A Randomized Controlled Clinical study to evaluate the efficacy of Raktapittahara Kashaya and Musali Khadiradi Kashaya in the management of Asrigdara with special reference to Dysfunctional Uterine Bleeding (DUB)

Menstruation is the visible manifestation of cyclic physiological uterine bleeding due to shedding of the endometrium following invisible interplay of hormones mainly through hypothalamic-pituitary ovarian axis1. Normal flow of menstrual blood represents a women’s reproductive health and wellbeing. In Ayurveda Artava is considered as a Updhatu of Rasa Dhatu and Rakta Dhatu.Asrigdara is a disease manifesting as excessive bleeding per vaginum. The majority of the Lakshanas of Asrigdara are due to aggravated Vayu, withholding the Rakta & Pitta vitiated due to Nidana Sevana (Ahara, Vihara & Manosambandhi Nidana), increases its amount, then reaching Rajovaha siras and carrying it to Garbhashaya leading to Atipravrutti of Asruk. Vitiation of Tridosha leads to Agnimandyata which leads to Vikrit Ahara Rasa Nirmana and Rasagni Vaishamya & due to this Vikrit Rasa Dhatu Nirmana takes place. Artava being Upadhatu of Rasa is also vitiated and because of this vikrit artava pramana vriddhi occur which affect the Garbhashayagata Sira which leads to Apana Vayu Dushti and Atyadhik and Chirakala Artavastrava (Asrigdara).Asrigdara is one of the Vikara of Raktavaha Srotas5, symptom of Pitta Avruta Apana Vayu6, Yoni Vyapat Upadrava and Artava Ativruddhi Lakshana7. It is the disorder leading to complications like Pandu, Bhrama, Murcha, Tama, Daha, Vataja roga, Trishna.This condition can be corelated to Dysfunctional uterine bleeding in the contemporary sciences. The condition is characterized by excessive or prolonged blood loss during menstruation with or without bleeding in intermenstrual period9, which is defined as a state of abnormal bleeding without any clinically detectable organic pelvic pathology. Conventional western medicine offers the use of COCs, Progestins, Androgens & agonist of Gonadotropin- releasing Hormone (GnRH), NSAIDs12. Side effects of COCs include increased risk of venous and arterial Thromboembolism (DVT, MI, stroke), mild increase in blood pressure, and possible increases breast and cervical cancer risk.The treatment principles of Raktayoni are adopted in Asrigdara, the haemostatic drugs

should be used in the management of Asrigdara.14 Keeping this in mind Raktapittahara Kashaya15 is selected for the study in comparision with Musali Khadiradi Kashaya. Raktapittahara Kashaya is having Pittavatahara karma and acts as Deepaka pachak, Rakta Stambhaka, Grahi, Rasayan and Brimhana.