A Randomized Open-Labelled Controlled Clinical Study to Evaluate the Efficacy of Jambavādi Kaṣāya in the Management of Asṛgdara with Special Reference to Menorrhagia

Background: Asṛgdara is a common gynecological disorder described in Ayurveda, characterized by excessive or prolonged menstrual bleeding and comparable to menorrhagia in contemporary medicine. It can adversely affect women's physical, psychological, and social well-being. Ayurvedic management focuses on correcting the underlying Samprāpti through Pitta Śamana, Rakta Prasādana, Rakta Sthāpana, and Stambhana. Jambavādi Kaṣāya, a classical formulation indicated in Raktapitta, possesses Stambhana, Rakta-Prasādana, and Pitta-Śamana properties and may therefore have therapeutic potential in Asṛgdara. However, clinical evidence regarding its efficacy in Asṛgdara remains limited. Aim: To clinically evaluate the efficacy of Jambavādi Kaṣāya in the management of Asṛgdara with special reference to menorrhagia. Methods: A randomized, open-label, controlled clinical study was conducted on 30 participants fulfilling the predefined diagnostic and inclusion criteria for Asṛgdara. Participants were randomly allocated into two groups of 15 each. Group A (n = 15) received Jambavādi Kaṣāya, while Group B (n = 15) received Pathyāmalakādi Kaṣāya. Treatment was administered for 2 months, followed by a 1-month follow-up period. The outcomes assessed included the amount and duration of menstrual bleeding, passage of clots, lower abdominal pain, bodyache, and fatigue, along with objective parameters such as the Pictorial Blood Assessment Chart (PBAC) score and hemoglobin level. Appropriate parametric and non-parametric statistical tests were used for within-group and between-group comparisons. Results: Both groups demonstrated improvement in the clinical features and objective parameters of Asṛgdara following treatment. Statistically significant improvement was observed in amount and duration of menstrual bleeding. Hemoglobin levels, PBAC scores, menstrual bleeding characteristics, associated symptoms, and quality-of-life measures showed significant improvement. No significant adverse effects were reported during the treatment and follow-up period. Discussion: Both Jambavādi Kaṣāya and Pathyāmalakādi Kaṣāya were associated with improvement in the clinical and objective parameters of Asṛgdara. The observed therapeutic effects of Jambavādi Kaṣāya may be attributed to its Stambhana, Rakta-Prasādana, Pitta-Śamaka, and Garbhāśaya-Saṅkocaka properties. However, comparative efficacy should be interpreted based on the statistical significance of the between-group differences. Conclusion: Jambavādi Kaṣāya was associated with improvement in the clinical and objective parameters of Asṛgdara after 2 months of treatment. Where between-group differences were statistically non-significant, the findings do not establish superiority of Jambavādi Kaṣāya over Pathyāmalakādi Kaṣāya. The results suggest that Jambavādi Kaṣāya may be a useful therapeutic option in the management of Asṛgdara, subject to interpretation of the observed between-group statistical differences. Keywords: Asṛgdara, Menorrhagia, Jambavādi kaṣāya, Pathyāmalakādi kaṣāya