An Ayurvedic Literary Review on Etiopathogenesis of Artavakshaya

Artava Kṣhaya, denoting a reduction in menstrual flow, constitutes an important clinical entity in Ayurvedic gynecology. The term Artava signifies not only menstrual blood but also includes the ovum, hormonal components, and reproductive secretions, whereas Kṣhaya refers to diminution or depletion. Classical Ayurvedic texts describe Artava Kṣhaya as a manifestation seen in several menstrual abnormalities, particularly those characterized by delayed cycles, scanty bleeding, and associated discomfort. This review presents a detailed appraisal of Artava Kṣhaya from an Ayurvedic standpoint, encompassing its conceptual definition, causative factors, pathophysiological mechanisms, and therapeutic principles. According to Acharya Suśruta, the condition arises due to derangement of Vāta and Pitta doṣas, leading to reduced or delayed menstrual discharge. Important causative factors include disturbance of Apāna Vāyu, impairment of Dhātu formation, excessive intake of heating substances, improper therapeutic interventions, and inappropriate administration of nasal therapies. The disease process involves a multifactorial disruption of doṣas and tissues, ultimately affecting the normal physiology of menstruation. Ayurvedic management employs both Śodhana (purificatory) and Śamana (palliative) measures. Therapies such as Vamana, Virechana, and Basti are utilized to eliminate aggravated doṣas and re-establish physiological balance, while internal medications, dietary regulation, and lifestyle modification support restoration of healthy menstrual function. Formulations like Rāja Pravartinī Vaṭi and Phala Ghṛta are commonly prescribed for their uterine and hormonal regulatory actions. From a contemporary biomedical viewpoint, conditions such as oligomenorrhea and hypomenorrhea resemble Artava Kṣhaya in their clinical presentation and underlying endocrine and functional disturbances. The integrative understanding of this condition highlights the value of combining Ayurvedic principles with modern medical knowledge for a comprehensive and holistic approach to the management of menstrual disorders.