The Role of Nasya (with Medhya drug) in the

Rajo-NivrittiJanya Lakshana w.s.r. to Menopausal syndrome

Scholar

Dr. Jatinder kour

Dr. S.B. Donga

Department of Stree Roga & Prasooti Tantra

Institute for Post Graduate Teaching & Research in Ayurveda

Gujarat Ayurveda University, Jamnagar

2014-2017

Prof. L.P. Dei

PRESENTING A WORK DONE BY Dr. DEVANGI PATEL

IN THE YEAR 2004.

Youth is a phase of excitement and adventure.

Middle age is a period of career, family andresponsibilities.

And old age means time to relax and slow down.The years of play, adventure long workinghours, stress, etc. Slow the body and maycause aches and pains.

INTRODUCTION

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Page 3

The woman is an axleAround whom notOnly the family or

the society but the wholeUniverse revolves.

Her health is more importantIn all stages of her

life more…………

But menopausal condition more severe and difficult to handle without proper understanding medical advice, social support

as well.

Currently, 43 million

Menopausal women

By 2026, 103 million Menopausal

women

Average age of

Menopause

47.5 years

According to

IMS

Third consensus meeting of Indian Menopause Society (2008): A summary

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• Now- a- days, due to change life style

psychological and physiological

symptoms of Menopause are much

pronounced and require much

importance in International Medicinal

world.

Continue----

SYMPTOMS

• Hot flushes

• Night sweating

• Sleep disturbances

• Tingling

sensations

Mood swings

Depression

Anxiety

Crashing fatigue

Loss of libido

Dysuria

Urine incontinence

Urinary Frequency

Dryness of vagina

Dyspareunia

Arthritis Hypertension

WHY NOT HRT ????loss of

memory

endometrial cancer

impaired motor function

allergic reactions

drug dependence

immobility

To evaluate the therapeutic efficacy

of Madhya Ghrita Nasya in

Rajonivrittijanya lakshanas

To study the effect of Nasya in psychological

parlance w.s.r. to menopausal syndrome.

Aims & Objectives

Materials and methods

Patients were

selected from the

O.P.D. of the

Department of

Stree roga &

Prasooti- tantra,

I.P.G.T. & R.A.

Jamnagar.

Patients fulfilling

the criteria for

selection were

integrated into the

study irrespective

of cast, religion

etc.

A detailed history

was filled up in the

specially prepared

proforma on

Ayurvedic

guidelines as well

as Modern.

Criteria for selection of Patients

Inclusion criteria

Age 40-55 yearsWillingness of patients

Amenorrhoea

for ≥ 12 months

Having clinical features

of Menopausal syndrome

Psychological

disturbances

Exclusion

Criteria

Established cases of HTN, DM,

hepatic disorders..

Text

Text

Text

Text

Text

Text

Evidence of malignancyMenopausal women with

untoward effects of HRT

Cont…

Investigations

Haematological : Hb, TLC, DLC, ESR

Bio-chemical : Lipid Profile, RBS

1.

Urine Examination : Sugar, Protein, WBC, RBC

Specific Examination: Vaginal Cytology

WHY MEDHYA GHRITA ????

Psychotropic

Anti-stress

Anti Aging

Tranquilizer

The drugs given in the form of Ghrita, a form of lipid, is likely to be rapidly

absorbed and distributed in the target areas of the body such as the nervous

system in this case. The main reason behind this is the molecular structure of

the blood brain barrier. The membrane separating the CNS tissue and the

circulating blood is lipophilic in nature.

The test drug 'Medhya Ghritawere prepared in the pharmacy of

Gujarat Ayurved Univeristy,

Jamnagar..

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WHY NASYA ????Nasya therapy is part of Panchakarma

and is a natural route for delivering

rejuvenating substances to the brain.

Treatment protocol

Nasya

Drug Medhya Ghrita

Dose 8 drops in each nostril

Route Nasal

Duration 2 courses of 8 days with an interval of 8 days

CRITERIA FOR ASSESSMENT

T

WResults of the treatment were

assessed on the basis of relief

in signs & symptoms of

Menopausal Syndrome with

the help of specific scoring

pattern as recorded in research

proforma.

To assess the effect of treatment

on Vaginal cytology were done

before treatment (BT) and after

treatment (AT) to see Maturation

Index (MI) & The mean

Maturation Value (MV) for the

estrogen level in the blood which

has positive effect on vaginal

cells.

Criteria for assessment of overall effect of the therapy

Unchanged 25% changes in the signs and symptoms

Mild Improvement: 25-50% relief in the signs and symptoms

Moderate improvement 51-75% relief in the signs and symptoms

Marked improvement: 76-100% relief in the signs and symptoms

Statistical estimation of results

The obtained data were analyzed statistically. The values were expressedas percentage of relief and Mean SEM and

P > 0.05 Insignificant

P < 0.05 & 0.01 Significant

P < 0.001 Highly significant

Paired ‘t’ test .

Status of the Patients

Trial Group Total no. of the patients

Registered 14

Completed 12

Discontinued 02

No Drugs Rasa Guna Virya Vipaka Prabhava Doshaghnata

1. Manduk parni Tikta,

Kashaya

Laghu , Sheeta madhura Medhya Tridosha shamak

2. . Yastimadhu Madhura

Tikta

Snigdha,

Guru

Sheeta madhura Medhya,

Kanthya ,Va

rnya

Vata Pitta Shamak

3. Guduchi Tikta

Kashaya

Snigdh,

Gurua

Ushna Madhura Rasayana,

medhya,Vr

ishya

Tridosh Shamak

4. shankh-pushpi Tikta

Katu

Snigdha

Pichchhila

Sheeta Madhura Medhya Tridosh Shamaka

Vata Pitta shamak

5. Jatamansi Madhura

Tikta

Kashaya

Snigdha

LaTikshnaG

hu, Tikshna

Sheeta Katu Bhutaghna

(Manasdosha

hara

Tridosh Shamak

Pharmacodynamic Properties of the ingredients of Medhya ghrita

EFFECT OF THERAPY IN CHIEF SOMATIC COMPLAINTS

0

10

20

30

40

50

60

70

80

75.23

54.4461.35

43

16.73

36.36

21.1416.73

%

%

THERAPY ON CHIEF PSYCHOLOGICAL COMPLAINTS

0102030405060708090

88.55

61.81 59.27

45.45 48.39 50

34.48

4.94

%

%

No. Vaginal

Epithelial

cells

Mean score of

Maturation

Index (MI)

Changes

in mean

number

of cells

BT AT

1 Parabasal cells 26 16 10

2 Intermediate

cells

54 55 1

3 Superficial cells 23 29 6

EFFECT OF THERAPY ON VAGINAL CYTOLOGY(BY MI)

TOTAL EFFECT OF THERAPY

0

10

20

30

40

50

60

Marked improvement

Moderate improvement

Mild improvement

No improvement

16.67

25

58.33

0

%

%

FOLLOWUP STUDY (Somatic symptoms)

0

10

20

30

40

50

60

70

80

18.18

37.527.27

25

50 53.13

75

0

%

%

FOLLOWUP STUDY (Psychological symptoms)

0

10

20

30

40

50

60

8.52

29.5532.14

50

37.5

5045

59.38%

%

DISCUSSION

• As Menopause is considered as a Vardhakya janita vyadhi,

Rasayana particularly in the form of Medhya Rasayana is

the first line of treatment, which is Medhya, Smritikara,

Vatahara, Ayuprada, Nidrajanaka, Bala Agnivardhaka,

etc.

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Efficacy of Medhya Ghrita

• The drug Medhya Ghrita, having Rasayan, Blaya, Medhya,

Indriya Tarpaka etc. properties, when administered through

nasal route, it reaches the Shirah (which is a pradhana

indriya) by various siras, and acts mainly on Tarpaka

Kapha, Prava Vayu and Manovaha Srotas, and gives

benefits like Mental ability, Will power, Intellect, Strength,

Immunity, Longevity, Vitality, Luster & Tint,

Youthfulness, Vigor-competence etc., which will be helpful

to extinguish the symptoms of Rajonivritti mainly in

psychological background.

• Drug like Yastimadhu may act as estrogen and helps to

alleviate stress.

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Efficacy of Medhya Ghrita

• Apart from these, Nasya may have some effect on

Thermoregulatory center of the brain, by which it could be able

to pacify the Hot flushes, Excessive sweating, etc., symptoms of

menopause.

• The probable role on Hypothalamo-Pituitary-Ovarian axis also

should be taken into consideration in this regard. The action on

brain may also seem to be beneficial in the symptoms like

Palpitations, Sensation of pins and needles prick in palms and

soles etc.

• The tranquilizing and antistress properties of majority ingredients

may help to allay the symptoms related to Manovaha Srotas like

Sleep Disturbances, Irritability, Depression, Mood Swings, etc.

Efficacy of Medhya Ghrita

• Due to limited actions of nasya, this therapy may not

able to prove its efficacy in the symptoms related to

GIT like Constipation, Flatulence etc and other

systemic symptoms like Pain in joints, Backache,

Loss of urinary control, etc. In these symptoms oral

administration of drugs may be more beneficial.

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conclusion•Medhya Ghrita Nasya is better in various Psychological disturbances

mainly include Irritability, Depression, Mood Swings, etc in

comparison of Somatic Complaints including GIT disturbances as well

as Vaginal dryness and Hot flushes, etc.

•In Vaginal Cytology, the process of Maturation of vaginal epithelial

cells was observed, which indicates some hormonal (mainly estrogenic)

effect of the drug.

•So, it can be concluded that in women with moderate symptoms of

menopausal syndrome, Nasya therapy may give better result in both

Somatic and Psychological complaints more on psychological.