Changes

*Food and beverages that are excessively hot in potency cause disturbances in the physiology of menstruation especially in the growth and development of follicles/ovum. (andopachaya). [ Ka. Sa. Kalpa Sthana 7/32]

*Food and beverages that are excessively hot in potency cause disturbances in the physiology of menstruation especially in the growth and development of follicles/ovum. (andopachaya). [ Ka. Sa. Kalpa Sthana 7/32]

*Consumption of excessive salty, sour, heavy, pungent substances, those producing burning sensation(vidahi), excessive use of unctuous substances, meat of domestic, aquatic and fatty animals, mixture of cooked rice and pulses (krushara), curd, vinegar, curd-water(mastu) and wine leads to excessive menstrual bleeding. [Cha.Sa. Chikitsa Sthana 30/204]

*Consumption of excessive salty, sour, heavy, pungent substances, those producing burning sensation(vidahi), excessive use of unctuous substances, meat of domestic, aquatic and fatty animals, mixture of cooked rice and pulses (krushara), curd, vinegar, curd-water(mastu) and wine leads to excessive menstrual bleeding. [Cha.Sa. [[Chikitsa Sthana]] 30/204]

'''2. Lifestyle factors:'''

'''2. Lifestyle factors:'''

*The daily activities in general and those during menstruation influence reproductive health. [Cha. Sa. Chikitsa Sthana 30/7-8], [Su.Sa. Sharira Sthana 2/24-25]

*The daily activities in general and those during menstruation influence reproductive health. [Cha. Sa. [[Chikitsa Sthana]] 30/7-8], [Su.Sa. Sharira Sthana 2/24-25]

*Suppression of natural urges (vega dharana) of micturition, defecation etc. leading to aggravation of “apana vayu” cause menstrual disorders. [Cha. Sa. Chikitsa Sthana 30/25-26].

*Suppression of natural urges (vega dharana) of micturition, defecation etc. leading to aggravation of “apana vayu” cause menstrual disorders. [Cha. Sa. [[Chikitsa Sthana]] 30/25-26].

A case control study in 300 subjects has proven the association of suppression of urges of micturition and defaecation with primary dysmenorrhoea.<ref>Vrinda Roy(2011),A case-control study to evaluate the association between Mutra-purisha vegadharana and primary dysmenorrhoea,PG dissertation,department of Swasthavrutta, VPSV Ayurveda college, Kottakkal, Kerala.</ref>

A case control study in 300 subjects has proven the association of suppression of urges of micturition and defaecation with primary dysmenorrhoea.<ref>Vrinda Roy(2011),A case-control study to evaluate the association between Mutra-purisha vegadharana and primary dysmenorrhoea,PG dissertation,department of Swasthavrutta, VPSV Ayurveda college, Kottakkal, Kerala.</ref>

*The specific activities like continuous travelling especially  in jerky vehicles,continuos sitting or standing in one position , excessive walking and exersion cause vitiation of “apana vayu” and lead to menstrual disorders. [A. Hr. Ni. 16/27]

*The specific activities like continuous travelling especially  in jerky vehicles,continuos sitting or standing in one position , excessive walking and exersion cause vitiation of “apana vayu” and lead to menstrual disorders. [A. Hr. Nidana thana 16/27]

*Use of artificial objects for sexual pleasure are considered as risk factors for menstrual disorders. [Cha. Sa. Chikitsa Sthana 30/7-8] [A. Hr. Uttara Sthana 33/27-28]  

*Use of artificial objects for sexual pleasure are considered as risk factors for menstrual disorders. [Cha. Sa. [[Chikitsa Sthana]] 30/7-8] [A. Hr. Uttara Sthana 33/27-28]  

'''3. Psychological factors:'''  

'''3. Psychological factors:'''  

*Mental stress, anxiety and excessive thinking causes vitiation of channels of transportation of [[rasa dhatu]] and lead to disturbances in the physiology of menstruation. [Cha. Sa. Vimana Sthana 5/13] Stress is a major cause for hormonal disturbance in HPO axis leading to menstrual abnormalities.

*Mental stress, anxiety and excessive thinking causes vitiation of channels of transportation of [[rasa dhatu]] and lead to disturbances in the physiology of menstruation. [Cha. Sa. [[Vimana Sthana]] 5/13] Stress is a major cause for hormonal disturbance in HPO axis leading to menstrual abnormalities.

'''4. Improper use of therapeutic interventions:'''

'''4. Improper use of therapeutic interventions:'''

'''5. Congenital factors:'''  

'''5. Congenital factors:'''  

*The defects in gametes (beejadosha), especially in the ovum of mother can cause congenital anomalies related to female reproductive system. [Cha. Sa. Sharira Sthana 4/ 30].

*The defects in gametes (beejadosha), especially in the ovum of mother can cause congenital anomalies related to female reproductive system. [Cha. Sa. [[Sharira Sthana]] 4/ 30].

It is responsible for altering the reproductive physiology and causing menstrual abnormalities. [Cha Sa Chikitsa Sthana 30/7-8], [Cha Sa Chikitsa Sthana 30/34-35]

It is responsible for altering the reproductive physiology and causing menstrual abnormalities. [Cha Sa [[Chikitsa Sthana]] 30/7-8], [Cha Sa [[Chikitsa Sthana]] 30/34-35]

===Pathophysiology===

===Pathophysiology===

*Heavy menstrual bleeding is also included in the disorders of blood (raktapradoshaja vikara).[ Cha. Sa. Sutra Sthana 28/11]

*Heavy menstrual bleeding is also included in the disorders of blood (raktapradoshaja vikara).[ Cha. Sa. Sutra Sthana 28/11]

*The obstructive pathology due to kapha usually leads to decrease in the fuction due increase in the properties like coldness[[sheeta]], dullness/slowness[[manda]] and immobility[[sthiratva]]. While explaining the pathology of secondary amenorrhoea(artava nasha), it is clarified that the [[dosha]] causing the occlusion of [[vata]] here is either [[kapha]] or another form of [[vata]] itself, but not [[pitta]].[Dalhana commentary on  Su. Sa. Sharira Sthana 2/21]

*The obstructive pathology due to [[kapha]] usually leads to decrease in the function due increase in the properties like coldness ([[sheeta]]), dullness/slowness ([[manda]]) and immobility ([[sthiratva]]). While explaining the pathology of secondary amenorrhoea(artava nasha), it is clarified that the [[dosha]] causing the occlusion of [[vata]] here is either [[kapha]] or another form of [[vata]] itself, but not [[pitta]].[Dalhana commentary on  Su. Sa. Sharira Sthana 2/21]

===General features===

===General features===