So far in this series of female wellness articles, we’ve covered the ayurvedic perspective on menarche and earlier menstrual disorders. Now, we’ll move on to the common reproductive disorders many women face during their child-bearing years. There are vast terrains of information that can be covered, but we’ll focus on three main female issues, looking at them from both a modern and an ayurvedic perspective.
Endometriosis
The uterus (womb) is where the woman carries the developing fetus during pregnancy. If conception does not occur, then the uterus lining is shed as mucus, blood, and dead cells during the monthly menstrual cycle. Endometriosis happens when the endometrial tissue lining the inside of the uterus starts to grow outside of its ‘home’ to areas behind the womb, on the ovaries or bladder, on the bowels, and even far-reaching areas of the body. Some women may not have any symptoms at all. But in others, the misplaced tissue can cause pain, a heavier menstrual flow, and infertility. While there are many theories on the cause of endometriosis, including a link to pesticide exposure, the exact cause is not known. The modern treatment of endometriosis is aimed at pain control, shrinking endometrial tissue through the use hormones and electrocautery to burn away the unwanted tissue. As a last resort, the uterus and ovaries are surgically removed. Many unwanted and severe side effects can occur from all of these options.
According to Ayurveda, endometriosis is considered a tridoshic (vata, pitta, and kapha) vitiation which involves rasa (plasma), rakta (blood), and artava (reproductive) tissues. Even before reproductive tissue is affected, vata gets vitiated through manas vikruti (anxiety, depression and other psychological imbalances in the mind) which jumpstarts endometriosis; vata is also at the root of endometrial pain. At the same time, the buildup of kapha ama (toxins) in the endometrial lining causes irritation and, over time, growth of excessive endometrial cells. The improper movement of apana vayu (downward movement of cellular growth) causes displacement of these cells from their original site to outside of the uterus. The accumulation of toxins in the reproductive circulation also obstructs blood flow causing excessive menstrual bleeding. Pitta gets vitiated by way of hormones, irritation and inflammation of local tissues. Kapha enters the inflamed tissues causing edema and dilation.
The ayurvedic management of endometriosis is to stop the build-up of ama or toxins through an easily digestible, nourishing diet which also ignites the digestive fire and promotes proper elimination. Practicing meditation, pranayama (breathwork), and chanting mantras such as Gayatri to soothe the mind and lower stress are also vital. Avoiding cold, raw, processed, sugary and heavy foods is of utmost importance. Taking herbs to cleanse and purify the blood, liver and reproductive organs is equally important. Boswellia-curcumin (guggulu-turmeric) are effective pain relieving, anti-inflammatory herbs. Lodhra, shatavari, aloe vera, kanchanar guggulu and ashoka are used for excessive tissue growth due to kapha, as well as for managing menstrual abnormalities and infertility in endometriosis. Brahmi is effective for relieving mental stress and promoting relaxation. After several weeks of following this diet-herb-lifestyle regimen, cleansing under the proper guidance of an experienced practitioner is undertaken using sweating, oiling, and purgation techniques to remove unwanted toxins and emotions from the body. Unlike allopathy, Ayurveda offers the wonderful options of not taking hormonal drugs with all of their side effects and avoiding surgically removing vital body parts given to us by the Creator for good reason.
Uterine Fibroids
Uterine fibroids are benign growths commonly found on the uterus in women. They develop inside the muscle layer and vary greatly in number, size, shape and location – such as inside the uterus wall, on the outside surface, or attached to the uterus. They can remain small in size for many years and suddenly grow in size, or grow slowly over many years. Uterine fibroids seem to be more prevalent among African Americans and in overweight women. Symptoms can range from none, to painful abdominal cramps, an enlarged uterus or protruding abdomen, excessive uterine bleeding, difficult or frequent urination, painful sex, lower back pain, constipation, rectal pain, infertility, and multiple miscarriages. The cause of fibroids is unknown in allopathy. No treatment is needed for small, asymptomatic fibroids that occur around the time of menopause. For others, hormonal agents are used to control heavy bleeding and shrink the fibroids. Pain relievers are given for those suffering with pain. Myomectomy is a type of surgery that removes fibroids but leaves the uterus intact; this allows the woman to bear children later, however, new fibroids can still form in the future. Other treatments to destroy fibroids use laser beams, ultrasound waves, and uterine artery embolization (which cuts off blood flow and shrinks the fibroid). Finally, surgical removal of the full uterus, or hysterectomy, is done when all other treatments have failed. The ovaries are sometimes removed as well. Allopathic procedures for treating uterine fibroids are not curative, but are costly and associated with significant side effects from medications and surgery, including loss of ability to bear children if the womb and ovaries are surgically removed.
Fibroids fall under the category of granthi in Ayurveda, which are localized nodular masses or growths. Fibroids form when vitiated blood (rakta), muscle (mamsa) and fat (meda) tissues mix with kapha (earth and water humors) and produce knotty, glandular swellings. An expert will be able to palpate excess bulk on the uterus. Depending on their location in the female yoni (reproductive tract), granthis can disrupt the menstrual cycle by causing menorrhagia (excessive bleeding), metrorrhagia (irregular bleeding), dysmenorrhea (painful menstrual cramps), and/or infertility.
The location of the uterus itself is the main home of vata dosha (air and space humors). Therefore, the pathogenesis of fibroids is predominantly due to the involvement of vata and kapha dosha accumulation. Ayurvedic herbal medications which pacify vata and kapha dosha along with herbs that are raktashodhaka (blood purifying), lekhana (scraping) and shothahara (anti-inflammatory) are beneficial for treating uterine fibroids. As always, first diet and lifestyle modifications are made to clear the reproductive channels, improve digestion, and remove toxins. Case studies have shown giving Shigru Guggulu, Kanchanar Guggulu, and Haridra Khanda for several weeks have shrunk the size of uterine fibroids. These contain the herbs of triphala, trikatu, kutki, nagarmotha, cardamom, ajwain, cumin, and other herbs that break down and eliminate hardened kapha.
Polycystic Ovary Syndrome (PCOS)
Polycystic ovary syndrome (PCOS) is when a woman’s ovaries or the adrenal glands make more testosterone than usual. It also disrupts ovulation and causes cysts to form on the ovaries. Women who are obese are more like to develop PCOS, and women with PCOS are more at risk for diabetes and heart disease. Symptoms of PCOS include excess growth of hair on the face and other areas, baldness on the scalp, facial acne, pelvic pain, and infertility. Hormonal medications are used to induce ovulation in women with PCOS trying to conceive. Some antidiabetic drugs can also improve fertility. Cosmetic treatments are given for facial hair, acne, and scalp baldness. And hair loss can be managed topically or with oral medications that lower androgen levels.
According to Ayurveda, artava-kshaya or loss of reproductive tissue is correlated with PCOS. This is a disorder involving all three doshas (vata, pitta, kapha), the tissues of meda (fat), rasa (plasma), rakta (blood), and shukra/artava (reproductive) and the corresponding bodily channels. But kapha vitiation is the predominant dosha in PCOS because it is responsible for lubricating and nourishing the reproductive tract and supporting the growth of the follicle along with thickening of the endometrial lining in preparation for possible fertilization of the egg.
Inappropriate diet and lifestyle cause kapha ama formation in the digestive tract, which diminishes digestive fire under the influence of the heavy, cold, sticky qualities of kapha. Food is improperly digested, accumulated ama (toxins) move out of the GI tract and enters rasavaha srota (circulation), causing it to become sticky and heavy and lowers overall immunity. The ama also coats individual cells, lowering cellular intelligence, so that receptors on the cell surface fail to recognize glucose molecules that normally activate insulin uptake into the cell. Insulin levels build up in the blood, move to artava dhatu, where the insulin interacts with receptors on the ovaries causing androgen formation and prevents ovulation of the follicle. Another mistake of cellular intelligence is expressed through the inhibition of apoptosis, the natural death of the defective follicle, which then transforms into a cyst on the ovary. Finally, the same kapha ama moves through the channels to meda dhatu (fat tissue) and becomes obesity. The multiple imbalances in kapha dosha in PCOS show up as symptoms of increased weight, infertility, hirsutism, insulin resistance, and diabetes. Pitta imbalance in PCOS is seen as hair loss, acne, irregular menstrual blood flow and clots. Kapha ama also causes stagnation of apana vayu, obstructing ovulation and causing scanty or lack of menstrual outflow. Vata blockage not only prevents outward flow, it also leads to further accumulation of kapha and pitta.
The ayurvedic treatment of PCOS is to clear the obstruction in the pelvis, normalize metabolism and regulate the menstrual system. Kapha reducing herbal formulations such as decoction of triphala, chandraprabha vati and manibhadra churna are good choices. Triphala and guggulu are also beneficial for reducing excess weight. Shatavari (asparagus root) balances hormones and realigns the menstrual cycle. Shatapushpa (dill) seeds, krishna jeeraka (black cumin seed) oil and sahachara (Barleria prionitis) help destroy ovarian cysts and stimulate follicular maturation. These herbal plants also promote digestion and remove toxins. Guduchi improves overall immunity and atibala powder helps women to conceive and avoid miscarriage in PCOS.
“Woman is the radiance of God. She is not a creature; she is the Creator.” –Rumi
We are all made in God’s image, as told in the bible. Every creation has a drop of the celestial essence within. Just as Prakruti herself held the womb of the universe in her being and manifested all forms of creation by combining with Purusha, every female is a creator. Rumi’s quote says, only women carry that magical ability to create another being. By taking care of her whole self, a woman can harness the true power of her internal Shakti (strength). By integrating her whole body-mind-emotion-psyche-social-spirit being with all other aspects of creation, we form a divine bond with one other. In this way, healthy, strong women bind and harmonize the energetics of the world.
Uma Hingorani
Advanced Ayurvedic Practitioner
References:
1.https://www.cdc.gov/reproductivehealth/womensrh/healthconcerns.html
2.https://www.webmd.com/women/ss/slideshow-women-reproductive-problems
3.https://www.planetayurveda.com/endometriosis-ayurvedic-treatment/. Accessed June 17, 2020
4.https://www.ayurvedacollege.com/blog/endometriosis/.
5.K Dhiman. Ayurvedic intervention in the management of uterine fibroids: A case series. Ayu. 2014 Jul-Sep; 35(3): 303-308.
6.Uterine Fibroids https://www.acog.org:443/en/Patient Resources/FAQs/Gynecologic Problems/Uterine Fibroids
7.UA Ndefo, A Eaton and M Robinson Green. Polycystic ovary syndrome. A review of treatment options with a focus on pharmacological approaches P&T. June 2013; (38)6: 336-338; 348; 355
8.http://www.atreya.com/ayurveda/Polycystic-Ovary-Syndrome-An.html. Accessed 6/13/20
9.SA Dayani Siriwardene et al. Clinical efficacy of Ayurveda treatment regimen on Subfertility with Poly Cystic Ovarian Syndrome (PCOS) Ayu. Jan-Mar 2010; 31(1): 24–27.
