A Holistic Ayurvedic Perspective on Anartava (Amenorrhea): Classical Insights and Clinical Application

Anartava, literally meaning the absence of Artava (menstrual flow), is discussed extensively in Ayurvedic classics. Different terminologies such as Nashtartava (by Sushruta), Anartava (by Vagbhata), absence of Raja (by Bhela), and Rajonasha (by Bhavaprakasha) are used to describe this condition, although it is considered more as a symptom than a standalone disorder. However, its significant impact on female fertility makes it a condition demanding careful clinical attention. Modern medicine identifies Amenorrhea (absence of menstruation) as a clinical condition often linked to hormonal imbalances such as PCOD, thyroid dysfunction, or hypothalamic-pituitary-ovarian (HPO) axis disturbances. Treatment is typically limited to hormonal replacement therapy (HRT), which may not always yield satisfactory results. This study explores the classical Ayurvedic understanding of Anartava and its practical integration with modern diagnostic concepts. A case of secondary amenorrhea persisting for 8–10 years with associated PCOD and thyroid dysfunction is presented. The patient had become unresponsive even to hormonal withdrawal bleeding. Ayurvedic management included Shodhana Chikitsa (detoxification), particularly Basti and Nasya, along with tailored oral medication and lifestyle modifications. Gradual restoration of the menstrual cycle was observed — initially after six months, then at two-month intervals, eventually stabilizing at a regular 35–40-day cycle with improved flow and quality. This case highlights the potential of Ayurveda in addressing chronic and resistant cases of Anartava through a personalized and root-cause-focused approach.