ABSTRACT
Perimenopause is the transition period from reproductive to non-reproductive phase. It usually begins with menstrual cycle irregularity and extends to one year after permanent cessation of menstruation. There is manifestation of varied physical, psychological and somatic symptoms. Menopause may be correlated to Rajakshaya. It usually occurs as part of the ageing process and is the period of transition from Pitta predominant middle age to vata predominant old age. Treatment in modern medicine includes hormone replacement therapy and use of anti-depressants etc. Acharyas mention Jara among Swabhavabala pravritta Vyadhi, and its management is to be done with drugs having Rasayana property. Here we present a 48-year-old lady who presented with complaints of hot flushes, severe sweating especially during night hours, reduced sleep, irritability, multiple joint pain, loss of interest in most daily activities and stress incontinence. Vayasthapana gana was administered as Ksheerapaka. Vayasthapana gana include ten drugs which are Rasayana, Medhya, Tridosha samana and possess anti-oxidant, free radical scavenging and anti-stress activity. Ksheera is Vata pitta samana, Rasayana, and Jeevaneeya. Vayasthapana gana ksheerapaka is given in the dose of 48ml twice daily one hour before food for thirty days. After treatment intensity of these symptoms were reduced. Follow up was done thirty days after stopping the medication, here also intensity of these symptoms remained less when compared to before treatment. Here we reviewed the probable role of Vayasthapana gana ksheerapaka in alleviating perimenopausal symptoms.
ABSTRACT
Vulvovaginal candidiasis is an infection caused by yeast like micro organisms called candida albicans. It is the second most common cause of vaginitis affecting women of reproductive age group. It is most distressing and irritating to women, hampers their day to day life and makes them irritable, depressed, anxious and disturbs their interpersonal relationships including marital life. In vulvovaginal candidiasis patients complain of vaginal discharge with intense vulvovaginal pruritus. The pruritus is out of proportion to the discharge. The symptoms of vulvovaginal candidiasis appear similar to the symptoms of Slaishmiki yoni vyapath mentioned in Ayurvedic classics. It is due to the vitiation of Kapha caused by usage of Abishyandi aharas and has symptoms like Pichila yonisrava, Kandu, Alpa vedhana or Avedhana in Yoni. Topical treatments have great importance in the treatment of several gynecological conditions (Yoni vyapaths). Yoni varti or vaginal pessary is used to cleanse the vaginal walls and make the local environment more healthy. It acts directly on the vaginal mucosa and enables easier and target specific action. They are also hygroscopic in property and act in accordance with the drugs they contain. Kandughna gana varti have Tiktha, Kashaya rasa, Laghu, Ruksha guna, Krimighna, Kandughna and Kaphaghna properties and all the ingredients have potent antifungal action also. This facilitates faster absorption of drugs through vaginal mucosa and relieves the symptoms more quickly. A pilot study was conducted in 5 cases to assess the effect of Kandughna gana varti in vulvovaginal candidiasis. It was found to be effective in vaginal discharge and vulvovaginal pruritus.
ABSTRACT
Uterine prolapse is a type of pelvic organ prolapse where the supporting pelvic structures of uterus weakens and result in descent of uterus from its normal position. Among them, Prasramsini can be most suitably correlated with 1st and 2nd degree uterine prolapse. The management principle of pelvic organ prolapse includes Vathika yoniroga chikitsa along with Sthanika chikitsa. Treatment mainly aims at Vathasamana, Brimhana, Sandhana, Balya and strengthening of pelvic floor musculature. Sthanika chikitsa like Yonilepana, Yonipurana, Pichu dharana, etc can be done in pelvic organ prolapse. In Sthanika chikitsa, medicines are applied intravaginally. Vaginal wall and adjacent tissues are extremely vascular and this facilitates absorption of drugs through vagina. Anatomically backward position of vagina helps in self retaining of drugs for a longer duration. In the present case, Yonilepa as Sthanika chikitsa was tried. A 56 year old lady was presented with complaints of urinary incontinence, low back ache, dyspareunia and feeling of mass per vaginum. On examination, she was diagnosed with 1st degree uterine descend. USG was done to exclude other pelvic pathologies. Pap smear was done which was – ve for intraepithelial lesion or malignancy. Lodhradi lepa was applied for 7 days in 3 consecutive months. During follow up, she was relieved from symptoms like feeling of mass per vaginum, urinary incontinence, low back ache and dyspareunia. From this case report, it is evident that Yoni lepa is effective for the management of uterine prolapse.