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A series of clinical trials on effect of a classical formulation of Cissampelos pareira (patha),  Piper longum Linn, Zingiber officinale, Piper nigrum Linn (trikatu), Holarrhena antidysenterica, (vrukshaka) mentioned for clotted type presentation (vata-kapha predominant granthibhuta artava dushti) was carried out. Oral administration of the formulation, therapeutic purgation(virechana), medicated enema(basti) showed good results in 170 patients of PCOS. The efficacy in terms of symptomatic relief, correction of hormonal levels and improvement in the quality of life was observed.<ref>Dr. krupa D. Patel (2011) A clinical study on Polycystic Ovarian Disease (PCOD) & it’s management by Shatpushpa tail matra basti & Pathadi Kwatha ,PG dissertation ,Dept of Prasutitantra and Stree Roga, IPGT&RA, Jamnagar.</ref> <ref>Dr. Ashokan (2014) ,Clinical study on Ayurvedic treatment modalities in the management  Vata – Kaphaja Artavadushti (w.s.r.to PCOS), PhD thesis ,Dept of Prasutitantra and Stree Roga, IPGT&RA, Jamnagar.</ref> <ref>Dr. Pravin Dhote (2015),Clinical study on Vata Kaphaja Artavdushti (w.s.r. to PCOS) and it’s management by Ayurvedic treatment Modalities” , PG dissertation ,Dept of Prasutitantra and Stree Roga, IPGT&RA, Jamnagar.</ref> <ref>Dr. Ashiya (2018), Managementof Artava Dushti w.s.r to Polycystic Ovarian Syndrome with Virechana and Pathadi kwatha – a randomized controlled clinical trial, PG dissertation ,Dept of Prasutitantra and Stree Roga, IPGT&RA, Jamnagar.</ref> <ref>Archana S. (2019),Management of ArtavaDushti w.s.r to polycystic ovarian syndrome by PalashadiBasti and PathadiChoorna : A randomized controlled clinical trial , PhD thesis ,Dept of Prasutitantra and Stree Roga, IPGT&RA, Jamnagar.</ref>   

A series of clinical trials on effect of a classical formulation of Cissampelos pareira (patha),  Piper longum Linn, Zingiber officinale, Piper nigrum Linn (trikatu), Holarrhena antidysenterica, (vrukshaka) mentioned for clotted type presentation (vata-kapha predominant granthibhuta artava dushti) was carried out. Oral administration of the formulation, therapeutic purgation(virechana), medicated enema(basti) showed good results in 170 patients of PCOS. The efficacy in terms of symptomatic relief, correction of hormonal levels and improvement in the quality of life was observed.<ref>Dr. krupa D. Patel (2011) A clinical study on Polycystic Ovarian Disease (PCOD) & it’s management by Shatpushpa tail matra basti & Pathadi Kwatha ,PG dissertation ,Dept of Prasutitantra and Stree Roga, IPGT&RA, Jamnagar.</ref> <ref>Dr. Ashokan (2014) ,Clinical study on Ayurvedic treatment modalities in the management  Vata – Kaphaja Artavadushti (w.s.r.to PCOS), PhD thesis ,Dept of Prasutitantra and Stree Roga, IPGT&RA, Jamnagar.</ref> <ref>Dr. Pravin Dhote (2015),Clinical study on Vata Kaphaja Artavdushti (w.s.r. to PCOS) and it’s management by Ayurvedic treatment Modalities” , PG dissertation ,Dept of Prasutitantra and Stree Roga, IPGT&RA, Jamnagar.</ref> <ref>Dr. Ashiya (2018), Managementof Artava Dushti w.s.r to Polycystic Ovarian Syndrome with Virechana and Pathadi kwatha – a randomized controlled clinical trial, PG dissertation ,Dept of Prasutitantra and Stree Roga, IPGT&RA, Jamnagar.</ref> <ref>Archana S. (2019),Management of ArtavaDushti w.s.r to polycystic ovarian syndrome by PalashadiBasti and PathadiChoorna : A randomized controlled clinical trial , PhD thesis ,Dept of Prasutitantra and Stree Roga, IPGT&RA, Jamnagar.</ref>   

      

      

*Various methods have been developed to quantify the menstrual blood loss and validated for the purpose of research. Among them, alkaline hematin method is considered as the gold standard and is considered as the best when used in conjunction with a pictorial method like menstrual pictogram.  

*Various methods have been developed to quantify the menstrual blood loss and validated for the purpose of research. Among them, alkaline hematin method is considered as the gold standard and is considered as the best when used in conjunction with a pictorial method like menstrual pictogram.<ref>Magnay JL, O'Brien S, Gerlinger C, Seitz C. A systematic review of methods to measure menstrual blood loss. BMC Womens Health. 2018;18(1):142. Published 2018 Aug 22. doi:10.1186/s12905-018-0627-8</ref>

*Medical therapies for heavy menstrual bleeding include hormonal treatments; levonorgestrel-releasing intrauterine system (LNG-IUS) and combined hormonal contraceptives are most commonly used. Endometrial ablation is a minor surgical procedure that is associated with low operative morbidity and can be performed as an outpatient. Hysterectomy remains the definitive treatment of choice when medical therapies have failed and endometrial ablation is not suitable.  

*Medical therapies for heavy menstrual bleeding include hormonal treatments; levonorgestrel-releasing intrauterine system (LNG-IUS) and combined hormonal contraceptives are most commonly used. Endometrial ablation is a minor surgical procedure that is associated with low operative morbidity and can be performed as an outpatient. Hysterectomy remains the definitive treatment of choice when medical therapies have failed and endometrial ablation is not suitable.<ref>Davies J, Kadir RA. Heavy menstrual bleeding: An update on management. Thromb Res. 2017;151 Suppl 1:S70‐S77. doi:10.1016/S0049-3848(17)30072-5</ref>

Clinical trials using certain Ayurveda formulations and therapeutic purgation (virechana) have shown appreciable results in the management of excessive menstrual bleeding, especially in case of dysfunctional uterine bleeding.

Clinical trials using certain Ayurveda formulations and therapeutic purgation (virechana) have shown appreciable results in the management of excessive menstrual bleeding, especially in case of dysfunctional uterine bleeding.<ref>Pooja Chauhan(2019)Management of Asrigdara with Virechana and Vasadi Ghanavati : An open labeled Randomized comparative clinical trial, PG dissertation,Department Stree Roga and of Prasuti Tantra, IPGT&RA, Jamnagar, Gujarat.</ref> <ref>Roopa K.V(2011),A critical study on the role of virechana in the samprapti vighatana of asrigdara w.s.r to DUB, PG Dissertation,Department of Prasuti tantra and stree roga, RGUHS,Bangalore.</ref> <ref>Jamuna Devi R(2004), Management of asrigdara with special reference to dysfunctional uterine bleeding with “ashoka yoga, PG Dissertation, Department of Prasuti tantra and stree roga,GAM,Puri,Orissa</ref>

   

   

*Conventional management options for dysmenorrhea include non-steroidal anti-inflammatory drugs and hormonal contraceptives. In Ayurveda, the drugs or procedures which pacify [[vata]] are advised for the treatment of dysmenorrhea .

*Conventional management options for dysmenorrhea include non-steroidal anti-inflammatory drugs and hormonal contraceptives. In Ayurveda, the drugs or procedures which pacify [[vata]] are advised for the treatment of dysmenorrhea .

Clinical trials have shown that enema with medicated oil (matra basti) is an effective protocol for the management of dysmenorrhea.

Clinical trials have shown that enema with medicated oil (matra basti) is an effective protocol for the management of dysmenorrhea.<ref>Dr. Kaumudi Karunagoda (2010)A comparative clinical study of Dashmoola Taila Matra Basti and Tila Taila Matra Basti in the management of Kashtartava, PG dissertation, Department Stree Roga and of Prasuti Tantra, IPGT&RA, Jamnagar, Gujarat</ref> <ref>Dr.Amit Tanna (2011),A further study of Kashtartava (Dysmenorrhea) and its management by Dashmula Taila Matra Basti and Tila Taila Matra Basti, PG dissertation, Department of Stree Roga and Prasuti Tantra IPGT&RA, Jamnagar, Gujarat.</ref> <ref>Dr. HLMG Sajeewani (2012),Further Clinical Study on Kashtartava with special reference to Primary Dysmenorrhea and its management by Matra Basti, PG Dissertation, Department of Stree Roga and Prasuti Tantra IPGT&RA, Jamnagar, Gujarat</ref>

Various Ayurvedic formulations having carminative, analgesic and anti-inflammatory properties are also proven their efficacy in the management of dysmenorrhea.

Various Ayurvedic formulations having carminative, analgesic and anti-inflammatory properties are also proven their efficacy in the management of dysmenorrhea.<ref>Arun gupta(2020),Management of Udavartini Yoni Vyapad(Dysmenorrhoea), with Shoola Prashamana Dashemani and Eranda Brusht Haritaki Shunthi Churna-a comparative clinical study, PG Dissertation, Department of Stree Roga and Prasuti Tantra IPGT&RA, Jamnagar, Gujarat</ref> <ref>Chayaa Der (2002),A comparative clinical study of Satapushpa Vati and Krishna Tila Kwatha on Artava Kshaya , PG Dissertation, Department of Stree Roga and Prasuti Tantra IPGT&RA, Jamnagar, Gujarat</ref>

*Topical heat, exercise, and nutritional supplementation are also beneficial and practice of Yoga has greater impact in patients of dysmenorrhea.  

*Topical heat, exercise, and nutritional supplementation are also beneficial and practice of Yoga has greater impact in patients of dysmenorrhea.<ref>Habeeb Mini (2003),A study on the effect of selected Yoga and Nature cure techniques in Udavarta Yoni Vyapada, Deptt. Of Swasthavrutta by Govt.Ayurvedic College Thiruvananthapuram, Kerala.</ref>

*Menstrual blood-derived stem cells (MenSCs) are a novel source of mesenchymal stem cells (MSCs). They are found to be having therapeutic effects in various diseases, including liver disease, diabetes, stroke, Duchenne muscular dystrophy, ovarian-related disease, myocardial infarction, Asherman syndrome, Alzheimer's disease, acute lung injury, cutaneous wound, endometriosis, and neurodegenerative diseases.  

*Menstrual blood-derived stem cells (MenSCs) are a novel source of mesenchymal stem cells (MSCs). They are found to be having therapeutic effects in various diseases, including liver disease, diabetes, stroke, Duchenne muscular dystrophy, ovarian-related disease, myocardial infarction, Asherman syndrome, Alzheimer's disease, acute lung injury, cutaneous wound, endometriosis, and neurodegenerative diseases.<ref>Chen L, Qu J, Xiang C. The multi-functional roles of menstrual blood-derived stem cells in regenerative medicine. Stem Cell Res Ther. 2019;10(1):1. Published 2019 Jan 3. doi:10.1186/s13287-018-1105-9</ref>

==='''List of abbreviations of classical Ayurveda texts:''' ===

==='''List of abbreviations of classical Ayurveda texts:''' ===