Menstrual Irregularity Through the Lens of Ayurveda: A Review of Artava Kshaya

Artava Kṣhaya is a common menstrual disorder in Ayurveda, characterized by delayed, irregular, or scanty menstruation, often with pain. It correlates with oligomenorrhea and hypomenorrhea in modern medicine. Lifestyle changes, stress, poor diet, and obesity have increased its prevalence. This review aims to present the Ayurvedic concept and management of Artava Kṣhaya with modern correlation. Methods: Classical Ayurvedic texts and their commentaries were reviewed along with relevant modern medical literature. Available clinical studies and trials evaluating Ayurvedic therapies in Artava Kṣhaya were analyzed. Results: Artava Kṣhaya arises from Tridoṣha imbalance, mainly increased Vata and Kapha with reduced Pitta, along with Agnimandya and obstruction of Artavavaha Srotas. Symptoms include delayed or irregular cycles, scanty flow, and menstrual pain. Ayurvedic treatments such as Shatapushpa–Shatavari Churna and Venuparvadi Kwatha improved menstrual regularity and flow. Discussion: Artava Kshaya in Ayurveda denotes oligomenorrhea and hypomenorrhea, with delayed (<3 days), scanty flow, and vaginal pain. It stems from Vata-Kapha dosha imbalance (especially Apan Vayu), impairing Artava vaha srotas and Ras and Rakta dhatu due to poor diet and lifestyle and excess Kaphaj foods, which weaken Agni and generate Ama. Management includes Shodhana (Vamana, Virechana, Basti), Dosha-specific Shamana drugs, yoga and lifestyle changes to bolster Agni and clear Ama, especially useful for adolescents. Modern views link it hormonal imbalances on the HPO axis from nutrition deficits and stress. Conclusion: Early, individualized Ayurvedic management using medicines, Panchakarma, lifestyle correction, and Rajaswala Paricharya offers a safe, holistic, and non-hormonal approach to restore menstrual health and prevent complications.