THERAPEUTIC ROLE OF UDUMBARA PHALA NASYA IN ASRIGDARA: A CASE SERIES ON HEMOSTASIS AND NEUROENDOCRINE REGULATION

Introduction: Nasya Karma, an Ayurvedic nasal therapy, provides a holistic, non-invasive approach to hormonal menstrual irregularities. By modulating the hypothalamic-pituitary-ovarian (HPO) axis, it influences GnRH, LH, and FSH secretion, thereby balancing estrogen and progesterone. In Ayurveda, Dysfunctional Uterine Bleeding (DUB) is closely correlated with Asrigdara, caused by Pitta-Rakta Dushti. Udumbara (Ficus racemosa), endowed with Kashaya Rasa, Sheeta Virya, and Raktastambhaka properties, is indicated in Asrigdara Chikitsa. Clinical Findings: Three patients presented with complaints of heavy or prolonged menstrual bleeding per vaginam (PV). There was no history suggestive of systemic illness such as diabetes mellitus, hypertension, thrombophilia, or thyroid dysfunction. Diagnosis: To exclude structural and systemic causes of abnormal uterine bleeding, patients were evaluated as per PALM-COEIN classification through ultrasonography and investigations including RBS, thyroid profile, and BTCT. After ruling out pathological etiologies, all were diagnosed as cases of DUB (Asrigdara). Baseline hormonal evaluation included LH and FSH levels. Intervention: Patients received Udumbara extract Nasya for 7 days after cessation of menses, for two consecutive cycles. No additional systemic therapy was administered. Follow-up and Outcomes: Administration of Udumbara nasal drops resulted in a marked reduction in both frequency and volume of uterine bleeding. Notably, prolonged cycles and early recurrence of menses were completely resolved. Post-treatment evaluation revealed improved LH and FSH levels, correlating with better hormonal regulation. Discussion: The observed clinical improvements suggest that Udumbara Nasya acts through modulation of the hypothalamic-pituitary axis, regulating GnRH, LH, and FSH secretion, which ultimately balances estrogen and progesterone levels. Additionally, its Raktastambhaka effect, coupled with Kashaya Rasa and Sheeta Virya, pacifies aggravated Pitta and Rakta, thereby reducing excessive menstrual blood loss. The therapy demonstrated both Shamana and Stambhana effects without adverse outcomes. Conclusion: Udumbara extract Nasya shows promising efficacy in managing DUB associated with hormonal imbalance. Its integrative mechanism of action aligns modern neuroendocrine regulation with Ayurvedic principles, offering a safe, effective, and non-invasive therapeutic option.