By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Nashtartava means complete absence of menstrual blood. It is also called as Anartava, which means lack of menstrual blood.
Anartava = Na + Artava = No menstrual blood
Both Master Sushruta and Vagbhata have described absence of menstrual blood after the description of ‘eight disorders of menstruation’. Read – Hypomenorrhoea: Causes, Remedies, Ayurvedic Treatment
Causative factors for absence of menstrual blood
Doshas, mainly vata and kapha obstruct the channels carrying menstrual blood. Thus menstrual blood is not discharged every month due to the block of channels by morbid doshas. Read – Srotas: Body Channels and Duct systems – Easy Explanation
In this instance, pitta will not be considered as causing the block of channels carrying menstrual blood because if pitta increases, it increases blood and thus produce excessive bleeding. Therefore the term doshas only points out towards involvement of vata and kapha. Read – Pitta Increase Symptoms – Pitta Vriddhi Lakshana
Even therapeutically it is evident that horse gram etc substances when prescribed for treating this condition are seen to suppress vata and kapha and remove the block. Even from this perspective it can be understood that the block in channels are caused by vitiated vata and kapha. Read – How To Balance Kapha Vata Dosha? 6 Factors To Consider
Pathogenesis as explained by Master Bhela –
Though the blood circulates in the whole body for seven days and nights, yet being abnormal and scanty in proportion it does not circulate in the reproductive system of women. This leads to desiccation of menstrual blood as well as the body of the women leading to absence of menstruation.
Bhavaprakasha treatise has named the same condition as rajonasha i.e. destruction of raja / menstrual blood which can be compared to amenorrhea. The author has counted this condition among eight specific disorders of vata. Read – Physiology Of Menstruation, Menstrual Cycle – Ayurvedic Perspective
In nashtartav / anartav, the menstrual blood or estrogen etc ovarian hormones are normal. In spite of that, blood is not properly accumulated in the endometrium, may be due to block in endometrial / uterine arteries as per explanation of Ayurveda. Consequently menstruation does not occur. Therefore, from modern perspective, this condition appears to be the description of amenorrhea caused by endometrial abnormalities. Read – Menstrual Pain, Painful Periods – Natural Ayurvedic Herbal Home Remedies
Treatment of Nashtartavam / Anartavam
Administration of uterine enemas is the most beneficial remedy in absence of menstrual blood. Use of Shatavaryadi unctuous enema is a good remedy.
Use of Phalaghrta and Brhat Shatavari Ghrta described in gynecological disorders are beneficial.
The below mentioned diet and drinks are beneficial in these conditions –
- Horse gram
- Sour substances like kanji
- Black gram
- Cow urine
- Buttermilk mixed with half quantity of water
- Shukta / chukra – fermented liquid etc
Foods and medicines capable of increasing pitta should be used.
A pessary made with powdered seeds of Lagenaria vulgaris, Baliospermum montanum, long pepper, jaggery, Randia dumetorum, fermented liquid / microbial inoculums and husk of barley triturated with latex of Euphorbia neriifolia should be placed in the cervix of the woman. This induces menstruation.