Kashtartav (Udavartini Yonivyapad): A Comprehensive Ayurvedic Review With Contemporary Correlation

Abstract

Background: Kashtartav, described in classical Ayurvedic texts as painful and difficult menstruation, is one of the most significant gynaecological complaints encountered in clinical practice. The condition is broadly encompassed under the nosological entity Udavartini Yonivyapad, one of the twenty types of Yonivyapad described by Acharya Charaka and Sushruta. Despite its prevalence, this condition remains underdiagnosed and undertreated in contemporary medical practice, necessitating a thorough Ayurvedic re-examination.

Objective: To critically review the Ayurvedic concept of Kashtartav under Udavartini Yonivyapad, its Nidana, Samprapti, Lakshanas, and Chikitsa Sutra, and to establish its correlation with contemporary gynaecological conditions such as primary and secondary dysmenorrhoea.

Methods: An extensive review of classical Ayurvedic texts — Charaka Samhita, Sushruta Samhita, Ashtanga Hridayam, Ashtanga Sangraha, Kashyapa Samhita, and Bhavaprakasha — was undertaken. Contemporary literature on dysmenorrhoea was also reviewed for correlation.

Conclusion: Kashtartav (Udavartini Yonivyapad) represents a Vata-predominant, Vataja Yonivyapad with significant Apana Vata vitiation. Its clinical features closely correlate with primary dysmenorrhoea, endometriosis, and related pelvic pain disorders. Ayurvedic management targeting Vata Shamana and Apana Anulomana offers a holistic and effective therapeutic approach...