Scientific Basis for Ayurvedic Therapies -38

Scientific Basis for

Ayurvedic Therapies 

edited by

Brahmasree Lakshmi Chandra Mishra

15

Diet and lifestyle are not very specific. Eating healthy foods and doing some simple

exercises (e.g., yoga) are believed to be beneficial according to the Ayurvedic treatment.

32.6.6 Premenstrual Syndrome (PMS)

32.6.6.1 Etiopathogenesis

In Ayurveda there is no specific information about this disease. The concept and symptoms

can be perceived on the basis of tridosa theory. The symptoms like heaviness of breasts,

change in appetite, nausea, vomiting, depression, and nervousness can be correlated to

kapha imbalance. Aggravated pitta contributes to irritability, anxiety, anger, vomiting, headache,

food cravings, and sleep disorders. Bloating of the stomach, pelvic pain, headache,

difficulty in concentrating, sleep disorders, mood swings, and anxiety are the features of

provoked vata.11

In the conventional medicine, though the exact cause of PMS is not yet known, the most

popular theory is cyclic change in hormones or estrogen levels. Another cause is chemical

changes in brain, especially seretonin levels. Some habits or addictions like eating salty

food and consuming alcohol and cold beverages containing caffeine aggravate the problem.

1,15

32.6.6.2 Clinical Features

PMS is a psychoneuroendocrinological disorder. It is characterized by physiological and

psychological changes in the body before or during each menstrual period and is severe

enough to disturb a woman’s routine life. Approximately 75% of women suffer from PMS.

Among them, 40% have a disturbed routine due to severity. The range of the symptoms

is very high. Common physical symptoms include tenderness and heaviness of breasts,

change in appetite and food cravings, nausea, vomiting, headache, pelvic pain, and bloating

of the stomach. Common psychological symptoms include mood swings, depression,

irritability, anger, sleep disorders, nervousness, anxiety, and difficulty concentrating.2,15

32.6.6.3 Diagnosis and Prognosis

PMS is diagnosed by using a proper history. No major investigations are required to

diagnose PMS. From an Ayurvedic point of view, the symptoms are differentiated based

on the dosa involved to choose the right remedy. Prognosis of PMS is good and is quite

successful.

32.6.6.4 Treatment

Externally, oleation with sesame oil and fomentation with herbal decoctions give excellent

results. In severe cases, medicated oil enema (anuvasana basti) is very beneficial (e.g.,

sesame oil and dashamoola kwatha).8 Internally, ashokarishtam and A. vera in combination

with some other drugs are used in Ayurvedic practice. For vata and pitta symptoms,

shatavari (asparagus), ashwagandha (Withania somnifera), amalaki (Indian gooseberry), and

yashtimadhu (licorice) work very well. To reduce kapha symptoms such as heaviness of

breasts and fluid retention, herbs such as triphala, trikatu (pepper, ginger, and long pepper),

and vacha (Acorus calamus) are very useful. Jeerakadyarishtom, manasamitra vatakam, saraswatarishtam,

shatavari kalpa, and kumaryasavam are some of the effective herbal formulas.10,14

In conventional medicine, a definite treatment has not yet emerged as a definition, and

the etiology of the disease is unclear. Symptomatic treatment can be given using sedatives,

diuretics, laxatives, and analgesics. Progesterone or its derivatives are recommended to

improve the condition.15

Women suffering from this disorder should specifically avoid vata aggravating a week

before the menstruation. Examples include dried fish and dry meat, deep fried and very

spicy foods, very cold foods, sprouts, beans, and potatoes.

32.6.7 Menopausal Syndrome

32.6.7.1 Etiopathogenesis

In Ayurveda, menopause is called rajonivrutti. It means that the menstrual flow stops

forever. As this is a natural phenomenon, it is not considered a disorder in Ayurveda.

However, a common understanding is that the three dosas are imbalanced during menopause.

Symptoms of menopause can be correlated to change in dosa dynamics. Among

the three dosas, vata is of prime importance. It is said that there is not a single disorder of

the reproductive system without aggravated vata. Women generally reach menopause

after the age of 45, which is when vata is dominant in the body. Pelvic region is a seat of

vata. It usually becomes vitiated when monthly flow ceases. All pains, roughness of skin,

etc. during menopausal age can be attributed to aggravated vata. Finally, vata can also

provoke kapha and pitta. Symptoms such as heaviness of body, fluid retention, and hot

flashes are some of the symptoms attributed to an imbalance in kapha and pitta during

menopause.3,10,11

Modern medicine defines menopausal age as between 47 and 52. Menopause is exactly

a last or final menstruation. Postmenopause refers to the phase that comes after menopause.

Menopause occurs when oocytes responsive to gonadotropins disappear from the

ovary, or the oocytes remaining do not respond to gonadotropins. When this phenomenon

occurs at certain age due to hormonal imbalance (i.e., change in levels of concentration

of FSH, estradiol, LH, etc.), it is called physiological menopause. If menopause is due to

cessation of ovarian function because of surgery (e.g., hysterectomy, oophorectomy), then

it is called as artificial menopause.22,23

32.6.7.2 Clinical Features

Symptoms start to show up from the pre- or perimenopausal period. The first and foremost

symptom is the alteration of the menstrual cycle. Abrupt cessation is rare. The usual

pattern is a gradual decrease in quantity, duration, and frequency of the menstrual flow.

In some patients it is heavy or more frequent before menopause. Another common symptom

is hot flashes. This is a feeling of excessive heat or burning sensation on the face,

neck, chest, and back, sometimes followed by sweating. Many times it is preceded by

pressure in the head or a headache. Other symptoms like regression of breasts, inadequate

lubrication in vagina, urinary urgency or incontinence, loss of libido, sleep disturbances,

or fatigue may be present. Psychological symptoms are also equally important, as they

may disturb a woman’s life. Mood swings, irritability, depression, anxiety, and dysphoria

are common psychological changes during menopause. Additionally, there are some major

metabolic changes that manifest in the body during in the postmenopausal period (e.g.,

osteoporosis and increased risk of heart attacks).22,23

32.6.7.3 Diagnosis and Prognosis

Menopausal syndrome is essentially diagnosed from the patient’s age and history. Routine

blood work will help differentiate the fluid retention in menopause from anemia and other

disorders. Menopause can be treated successfully using Ayurvedic herbs and dietary

advice.

32.6.7.4 Treatment

The major goal of the treatment is to reduce symptoms and discomfort as well as to

enhance well-being and prevent cardiovascular changes or osteoporosis. No drastic

cleansing procedures are advised to menopausal women. Shirodhara (continuous flow

of medicated oil, decoctions, or buttermilk on the head) and gentle a body massage are

advised, as these treatments relieve muscle spasms, pains, burning, and restlessness.

Internally, chandanasava, ushirasavam, and draksharishtom are some of the drugs that

reduce hot flashes, burning, and urinary incontinence. Shatavari, vidari, and kumari are

the herbs that reduce fatigue and vaginal dryness and give a rasayana effect. For psycological

symptoms, like irritability, anxiety, or depression, there are very effective drugs

like brahmi, vacha, jyotishmati, and shankhapushpi or formulas such as panchagavya ghrita,

kalyanaka ghrita, stresscom cap, and manasmitra vatakam. On the whole, Saraca indica

(ashoka) is the herb of choice that takes care of most of the problems.3,8,14

The American Association of Clinical Endocrinologists recommends hormone replacement

therapy (HRT) as a preventive medicine for menopausal syndrome. HRT relieves

menopausal symptoms and prevents osteoporosis. It also plays a role in protecting the

heart. A goal of this treatment also is managing weight, stress reduction, vagina lubrication,

etc. Steroids, moisturizers, and oral contraceptives may be used to treat menopause.

15,22

No specific diet is advised other than avoiding those that have been mentioned above

for other conditions.

32.7 Scientific Basis of Ayurvedic Therapies

Our literature search found very few scientific studies and clinical trials on Ayurvedic

therapies. These studies are reviewed and summarized here.

32.7.1 Clinical Studies on Compound Formulas

In one study24 on leucorrhea (n = 52), the resin of Shorea robusta was given at a dose of

1 g/day in divided doses for 30 days. Externally, a Terminalia chebula decoction was

administered for vaginal douche. At the end of 30 days of treatment, there was 100%

improvement in the symptoms of leucorrhea. Of the 12 cases infected with trichomonas

infection at the baseline, 10 cases showed a negative smear test for trichomonas infection

at the end of treatment. Similarly, 5 cases of erosion of cervix showed complete healing

of erosion at the end of the treatment. The authors of the study reported that there were

no adverse reactions observed during the full length of the study.

In the second study (n = 32) on leucorrhea, Masilamani et al.25 reported that the combination

of oxidized alum ash (padigara barpam) in the dosage of 300 mg three times/day

with milk, along with a vaginal douche and a decoction of T. chebula, showed promising

results. The duration of the study was 30 days. Of the 32 patients, 26 (81%) were clinically

cured and 6 (19%) were clinically relieved of their symptoms of leucorrhea. There are no

follow-up data or any adverse event information given in the article.

Ashokarishta, a very popular formulation for gynecological disorders, was studied for

its efficacy in 22 subjects suffering from menorrhagia (dysfunctional uterine bleeding) for

3 months. A dose of 25 ml three times/day was given until the onset of the next menstruation.

It was continued for another 2 months from the fourth day of the menstrual cycle

with another break during the next cycle. The trial drug was continued for three consecutive

cycles. Results of the study indicate that ashokarishta gave relief from excessive

bleeding and pain in all the cases. Subjects who had vata- and kapha-predominant symptoms

showed relief within 3 days after starting the formulation. One patient with a

follicular cyst and one patient with an ovarian cyst had to undergo a hysterectomy after

3 months of the study. An interesting finding of this study was that the hemoglobin

automatically increased as soon as the bleeding was stopped. With the help of this study,

we can infer that the properties of Saraca indica — oxytocic, hemostatic, and analgesic —

have been investigated.26

32.7.2 Pharmacological Studies on Single Herbs and Bhasmas

32.7.2.1 Saraca indica

Research has found that Saraca indica (saracin) is a good uterine tonic, which is effective

in normalizing menstruation and reducing associated symptoms.27,28 In another study,29

saracin seems to be an interesting immunomodulator for the mammalian immune system.

It has been found to be mitogenic for human lymphocytes, and this mitogenic activity

could be inhibited in presence of fetuin. It also revealed that treatment with saracin could

induce secretion of interleukin-2 (IL-2) in a culture of resting human peripheral blood

mononuclear cells after 48 h. The study found that saracin has a higher affinity for the

CD8(+) than the CD4(+) T-cells.

32.7.2.2 Aloe vera

In an interesting study,30 the aqueous extract of Aloe barbadensis Miller in an in vitro culture

of Trichomonas vaginalis revealed that within 24 h, percentages of inhibition greater than

50% were obtained from concentrations of 20.8 mg/ml. The researchers studied three

strains of this parasite. The aqueous extracts were used as an initial concentration of 400

mg/ml of the extract and double serial dilutions were performed; final concentrations

based on the dried weight of the extract were 10.4, 20.8, 41, 83, and 160 mg/ml. The

inhibition of growth was greater than 50% even when tried with lower concentrations of

the extract but it took 48 to 72 h for such an action.

In another study,31 CARN 750 (injectable acemannan), a polydispersed beta-(1,4), linked

acetylated mannan isolated from the A. barbadensis plant, was evaluated for its multiple

therapeutic properties. It was found helpful in wound repair and acts as a biological agent

for the treatment of neoplasia in animals; it was also noted for its ability to activate

macrophages.

It was also found that CARN 750 directly or indirectly has significant hematoaugmenting

properties. Subcutaneous administration of CARN 750 significantly increased splenic and

peripheral blood cellularity, as well as hematopoietic progenitors in the spleen and bone

marrow as determined by the IL-3-responsive colony-forming unit culture assay and the

high-proliferative-potential colony-forming cell assay (a measure of primitive hematopoietic

precursors) in myelosuppressed (7 Gy) C57BL/6 mice. It was observed that the greatest

hematopoietic effect was obtained after sublethal irradiation in mice receiving 1 mg of

CARN 750/animal, with less activity observed at higher or lower doses. Results showed

activity equal to or greater than the injection of an optimal dose of granulocyte-colonystimulating

factor in myelosuppressed mice when CARN was injected daily.

In another study,32 lyophilized A. barbadensis at concentrations of 7.5 and 10% proved

to be spermicidal when used along with zinc acetate. The action was attributed to the

multiple microelements boron, barium, calcium, chromium, copper, iron, potassium, magnesium,

manganese, phosphorus, and zinc; these elements were toxic to the tail and caused

instant immobilization. The two compounds did not show any signs of irritation or cause

ulceration of rabbit vaginal epithelium. These results suggest the possibility of using zinc

acetate and lyophilized A. barbadensis as a new, effective, and safe vaginal contraceptive.

The effects of another species of aloe on some physiological and biochemical parameters

of reproduction in immature female rats based on the history of their use by the folklore

medicine in Cameroon was studied.33 Aloe buettneri, Justicia insularis, Hibiscus macranthus,

and Dicliptera verticillata were given in different doses daily to 22-day-old rats for 5, 10,

15, 20, and 25 days by gastric intubation. The weights of ovaries and uteri, levels of uterine

and ovarian proteins, ovarian cholesterol, and serum estradiol were evaluated at the end

of each experimental period. The results of the study showed a decrease in growth rate

of animals treated with 94 mg/kg/day at the end of the experimental period. Interestingly

enough, the ovarian and uterine weights increased in all treated groups, especially within

the pubertal period (36 to 41 days old), when compared with the respective controls.

During the same period, other parameters that were also observed showed significant

differences in treated rats when compared with the controls. Ovarian and uterine protein

levels, as well as serum estradiol, also increased in the groups given 49 or 94 mg/kg/day

of the plant extracts. The investigators concluded that these results suggest a possible

presence of estrogenic compounds in the plant extracts.33

The study was repeated with the aqueous extract of the leaf mixtures of A. buettneri,

Dicliptera verticillata, Hibiscus macranthus, and Justicia insularis at doses of 13, 49, and 94

mg/kg/day for 15 days given by oral route to immature female rats. Results showed that

the extracts induced a significant increase in ovarian and uteri weight as well as serum

and ovarian estradiol.34

Aloe vera was also studied for its anti-inflammatory property. In this study, the effects

of aqueous, chloroform, and ethanol extracts of A. vera gel on carrageenan-induced edema

in the rat paw and neutrophil migration into the peritoneal cavity stimulated by carrageenan

were studied. The results showed that the aqueous and chloroform extracts

decreased the edema induced in the hind-paw and the number of neutrophils migrating

into the peritoneal cavity; the ethanol extract decreased only the number of neutrophils.

The mechanism of action of the aqueous extract was due to the inhibited prostaglandin-

E2 production from [14C]arachidonic acid. The investigators conducted an assay of the

extracts and found that the aqueous extract contained anthraglycosides, reductor sugars,

and cardiotonic glycosides; in the ethanol extract, the chemical tests performed for

saponins, carbohydrates naftoquinones, sterols, triterpenoids, and anthraquinones turned

out positive. The chemical tests performed in the chloroform extract showed positive

reaction for sterols type delta 5 and anthraquinones. On the basis of these findings, it was

concluded that the extracts of A. vera gel have anti-inflammatory activity and suggested

its inhibitory action on the arachidonic acid pathway via cyclooxygenase.35

32.7.2.3 Muktashukti Bhasma

Muktashukti bhasma, a compound formulation consisting of pearl, A. vera, and vinegar,

inhibited acute and subacute inflammation in albino rats as induced by subplanter injection

of carrageenan, histamine, serotonin (5-HT), nystatin, and subcutaneous implant of

cotton pellets. The anti-inflammatory response of 1000 mg/kg MSB was comparable with

the response observed with 300 mg/kg acetylsalicylic acid (ASA) in all the test procedures.

According to the investigators, the anti-inflammatory activity of the compound was attributed

to its ability to cause inhibition of prostaglandins, histamine, and 5-HT and stabilization

of the lysosomal membranes. The anti-inflammatory activity of MSB seems to be

only one third to half as potent as ASA.36

32.7.2.4 Glycerrhiza glabra

Glycyrrhyzin, a constituent of Glycerrhiza glabra, inhibits inflammation and prostaglandin

synthesis. It blocks estrogen effects binding to estrogen receptors. In other studies for

treating menopausal syndrome, licorice was found an effective source of estrogen.

Glycyrrhizae radix is found to suppress estradiol-17 beta (E2)-induced expression of

c-fos/jun in uterine corpus and inhibited N-methyl-N-nitrosourea and E2-induced

endometrial carcinogenesis in mice. The probable mode of action could be through

suppression of estrogen-induced c-fos/jun expression and could be promising in preventing

agents for endometrial cancers.37,38

Tamir et al.16 reported that the stimulatory effects of 2.5 to 25 mg/animal glabridin

were similar to those of 5 mg/animal estradiol. Glabridin, the major isoflavon in licorice

root, was tested for the estrogenic properties, in view of the resemblance of its structure

and lipophilicity to those of estradiol. The results indicate that glabridin is a phytoestrogen,

binding to the human estrogen receptor and stimulating creatine kinase activity in

rat uterus, epiphyseal cartilage, diaphyseal bone, aorta, and left ventricle of the heart.

During the course of the study, the researchers found that the position of the hydroxyl

groups has a significant role in binding to the human estrogen receptor and in proliferation-

inducing activity. There was a biphasic effect of increasing concentrations of

glabridin on the growth of breast-tumor cells. It showed an estrogen-receptor–dependent,

growth-promoting effect at low concentrations (10 nM to 10 mM) and estrogenreceptor–

independent antiproliferative activity at concentrations of >15 mM. The investigators

concluded that glabridin and its derivatives exhibited varying degrees of estrogen-

receptor agonism in different tests and demonstrated growth-inhibitory actions on

breast cancer cells.

32.7.2.5 Curcuma longa

It has been proven that this herb has antibacterial, anticancerous, antihemorrhagic, and

anti-inflammatory properties and hence can be effective in menstrual difficulties like

menorrhagia or abnormal uterine bleeding, vaginitis, and leukorrhea. Laboratory research

has shown that it may modulate estrogen and progesteron activity.39

32.7.2.6 Nardostachys jatamansi (Jatamansi)

The clinical trials showed reduced restlessness, insomnia, and aggressiveness. These properties

are very useful in menopause as well as in PMS.

A study was proposed to evaluate the protective effect of Nardostachys jatamansi on

neurobehavioral activities, thiobarbituric acid reactive substance, reduced glutathione,

thiol group, and catalase and sodium-potassium adenosine triphosphatase activities in

the middle cerebral artery (MCA) occlusion model of acute cerebral ischemia in rats.

Findings showed that the changes induced by ischemia were significantly attenuated by

a 15-day pretreatment of N. jatamansi (250 mg/kg orally) and correlated well with histopathology

by decreasing the neuronal cell death after MCA occlusion and reperfusion.

The study provided first evidence of effectiveness of N. jatamansi in focal ischemia probably

by virtue of its antioxidant property.40

32.7.2.7 Zingiber officinale (Ginger)

Ginger was found effective in the symptoms such as nausea and vomiting in pregnant

women. In a randomized, placebo-controlled, double-blind trial (n = 70),41 women received

either oral ginger 1 g/day or an identical placebo for 4 days. At a follow-up visit 7 days

later, all participants except three in the placebo group remained in the study. After the

therapy, nausea decreased significantly in the ginger group (2.1 ± 1.9) compared with the

placebo group (0.9 ± 2.2, p = .014). The number of vomiting episodes also decreased

significantly in the ginger group (1.4 ± 1.3) compared with the placebo group (0.3 ± 1.1,

p < 0.001). No adverse effect of ginger on pregnancy outcome was detected. It can also be

used in PMS symptoms such as nausea and vomiting.

32.7.2.8 Commiphora mukul (Myrrh)

In laboratory research, Commiphora mukul showed antibacterial and antifungal properties,

especially in Candida albicans. Therefore, it can be used in vaginitis and related leukorrhea.42

In a study on the species Commiphora guidotti, known as scented myrrh, all sesquiterpenes

were isolated and characeterized. Seven compounds, with cadinane, guaiane, oplopane,

and eudesmane skeletons, were obtained. Two of seven are new and two are reported

from a natural source for the first time. The present study was planned to compare the

effects of the minor sesquiterpenes with those of the previously isolated major component,

T-cadinol, which has shown to possess smooth muscle-relaxing properties. The results

showed that the minor sesquiterpenes are more efficient in reducing K(+)-induced contractions

than those induced by the alpha-adrenoceptor agonist phenylephrine. However,

they were all less potent than T-cadinol in their action.43

In another study, Kimura et al.44 reported that myrrhanol A, a new triterpene isolated

from Balsamodendron or C. mukul Hook-gum resin, showed a potent anti-inflammatory

effect on exudative pouch fluid, angiogenesis, and granuloma weights in the adjuvantinduced

air-pouch granuloma of mice. The interesting finding of this study is that its

effects were more marked than those of hydrocortisone and the 50% aqueous methanolic

extract of the crude drug.

32.7.2.9 Withania somnifera

Withania somnifera is found effective in combination with other rejuvenating drugs like

licorice in menopausal syndrome in studies conducted by National Institute of Ayurveda,

Jaipur, India. It increases levels of estrogen and helps reduce the symptoms like hot flashes,

fatigue, and depression because of its antioxidant.45,46 It also has immunomodulatory,47

antidepressant,48 anti-inflammatory, and adaptogenic effects.49,50 Information on the studies

on these effects are available in other chapters.

32.7.2.10 Tinospora cordifolia

The active principles of Tinospora cordifolia, cordioside (TC-2), cordiofolioside A (TC-5),

and cordiol (TC-7) are found to possess the macrophage activation. Syringin (TC-4) and

TC-7 inhibited the in vitro immunohaemolysis of antibody-coated sheep erythrocytes by

guinea pig serum. The anticomplementary and immunomodulatory activities were found

to be caused by inhibition of the C3-convertase of the classical complement pathway.

Higher concentrations showed constant inhibitory effects. The authors reported that the

compounds also gave rise to significant increases in immunoglobin-G (IgG) antibodies in

serum. Humoral and cell-mediated immunity were also enhanced but were dose dependant.

51

In another study,52 T. cordifolia extract (100 mg/kg body weight for 15 days) given to

CCl4 intoxicated rats was found to protect the liver, as indicated by enzyme level in serum.

A significant reduction in serum levels of serum glutamic oxaloacetic transaminase

(SGOT), serum glutamate pyruvate transaminase (SGPT), alkaline phosphatase (ALP),

and bilirubin were observed after T. cordifolia treatment during CCl4 intoxication. The

extract also deleted the immunosuppressive effect of CCl4.

32.7.2.11 Asparagus recemosus

Asparagus recemosus was tried in menopausal syndrome for relieving symptoms like hot

flashes, excessive sweating, tiredness, and sleep disturbances in a study conducted by

Government Ayurveda College, Trivandrum, India. The report reads that the treatment

was effective. No further details were available about the author, dosage, and or duration.

In another study,50, 53–55 A. recemosus, T. cordifolia, W. somnifera, and Picrorhiza kurrooa were

tested on the functions of macrophages obtained from mice treated with the carcinogen

ochratoxin A (OTA). At the end of 17 weeks of treatment, the chemotactic activity of

murine macrophages was significantly decreased with OTA compared with controls.

Production of interleukin-1 (IL-1) and tumor necrosis factor (TNF) was also markedly

reduced. OTA-induced suppression of chemotactic activity and production of IL-1 and

TNF-alpha by macrophages was significantly inhibited with the treatment with A. racemosus,

T. cordifolia, W. somnifera, and P. kurroa. It was also noted that W. somnifera treated

macrophage chemotaxis and A. recemosus-induced excess production of TNF-alpha when

compared with controls.

Mandal et al.56 studied the antibacterial activity of A. racemosus and compared it with

chloramphenicol. The methanol extract of the roots of A. recemosus were given in concentrations

of 50, 100, and 150 mg/ml. Results showed considerable in vitro antibacterial

efficacy against Escherichia coli, Shigella dysenteriae, Shigella sonnei, Shigella flexneri, Vibrio

cholerae, Salmonella typhi, Salmonella typhimurium, Pseudomonas putida, Bacillus subtilis, and

Staphylococcus aureus.

Antioxytocic action of saponin isolated from A. recemosus on uterine muscle was further

studied.57 The details of this study could not be accessed. Similar studies58,59 on the

lactogoggue effect of Asparagus recemosus showed positive effects, but details were not

available.

References

1. Carlson, K.J. and Ziporyn Terra, E.S., Harvard Guide to Women's Health, Harvard University

Press, Cambridge, 1996.

2. Kjerulff, K.H., Erickson, B.A., et al. Chronic gynecological conditions reported by US women:

findings from the National Health Interview Survey, 1984 to 1992, Am. J. Public Health, 86(2),

195-199, 1996.

3. Nayak, B., Ed., Menarche to Menopause, Ayurmedline, Banglore, India, 2002.

4. Martin, M.C., Infertility, in Current Obstetrics & Gynecologic Diagnosis & Treatment, 8th ed.,

Decherney, A.H. and Permoll, M.L., Eds., Appleton & Lange, Norwalk, CT, 1994, pp. 996–1006.

5. Rannestad, T., Eikeland, O.J., Helland, H., and Qvarnstrom, U., Quality of life, pain, and

psychological well-being in women suffering from gynecological disorders, J. Womens Health

Gender-Based Med., 9(8), 897–903, 2000.

6. Agadjanian, V., Women's choice between indigenous and Western contraception in urban

Mozambique, Women Health, 28(2), 1–17, 1998.

7. Bhishagratna, K.L., Ed., Sushrut Samhita, Chaukhambha Orientalia, Varanasi, India, 1981.

8. Sharma, P., Ed., Charaka Samhita, 1st ed., Vol. 2., Chaukhambha Orientalia, Varanasi, India,

1983.

9. Neldner, K.H., Complementary and alternative medicine, Dermatol. Clin., 1, 189–193, 2000.

10. Mishra, S.S., Management of gynecological problems, in Menarche to Menopause, Nayak, B.,

Ed., Ayurmedline, Banglore, India, 2002.

11. Vartak, D., Dosha-Dhatu-Mala Vignyan, The Pragnya Press, Maharashtra, India, 1962.

12. Frawley, D., Ayurvedic Healing a Comprehensive Guide, Motilal Banarasidas Publishers Pvt. Ltd.,

Delhi, India, 1992.

13. Tripathi, A., Ed., Uttara vasti: uterine and utero-vesicle enema, in Menarche to Menopause,

Nayak, B., Ed., Ayurmedline, Banglore, India, 2002.

14. Bhavamishra, A., Bhavaprakash Nighantu, Chaukhambha Bharati Academy, Varanasi, India,

1984.

15. Decherney, A.H. and Permoll, M.L., Current Obstetrics & Gynecologic Diagnosis & Treatment, 8th

ed., Appleton & Lange, Norwalk, CT, 1994.

16. Tamir, S., Eizenberg, M., Somjen, D., et al., Estrogenic and antiproliferative properties of

glabridin from licorice in human breast cancer cells, Cancer Res., 60(20), 5704–5709, 2000.

17. Anon., Effect of Takradhara in Menorrhagia, Ayurveda Update, 1, 6–8, 1998.

18. Syamalakumari, S. et al., Effect of Kashmarya kutaja ghrita in Menorrhagia, thesis, Government

Ayurveda College, Trivandrum, India, 1992.

19. Anon., Effect of Ashokarishta and Musalikhadiradi Kwatha in Menorrhagia, M.D. thesis,

Government Ayurveda College, Trivandrum, India, 2002.

20. Anon., Effect of Kutajashtaka lehyam in DUB and Menorrhagia, M.D. thesis, Government

Ayurveda College, Trivandrum, India, 2002.

21. Venugopal, S., Role of Saraca indica, Aloe vera and Cyperus rotundus in oligomenorrhea,

Antiseptic, 95, 329–330, 1998.

22. Kulkarni, K.S., Menopause and its management modalities, in Menarche to Menopause, Nayak,

B., Ed., Ayurmedline, Banglore, India, 2002.

23. Novaes, C., Almeida, O.P., et al., Mental health among perimenopausal women attending a

menopause clinic: possible association with premenstrual syndrome?, Climacteric, 1(4),

264–270, 1998.

24. Rajalakshmi, S.V.G., Clinical evaluation of Kungila Barpam and Kadukkai decoction in the

management of Vellai Noi (leukorrhea), J. Res. Ayurveda Siddha, 17, 157–161, 1996.

25. Masilamani, G. and Subbulakshmi, A.A., Clinical study of vellainoi (leukorrhea). V, J. Res.

Ayurveda Siddha, 16, 125–133, 1996.

26. Geeta, A. and Nalini, A.M., Treatment of pradara with ashokarishta. VI, J. Res. Ayurveda Siddha,

16, 177–180, 1996.

27. Satyavati, G.V., Prasad, D.N., Sen, S.P., and Das, P.K., Oxytocic activity of a pure phenolic

glycoside (P2) from Saraca indica Linn (ashoka): a short communication, Indian J. Med. Res.,

58(5), 660–663, 1970.

28. Satyavati, G.V., Prasad, D.N., Sen, S.P., and Das, P.K., Further studies on the uterine activity

of Saraca indica Linn., Indian J. Med. Res., 58(7), 947–960, 1970.

29. Ghosh, S., Majumder, M., Majumder, S., Ganguly, N.K., and Chatterjee, B.P., Saracin: a lectin

from Saraca indica seed integument induces apoptosis in human T-lymphocytes, Arch. Biochem.

Biophys., 371(2), 163–168, 15 1999.

30. Rojas, L., Matamoros, M., Garrido, N., and Finlay, C., The action of an aqueous extract of Aloe

barbadensis Miller in an in-vitro culture of Trichomonas vaginalis, Rev. Cubana Med. Trop.,

47(3), 181–184, 1995.

31. Egger, S.F., Brown, G.S., Kelsey, L.S., Yates, K.M., Rosenberg, L.J., and Talmadge, J.E., Hematopoietic

augmentation by a beta-(1,4)-linked mannan, Cancer Immunol. Immunother., 43(4),

195–205, 1996.

32. Fahim, M.S. and Wang, M., Zinc acetate and lyophilized aloe barbadensis as vaginal contraceptive.

Contraception, 53(4), 231–236, 1996.

33. Telefo, P.B., Moundipa, P.F., Tchana, A.N., Tchouanguep Dzickotze, C., and Mbiapo, F.T., Effects

of an aqueous extract of Aloe buettneri, Justicia insularis, Hibiscus macranthus, Dicliptera

verticillata on some physiological and biochemical parameters of reproduction in immature

female rats, J. Ethnopharmacol., 63(3), 193–200, 1998.

34. Telefo, P.B., Moundipa, P.F., and Tchouanguep, F.M., Oestrogenicity and effect on hepatic

metabolism of the aqueous extract of the leaf mixture of Aloe buettneri, Dicliptera verticillata,

Hibiscus macranthus and Justicia insularis, Fitoterapia, 73(6), 472–478, 2002.

35. Vazquez, B., Avila, G., Segura, D., and Escalante, B., Antiinflammatory activity of extracts from

Aloe vera gel, J. Ethnopharmacol., 55(1), 69–75, 1996.

36. Chauhan, O., Godhwani, J.L., Khanna, N.K., and Pendse, V.K., Antiinflammatory activity of

muktashukti bhasma, Indian J. Exp. Biol., 36(10), 985-989, 1998.

37. Mori, H., Niwa, K., Zheng, Q., Yamada, Y., Sakata, K., and Yoshimi, N., Cell proliferation in

cancer prevention; effects of preventive agents on estrogen-related endometrial carcinogenesis

model and on an in vitro model in human colorectal cells, Mutat. Res., 480–481, 201–207, 2001.

38. Niwa, K., Hashimoto, M., Morishita, S., Yokoyama, Y., Mori, H., and Tamaya, T., Preventive

effects of Glycyrrhizae radix extract on estrogen-related endometrial carcinogenesis in mice,

Jpn. J. Cancer Res., 90(7), 726–732, 1999.

39. Garg, S.K., Effect of Curcuma longa (rhizomes) on fertility in experimental animals, Planta Med.,

26(3), 225–227, 1974.

40. Salim, S., Ahmad, M., Zafar, K.S., Ahmad, A.S., and Islam, F., Protective effect of Nardostachys

jatamansi in rat cerebral ischemia, Pharmacol. Biochem. Behav., 74(2), 481–486, 2003.

41. Vutyavanich, T., Kraisarin, T., and Ruangsri, R., Ginger for nausea and vomiting in pregnancy:

randomized, double-masked, placebo-controlled trial, Obstet. Gynecol., 97(4), 577–582, 2001.

42. Dolara, P., Corte, B., Ghelardini, C., et al., Local anaesthetic, antibacterial and antifungal

properties of sesquiterpenes from myrrh, Planta Med., 66(4), 356–358, 2000.

43. Andersson, M., Bergendorff, O., Shan, R., Zygmunt, P., and Sterner, O., Minor components

with smooth muscle relaxing properties from scented myrrh (Commiphora guidotti), Planta

Med., 63(3), 251–254, 1997.

44. Kimura, I., Yoshikawa, M., Kobayashi, S., et al., New triterpenes, myrrhanol A and myrrhanone

A, from guggul-gum resins, and their potent anti-inflammatory effect on adjuvant-induced

air-pouch granuloma of mice, Bioorg. Med. Chem. Lett., 11(8), 985–989, 2001.

45. Archana, R. and Namasivayam, A., Antistressor effect of Withania somnifera, J. Ethnopharmacol.,

64(1), 91–93, 1999.

46. Scartezzini, P. and Speroni, E., Review on some plants of Indian traditional medicine with

antioxidant activity, J. Ethnopharmacol., 71(1–2), 23-43, 2000.

47. Davis, L. and Kuttan, G., Immunomodulatory activity of Withania somnifera, J. Ethnopharmacol.,

71(1–2), 193–200, 2000.

48. Battacharya, S.K., Attacharya, B.A., Sairam, K., and Ghosal, S., Anxiolytic-antidepressant activity

of Withania somnifera glycowithanolides: an experimental study, Phytomedicine, No. 7,

463–469, 2000.

49. Mishra, L.C., Singh, B.B., and Dagenais, S., Scientific basis for the therapeutic use of Withania

somnifera (ashwagandha): a review, Altern. Med. Rev., 5(4), 334–346, 2000.

50. Dhuley, J.N., Adaptogenic and cardioprotective action of ashwagandha in rats and frogs,

J. Ethnopharmacol., 70(1), 57–63, 2000.

51. Kapil, A. and Sharma, S., Immunopotentiating compounds from Tinospora cordifolia, J. Ethnopharmacol.,

58(2), 89–95, 1997.

52. Bishayi, B., Roychowdhury, S., Ghosh, S., and Sengupta, M., Hepatoprotective and immunomodulatory

proprties of Tinospora cordifolia in CCl4 intoxicated mature albino rats, J. Toxicol.

Sci., 27(3), 139–146, 2002.

53. Dhuley, J.N., Effect of some Indian herbs on macrophage functions in ochratoxin A treated

mice, J. Ethnopharmacol., 58(1), 15–20, 1997.

54. Dhuley, J.N., Effect of ashwagandha on lipid peroxidation in stress-induced animals, J. Ethnopharmacol.,

60(2), 173–178, 1998.

55. Dhuley, J.N., Nootropic-like effect of ashwagandha (Withania somnifera L.) in mice, Phytotherapy

Res., 15(6), 524–528, 2001.

56. Mandal, S.C., Nandy, A., Pal, M., and Saha, B.P., Evaluation of antibacterial activity of Asparagus

racemosus willd. root, Phytotherapy Res., 14(2), 118–119, 2000.

57. Gaitonde, B.B. and Jetmalani, M.H., Antioxytocic action of saponin isolated from Asparagus

racemosus Willd (Shatavari) on uterine muscle, Arch. Int. Pharmacodyn. Ther., 179(1), 121–129,

1969.

58. Joglekar, G.V., Ahuja, R.H., and Balwani, J.H., Galactogogue effect of Asparagus racemosus,

Preliminary communication, Indian Med. J., 61(7), 165, 1967.

59. Sharma, S., Ramji, S., Kumari, S., and Bapna, J.S., Randomized controlled trial of Asparagus

racemosus (shatavari) as a lactogogue in lactational inadequacy, Indian Pediatr., 33(8), 675–677,

1996.

 

Om Tat Sat

                                                        

(Continued...) 

(My humble salutations to H H Maharshi ji,  Brahmasri Sreeman Lakshmi Chandra Mishra ji and other eminent medical scholars and doctors   for the collection)