A Narrative Review on the etiopathogenesis of Primary Dysmenorrhea with reference to Kastartava in Ayurveda literature

Abstract

Objectives: Different dimensions of Primary Dysmenorrhea in Ayurveda literature has been explored and conceptualised it with the available physiological and anatomical understanding. Content: The concept of Primary Dysmenorrhea is better understood upon the basic understanding of Kastartava dating back to the phase of adolescence. 75% of adolescent girls’ experiences problems related to menstruation including delayed, irregular, painful, and heavy menstrual bleeding. Among these, painful menstruation or dysmenorrhea is the most common gynecological problem seen in reproductive age group. “Primary dysmenorrhea, one among its two types, is a cyclical lower abdominal or pelvic pain of sufficient magnitude so as to incapacitate day to day activities without any identifiable or evident pelvic pathology”. Ayurveda classics were reviewed to analyse the various aspects of Kastartava and correlated with research papers in terms of evidence-based physiological and anatomical advancements. Databases like PubMed, Scopus were searched using keywords like Shoola, Kastartava, Udavartini, Vatiki Yonivyapat, Dysmenorrhea, Primary Dysmenorrhea AND Ayurveda, Pain measurement, Quality of life, Inflammatory Markers, Prostaglandin theory. Summary: Various aspects of Shoola and Kastartava in Ayurveda from evidence-based advancements in Primary Dysmenorrhea based on recent researches have been put forward for basic evidence in relation with Pathophysiology of Primary Dysmenorrhea. Outlook: Understanding the pathophysiology of pain in Primary Dysmenorrhea with respect to the clinical presentation of Kastartava will give new insights to manage the clinical condition.