
Mana. The clinical features would be accordance to it and treatment should be
multidimensional. So wide variety of alternative medicine are used to improve
menopausal symptoms, with proper Aahar, Vihar, Aaushadhi, Rasayana Therapy,
Panchakarma, Vayasthapaka type of drug, so the effect of menopause can be minimized
to great extent.
KEYWORDS : Menopause, Rajonivrutti, Dhatukshaya, Rasayana, Vayasthapak.

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INTRODUCTION :
Menopause means permanent cessation of menstruation at the end of reproductive life
due to loss of ovarian follicular activity. It is the point of time when last and final
menstruation occurs. The clinical diagnosis is confirmed following stoppage of
menstruation for 12 consecutive months without any other pathology. The age of
menopause is ranges between 45 - 55 years and is mainly genetically predetermined. The
age of menopause is not related to age of menarche or age at last pregnancy. It is variably
related to lactation, use of OCP, socioeconomic condition, race, height. Thinner women
have early menopause. However, cigarette smoking and severe malnutrition living in
high altitude may cause early menopause. Late menopause is seen in women with high
parity or high BMI. [1]
Menopause trasition is the period of time during which a women passes from
reproductive to the non-reproductive stage. This phase covers 4-5 years on either side of
menopause. It is associated with elevated serum FHS levals and variable length of
menstrual cycle or missed menses.
In Ayurveda the concept of menopause is described as Jarapakwa avastha of body and
Rajonivrutti. Rajas means Menses and Nivrutti means Cessation or pause. Permanent
cessation of menses is Rajonivrutti (menopause). Rajonivrutti janya lakshana is a group
of symptoms produced by degenerative changes in the body. Degenerative changes are
explained in Ayurveda as Dhatukshaya lakshana. Vata dosha dominance is seen in the
later stage of life. According to Ayurveda all acharyas have agreed regarding the age of
menopause as 50 years. Menopause involves Dosha, Dhatu, Strotas and Mana. The
clinical features would be accordance to it and treatment should be multidimensional. So
wide variety of alternative medicine are used to improve menopausal symptoms, with
proper Aahar, Vihar, Aaushadhi, Rasayana Therapy, Panchakarma, Vayasthapaka type of
drug. [2]
To understand the rationale of therapy, it is important to understand the problem
according to fundamental principles of Ayurveda.
MATERIAL AND METHODS :
All available authentic books viz. Samhitas and their respective commentaries have
been referred for specific materials. Different related modern books, websites on
internet, magazines, articles etc. have been used as literary materials and humble attempt
has been made to draw conclusion.

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Modern aspect of Menopause :
Menopause is defined as permanent cessation of ovarian function resulting in
permanent amenorrhoea, it occurring between age of 45- 55 years of average is 47 years.
Climacteric is phase of declinimg in ovarian function. Therefore no corpus luteum and
hence no progesterone is secreted by the overy leading to anovulatory cycle and thus
irregular menstruation occurs. later graffian follicle formation also stop , estrogen activity
and atrophy of endometrium leads to amenorrhoea. Therefore , there is fall in estrogen
leval and rebound increase in FSH and LH leval by anterior pituitary gland. [3]
Menopausal Symptoms : [4]
Hair loss, digestive disturbance, cystitis, vaginitis, anxiety, narvousness and
depression, vaginal dryness, excessive sweating, hot flushes, irregular periods,
disturbances in menstrual pattern, sore breast, fatigue, dizziness, joint pain, headaches,
tachycardia, decresed libido, bladder incontinence, vaginal atrophy, palpitation,
osteoporosis.
Diagnosis of Menopause : [5]
Cessation of menstruation for consecutive 12 months during climacteric.
Average age of menopause is 50 years.
Appearance of menopausal symptoms Hot flushes and night sweating.
Vaginal cytology – showing maturation index of at least 10/85/5 (features of low
estrogen).
Serum estradiol : <20 pg/ml.
Serum FSH and LH : >40 mlU/ml (three values at weeks interval required).
Management :
Counseling, Cessation of smoking and alcohol.
Lifestyle modification – Physical activity, adequate calcium intake.
Nutritious diet – Balance with calcium and protein.
Antioxidants and multivitamins – Supplementation of vitamin D3 1500-2000 IU/ day.
HT (Hormonal Therapy) : [6]
Indicated in menopausal women to overcome the short-term and long-term cocequences
of estrogen deficiency.

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Duration of HT – Hormonal therapy should be used with lowest effective dose and for
the shortest period of time as possible.
Indication of HT :
Relief of menopausal symptpoms, Relief of vasomotor symptoms, Prevention of
osteoporosis, To maintain the quality of life in menopausal years, Premature ovarian
failure, Gonadal dysgenesis, Surgical or radiation menopause.
Contra-indications of HT :
History of breast cancer, Undiagnosed genital tract bleeding, Estrogen – dependent
neoplasm in the body, History of venous thromboembolism or active deep vein
thrombosis (DVT), Active liver disease, Prior cholestatic jaundice, Gall bladder disease,
Prior endometriosis.
Benefits of HT :
Improvement of vasomotor symptoms (70-80%), Improvement urogenital atrophy,
Increase in bone mineral density (2-5%), Decreased risk in vertebral and hip fracture (25-
50%), Reduction in colorectal cancer (20%), Possibly cardioprotection.
Risk of HT :
Endometrial cancer, Endometrial hyperplasia, Breast cancer,
Gall bladder disease, Thrombophlebitis, Coronary heart disease.
Ayurvedic view on menopausal symptoms :
According to Ayurveda , all classics have mentioned the age around 50 years for
Rajonivrutti. Kashyap adds the age of menarche or menopause depends on nutrition and
health status of an individual. Acharya sushruta has explain that there is shareera shithilta
in vrudha-vastha and women attains rajonivrutti stage at around 50 years. The age is
dominated by vatadosha, this affect the female body. This further leads to dhatukshaya
leading to artava nasha (amenorrhoea). [7]
Types of Rajonivrutti :
1] Akalaja Rajonivrutti – Rajonivrutti occurs brfore or after its probable age.
2] Kalaja Rajonivrutti – Rajonivrutti occurs at its probable age.
Clinical features according to Dosha, Dhatu and Mana : [8]
Vata Dosha : Anxiety, nervousness, insomnia, depression, shabdasahishnuta, dryness of
skin and vagina, palpitation, bone and joint pain.

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Pitta Dosha : Hot flushes, midnight sweating, ache, mutradaha, amlodgara, skin rashes.
Kapha Dosha : Excessive sleep, aruchi, agnimandya, lethargy, weight gain.
Rasa Dhatu : Palpitation, shabdasahishnuta, thirst, srama.
Rakta Dhatu : Hot flushes, excessive sweating, shira shaithilya.
Mansa / meda / asthi Dhatu : Sandhi vedana, sandhi sputana, asthi kshaya, bone pain,
asthi and sandhi shaithilya.
Artava : Anartava, vaginal dryness.
Manasika : Bhaya, shoka, krodha, mood swings etc.
Samprapti of Rajonivrutti :
Vrudhavastha – increased vata dosha – affects manas guna (raja and tama) /Dhatukshaya
– Artava kshaya – menopausal symptoms.
Management :
Hormonal imbalance produced in condition of menopause, is the base of various
physical and psychological manifestations.
Drug advised according to Doshas : [9]
Vata dosha – Kumari, ashwagandha, saffron, arjuna, jiraka, ela, giggulu, lasuna,
madhuka.
Pitta dosha – Arjuna, aloe vera, brahmi, shatavari, madhuyashti, chandana.
Kapha dosha – Trikatu, haridra, twak, guggulu,.
Preparations like :
Ashwagandha ghrita ,Shatavari ghrita, Rason kshirpaka, Brahmi ghrita, Saraswararishta,
Chyawanprash.
Ahar : Soya, wheat, egg white, milk, pea, nuts, dadima, garlic,
Vihar : Ashtangyog, asanas, change of lifestyle, yoga.
Panchakarma : Snehana, swedana, shirodhara, basti, nasya, picchu, uttarbasti.
DISCUSSION :
Menopause is simply not an estrogen deficiency state but it is associated with large
number of stmptoms which disturbs womens routine life. So it needs an effective and
safe treatment. In modern science hormonal therapy (HT) is one and only alternative for

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this health condition. But it has wider range of secondary health complications like
vaginal bleeding, breast cancer, endometrial cancer, gall bladder disease etc.
Therefore, wide scope of research to find safe, potent, cost effective remedy from
Ayurveda for the management. It has proven that this health condition can be well
manage by certain ayurvedic therapeutics having Medhya and Rasayanas properties.
Which are very well proved for physical and psychological health.
CONCLUSION :
Nowadays , symptoms related to menopause are becoming a major problem. For
which a safe and effective line of treatment is necessary. In Ayurveda Rasayana therapy
is explained, which is life promoting and deals with the aging problem, to improve health
as well as longevity. So the concept of menopause according to ayurvedic literature is not
only unique but also scientific with beneficial in todays era.
REFERANCES :
1] D. C. Datta textbook og Gynaecology, Edited by Hiralal konar, Edition 8th , page
no. 46-53.
2] Kaviraaj ambika dutta shashtri edited with Ayurveda tattva sandeepika, sushrut
samhita hindi commentary chaukhamba Sanskrit sansthan, Varanasi- publication
reprint 2007.
3] Howkins & bourne edited by V. padubidri & shrish N Daftrary, shaw text book of
gynaecology by 11th edition, church hill living stone Pvt. Ltd. New dehli chapter 3
Physiology page no. 53-57.
4] Ash monga, Stephen Dobbs, Gynaecology by Ten teachers, 19th edition, page no.
167.
5] D. C. Datta textbook og Gynaecology, Edited by Hiralal konar, Edition 8th , page
no. 46-53.
6] D. C. Datta textbook og Gynaecology, Edited by Hiralal konar, Edition 8th , page
no. 46-53.
7] Vidyadhar shukla, Ravi dutt tripathi, charak samhita, dehli, chaukhamba Sanskrit
pratishthan, 2006 , page no. 203.
8] A Comprehensive treatise on Striroga by Dr. Hemalatha Kapoorchand , Edition
2018 , reprint 2020, chaukhamba vishvabharati, page no. 399- 401.
9] A Comprehensive treatise on Striroga by Dr. Hemalatha Kapoorchand , Edition
2018 , reprint 2020, chaukhamba vishvabharati, page no. 399- 401.

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 Psychological problemsin geriatric women
Dr. Vaibhav Mishra
1st year ,PG Scholar of shalya(Dept.of shalya Tantra ), PIA

Abstract
Disease is nothing but Dysregulation in easiness.
21st century is the country of Psychosomatic Disorders and SADD syndrome (Stress,
Anxiety, Depression and Disease)1. The real meaning of healthy life is 7 dimensional
equilibrium , Bhautik (physical), Bouddhik (Intellectual), Bhavanatmak (Emotional ),
Samajik (Social), Adhyatmik (spiritual), Vyavsayik (occupational), Paryavaran
(environmental).
According to ayurveda ageing is in evitable outcome of kala or Parinaam2. Geriatrics
is a progressive irreversible phenomena of body rather than disease in which the body
loses its ability to respond to a challenge to maintain homeostasis. In Ashtanga Ayurveda
―Jara‖ is incorporated at 7th number among its eight branches. The aging experience of
women is distinctively different from that of men, which underpins their differences in
mental health problems. The proposed project is aimed to explore the knowledge about
geriatric women psychological problems and measures to cope with them.
Keywords :- Geriatric Women,Psychological Ailment
Introduction
Late onset mental illness can be complex. Women's mental health is textured and
varies as much as women themselves.3 Women's health has become a particular specialty
in health care, many women have births that result in posttraumatic stress disorder
(PTSD). Women's mental health has a direct impact on their physical health. For
example, depression is a major risk factor for heart disease. Women's Mental Health
Across the Lifespan covers mental health from a lifespan developmental perspective,
from adolescence to old age. Older women are vulnerable to mental health issues because
they are both women and older persons, which is usually described as double jeopardy or
layered vulnerability. Older women also show resilience in mental health as a result of
acquired coping strategies from being a disadvantaged group.
Many risk factors for older women's mental health have been identified, including
genetic, behavioral, and physical health, which are also shared by women at other life
stages. The aging experience of women is distinctively different from that of men, which
underpins their differences in mental health problems and their contributing factors.

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Perspectives to Understand Women's Mental Health 4
Older women are more likely to live in poverty, be widowed, and have poorer health,
which suggests more stressors and poorer mental health; on the other hand, older women
also display unique resilience factors that counter balance their disadvantages, such as
that women have advantages in using coping strategies (e.g., intrapsychic coping) that are
effective to cope with adversities in old age as a consequence of their lifelong
disadvantaged situation, and reduced differences in traditional social and gender roles
when people get older.
Poverty and financial strain among older women are serious problems, and they are
both strong predicators of poor mental health and barriers to mental health utilization.
Social Relationships and Older Women's Mental Health-
• Spouse‘s declining health- Older women's mental health is intertwined with and
profoundly affected by the people around them, especially spouses. In old age, declining
health in spouses imposes higher risks on older women for poor mental health outcomes
due to the caregiving burden caused by providing care to their spouses. older women's
mental health negatively affected by their spouses' onset of health problems.
• Widowhood-Widowhood is a remarkable experience in old age, starts a significant
transition in life and loss of roles with accompanying stressors, and has important mental
health consequences. Financial strain is a major problem for widowed women and an
important reason for higher levels of depression among widows. Widowhood also has an
indirect negative effect on women's mental health through the increased likelihood of
living alone.
• Relationship with children—Relationships and interactions with children have been
prominent factors that affect older adults' mental health. Older women are more likely to
have stronger ties with their adult children, such as they are more likely to coreside with
children, have more contact, and exchange more support, the effects of intergenerational
relationships on older women are different.
• Grandparenting-Older women's mental health is affected by their involvement in
grandparenting, custodial grandmothers usually have more mental health problems, such
as depression and anxiety, than other grandmothers because of higher levels of stressors
in their lives as a result of competing obligations. Risk factors for higher levels of mental
health problems among those grandmothers, include higher levels of stress, poverty,
shorter time after stepping into the primary caregiver roles, poor health, and lack of social
support.

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• Retirement-Retirement typically happens in later life and is an important transition that
could tremendously change individuals' social roles, financial security, lifestyle, and
support system, and thus has noticeable mental health implications.
 Potential Triggers Mental Illness5
According to the World Health Organization and the Geriatric Mental Health Foundation.
These include:
 Alcohol or substance abuse
 Dementia-causing illness (e.g., Alzheimer‘s disease)
 Illness or loss of a loved one
 Long-term illness (e.g., cancer or heart disease)
 Chronic pain
 Medication interactions
 Physical disability or loss of mobility
 Physical illnesses that can affect emotion, memory, and thought
 Poor diet or malnutrition
The 3 D's of Geriatric Psychiatry
Dementia / Delirium /Depression
 Dementia: A condition of acquired cognitive deficis, sufficient to interfere with
functioning, in a person without depression (pseudo-dementia) or delirium.

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 Warning Signs for Caregivers Behavioural Flags for
Healthcare
Difficulty performing familiar tasks Frequent phone calls

Problems with language Poor historian, vague

Disorientation to time and place Poor compliance/meds

instructions

Poor or decreased judgment Change in Appearance /

hygiene / makeup

Problems with abstract thinking Word finding / decreased

interaction

Misplacing things Appointments - missing /wrong

day

Changes in mood and behaviour Confusion: surgery, meds

Changes in personality Weight loss / dwindles

Loss of initiative Driving: accident/ problems

Memory loss that affects day-to-day Head turning sign

function

Warning signs of Dementia:-

 Delirium: An acute, potentially reversible, condition characterized by fluctuating
attention & level of consciousness, disorientation, disorganized thinking,
disrupted sleep/wake cycle.
 Poor historian.
 Assumptions are made about "usual" functioning.
 Increased risk of permanent cognitive decline.
 Higher death rates.
 Worse rehabilitation outcomes.
 Depression: Alteration in usual mood with sadness, despair, lack of enjoyment in
previously enjoyed activities and vegetative symptoms sufficient to interfere with
functioning. Alteration in usual mood with sadness or negative mood state (anger,
irritability, despair), lack of enjoyment in previously enjoyed activities and
vegetative symptoms sufficient to interfere with functioning.

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 View late life depression as a sentinel event that substantially increases the risk for
decline in general health and function.,older women have a higher prevalence rate of
depression. Caregiving responsibilities have also impaired older women's health and
exposed them to long-term stressful situations.
 Some risk factors for geriatric depression:-
 Major life events such as widowed or divorced
 Structural brain changes
 Peripheral body changes such as major physical or chronic debilitating illness.
 Previous history of depression
 Caregiver for person with dementia or other debilitating medical condition
 Excessive alcohol consumption
 Taking medications, such as centrally acting BP meds, analgesics, steroids,
antiparkinsons, benzodiazepines.
 Cognitive deficits: can be a decline compared to previous levels in language,
executive function, memory, orientation, visuo-spatial abilities etc. older women have
higher risks of developing Alzheimer's disease. the average age of schizophrenia onset in
women is several years older than in men and the majority of later-onset cases i.e.,
after45 years.
Mood Disorder due to Medical Condition:
 Stroke induced depression or mania
 Depression associated with Parkinson's disease
 Depression or mania due to endocrine disorders (thyroid, adrenal)
 Depression due to infectious illnesses
 Substance-induced depressive or manic syndromes (alcohol, benzo)
 Depression and cognitive problems due to sleep apnea
Triggering causes for Psychological Ailment among geriatric women :-
 Role changes-Change of roles in old age affects older women's mental health. Old
age is associated with loss of roles. And older women experience the loss of roles
in different ways. having multiple roles results in competing demands and reduces
the performance for each role, which results in burnout, failure, and stress that
compromise individuals' mental health.
 Anxiety Disorders and Posttraumatic Stress Disorder-Older women are more
likely to have anxiety disorders because of various medical, psychosocial and
substance usage factors. In addition, women are more at risk of developing
posttraumatic stress disorder symptoms as they are more frequently subjected to
the high frequency of trauma in the form of physical and sexual assault. Older age
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 presents more challenges for older women because older trauma survivors are
likely to experience greater severity of trauma symptoms, or have delayed trauma
reactions because of the co-occurrence of stressful life events, such as retirement
and loss of social supports, and compromised coping capacities.
 Menopausal syndrome-It is a natural and normal phenomenon of ageing. Reduced
production of sex hormones due to less active ovaries lead to menopause.
Menopausal Syndrome includes symptoms associated with the physiological
changes that take dace in a woman's body as period of fertility ends. severe
symptoms in this period ,it mainly associated with mood swings ,sleeplessness
,lassitude, stress incontinence, loss of sexual desire because of dysregulation in sex
hormones (Estrogen & Progestrone).
 Effects Of Mental Health On Health Among Older Women-Mental health
problems, especially depression, are closely related to mortality, morbidity, and
functional decline among older women. For example, depression was associated
with higher risk of mortality, self-rated health, cardiovascular disease, diabetes,
fracture and other dimensions of functioning, such as negative attitudes of aging,
and self-rated success in aging. The effect may depend on the types of depression,
The risks of depression on mortality, morbidity, and functional decline could be
the result of risky behaviors, such as reduced physical activities and social
interactions, higher risks of indulging behaviors such as smoking, compromised
sleep quality, and persistent fatigue. It could also be the result of mental stress that
is closely related to risk factors associated with mortality, such as hypertension,
autonomic dysfunction, and increased circulating platelets.
Investigations
Examination of Geriatric Mental status
Prevention, early identification, treatment and follow-up are key to recovery/well being
We do not have the precise tools to assess the stale of mental health unlike physical
health.
Ashtvidha Sattva Pariksha6 -Eight fold mental status examination has been prescribed
to examine a patient‘s mental status.
 Identity Basic Detail Psychiatric assessment
 Chief Complaint
 History of present illness
 Medical history
 Family history,Habits, temperaments,Psychomotor activity

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  Decision,Memory
 Orientation and responsiveness
 Desire
 Constitution
 Mental Stamina
Treatment
 To treat women, clinicians need to take into account how women's size and body
composition (e.g., smaller stature, higher percentage and different location of body
fat) affect treatment .
 In addition, monthly cycles, pregnancy, postpartum, lactation, and menopause
need to be seen as integral to comprehensive care.
 Medication & Psychotherapies can be an important part of treatment/recovery7.
 ECT can be an important part of treatment/ recovery
 Physical exercise, healthy diet, stable housing, stable finances, spiritual well
being, social connections, laughter, brain exercise are all important parts of
recovery and well being.
Suggestive Preventive Measures-
 Practice personal and social good conduct.
 Try to search happiness among all the minute activities.
 Avoid watching/listening more negative news.
 Follow a schematic Daily Routine.
 Sound Routine Sleep.
 Try to bounce bank and pull back the life on healthy pathways.
Ayurvedic Dietery Suggestions
Pathya8
Madhura, Brimhana , Masha, Mudga, Nuts, Egg, Muttons, Pulses, Grains, Milk, Ghee,
Soumanasyam, Mithavyayamam
Apathyam
Amla, Lavana, Katu, Tiktha, Pappaya, Pineapple, Pickle, Beef, freezed meat, carrot,
cabbage, brinjal, coffee , Krodha, soka, Bhaya, Athivyayama etc.
Broiler chicken alters hormone level.
Conclusion

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 Women in their older age are facing special challenges as a result of accumulated
social, economic, and health disadvantages over the life course. But older women also
show resilience because of developed coping skills and better developed social networks
and family engagement due to kin keeping and caregiving roles. Older women experience
resilience in mental health regardless of life-long disadvantages; however, the resilience
has to be understood in the broader social context of vulnerability, especially cumulative
disadvantages that could exacerbate among the disadvantaged subgroups among older
women, such as those who are of lower socioeconomic status, minority status, and with
traumatic experiences. Thus an additional efforts should be made to examine older
women's mental health from a life-course perspective with emphasis on social
connections, social positions, and heterogeneity among older women to better meet their
mental health needs. Lifestyle, food habits, family history, occupation, psycho-social,
marital relationships are major contributors. Contribution of Ayurveda is valuable in this
juncture.
References :-
1. The Supreme Doctor by DR.B.K. Chandrashekhar,Times Group Books
2. Charaka [700BC],Charak Samhita,Ed Sharma,P.V.,Chikitsa Sthana,Chapter
1,Chaukhambha Orientalia,Varanasi.
3. Women Mental Health Across the Life Span;challenges;vulnabrilities&Strength
by (Kathleen A.Kendall-Tackett).
4. The Supreme Doctor by DR.B.K. Chandrashekhar,Times Group Books.
5. Ayurvedic Management of Selective Geriatric Disease Conditions (CCRAS-
WHO) collaboration,Project 2011
6. The Psychosomatic Axis in Ayurved Treatment by Dr.Suresh Babu,Chaukhambha
krishnadas Academy.
7. Women Mental Health Across the Life Span;challenges;vulnabrilities&Strength
by (Kathleen A.Kendall-Tackett).
8. Ayurvedic Management of Selective Geriatric Disease Conditions (CCRAS-
WHO) collaboration,Project 2011

***

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 Psychological problems in geriatric women
Vidhya M Sanker
designations of authors is missing
M Jithesh.

Abstract : Ageing is a natural process happening in everyone‘s life and the world‘s
population is ageing rapidly. Even though the older adults are capable in contributing
decades of experiences to their family and society, only a few percentages enjoy the
privilege of healthy aging. More than 20% of adults above the age of sixty reported to
have mental or neurological diseases. Among them the majority is women. The trend
Feminization of aging also got several health implications in women‘s mental health.
Many a times the mental health in older women often masked underneath their physical
issues including chronic pain, hormonal changes etc. They fall in a relatively neglected
group and their mental health is least addressed. Commonly reported psychological issues
in older women are depressive disorders, anxiety, somatization, sleep disturbances,
decreased concentration and other cognitive impairments. The life stressors that women
experience in all the phases of life contribute her bad health. Menopausal transitions do
play a role in determining the mental health of older women. Ayurvedic concept also
explains a decline in the functions of dhathus, indriyas, dharana, smarana etc during
vridhavasta. Vridha being a vata dominant phase are more prone to vataja nanatmaja
vyadhis like vishada, anavastitha chitatva etc. Various psychotherapies including
satwavajaya chikitsa that encourage empowerment have a role in restoring the mental
health. Symptomatic treatments based on dosha predominance and rasyanas can also be
adopted. Dravyas like aswagandha, sankupushpi, jatamamsi, somalatha etc can do
wonders in restoring the mental health. Thus an early diagnosis and a professional
intervention at the right time will help.
Key words: Older women, Psychological issues, Menopause, Satwavajaya chikitsa,
Rasayana
*Final year PG Scholar, ManoVigyan Avum Manasroga, VPSV Ayurveda College,
Kottakkal
**Guide, Professor and HOD, Department of Kayachikitsa, VPSV Ayurveda College,
Kottakkal
Introduction: Ageing is a natural process happening in everyone‘s life and the world‘s
population is ageing rapidly1. As per the data of WHO, the proportion of older adults is
estimated to be almost double between the years 2015 to 20501. Even though the older
adults are capable in contributing decades of experiences to their family and society, only
a few percentages enjoy the privilege of healthy ageing. More than twenty percentages of
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adults above the age of sixty reported to have mental or neurological diseases and among
them the majority is women1. Also women hold a major share in the proportion of old
age population. They are more likely to experience mental health issues like depression,
anxiety2 etc.
Feminization of aging: Women aged above sixty years comprise more than their male
counterparts in many regions, this trend is feminization of aging3. This many a time
resulting in an increased likelihood of women ending up alone. It has got several health
implications including the need for women‘s healthcare services3.
Probable causes: Many a times the mental health in older women often masked
underneath their physical health including chronic pain, hormonal changes etc. They fall
in a relatively neglected category and their mental health is least addressed or concerned.
The life stressors that women experience in all the phases of her life contribute her bad
health. Pressure created by their multiple roles, gender discrimination, sexual or domestic
violence, socio-economic disadvantages like income-inequality, low or sub-ordinate
social status 4 etc adds to this. Older women widowed, separated or divorced may not
remarry as common as men, and when their children move away and begin adult life
these mothers often felt isolated and depressed. Social and cultural norms imposed
unremitting responsibilities for the care of others in women. Older caregiver women who
care for an unhealthy partner or children are more vulnerable to developing mental health
disorders 5.
Psychological /psychiatric conditions: Depressive disorders, Anxiety, Somatization,
Sleep disturbances, decreased concentration and other cognitive impairments6 are the
common conditions reported in older women when comparing to men. Even though
exacerbation of other psychiatric conditions like schizophrenia noted in menopausal
period, late onsets are rarely reported6. Depressive disorders are common psychiatric
disease in older women and may present with physical complaints rather than the
complaints of depression and often misdiagnosed7. Also the new onset of insomnia may
occur during menopause and persist even after other symptoms resolved8.
Menopause and mental health: Menopause transition is a time in women‘s life that can
be marked by various physical and psychological changes. Fluctuations and decline of
ovarian hormones can cause these changes9.
Biological changes associated with ageing:
Neuropsychiatric changes like takes longer to learn, psychomotor speed declines etc
happens, in memory, task requiring shifting attention will be difficult, simple recall
declines etc happens in old age. Also changes in neurotransmitters will happen for

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example norepinephrine decreases, monoamine oxidase increases etc. In brain the gross
weight decreases, ventricles enlarge, gyral atrophy happens, sulci get widened during old
age and in women estrogen level decreases and FSH , LH increases in menopause10
Ayurvedic concept of aging: Ayurvedic concept also explains a decline in the functions
of dhathus, indriyas, dharana, smarana etc during vridhavasta. Vridha being a vata
dominant phase are more prone to vataja nanatmaja vyadhis like vishada, anavastitha
chitatva etc.
Management: To promote healthy ageing one must follow dinacharyas, rtucharyas etc in
their life. Seasonal purifications (rtu sodhana) will also help to eliminate the accumulated
doshas on time and in turns it keeps one‘s body and mind healthy. Considering the
prakrti, doshas, bala etc vatatapika rasayanas can also be taken. Dravyas like
aswagandha, sankupushpi, jatamamsi, somalatha etc can do wonders in restoring the
mental health. Aswagandha being an adaptogen with its active principle component
withanolides seems to be more acceptable in conditions like anxiety, depression, aging
etc. A study particularly reported its action in mental and physical health of elderly
women says that it improves the nutritional status and cognitive functions11 in elderly.
Antioxidant, antidepressant and anxiolytic activities of Sankupushpi were also reported in
studies and are widely used12. Somalatha, bala, jatamamsi etc can also be used according
to dosha and vyadhi in geriatric population.
In psychiatric conditions were insight remains intact psychotherapies can also be adopted.
Ayurveda explains a well structured psychotherapy module i.e, satwavajaya chikitsa, and
the process includes 1.jnana, (Knowledge of self) in this, help them to get an awareness of
their own health conditions, make them aware about their potentials and strength, make
them aware about the opportunities they have and re-inforce that old age is the golden
years of adulthood and they can do better.2. Vijnana (Scientific knowledge) in this step
makes sure that they are interacting with qualified health professionals for their signs and
symptoms instead of doing some unscientific things.3. In Dhairya (Determination or
patience) help them to be determined to not give up, for that reinforce the coping skills.
Join in voluntary groups or in group activities according to their field of interest.4. In
smrithi (application of recollections) help them to recollect their own happy moments,
moments they overcome failures etc, and discuss the techniques they used then and
modify them accordingly. 5. In the step of Samadhi help them to attain a stable state of
mind by doing Deep Relaxation Techniques, simple stretching movements according to
their mobility, pranayamas etc. Thus an early diagnosis and timely intervention by a
qualified professional will certainly help those mothers who spend the major portion of
their life in serving others to make the rest of their life as golden years.

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