Role of Matra Basti in the Management of Menopausal Syndrome: A Comprehensive Review of Classical Concepts and Clinical Evidence

Menopause is a natural biological transition characterized by the permanent cessation of menstruation due to depletion of ovarian follicular activity. Declining estrogen levels during menopause are associated with vasomotor symptoms, psychological disturbances, musculoskeletal pain, urogenital atrophy, sleep disorders, and deterioration in quality of life. Although hormone replacement therapy (HRT) remains the standard treatment for symptomatic menopause, concerns regarding its long term safety have increased interest in complementary and integrative medical approaches. Ayurveda recognizes menopause as Rajonivritti, a physiological event occurring during Jara (ageing) and primarily associated with Vata Dosha predominance, Dhatu Kshaya, and diminished Artava. Among Panchakarma procedures, Matra Basti, a subtype of Sneha Basti administered in small quantities of medicated oil, is considered the most appropriate therapy for Vata predominant disorders and age related degenerative conditions. Classical Ayurvedic texts describe Matra Basti as a nourishing (Brimhana), rejuvenating (Rasayana), and Vata pacifying intervention capable of improving tissue integrity and physiological balance. Contemporary studies evaluating Ayurvedic management of menopausal syndrome suggest improvements in vasomotor symptoms, sleep quality, psychological well being, musculoskeletal discomfort, and overall quality of life. However, high quality clinical evidence specifically evaluating Matra Basti remains limited. This review critically examines the classical concepts of Rajonivritti and Matra Basti, summarizes available clinical evidence, explores probable mechanisms of action from Ayurvedic and biomedical perspectives, identifies current research gaps, and highlights future directions for evidence based integration of Matra Basti into menopausal healthcare.