Basti Therapy (medicated enema) in gynecological practice: A way forward in managing oligo-hypomenorrhoea (Artavakshaya)

Artavakshaya (oligo-hypomenorrhoea) is a condition described in Ayurvedic classics in which vitiated vata and kapha dosha causes obstruction in the artavavahasrotas (channels that carries menstrual blood or artava). The characteric features of Artavakshaya include yathochitakalaadarshana (prolonged intermenstrual period), alpata (scanty bleeding) and yonivedana (pain in vagina or pain during menses). Artavakshaya is a condition very much similar to the oligohypomenorrhoea which is characterized by cycle which are longer than 35 days and with bleeding less than 2 days. The principles of management of Artavakshaya are vatakaphashamaka (vata and kapha dosha pacifying) and agnivardhaka (stimulant, digestive and pitta analogue) therapy. Basti (medicated enema) which comes under Panchakarma (five biopurificatory measures) is considered as superior treatment in vata and vata predominant conditions. Matrabasti (low dose medicated oil enema) is a type of anuvasana basti (medicated lipid enema) which can be administered without much contraindication. Matrabasti administered with vatakaphashamaka and agnivardhaka drug can be better choice in the treatment of artavakshaya. Basti which is administered through guda maarga (rectal route) reaches the pakwashaya (large intestine) and spreads the virya (potency) of the drug to sarvasharira (whole body) through the microchannels. Basti which can act on the enteric nervous system and thereby act on the Central Nervous System can further stimulate the Hypothalamo-Pituitary-Ovarian (HPO) axis. A well co-ordinated HPO axis can normalise the menstrual cycle.