An Ayurvedic Approach to the Treatment of Secondary Amenorrhea By: Zoe Middlebrooks

AN AYURVEDIC APPROACH TO AMENORRHEA

Overview of Women’s Reproductive Cycle

The glands of the endocrine system that regulate a women’s menstrual cycle are the hypothalamus, pituitary gland, and the ovaries. The hypothalamus is the master gland of the system; it secretes Luteinizing Hormone Releasing Hormones (LHRH) and stimulates the pituitary gland to release Luteinizing Hormone (LH) and Follicle-‐Stimulating Hormone (FSH). As the pituitary gland secretes LH and FSH, these hormones act on the follicle in the ovary and stimulate its maturation. At the ovary, estrogen and progesterone are released. As the follicle matures, estrogen affects the development of a woman’s body and maturing egg. At the same time, progesterone affects the development of the endometrium and the breast tissue. The hormonal flow between the three glands is a negative feedback system; if the body has enough estrogen then no LHRH is produced, however, if estrogen levels are running low, than the hypothalamus secretes LHRH. A healthy menstrual cycle is dependent on functioning of the endocrine system.1

Every month an egg matures and a woman’s body and uterus prepare for pregnancy. If pregnancy does not occur, than the endometrial lining is released. Following menstruation, the endometrial lining of the uterus builds again as the uterus prepares for a fertilized egg. During this time there is an increase in arterial and venous blood flow. This is called the proliferative phase of the uterine (menstrual) cycle. Then, during the secretory phase, the tissue leftover after the egg is released, known as the corpus luteum, secretes estrogen and progesterone to act on the uterus and body. At this point in the cycle, if fertilization has occurred, estrogen and progesterone remain high and there is no need for the hypothalamus to secrete LHRH. However, if the egg was not fertilized then production of estrogen and progesterone drops, triggering the shedding of the endometrium-‐ the start of another menstrual cycle.2 This monthly release is the motion of apana vayu. The subdosha of vata associated with downward movement.

1
Halpern, Clinical Ayurvedic Medicine, 6th Ed. (Grass Valley: California College of Ayurveda 2012)
2
American Medical Woman’s Association, Inc., The Women’s Complete Healthbook: Up-‐to-‐the-‐Minute Medical Information on the Issues that Concern Women Most (New York: Delacorte Press,1995) p.213

Menarche & Menstruation

The onset of menses in a young woman is called menarche, according to the American Medical Women’s Association, this occurs “between the ages of 10 and 14, when the ovaries begin producing the hormone estrogen. This causes the hips to widen, breasts to develop, and body hair to grow. It also triggers menstruation, the monthly cycle of bleeding that is a key part of a woman’s fertility.”3 On average, menstruation lasts 3-‐5 days. Women’s menstrual cycles can range in length from 21 to 35. A 28-‐day cycle is the average and is thought to be the healthiest length for a woman. Health complications become more common the farther away from 28 days a women’s cycle gets.

The classical Ayurvedic description of menses was more specific; according to the Astanga Hrdayamis, “in women, the rajas (menstrual blood) which is the product of rasa (the first dhatu), flows out of the body for three days, every month, after the age of twelve years and undergoes diminision by the age of fifty years.”4

There are many Sanskrit terms that refer to the menstrual cycle. In Sanskrit, “the menstrual cycle of a woman is called rajodarshana. The root raja means ‘blood’ while dharshana means ‘to see.’ Thus rajodharshana is the ‘seeing of blood.’”5 Other Sanskrit terms include rutukala, or “woman’s season,”6 arajaska from the Charaka Samhita.7

Amenorrhea

Amenorrhea is a condition in which there is an absence of menstruation. “This absence is normal before puberty, after menopause, and during pregnancy [& lactation].”8 Amenorrhea can be a primary or secondary condition. “Primary amenorrhea occurs when a woman reaches the age of 18 and has never had a period. It is usually caused by a problem in the endocrine system that regulates hormones.”9 Reasons a woman could experience primary amenorrhea include “ovarian failure,” “problems in the nervous system or the pituitary gland in the endocrine system that affect maturation at

3 Ibid. p.210
4 Astanga Hrdayam 1:360
5 Halpern, Clinical Ayurvedic Medicine, 6th Ed. (Grass Valley: California College of Ayurveda 2012) p.5-‐4 6 Ibid.
7 Dash & Sharma, Charaka Samhita: Text With Translation & Critical Exposition Based on Cakrapani Datta’s Ayurveda Dipika 4th Ed. (Varanasi: Chowkhamba Sanskrit Series), Volume 5 p.155, XXX:17
8 American Medical Woman’s Association, Inc., The Women’s Complete Healthbook: Up-‐to-‐the-‐Minute Medical
Information on the Issues that Concern Women Most (New York: Delacorte Press,1995) p.232
9 Ibid.

puberty,” or “birth defects in which the reproductive structures do not develop properly.”10 The Sanskrit term for amenorrhea from the Charaka Samhita is and nashta-‐rakta with nashta meaning lost, destroyed or missing, and rakta meaning blood.11

“Secondary amenorrhea is an absence of menstruation for greater than or equal to three months.”12 Secondary amenorrhea can be triggered by “problems that affect estrogen levels, such as stress, weight loss, exercise, or illness;” “problems affecting the pituitary, thyroid, or adrenal gland;” or “ovarian tumors or surgical removal of the ovaries.”13 Stress, whether physical or emotional, “causes low levels of FSH and LH along with low estrogen levels.”14 Another common cause is coming off of birth control. According to Rosemary Gladstar, “many women have waited for months, even years, for their menstrual cycle to return after having been on birth control pills for an extended period of time.”15

A woman experiencing Amenorrhea should consult a western doctor or other diagnostician in order to identify any obvious reasons for her lack of menses. Common diagnostic tools are blood tests for thyroid function, female and male hormone, and possible ultrasound imaging to view the reproductive organs.16 This paper will focus on the pathology and treatment of secondary amenorrhea.

Pathology of Amenorrhea

According to Charaka, “a woman never suffers from gynecic diseases except as a result of affliction by the aggravated vayu. Therefore, first of all, the aggravated vayu should be alleviated, and only thereafter, therapies should be administered for the alleviation of other doshas.”17 Dr. Frawley has a similar claim, stating that “as a long-‐term or frequent condition [amenorrhea] is mainly a deficiency disease due to Vata. But other doshas can cause it as well.”18 While both pitta and vata can play a role in amenorrhea they are uncommon, and in most cases, vata is the primary vitiated dosha. The nidana, or etiology of this condition is caused by vata-‐provoking lifestyle regimens that lead to depletion. The

10 Ibid.
11 Halpern, Clinical Ayurvedic Medicine, 6th Ed. (Grass Valley: California College of Ayurveda 2012) p.5-‐100 12 Halpern, Clinical Ayurvedic Medicine, 6th Ed. (Grass Valley: California College of Ayurveda 2012) p.5-‐100 13 American Medical Woman’s Association, Inc., The Women’s Complete Healthbook: Up-‐to-‐the-‐Minute Medical
Information on the Issues that Concern Women Most (New York: Delacorte Press,1995) p.232
14 Halpern, Clinical Ayurvedic Medicine, 6th Ed. (Grass Valley: California College of Ayurveda 2012) p.5-‐100
15 Gladstar, Herbal Healing for Women: Simple Home Remedies for Women of All Ages (New York: Fireside 1993)
p.122
16 Mayo Clinic, Mayo Clinic Staff, Amenorrhea, http://www.mayoclinic.com/health/amenorrhea/DS00581
17 Dash & Sharma, Charaka Samhita: Text With Translation & Critical Exposition Based on Cakrapani Datta’s Ayurveda
Dipika 4th Ed. (Varanasi: Chowkhamba Sanskrit Series) Volume 5 p.159, XXX:114.5-‐116.5
18 Frawley, Ayurvedic Healing: A Comprehensive Guide 2nd Ed. (Twin Lakes, WI: Lotus Press 2000) p.248

consumption of old, dry and light foods that lead to malnourishment is a very important contributing factor. So too is excessive motion such as a fast paced lifestyle filled with travel, stress and overwhelm. Physically, excessive exercise provokes vata.

Symptoms accompanying amenorrhea can include other symptoms of depletion and dryness including “constipation, dry skin, dry hair, weight loss, worry and anxiety.”19 As all these symptoms are those of vata dosha, the samprapti of amenorrhea will be primarily vata associated. In Dr. Halpern’s Clinical Ayurvedic Medicine, he concisely describes the six stages of disease of amenorrhea as the vitiation of vata travels through accumulation, aggravation, overflow, relocation, manifestation, and diversification.

“Vata accumulates and becomes aggravated in the purishavaha srota. It overflows to the rasa and rakta vaha srotas and relocates deeper into the rasa dhatu as well as into the medas and shukra dhatus. Relocation to the rasa dhatu leads to dryness throughout the body and a decrease in the production of menstrual fluid. Relocation to the medas dhatu results in weight loss and further drying of the body. Relocation to the shukra dhatu inhibits ovulation. Relocation to the mind results in anxiety and overwhelm along with other vata emotions. “ 20

In addition, after accumulation and aggravation in the purishavaha srota, apana vayu could relocate in the purishavaha srota with a decrease in rasa dhatu leading to a possible and likely symptom of constipation.

Western Approach to Treatment

According to the Mayo Clinic staff, depending on the nidana of the amenorrhea, treatments include contraceptive pills to jumpstart the menstrual cycle, medications to treat possible thyroid or pituitary disorders or surgery in the case of tumors or structural blockages. In addition, they also mention “lifestyle and home remedies” a woman can work with, including a recommendation to “strive for balance in work, recreation and rest. Assess areas of stress and conflict in your life.”21 The American Medical Women’s Association notes that patients are often asked to record their basal body

19 Halpern, Clinical Ayurvedic Medicine, 6th Ed. (Grass Valley: California College of Ayurveda 2012) p.5-‐100 20 Ibid. p.5-‐100/101
21 Mayo Clinic, Mayo Clinic Staff, Amenorrhea, http://www.mayoclinic.com/health/amenorrhea/DS00581

temperatures in order to help detect whether or not a woman is ovulating.22 Taking ones basal body temperature daily is also useful in bringing awareness and mindfulness to a woman’s monthly cycle and accompanying patterns.

Ayurvedic Treatment

As a holistic health, in treating an absence of menses ayurvedically, a practitioner would treat the patient through their mind, body, and spirit. Their treatment plan would include dietary and lifestyle changes in addition to herbal and five sense therapies.

Dietary Recommendations

As a condition of vata vitiation, women with amenorrhea will likely experience an increase in the qualities of dry, cold, light and mobile. To counteract these qualities they should alter their diet to concentrate on warm, moist and heavy foods. The most beneficial tastes for them at this time are sweet, in addition to salty and sour. The spicing of foods with dipanas is important to ensure that samana and apana vayu are functioning, as absorption and elimination of nutrients is key. Classical Ayurvedic dietary recommendations from the Susruta Samhita include taking “fish, Kulattha pulse, Masa pulse, Kanjika (fermented sour gruel etc.), Tila, wine (Sura), cow’s urine, whey, half diluted Takra, curd and Sukta.”23 These suggestions include the sweet, sour and salty tastes as well as heavy and oily foods to nourish vata. A woman with amenorrhea should increase her consumption of whole grains, root vegetables, nuts, dairy and oil. The addition of oils to the diet will be very nourishing and help to keep moisture in the body. It is also important to consider a woman’s daily caloric intake and make sure that it is adequate especially in cases of amenorrhea and vata vitiation due to anorexia nervosa or excessive exercise.

For some women, taking daily supplements will help them to get any vitamins or minerals that their diet is lacking. According to the University of Maryland Medical Center, for women lacking menstruation, it may be beneficial to supplement the diet with calcium, magnesium, vitamin D, vitamin K, boron, Vitamin B-‐6, and essential fatty oils. “Women who don’t have periods are at higher risk of

22 American Medical Woman’s Association, Inc., The Women’s Complete Healthbook: Up-‐to-‐the-‐Minute Medical
Information on the Issues that Concern Women Most (New York: Delacorte Press,1995) p.232/233
23 Bhishagratna, Susruta Samhita(Varanasi: Chowkhamba Sanskrit Series 2002) p. 146, II:22-‐23

osteoporosis”, calcium, magnesium, vitamin D, vitamin K, and boron “may help keep bones strong.”24 Vitamin B-‐6 is recommended because it may help reduce high prolactin levels. “Prolactin is a hormone released by the pituitary gland, and women with amenorrhea often have higher levels of prolactin.”25 Essential fatty acids are important to supplement into the diet, as the human body is not able to synthesize these fats. A couple examples of oils containing omega 3 and 6 fatty acids are flaxseed oil and cod liver oil.

Herbs for Amenorrhea

Herbal treatments for amenorrhea can be very effective when taken in addition to dietary and lifestyle changes. The suggested herbal treatment for amenorrhea in the Charaka Samhita is to “drink the blood of deer, goat, sheep and pig mixed with yoghurt, juice of sour fruits and ghee. She may also take the milk boiled with drugs belonging to Jivaniya group (jivaka, rasabhaka, meda, maha-‐meda, kakoli, ksira-‐kakoli, mudga-‐parni, masa-‐parni, jivanti and madhuka).”26 Only some of these classical recommendations can be utilized in the twenty-‐first century as few women will agree to drinking the blood of animals and many of the suggested herbs are no longer available. “The first six herbs listed in Jivaniya are listed in a group of herbs known as Ashtvarga-‐ eight herbs. These eight herbs became extinct 500 years ago.”27 Bhavamisra the author of Bhavaprakasa Nighantu has made some suggested substitutions for the extinct herbs; these include replacing meda and mahameda with shatavari, and jivaka and rasabhaka with vidari kand.28

In Dr. Halpern’s text he writes “herbs that are nutritive tonics should be taken along with spices to improve digestion. Most nutritive female reproductive tonics are demulcents and build the rasa dhatu supporting the production of menstrual flow.”29 Therefore, reproductive tonics, demulcents, nervine tonics, and tonifying emmenogogues are herbal categories that should be concentrated on. Most herbal treatments must be continued for several months before the menses returns as rebuilding the health and tone of the reproductive system takes time. While a woman may be tempted to work with

24 University of Maryland Medical Center, http://umm.edu/health/medical/altmed/condition/amenorrhea 25 Ibid.
26 Dash & Sharma, Charaka Samhita: Text With Translation & Critical Exposition Based on Cakrapani Datta’s Ayurveda Dipika 4th Ed. (Varanasi: Chowkhamba Sanskrit Series) Volume 5 p.155, XXX:101.5-‐102.5
27 Skudder, Vitalizing Herbs-‐Jivaniya, http://www.atreya.com/ayurveda/Vitalizing-‐Herbs-‐Jivaniya.html 28 Ibid.
29 Halpern, Clinical Ayurvedic Medicine, 6th Ed. (Grass Valley: California College of Ayurveda 2012) p.5-‐101

emmenogogues, “purifying emmenogogues…while stimulating menstrual bleeding, should not be taken as they are drying to the body and lead to greater depletion.”30

The Jivaniya herbal substitutes of shatavari and vidari kand in addition to wild yam are nutritive female reproductive tonics that will benefit women with amenorrhea. These are the reproductive tonics are also recommended in the Dr. Halpern’s Clinical Ayurvedic Medicine text. Dong quai is another suggested herb because of its actions as a tonifying emmenogogue. The roots of these four herbs are the part of the plant used medicinally as tonics. All of them are considered to have a sweet rasa (taste). The sweet taste in Ayurveda is composed of the earth and water elements. According to Michael Tierra “it is cooling, nutritive, pleasant and softening…the essence of nourishment.”31

Shatavari

Asparagus racemosus is the variety of asparagus root used medicinally in Ayurveda, known as Shatavari. The translation of Shatavari is one “’who possesses a hundred husbands,’ as its tonic and rejuvenative action on the female reproductive organs is said to give the capacity to have a hundred husbands”32 Shatavari is an heavy and oily tonic used often in Ayurveda “for gynecological purposes and to strengthen female hormones.”33 Its demulcent quality helps to nurture the mucous membranes. “It both nourishes and cleanses the blood and the female reproductive organs.”34

Vidari Kand

Vidari Kand, or Ipomea digitati, falls into the herbal categories of rasayana and demulcent, as well as many others. This sweet root is related to the sweet potato. Studies have shown that vidari kand has “significant oestrogenic and progesteronogenic activities with no toxicity.“35 In addition, patients have responded positively when taking vidari kand as a replacement for routine hormonal therapies.36

30 Ibid.
31 Tierra, Plantetary Herbology: An Integration of Western Herbs into the Traditional Chinese and Ayurvedic Systems
(Twin Lakes, WI: Lotus Press 1988) p.41
32 Frawley & Lad, The Yoga of Herbs: An Ayurvedic Guide to Herbal Medicine, 2nd Ed. (Twin Lakes, WI: Lotus Press, 2008) p.183
33 Tierra, Plantetary Herbology: An Integration of Western Herbs into the Traditional Chinese and Ayurvedic Systems
(Twin Lakes, WI: Lotus Press 1988) p.321
34 Frawley & Lad, The Yoga of Herbs: An Ayurvedic Guide to Herbal Medicine, 2nd Ed. (Twin Lakes, WI: Lotus Press, 2008) p.184
35 Puri, Rasayana: Ayurvedic Herbs for Longevity and Rejuvenation (Traditional Herbal Medicines for Modern
Times)(London: Taylor & Francis 2002) p.306
36 Ibid.

Wild Yam

Deioscorea villosa also known as wild yam is a sweet herb that “contains hormones and is an effective tonic for the female reproductive system.”37 The phytoprogesterones contained in wild yam help “to regulate the ratio of progesterone to estrogen in the system,” making wild yam beneficial to both the herbal and scientific communities.38 When treating disorders of the women’s reproductive system it is important to consider the liver. The liver is a detoxifier, filtering toxins from the bloodstream. It also plays a major role in the balance of hormones.39 When there is stagnation in the liver, these processes slow. Wild yam is a recommended herb to use in this case, in addition to working on the reproductive system. Wild yam is a great liver tonic, as it “activates and stimulates liver activity.”40

Dong quai

Dong quai, or Angelica sinensis is another sweet root that “can be used to treat almost every gynecological imbalance because of its strengthening and building qualities…Though dong quai has no specific hormonal action, it exerts a regulating and normalizing influence on hormonal production through its positive action on the liver and endocrine system.”41 It can be used in all complaints of the female reproductive system. In addition, don quai is also a mild nervine tonic, helping to lower stress by calming and relaxing the nervous system.

Dipanas

Shatavari, vidari kand, wild yam, and dong quai are all heavy and cooling herbs, therefore they turmeric. Cinnamon (Cinnamomum cassia) is a good choice because of its demulcent and stimulating properties. Dried ginger (Zingiberis officinale) would be a useful carrier herb in a formula because it is also considered an emmenogogue. Turmeric (Curcumae longa) is less stimulating than cinnamon and ginger, but it helps to regulate menses by decongesting the liver.42

37 Frawley & Lad, The Yoga of Herbs: An Ayurvedic Guide to Herbal Medicine, 2nd Ed. (Twin Lakes, WI: Lotus Press, 2008) p.186
38 Gladstar, Herbal Healing for Women: Simple Home Remedies for Women of All Ages (New York: Fireside 1993) p.258
39 Ibid. p.78-‐79 40 Ibid. p.259 41 Ibid. p.241
42 Ibid. p.244-‐245, 274

Anupanas

When considering the appropriate anupana for these herbs in pacifying vata, it would be best to cook a formulation of these herbs into a medicated ghee or oil. A teaspoon of this ghee would be taken an hour away from food in the morning and evening. As long as there are appropriate dipanas in the medicated ghee then it could be melted into warm milk, another option is to take it with ginger tea. This treatment will need to be continued for several months in order to give the uterus and reproductive system time to rebuild itself.

Chyawanprash

Chyawanprash is another beneficial herbal supplement, recommended for its nutritional value and general tonifying effects. In Parle & Bansal’s review of the herbal formula it is said that it “streamlines menstrual cycles in females.”43 Comprised of around fifty herbs, Chyawanprash is a comprehensive tonic, great for maintaining homeostasis. As the carrier, the honey in formula helps drive the herbs deep into the body’s tissues.44 In the case of amenorrhea this is useful for the honey’s action of driving the tonifying herbs into the tissues of the uterus. It is also commonly used in the reduction of stress. As a daily tonic, a woman can take 1-‐2 teaspoons of Chyawanprash morning and evening; taking it with warm milk will enhance the tonifying effect.45

Rejuvenative Therapies

Women with amenorrhea should consider treating themselves to a series of Ayurvedic body therapies. A Bliss therapy consisting of abhyanga, shirodhara, and svedana treatments would be beneficial as these treatments are pacifying to vata and very nourishing to the system. In addition to the Bliss therapy, anuvasana and uttara bastis would help to encourage healthy downward movement and svadhisthana basti would localize energy and release to the 2nd chakra. These treatments would be most helpful if the woman repeated them every month several times until menstruation returned.46

43 Parle, & Bansal, “Traditional medicinal formulation, Chyawanprash-‐ A Review,” Indian Journal of Traditional Knowledge 5(4)(October 2006)487
44 Ibid. p.484
45 Frawley, Ayurvedic Healing: A Comprehensive Guide 2nd Ed. (Twin Lakes, WI: Lotus Press 2000) p.116 46 Halpern, Clinical Ayurvedic Medicine, 6th Ed. (Grass Valley: California College of Ayurveda 2012) p.5-‐101

Lifestyle Changes

Lifestyle and yoga therapies are very important for women experiencing amenorrhea. They need to partake in vata pacifying behaviors and therapies. Most importantly this includes rest and minimizing the amount of things or stressors that are apart of their everyday lives. In addition, women can look toward the support of other women, Yoga Nidra, daily movement, and releasing pranayama practices.

Sharing Pheromones

In Herbal Healing for Women it is recommended for women experiencing amenorrhea to spend extra time surrounded by menstruating women. She states, “menstruating women secrete a chemical called pheromone. This enzyme triggers a hormonal reaction in other women which can stimulate the menstrual cycle.”47 In 1998 at the University of Chicago a study was done that demonstrates “the existence of human pheromones and identify[ing] a potential pheromonal mechanism for menstrual synchrony, as well as for other forms of social regulation of ovulation.”48

Yoga Nidra

A six-‐month trial study with women experiencing menstrual disorders suggested, “in patients with menstrual irregularities, Yoga Nidra not only has utility as a possible therapeutic strategy, but also may be a method for improving headache, giddiness, nervousness and irritability.49 In the study, amenorrhea was included in the various menstrual symptoms whose changes were tracked in both the intervention (Yoga Nidra & medication) and control (medication only) groups. In the group of women that experienced Yoga Nidra for 35 minutes five days a week for six months there was a larger decrease in the occurrence of amenorrhea than in the control group. 50

Daily Movement

When excessive exercise is not the cause of amenorrhea, it is recommended to incorporate 30 minutes of movement daily. This exercise should be gentle and can include walking in nature or a

47 Gladstar, Herbal Healing for Women: Simple Home Remedies for Women of All Ages (New York: Fireside 1993)
p.123
48 Stern & McClintock, “Regulation of ovulation by human pheromones,” Nature 392 (March 1998) 177-‐179
49 Rani, Tiwar, Singh, Agrawai, “Six-‐month trial of Yoga Nidra in menstrual disorder patients: Effects on somatoform
symptoms,” Industrial Psychiatry Journal 20(2) (July-‐December 2011) 97-‐102
50 Ibid.

restorative yoga asana practice and should only be preformed if the woman is strong enough. Yoga is beneficial when trying to bring back the menstrual cycle because when done consistently it to reduce stress and brings balance to the endocrine system. A balanced practice would include a full range of motion, focusing on inversions, twists, and backbends. “Inversions increase blood circulation, and balance your endocrine system, backbends tone your liver, and twists massage your internal organs.”51 A suggested sequence for healthy menstruation could include supta baddha konasana, adho mukha virasana, jahu sirsasana, triang mukhaikapada paschimottanasana, paschimottanasana, upavistha konasana I, parsva upavistha konasana, upavistha konasana II, viparita dandasana, setu bandha sarvangasana, savasana.52

Conclusion

Western medicine and Ayurveda both offer options for the treatment of amenorrhea. In most cases, Western medicine encourages the return of menses through the use of artificial hormone therapy. Ayuveda offers more options and avenues for treatment that allow women to bring awareness to their own cycles and lives. Taking charge of their own treatment by making positive lifestyle changes and utilizing the natural but effective medicine of herbs.

51 Sparrowe & Walden, Yoga for a healthy menstrual cycle (Boston: Shambhala Publications, Inc 2004) p.29
52 Ibid. p.11

Sources Cited

• American Medical Woman’s Association, Inc., The Women’s Complete Healthbook: Up-‐to-‐the-‐ Minute Medical Information on the Issues that Concern Women Most (New York: Delacorte Press,1995)
• Bhishagratna, Susruta Samhita(Varanasi: Chowkhamba Sanskrit Series 2002)
• Dash & Sharma, Charaka Samhita: Text With Translation & Critical Exposition Based on Cakrapani Datta’s Ayurveda Dipika 4th Ed. (Varanasi: Chowkhamba Sanskrit Series)
• de la Foret, Herbal Remedies Advice, Female Reproductive System, http://www.herbalremediesadvice.org/female-reproductive-system.html
• Frawley, Ayurvedic Healing: A Comprehensive Guide 2nd Ed. (Twin Lakes, WI: Lotus Press 2000)
• Frawley & Lad, The Yoga of Herbs: An Ayurvedic Guide to Herbal Medicine, 2nd Ed. (Twin Lakes, WI: Lotus Press, 2008)
• Gladstar, Herbal Healing for Women: Simple Home Remedies for Women of All Ages (New York: Fireside 1993)
• Halpern, Clinical Ayurvedic Medicine, 6th Ed. (Grass Valley: California College of Ayurveda 2012)
• Mayo Clinic, Mayo Clinic Staff, Amenorrhea, http://www.mayoclinic.com/health/amenorrhea/DS00581
• Parle, & Bansal, “Traditional medicinal formulation, Chyawanprash-‐ A Review,” Indian Journal of Traditional Knowledge 5(4)(October 2006)484-‐488

ABSTRACT

Pheromones are airborne chemical signals that are released by an individual into the environment and which affect the physiology or behaviour of other members of the same species1. The idea that humans produce pheromones has excited the imagination of scientists and the public, leading to widespread claims for their existence, which, however, has remained unproven. Here we investigate whether humans produce compounds that regulate a speciﬁc neuroendocrine mechanism in other people without being consciously detected as odours (thereby fulﬁlling the classic deﬁnition of a pheromone). We found that odourless compounds from the armpits of women in the late follicular phase of their menstrual cycles accelerated the preovulatory surge of luteinizing hormone of recipient women and shortened their menstrual cycles. Axillary (underarm) compounds from the same donors which were collected later in the menstrual cycle (at ovulation) had the opposite effect: they delayed the luteinizing-‐hormone surge of the recipients and lengthened their menstrual cycles. By showing in a fully controlled experiment that the timing of ovulation can be manipulated, this study provides deﬁnitive evidence of human pheromones.

• Puri, Rasayana: Ayurvedic Herbs for Longevity and Rejuvenation (Traditional Herbal Medicines for Modern Times)(London: Taylor & Francis 2002)
• Rani, Tiwar, Singh, Agrawai, “Six-‐month trial of Yoga Nidra in menstrual disorder patients: Effects on somatoform symptoms,” Industrial Psychiatry Journal 20(2) (July-‐December 2011) 97-‐102

ABSTRACT

Background:

Emotional insecurity, stress, depressive or/and anxiety symptoms are common with variable severity among patients with menstrual disorder. Yogic relaxation therapy (Yoga Nidra) leads to conscious and subconscious recognition of these underlying psychological factors and helps releasing of suppressed conflicts.

Objective:

To evaluate the effect of Yoga Nidra on anxiety and depressive symptoms in patients with menstrual disorders.

Materials and Methods:

Subjects were recruited from the Department of Obstetrics and Gynecology, C.S.M. Medical University (erstwhile KGMU), Lucknow Uttar Pradesh, India. The subjects were randomly divided in to two groups: Intervention group (with yogic intervention) and control group (without yogic intervention). Assessments of all subjects were carried out by administering Hamilton anxiety scale (HAM-‐A) and Hamilton rating scale for depression (HAM-‐D) at baseline and after six months.

Results:

The mean age with S.D of the intervention group was 27.67 ± 7.85 years, and for control group was 26.58 ± 6.87 years (among completed intervention group nn = 65 and control group nn = 61). There was significant reduction of scores in HAM-‐A (P<0.003) and HAM-‐D (P<0.02) respectively in subjects with mild to moderate anxiety and depressive symptoms after six months of yoga therapy (Yoga Nidra) in intervention group in comparison to control group.

Conclusion:

The patients with mild to moderate anxiety and depressive symptoms improve significantly with ‘Yoga Nidra’ intervention. There is no significant improvement in the patients with severe anxiety and depressive symptoms.

• Skudder, Vitalizing Herbs-‐Jivaniya, http://www.atreya.com/ayurveda/Vitalizing-‐Herbs-‐ Jivaniya.html
• Sparrowe & Walden, Yoga for a healthy menstrual cycle (Boston: Shambhala Publications, Inc 2004)
• Stern & McClintock, “Regulation of ovulation by human pheromones,” Nature 392 (March 1998) 177-‐179

ABSTRACT

• Tierra, Plantetary Herbology: An Integration of Western Herbs into the Traditional Chinese and Ayurvedic Systems (Twin Lakes, WI: Lotus Press 1988)
• University of Maryland Medical Center, http://umm.edu/health/medical/altmed/condition/amenorrhea

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