Randomized controlled clinical study to evaluate the efficacy of kulatthadi kashay in management of udavartini yonivyapad (primary dysmenorrhea)

In Ayurvedic classics Gynaecological disorders have been described  under caption Yonivyapad. Among them Udavartini Yonivypad given by  Acharya Charak is closely related to the symptoms of Primary Dysmenorrhea. Here Vata vitiated by vegadharana pushes the menstrual blood upward and then expel it out with difficulty leading to pain. Pain will relieve by itself once the menstrual flow starts, which itself indicate the spasmodic nature of pain. Acharya Sushrut said such symptoms in Udavarta Yonivyapad, the women eliminates frothy menstrual blood with difficulty. Acharya Vagbhat also mentioned Vata aggravated by suppression of the urges, torments the vagina and expels frothy menstrual blood with difficulty.  All classical Samhitas like Charak Samhita, Sushrut Samhita, Vagbhat Samhita have mentioned Udavartini/Udavarta/ Udavritta Yonivyapad respectively as Vataj Yonivyapad. So Vatanulomak and Vatashamak dravyas have main role in treatment. Kulatthadi Kashay is one among lots of herbal preparation which has indication in Udavarta and shul.

Prevalence of Dysmenorrhea in India is 70.2%. Majority of subjects experienced pain for 1-2 days during menstruation. 23.2% girls experienced pain for 2-3 days during menstruation. It is responsible for highest incidence of absenteeism resulting in loss of work hours and economic loss. Hence these females are forced to take antispasmodic, analgesics, prostaglandin synthetase inhibitors etc. during menstruation. However Prostaglandin synthetase inhibitors are contraindicated in women with gastrointestinal ulcer and bronchial asthma. Side effects includes nausea, vomiting, blurred vision,

nephrotoxicity and gastric ulcer on prolong use.

Previous studies on Udavartini Yonivyapad primarily focused on various types of Basti, and there are very few studies on oral medication. This reveals the necessity of alternate treatment to tackle this situation with suitable remedies. Kulatthadi Kashay mentioned in Sahasrayoga containing drugs which are Kulattha, Lahsun, Erand, Patha, Granthik, Nagar and Yavkshar having properties of Dipan, Pachan, Anuloman and Vedanashaman. Previously no research was done on Kulatthadi Kashay, considering above facts it is selected for study.

Study will be conducted on 100 diagnosed patients of Udavartini Yonivyapad. Written consent will be taken. Initial assessment will be done. Patient treated with interventional group Kulatthadi Kashay and control group Shatapushpa Churna. Patients will be assessed at follow ups. Observation and Results will be noted and Statistical Analysis, Discussion and Conclusion will be drawn.