{"paper_id":"2f2192bc-d41a-45c3-8201-454c05b02f2b","body_text":"International Journal for Multidisciplinary Research (IJFMR) \n \nE-ISSN: 2582-2160   ●   Website: www.ijfmr.com       ●   Email: editor@ijfmr.com \n \nIJFMR240426064 Volume 6, Issue 4, July-August 2024 1 \n \nA Conceptual Co-Relation of Endometriosis with \nUdavarta Yonivyapad \n \nPriti Arikar1, B.R Patel2, Shilpa Donga3 \n \n1PG Scholar Dravyaguna Department, ITRA Jamnagar \n2Professor Dravyaguna Department, ITRA Jamnagar \n3Professor PTSR Department, ITRA Jamnagar \n \nAbstract \nEndometriosis is one of the most mysterious benign gynecological disorder defined by implantation of \nfunctioning endometrial tissue outside the uterine cavity. The worldwide prevalence is about 10%. Women \nwith endometriosis are usually confronted with one or more major problems like pain and infertility. Pain \nincludes dysmenorrhea, dysperunia and chronic pelvic pain. It can be co-relate as it is one of the condition \nwhich consider under Udavarta yonivypad on the basis of dysmenorrhea and relief in pain just  after the \nmenstruation. As in Udavarta Yonivyapad vitiation of Apana and Vyana Vayu occurs. Further it causes \nalteration in Karma of Apana Yayu resulting retrograde menstruation with dysmenorrhea. Syndrome \ncomplex of Udavarta Yonivyapad resembles with End ometriosis. We can state that if pathology of \nUdavarta yonivypada continues for longer time, further it results into a condition of endometriosis. In \nUdavarta Yonivyapad Retrograde menstruation with painful menstruation occurs, as this continues for \nlonger time due to vitiation of Apana and Vyana vayu, Strotovaigunya, Vimargagamana, Doshasanghat \nand Siragranthi type of Srotodusthi occurs accordingly. Also, we can relate this to the complication of \nuntreated Udavarta due to which adhesion in uterus and pelvi s takes place, thereafter formation of \nChocolate cyst which can relate to Granthi at Ovarian site. \n \nINTRODUCTION \nOnset of Artava marks the starting of reproductive life of women and it should be devoid of Shoola, Daha, \nPaichhilya and should not be excessive or scanty in matra is considered as Shuddha Artavai. Abnormalities \nof Artava leads to many diseases like Yonivyapad, Artavavyapad, which may result in complications like \ninfertility. Udavarta Yonivyapad is one such amongst the 20 Yonivyapad which are mentioned in \nBruhatrayi as well as in Madhav Nidan and Yogaratnakar. According to Acharya Vagbhata, Prakruta Apana \nVayu is responsible for excretion of Shukra, Artava, Mala, Mutra, Garbhaii. If natural urges are supressed, \nVayu takes upwards course in the genital tract due to which the women suffer painful discharges of the \nmenstrual blood with difficulty because of its upward tendency. After discharge of the menstrual blood, \nthere will be relief instantly. Because of the upward course of menstrual blood, it is known by the wise as \nUdavartiniiii. In nut shell, the Vimargagamana in Artavavaha Srotas accounting to the Vaigunya in Apana \nVayu results in displacement of Raja from its original place in altered form (Gunatah and Dravyatah), \nwhich corelates the condition of endometriosis. \nवेगोदावर्तन ाद्योनन मुदावर्तयर्ेऽनन लः| \nसारुगार्ात रजः कृ च्छ्रेणोदावृत्त ं  नवमुञ्चनर्|| \n\n \nInternational Journal for Multidisciplinary Research (IJFMR) \n \nE-ISSN: 2582-2160   ●   Website: www.ijfmr.com       ●   Email: editor@ijfmr.com \n \nIJFMR240426064 Volume 6, Issue 4, July-August 2024 2 \n \nआर्तवे सा नवमुक्ते  र्ु र्त्क्षणं लभर्े सुखम्| \nरजसो गमन ादूर्ध्वं ज्ञेयोदावनर्तनी बुध ः|| (cha.chi.30/25-26)  \nAccording to the contemporary science, the syndrome complex of Endometriosis can be resemble with \nUdavarta yonivyapad and can be consider under Udavarta Yonivyapad. It means presence of endometrial \ntissue (gland and stroma) outside the uterus. Endometriosis presents in three different entities, which are \nfrequently found together: peritoneal lesions, deep endometriosis and ovarian endometriotic cyst \n(endometriomas). Ovarian endometrioma is a benign oestrogen dependent cystic  mass from ectopic \nendometrial tissue within the ovary. It contains thick, brown, tar like fluid which may referred as chocolate \ncyst. The pathogenesis of endomet riomas remains contentious, with a variety of theories proffered, \nincluding invagination and subsequent collection of menstrual debris from endometriotic implants, which \nare located on the ovarian surface and adherent peritoneum. Endometriosis is perceived  as a chronic \ndisease should be suspected with, Dysmenorrhea, Dyspareunia, subfertility, chronic pelvic pain and \nmenstrual irregularity. Endometriosis can be associated with significant gastrointestinal symptoms (pain, \nnausea, vomiting, early satiety, bloating and distention, altered bowel habitsiv. \nEndometriosis is one of the most benign gynaecological conditions that affects 1 out of every 10 women \nof reproductive age and second to uterine fibroid needing major gynaecological surgery. Endometriosis \nprevalence ranged from 15.4% to 71.4% v, study has been taken  to diagnose the disease in early stage,  \nunderstanding the condition and corelating endometriosis with Udavarta yonivyapad to avoid further \ncomplications. \n \nMATERIALS AND METHODS \nFor the study the literary materials which include the reference of Udav arta Yonivyapad through the \navailable ayurvedic text and for endometriosis, available modern texts and articles has been collected. \n \nCONCEPTUAL REVIEW \nUDA V ARTA YONIVYAPAD \nIt is one of the Vishmati Yonivyapdas told by all acharyas. Vata is causative dosha of udavarta yonivyapad \nby all the acharyas. \nNIRUKTI-The act of going up. In udavarta, Gati of Vayu turns into upward direction. \nDEFINITION-Udavarta is the Urdhvagamana of Raja due to Vata vitiation. In Madhukosha teeka, \nUdavarta is defined as the condition where vitiated Vata takes the Raja upward and then discharges \npainfully. There will be painful menstruation and pain gets relieved immediately following discharge of \nmenstrual blood. \nNIDANA-It can be classified into two types for convenience i,e Samanya and Vishesha. \nSamanya nidana- \nMithyachara: It includes both mithya ahara and mithya vihara \nMithya aahara   \n• Anashana \n• Alpashana \n• Atyashana \n• Vishmashana \n• Katu, tikta, kashaya rasa aahara sevana \n\n \nInternational Journal for Multidisciplinary Research (IJFMR) \n \nE-ISSN: 2582-2160   ●   Website: www.ijfmr.com       ●   Email: editor@ijfmr.com \n \nIJFMR240426064 Volume 6, Issue 4, July-August 2024 3 \n \n• Ruksha, laghu, sheeta aahara sevana \nMithya Vihara \n• Excessive coitus, coitus in abnormal body posture. \n• Vishama sthana shayana \n• Ratrijagarana \n• Bhaya, Shoka etc. \n• Apadravya sevana: Introducing artificial objects into the vagina in an Unhygienic way which leads to \nlocal resistance and facilitate the Invasion of the organisms,  precipitating infection. These leads to \nvitiation of Vata specifically Apana Vata  which then moves upward instead of moving downwards  \nthereby causing movement of Raja in reverse diversion and fails to expel the Raja. \nPradushta artava \nWhen the Artava does not possess Shuddha Artava lakshanas, it is pradushta Artava. And is the cause of \nAshta Artava Dushti. These Dushti occurs due to the vitiation of Tridosha which affects not only the \nquantity and quality of the Artava but also causes painful menstruation. According to modern perspective \nit resembles Hormonal imbalance as hormones are responsible for the normal and abnormal flow of \nmenstrual blood. \nBeeja dosha \nBeeja dosha refers to abnormalities in Artava and Shukra, which results into abnormal formation of genital \ntract of the female foetus like Suchimukhi causing Kricchrartava. In modern correl ation, congenital \nanomalies in the women like pin hole Os of cervix, septate uterus, imperforate hymen etc. are the causes \nof painful menstruation due to difficulty in escaping of menstrual blood. \nDaiva \nWhen the cause is not known, the disease is said to develop due to Adharma done by the women and also \ndue to Purvajanma kruta papa karma. \nVishesha nidana- \nVegadharana is the vishesha nidana told by Acharya Charaka and Vagbhatavi. \n \nSAMPRAPTI-                            \nNidan sevana \n \nDhatu kshay and strotovaigunya, \n \nVyan and Apan vayu prakopa (kapha Anubandha) \n \nMarga Avrodh evam avaran, Vimargagamana Doshasangata \n \nArtava urdhwagamana \n \nKasthartawa,Yonishoola \n \nUdavarta Yonivyapada \n \n\n \nInternational Journal for Multidisciplinary Research (IJFMR) \n \nE-ISSN: 2582-2160   ●   Website: www.ijfmr.com       ●   Email: editor@ijfmr.com \n \nIJFMR240426064 Volume 6, Issue 4, July-August 2024 4 \n \nSAMPRAPTI GHATAKA \nTable 1: Samprapti ghataka of Udavarta yonivyapad \nSamprapti ghataka Details  \nDosha Vayu Pradhana Tridosha \nUdbhavsthana Garbhashaya /yoni \nSanchara Shroni, Yoni, Udar, Stana, Shira, Adhokaya, \nSarwasharir  \nAvayava Garbhashaya /yoni \nAshraya Pakwashaya Ashrita \nRogmarga Abhyantar roga marga  \nStrotas Artavavaha Srotas, Rasavaha, Raktavaha \nSroto vikruti Sanga, Vimarga gamana  \nDhatu /Mala  Rasa mansa Artava  \nAnubandha Kapha and pitta  \nAnubandhya  Vayu \n \nSYMPTOMS \nTable 2: symptoms of Udavarta yonivyapad \nCharaka Sushruta  Madhava \nnidana \nVagbhata  Yogratnakara  \nKricchartava \nArtava \nvimukshesukham \nRuka \nKricchartava \nPhenilata \nKricchartava \nPhenilata \nKricchartava \nPhenilata \nYonipradeepana \nbadhha artava \nKricchartava \nPhenilata \nKaphanivam \nartvam vii \n \nENDOMETRIOSIS \nIt means presence of endometrial tissue [gland and stroma] outside the uterus . Endometriosis present in \nthree different entities, which are frequently found together: peritoneal lesions, deep endometriosis and \novarian endometriotic cyst (endometriomas)viii. It contains thick, brown, tar like fluid which may referred \nas chocolate cyst ix. The pathogenesis of endometriomas remains continues, with a variety of theories \nproferred, including invagination and subsequent collection of menstrual debris from endometriotic \nimplants, which are located on the ovarian surface and adherent peritoneum. \nCOMMON CAUSES -Retrograde Menstruation , Coelomic Metaplasia , Direct implantation theory , \nLymphatic and vascular theory, Genetic and immunological factors. \n \nPATHOGENESIS \nRetrograde menstruation \n \n                                Endometrial fragments get implanted in peritonial surface  \n \nOutflow tract obstruction in genital tract \n \n\n \nInternational Journal for Multidisciplinary Research (IJFMR) \n \nE-ISSN: 2582-2160   ●   Website: www.ijfmr.com       ●   Email: editor@ijfmr.com \n \nIJFMR240426064 Volume 6, Issue 4, July-August 2024 5 \n \nAdhesions in pelvic region \n \n                              Patient suffers from Dysmenorrhea,Pelvic pain(Endometriosis) \n \nCOMMON SITES-Ovaries, Pelvic peritoneum, Pouch of Douglas, Uterosacral ligaments, Rectovaginal \nseptum, Appendix, Fallopian tubes.x \nSYMPTOMS-Leading symptoms are  Dysmenorrhea, Dyspareunia, subfertility, chronic pelvic pain, \nmenstrual irregularity. Endometriosis can be associated with significant gastrointestinal symptoms (pain, \nnausea, vomiting, early satiety, bloating and distention, altered bowel habits). \n \nDISCUSSION \nCo-relation between Endometriosis and Udavarta Yonivyapad-As there dysmenorrhea, Chronic pelvic \npain and relief in pain just after the menstruation are the common symptom in both . Thus, we can state \nthat if pathology of Udavarta yonivypada continues for longer time, further it results into a condition of \nendometriosis. In Udavarta Yonivyapad Retrograde menstruation with Painful  discharge occurs, as this \ncontinues for longer time due to vitiation of Apana and Vyana vayu, Strotovaigunya, Vimargagamana, \nDoshasanghat and Siragranthi type of Srotodusthi occurs accordingly. Also, we can relate this to the \ncomplication of untreated Udavarta due to which adhesion in uterus and pelvis takes place, thereafter \nformation Chocolate cyst which can relate to Granthi at Ovarian site.  \nIn contemporary science, the primary management of this conditions includes NSAIDs, OCPs and \nhormonal therapy which have long list of side effects and do not provide long lasting relief. Ayurveda can \nprovide a radical treatment of this disease by normalisi ng the function of Apana Vayu, for that proper \ndiagnosis should done to avoid further complications in future.  \n \nCONCLUSION \nSymptoms of both the diseases can be resembles that is why we can Correlate them as endometriosis is \none of the conditions which can consider under the Udavarta Yonivyapad.  \nFinancial support and sponsorship-Nil \nConflicts of interest-There are no conflicts of interest. \n \nReferences \n \n1. Agnivesh, Charak Samhita of Aacharya Charaka,Dridhbalakrit, Edited by Pandit Kashinatha Shahtri \nand Dr. gorakhanatha Chaturvedi,  Chikitsa sthana, cha.30, ver-226, Chaukhambha Bharati academy, \nVaranasi, Reprint 2019, pg. 870 \n2. Aacharya Vagbhatt, Ashtanghruday, Dr. bramhananda Tripathi, Edited with ‘NIramala’ Hindi \ncommentary, Sutra Sthana, cha. 12, ver-9, Chaukhambha Sanskrit Prakashana, Delhi, pg. 172  \n3. Premavati Tiwari, Ayurvediy prasuti tantra evum stree rog part2, Adhyay 1 Yonivyapada ,Chaukhamba \nOrientalia Varanasi, pg no.34 \n4. Berek & Novak’s Gynaecology, fourteenth edition, Published by Wolters Kluwer(India) pvt.ltd,new  \ndelhi, reprint-ISBN- 13:978-81-89836-11-5, section-7, cha.29, pg.1137& 1143 \n5. https://www.researchgate.net \n\n \nInternational Journal for Multidisciplinary Research (IJFMR) \n \nE-ISSN: 2582-2160   ●   Website: www.ijfmr.com       ●   Email: editor@ijfmr.com \n \nIJFMR240426064 Volume 6, Issue 4, July-August 2024 6 \n \n \n6. Vagbhata,Asthanghruday with commentaries of Arundatta and Hemadri. Edited by PL Harisadashiva \nshastriparadkar,Chaukhamba Sanskrit sansthana, Varanasi , edition reprint 2010 \n7. http;/www.wjpmr.com/article/view/ISSN 2455-3301 \n8. Sajeewani, H., and Parera, M.S.(2021, January 1). Ayurvedic management of Udavartini \nYonivyapad(Ovarian Endometrioma) - A case report. International journal of AYUSH case \nreports,4(4),226-232.Retrived from https:www.ijacare.in/index.php/ijcare/article/view/180 \n9. Berek & Novak’s Gynaecology, fourteenth edition, Published by Wolters Kluwer (India) pvt.ltd,new  \ndelhi, reprint-ISBN- 13:978-81-89836-11-5, section-7, cha.29, pg.1137& 1143","source_license":"CC0","license_restricted":false}