A COMPREHENSIVE AYURVEDA REVIEW: MANAGEMENT OF KASHTARTAVA W.S.R. TO PRIMARY DYSMENORRHEA

Background: Kashtartava, correlated with primary dysmenorrhea in contemporary medicine, is one of the most prevalent gynecological complaints affecting reproductive-aged women globally. Characterized by painful menstruation sufficient to impair daily activities, it significantly impacts quality of life, academic performance, and work productivity. While modern management primarily employs NSAIDs and hormonal contraceptives, these interventions often provide symptomatic relief with associated adverse effects and do not address the underlying pathogenesis. Objective: This comprehensive review aims to elucidate the Ayurvedic understanding of Kashtartava, explore its etiopathogenesis through classical textual references, and systematically present the therapeutic approaches including Shamana (palliative), Shodhana (bio-cleansing), and lifestyle interventions. Material and Methods: A systematic review of classical Ayurvedic texts including Charaka Samhita, Sushruta Samhita, and Ashtanga Hridaya was undertaken alongside contemporary literature searches using keywords "Kashtartava," "dysmenorrhea," "Udavartini Yonivyapad," and "Ayurvedic management." Clinical studies, trial registries, and review articles were analyzed to synthesize evidence-based therapeutic protocols. Discussion: Kashtartava manifests primarily due to vitiation of Apana Vayu, leading to obstruction (Margavarodha) or reverse flow (Pratiloma Gati) of menstrual blood. The condition finds its classical description predominantly under Udavartini Yonivyapad. Therapeutic strategies focus on Vata pacification through Vatanulomana (facilitating downward flow), Snehana (oleation), and Swedana (fomentation). Interventions range from oral formulations like Pippalayadi Phanta, Rajapravartini Vati, and Kuberaksha Vati to Panchakarma procedures, particularly Matra Basti with Vata-shamaka oils. Conclusion: Ayurveda offers a comprehensive and holistic approach to managing Kashtartava by addressing the root pathology—vitiated Vata Dosha—rather than merely suppressing pain. Integrating Shodhana with Shamana therapies, alongside appropriate lifestyle modifications (Rajaswala Charya), provides sustainable relief and prevents recurrence. Future large-scale clinical trials are warranted to further validate these classical interventions.