Samanvaya

Kashtartava & Asrigdara ↔ Dysmenorrhoea & Abnormal Uterine Bleeding

Kashtartava (painful menstruation) and Asrigdara (excessive bleeding) are classical syndromes whose modern counterparts — primary/secondary dysmenorrhoea and the PALM-COEIN causes of abnormal uterine bleeding — require distinguishing benign symptomatic disease from endometriosis, coagulopathy and gynaecological cancer before treatment.

IN PLAIN LANGUAGE

Kashtartava is painful periods, treated classically as blocked downward-moving vata; Asrigdara is heavy bleeding, treated as excess pitta acting on the blood. Modern medicine separates period pain into ordinary cramps versus pain caused by disease like endometriosis, and separates heavy bleeding into structural causes (polyps, fibroids, cancer) and non-structural causes (clotting disorders, hormone imbalance) using the PALM-COEIN system.

Ayurveda's warming, spasm-relieving and astringent measures parallel modern non-hormonal treatments (heat, NSAIDs, tranexamic acid) for straightforward cases; modern medicine's essential added value is diagnosing and treating the underlying causes — endometriosis, fibroids, bleeding disorders and cancer — that the classical framework cannot detect on its own.

WHEN TO SEEK CARE

Pain that worsens over years, starts days before the period, or comes with pain during sex or bowel motions needs assessment for endometriosis; any bleeding after menopause, bleeding between periods or after sex, or periods heavy since their very first onset needs urgent assessment.

🔴 REFER IMMEDIATELY

  • Any bleeding after menopause
  • Bleeding between periods or after intercourse
  • Progressive pain worsening year on year, or pain preceding the period by several days
  • Heavy periods present since menarche (possible coagulopathy)
  • Heavy bleeding with symptoms of significant anaemia
  • Any postmenopausal, intermenstrual or postcoital bleeding
  • Suspected endometriosis or other secondary dysmenorrhoea
  • Menorrhagia with suspected coagulopathy or significant anaemia

Never do this

Do not treat progressive or secondary dysmenorrhoea, or any postmenopausal/intermenstrual/postcoital bleeding, with classical measures alone without gynaecological investigation to exclude endometriosis, structural disease and malignancy.

🟢 SUITABLE FOR ROUTINE / COLLABORATIVE CARE

AYURVEDA SCOPE

Vatanulomana measures (snehana, swedana, warm regimen) for uncomplicated primary dysmenorrhoea; rakta-stambhaka and pitta-pacifying measures with nutritional support as adjuncts for mild, investigated menorrhagia.

MODERN MEDICINE SCOPE

NSAIDs and hormonal contraception for primary dysmenorrhoea; laparoscopic diagnosis and treatment of endometriosis; PALM-COEIN work-up including ultrasound, endometrial sampling and coagulation screen; tranexamic acid, hormonal therapy, the levonorgestrel IUS, and surgery for abnormal uterine bleeding.

COLLABORATIVE SCOPE

Classical warming/spasmolytic and astringent measures as adjuncts to modern treatment once secondary dysmenorrhoea and the structural/malignant causes of bleeding have been excluded.

Sign in to read the full comparison

The plain-language summary and safety guidance above are free for everyone. The 10-dimension scholarly comparison needs an account.

Sign in