ORIGINAL ARTICLE January 2024

Comparative clinical evaluation of Jeevantyadi Yamaka Matra

Basti and Uttara Basti in Bandhyatva (Anovulation)
Rupali Purohit1, Arvind Gupta2, Poonam Khot3, Vandana4
1Post Graduate Scholar, Dept. of Panchakarma, Himalayiya Ayurvedic (P.G) College & Hospital, Doiwala, Dehradun, Uttarakhand, India.
2Professor & HOD, Dept. of Panchakarma, Himalayiya Ayurvedic (P.G) College & Hospital, Doiwala, Dehradun, Uttarakhand, India.
3Associate Professor, Dept. of Stri Roga & Prasuti Tantra, Himalayiya Ayurvedic (P.G) College & Hospital, Doiwala, Dehradun, Uttarakhand, India.
4Assistant Professor, Dept. of Panchakarma, Himalayiya Ayurvedic (P.G) College & Hospital, Doiwala, Dehradun, Uttarakhand, India.

ABSTRACT
Introduction: Infertility is presently a leading and longstanding gynaecological issue affecting approximately 15%
of the couples in reproductive age group around the globe while 10-15% in Indian population. Ovulatory dysfunctions
form the major cause of female infertility, out of which Anovulation accounts for 40%. Anovulation can be interpreted
as Abeejotsarga or Abeejata. Panchakarma plays an important role in the management of Infertility. Thus, the
present study aimed at evaluating the ovulation inducing effect of Jeevantyadi Yamaka through Matra Basti and
Uttara Basti. Methodology: The study was conducted on 40 female subjects, diagnosed of anovulation with either
primary or secondary infertility, fulfilling the inclusion and exclusion criteria and were randomly allocated into two
groups with 20 subjects in each. But only 33 patients completed the trial with 18 patients in Group A and 15 patients
in Group B. Group A received Jeevantyadi Yamaka Matra Basti while Group B were administered with Jeevantyadi
Yamaka Uttara Basti for a period of three menstrual cycles. The assessment of results was done by follicular study
conducted from 9th day of menstrual cycle till 20th day of every cycle for consecutive three cycles. Results: Both
the groups showed significant improvement in assessment parameters. Although the number of patients were less
in Group B than Group A but Ovulation was observed in 5.5% of subjects in Group A and 40% of subjects in Group
B. Discussion: Jeevantyadi Yamaka Matra Basti and Uttara Basti both are equally effective in increasing the size of
follicles and other assessment parameters. But in overall, Jeevantyadi Yamaka Uttara Basti was more effective in
achieving Ovulation due to its local effect. As, this study was only for three months so no result was seen on
Conception.

Key words: Bandhyatva, Infertility, Anovulation, Uttara Basti, Matra Basti, Jeevantyadi Yamaka.

INTRODUCTION WHO estimates the overall prevalence of primary

According to WHO, Infertility is a disease of the infertility in India to be between 3.9 and 16.8
reproductive system defined by the failure to achieve percent.[2] According to International Federation of
a clinical pregnancy after 12 months or more of regular Gynaecology and Obstetrics (FIGO) manual, ovarian
unprotected sexual intercourse.[1] It affects factor contributes 15-25% in causes of the female
approximately 10-15% of reproductive couples. The infertility.[3] So, it is the second common cause of
infertility. Ovulatory cause is an important subset in
Address for correspondence:
Dr. Rupali Purohit
infertility among women, accounting about 40% of
Post Graduate Scholar, Dept. of Panchakarma, Himalayiya cases. (Infertility of Leon Sperrof et.al).[4] Anovulatory
Ayurvedic (P.G) College & Hospital, Doiwala, Dehradun, or inability to produce a fertile ovum is an important
Uttarakhand, India.
E-mail: [email protected] cause among the women for infertility. In modern
Submission Date: 14/11/2023 Accepted Date: 21/12/2023 science there is treatment of infertility (due to
Access this article online
anovulation) which includes usage of Ovulation
Quick Response Code
induction by Human Menopausal Gonadotrophins
Website: www.jaims.in
(HMG) Injections, Gonadotrophins, Clomiphene Citrate
etc. but they have unsatisfactory results, enormous
expenses and lots of side effects like ovarian hyper
DOI: 10.21760/jaims.9.1.1 stimulation, frequent abortion, multiple gestations,
and major long-time possibility of ovarian cancer. In
this Particular disease, treatment which improves
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quality of life with nil or minimal side effects is the need a combination of Ghrita and Taila which itself is Vata
of hour. Shamaka and Taila is also mentioned as
Yonivishodhaka. Moreover, all the contents of
In Ayurveda, Bandhya can be defined as the cessation
Jeevantyadi Yamaka are Vata Shamaka mostly with
of Artava.[5] According to Ayurveda, Fertility of women
Laghu, Ushna, Tikshna property like Satapushpa, Shati,
depends on the healthy states of Ritu (appropriate
Vacha, and most of them like Jeevanti, Sauf, Vacha,
time), Kshetra (healthy Uterus and passage), Ambu
Karkatashringi, Madan, Pippali having Vatanulomaka
(proper nutrition of mother) and Beeja (healthy ovum
property and so it will be probably act on anovulation.
and sperm).[6] Imperfection in any one of them leads to
According to Acharya Kashyapa, the women having
Bandhyatva (Infertility). Among them Beeja is the core
amenorrhea, Scanty menstruation, non-ovulation or
stone of the female reproductive process and in its
useless ovulation (ovum with minimal or absence of
absence Garbha- Fetus cannot be formed in spite of all
capacity of fertilization) should be treated with Matra
the other factors. Here the Beeja is taken as
Basti.[12] In condition of anovulation, Uttar Basti
Antahpushpa[7] i.e., ovum. So, anovulation can be
removes the Srotosangha and corrects the Artavagni
included under Beeja Dushti.
which regulates the menstrual cycle, thus resulting in
Vata is considered to be the root cause of all the ovulation. So here, Jeevantyadi Yamaka for Matra
disorders cognate to the female reproductive system Basti and Uttara Basti is selected for the study. This
including female infertility. Without Vata, the Yoni study is related to anovulatory cycle so only Females
(Female genital organs) never gets spoiled. Moreover, are considered.
the most important functions of Vayu are Vibhajana
and Pravartana. Because of Vibhajana, Ovum is AIMS AND OBJECTIVES
prepared in the ovary by cell division and because of 1. To find out the efficacy of Jeevantyadi Yamaka
Pravartana Ovulation takes place. This function of cell Matra Basti in Anovulation.
division to form ovum is completed by Vata. The whole
activity is known as Dhatu Vyuha Kara i.e., it places 2. To find out the efficacy of Jeevantyadi Yamaka
every Dhatu at its proper place, which is also an Uttara Basti in Anovulation.
important function of Vata. The process of Pravartana 3. To compare the efficacy of Jeevantyadi Yamaka
is governed by Apana Vayu.[8] Therefore, we can say Matra Basti and Jeevantyadi Yamaka Uttara Basti
that ovulation is under the control of Vata. Therefore, in Anovulation.
any vitiation of Apana Vata will affect the ovulation. In
this aspect, Basti is considered to be the best
MATERIALS AND METHODS
treatment for Vata. Basti cures all the disease of The materials used for this study are categorised under
Vata.[9] So, it may act on anovulation by normalising the following three headings -
the pelvic reproductive physiology. In Ayurveda,
1. Literary Sources - For the present Study, Literary
Anovulation refers to Abeejotsarga. The Term Utsarga
data was collected from Vedic Scriptures,
means to expel or to leave. So, Expulsion of matured
Ayurvedic Samhitas and Sanskrit dictionaries.
ovum from the Beejagranthi means Beejotsarga. As
Retrospective study of database-books related to
Utsarga is Karma of Vata so vitiation of Apana Vata
modern Science, research studies published in
Dosha causes Abeejotsarga. Abeejotsarga is symptom
peered-review journals and conference
as well as a disease caused due to vitiation of Vata and
proceedings and various web-sources like
Kapha Doshas as they do Marga-Avarodha to Artavaha
GOOGLE, DHARA etc. was done for seeking
Strotas leading to Abeejotsarga.[10]
information about related research work.
Acharya Vaghbhatta has mentioned Jeevantyadi
2. Drug source - For the preparation of Jeevantyadi
Yamaka Anuvasana Basti for Bandhyatva.[11] Yamaka is
Yamaka, Raw drug was collected from Herbal

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Automation, Haridwar and prepared in pharmacy ▪ Ethical committee Clearance (Reference No.) - As
of Himalayiya Ayurvedic Medical College and this is a clinical study, Institutional Ethical
Hospital, Dehradun. Committee (IEC) approval was taken in prior to
initiation of the study with the Reference no. -
Plan of Study
HAMC/2021/968
1. Selection of Patient
▪ CTRI Registration - This clinical study was
2. Research design registered in Clinical Trial Registry of India (CTRI)
3. Assessment with the registration no. CTRI/2022/09/045244

Selection of Patients Inclusion Criteria

In total, 50 female patients were screened on the basis ▪ Married Female Patients from 20 - 40 years of age.
of signs and symptoms showing classical features of ▪ Patients having active married life (minimum 1
the Bandhyatva due to Anovulation in the OPD and IPD year)
of P.G. Department of Panchakarma and Department
▪ Patients with at least 2 or more consecutive
of Stree Rog and Prasuti Tantra, Himalayiya Ayurvedic
anovulatory cycles in serial Trans Vaginal
(P.G) Medical College and Hospital, Dehradun. Total 40
Sonography.
patients were enrolled irrespective of religion, socio-
economic conditions, etc. Enrolled patients were ▪ Patients with Primary or secondary both types of
randomly divided into 2 groups, 20 patients were infertility.
registered in each group with detailed clinical study, ▪ Patients having anovulatory cycle with or without
physical examination and investigation in a special PCOD.
proforma.
▪ Patients who will be ready for consent, necessary
Research Design investigations and regular follow up.
▪ Study design - Randomized Clinical Comparative Exclusion Criteria
Trial
▪ Patients suffering from the disorders of the
▪ Masking - Open type (As Masking was not possible reproductive tract such as tuberculosis, carcinoma,
with Panchakarma procedure) and congenital deformity of reproductive tract.

▪ Randomization - The patients were randomised ▪ Patients suffering from Systemic diseases like
using Computer generated randomization. Tuberculosis, Uncontrolled Hypertension and
Diabetes Mellitus, Cardiac Disease, Thyroid disease
▪ Sample Size and Grouping: 40 patients of and Hyperprolactinemia, STDs, HIV, HBsAg.
Bandhyatva due to Anovulation were randomly
▪ Patient suffering from fibroids, endometriosis,
selected and equally divided into 2 groups.
adenomyosis.
o Group A: 20 patients received Matra Basti with
▪ Infertility associated with other factors like tubal
Jeevantyadi Yamaka.
blockage, uterine factors, cervical factors etc.
o Group B: 20 patients received Uttara Basti with
▪ Menorrhagia, Metrorrhagia, Dysfunctional Uterine
Jeevantyadi Yamaka Bleeding (DUB)
▪ Level of Study: OPD and IPD level Diagnostic Criteria
▪ Period of Study: 18 Months ▪ Menstrual disturbances -Oligomenorrhoea,
Irregular Menses
▪ Duration of Treatment: 3 Months

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▪ Hormonal assessment
Route of Rectal Route Vaginal Route
▪ Ultrasonography (USG) Administration

▪ Follicular study Procedure

Withdrawal Criteria
Purva Karma Before On each Night Before
▪ Any Intercurrent Illness. administration of the Uttara Basti
Basti, Patients Administration, Haritki
▪ Personal reason. were asked to take Churna in Dose of 3
light meal. Then, gm was given in
▪ If any Side effect occurs Sthanika lukewarm water for
Abhyanga with cleaning the bowels.
Investigations Tila Taila and Sthanika Abhyanga
Sthanika Swedana with Tila Taila and
▪ Routine blood and Urine Examination with Dashmoola Sthanika Swedana
Kwath were done with Dashmoola
▪ Hormonal Profile (S. Prolactin, S. TSH, S. FSH, S. LH, on the region of Kwath were done over
AMH, S. Progesterone) Udara, Kati and Udara, Kati and
Prishtha Pradesh. Prishtha Pradesh. All
▪ USG the instruments used
during the procedure
▪ TVS for Follicular Study including the medicine
were autoclaved and
▪ Serological Examination to screen for HIV, HbsAg, kept ready. Yoni
HCV, VDRL. Prakshalana was done
with Panchavalkal
▪ Human Semen Analysis Kwath.

Table 1: Showing Method of Intervention Pradhana Patients were The patient is

Karma advised to take left examined for the
Intervention Group A Group B lateral position parameters like BP,
Name with left straight pulse, temperature
and right leg flexed etc. before she is put
on knee and hip to table. Then the
Selected Drugs For Snehana - Tila For Mridu Virechana -
joint and were patient is kept in
Taila Haritki Churna (3 gm)
asked to keep their lithotomy position
For Swedana - For Yoni Dhawan - left hand below with the part exposed,
Nadi Sweda with Panchavalkal Kwath the head. Enema cleaned and draped.
Dashmoola (500 ml) nozzle was pushed The part is covered
Kwatha into rectum after with the ring towel
For Snehana - Tila lubricating nozzle and only the perineum
For Matra Basti - Taila and Guda. Then, is exposed. Later the
Jeevantyadi Jeevantyadi lubricated Sim’s
Yamaka For Swedana - Nadi Yamaka Matra speculum is slowly
Swedana with Basti was inserted to expose the
Dashmoola Kwath administered cervix and held with
slowly in the dose Allis forceps. After
For Uttara Basti -
of 60 ml. that, Os is dilated
Jeevantyadi Yamaka
using Hegar’s dilators.
After dilating the Os,
Dose of 60 ml 5 ml the lubricated IUI
Medicine cannula is carefully
introduced to the

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uterus through the

Moderate Pain 2
cervix. Then, 5 ml of
Jeevantyadi Yamaka is
Severe Pain 3
injected gently with
the help of disposable
2. Duration of Menstruation 4 - 5 days 0
syringe of 5 ml
attached from the
3 days 1
other side of IUI
Canula (after removing
1 - 2 days 2
the air bubble)
1 day 3
Paschat After the Patient was kept in
Karma administration of head low position for 3. Interval Of Menstruation 21 to 35 days 0
Basti, the patients at least 2 hours for
were advised to lie better absorption of 36 to 45 days 1
in supine position drug from vagina and
with the arms and to prevent any 46 to 55 days 2
legs spread out vasovagal shock.
freely over the Abdominal hot More than 55 days 3
table. Buttocks of fomentation with hot
the patient were water bag was given. 4. Quantity of Bleeding 2-3 pads/day 0
patted with palms Light diet advised.
for 3 times and 1-2 pads /day 1
patient was
advised to relax in 1 pad/day 2
supine position.
No Bleeding / 3
Duration 7 Days after Consecutive 3 days Spotting
cessation of after cessation of
menses for menses for 5. Follicle Size Ovulated 0
Consecutive 3 Consecutive 3 months.
months >20 mm 1

12-19 mm 2
Improvement was assessed on 90th day

< 12 mm 3
Follow up of patients was done on the basis of ovulation
study which was done from 9th day onwards till 22nd day
6. Viscosity of Cervical Sticky, Resembles 0
depending upon the Ovulation.
Mucous egg white

Assessment Mildly Viscous 1

The assessment was done on the Subjective
Intermediate Type 2
parameters and Overall assessment and scoring was
done before and after the Treatment. Highly viscous, 3
non-sticky
Table 2: Showing Assessment Criteria with Grading

SN Subjective Parameter Severity of Grade

Statistical Analysis
Symptoms
Parameters Intragroup result Intergroup comparison
1. Pain during Menses No pain 0
Subjective Wilcoxon Signed rank Mann Whitney U test
Mild Pain 1 parameter test

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RESULT Follicular Negativ 11 6.00 66.00 - .002 S*

size_AT- e Ranks m 3.127
Effect of Matra Basti (Group A) On Subjective Follicular b

Parameters size_BT Positiv 0n .00 .00

e Ranks
(Wilcoxon Signed Rank test)
Ties 7o
Ranks
Total 18
Variables N Mea Sum Z P Resul
n of Valu t Viscosity Negativ 13p 7.00 91.00 - .001 S*
Valu
Rank Ranks e of cervical e Ranks 3.419
e
mucous_A b

Pain Negativ 10a 5.50 55.00 - .003 S* T-Viscosity Positiv 0q .00 .00
during e Ranks 2.972 of cervical e
menses_A b mucous_B Ranks
T – Pain Positiv 0b .00 .00 T
during e Ranks Ties 5r
menses_
BT Ties 8c Total 18

Total 18 S* - Significant, HS**- Highly significant

Effect of Uttara Basti (Group B) On Subjective

Duration Negativ 12d 6.50 78.00 - .001 S*
of e Ranks 3.176 Parameters
menses_A b
(Wilcoxon Signed Rank test)
T- Positiv 0e .00 .00
Duration e Ranks
Ranks
of
menses_B Ties 6f
Variables N Mea Sum Z P Resul
T
n of Valu t
Total 18 Valu
Rank Ranks e
e
Interval Negativ 12g 6.50 78.00 - .002 S*
between e Ranks 3.145 Pain Negativ 9a 5.00 45.00 - .006 S*
two b during e 2.739
Positiv 0h .00 .00 menses_A Ranks b
cycles_AT
– Interval e Ranks T - pain
between during Positiv 0b .00 .00
two Ties 6i menses_B e
cycles_BT T Ranks
Total 18
Ties 6c
Quantity Negativ 15j 8.00 120.0 - .000 HS**
of e Ranks 0 3.542 Total 15
bleeding_ b

AT- Positiv 0k .00 .00 Duration Negativ 11d 6.00 66.00 - .003 S*
quantity of e Ranks of e 3.002
menses_A Ranks b
bleeding_
BT Ties 3l T-
duration Positiv 0e .00 .00
Total 18 of e
Ranks

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menses_B
Ties 4f
Intergroup comparison in various Subjective
T parameters of Bandhyatva by Mann Whitney test
Total 15
Ranks
Interval Negativ 5g 3.00 15.00 - .025 S*
between e 2.236 Variables Grou N Mea Sum Z P Resul
two Ranks b p n of Valu Valu t
cycles_AT Rank Ranks e e
– interval Positiv 0h .00 .00
between e Pain A 18 15.1 273.0 - .206 NS*
two Ranks during 7 0 1.26
cycles_BT menses_B 5
Ties 10i T B 15 19.2 288.0
0 0
Total 15
Total 33
Quantity Negativ 13j 7.00 91.00 - .001 S*
of e 3.272 Pain A 18 15.7 283.5 -.881 .378 NS*
bleeding_ Ranks b during 5 0
AT- menses_A
quantity of Positiv 0k .00 .00 T B 15 18.5 277.5
bleeding_ e 0 0
BT Ranks
Total 33
Ties 2l
Duration A 18 17.4 313.5 -.300 .764 NS*
Total 15 of 2 0
menses_B
Follicular Negativ 14 7.50 105.0 - .001 S* T B 15 16.5 247.5
size_AT - e m 0 3.384 0 0
follicular Ranks b

size_BT Total 33
Positiv 0n .00 .00
e Duration A 18 19.3 347.5 - .089 NS*
Ranks of 1 0 1.70
menses_A 2
Ties 1o T B 15 14.2 213.5
3 0
Total 15
Total 33
Viscosity Negativ 13p 7.00 91.00 - .001 S*
of cervical e 3.247
mucous_A Ranks b
Interval A 18 19.3 349.0 - .096 NS*
T- viscosity between 9 0 1.66
of cervical two 4
Positiv 0q .00 .00
mucous_B cycles_BT B 15 14.1 212.0
e
T 3 0
Ranks

Total 33
Ties 2r

Interval A 18 19.3 348.0 .071 NS*

Total 15 between 3 0

S* - Significant

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two NS* - Not Significant, S**- Significant

B 15 14.2 213.0 -
cycles_AT
0 0 1.80 Improvement of Subjective Parameters in Each Group
7
Total 33 SN Subjective parameters Result in Percentage

Quantity A 18 17.9 322.5 -.628 .530 NS* Group A (in Group B (in
of 2 0 %) (n=18) %) (n=15)
bleeding_
BT B 15 15.9 238.5 1. Pain during menses 52.2% 51.6%
0 0
2. Duration of Menses 51.8% 70.6%
Total 33
3. Interval between two 64% 76.9%
Quantity A 18 19.3 349.0 - .075 NS* cycles
of 9 0 1.78
bleeding_ 2 4. Quantity of bleeding 62.3% 83.1%
AT B 15 14.1 212.0
3 0 5. Follicular size 27.2% 59.8%

Total 33 6. Viscosity of Cervical 30.5% 53.8%

mucous
Follicular A 18 17.0 306.0 .000 1.00 NS*
size_BT 0 0 0 Average % of relief 48% 65.9%

B 15 17.0 255.0 Overall Effect of Therapy

0 0
Group A Group B Overall
Total 33
effect

Follicular A 18 20.6 371.5 - .008 S**

% N N % N %
size_AT 4 0 2.65
1
Complete 1 5.6% 6 40% 7 21.21%
B 15 12.6 189.5
Remission :100%
3 0
relief (Ovulation)

Total 33
Marked 1 5.5% 3 20% 4 12.12%
Viscosity A 18 17.5 316.0 -.451 .652 NS* Improvement:
of cervical 6 0 >75% relief to <99
mucous_B % relief (Increase
T B 1 16.3 245.0 in size of follicle
5 3 0 i.e., 19-23
mm)
Total 3
3
Moderate 14 77.7% 5 33.4% 19 57.56%
Improvement: >50
Viscosity A 1 20.2 365.0 - .023 S**
% to 74 % relief
of cervical 8 8 0 2.28
(Increase in size of
mucous_ 0
follicle i.e., 12-19
AT B 1 13.0 196.0
mm)
5 7 0
Mild 2 11.3% 1 6.6% 3 9.09%
Total 3
Improvement:
3
<25% to > 49%

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relief (< 12mm Effect of Therapy on Quantity of bleeding:

size of follicle)
Group B was found with better result with Average %
Total 18 100% 15 100% 33 100% of relief 59.8% and Significant p value (p>0.005).
Jeevanti is Vasodilator, hence the drug when instilled
directly into the Uterus in the form of Uttar Basti,
Overall effect of therapy causes vasodilatation of the spiral arteries in the
60.00% 57.56% Uterus thereby increasing the endometrial
proliferation hence increases menstrual flow.
50.00%

40.00%
Effect of Therapy on Follicular size and Ovulation:

30.00%
Group B was found with better result with Average %
21.21%
of relief 83.1% and Significant p value (p>0.005). Most
20.00%
12.12%
9.09% of the contents of Jeevantyadi Yamaka have Ushna,
10.00%
Tikshna, Kapha-Vatashamaka, Vatanulomaka,
0.00% Srotoshodhana, Amapachana, Artava Janana and
Ovulation Marked Moderate Mild or No
improvement in improvement in improvement in Garbhashaya Sankochaka property, thus, relieves the
size of follicle size of follicle size of follicle
Kapha which has done Avarana of Apana Vayu by
blocking the Artavaha Srotasa and therefore removes
DISCUSSION the Margavarodha leading to Rajah Pravritti and Beeja
Discussion on Post Treatment (Result) Nirmana. Uttara Basti causes local uterine contractions
which stimulates the ovarian hormone. Ovaries contain
Effect of Therapy on Pain during menses:
receptor which receives the hormone secreted from
Group A was found with better result with Average % hypothalamus and pituitary gland, thus regulate the
of relief 52.2% and Significant p value (p>0.005). Matra HPO Axis regulating the menstrual cycle with
Basti stimulates the CNS through ENS and helps to Ovulation. Uttara Basti stimulates these receptors so
excrete increased prostaglandins which result in that Maturation of follicles and ovulation occurs in
activation of HPA Axis and ANS involving the release of each cycle.
neurotransmitters like Serotonin, thus relives
Effect of Therapy on Viscosity of Cervical mucous:
dysmenorrhoea.
Group B was found with better result with Average %
Effect of Therapy on Duration of menses:
of relief 53.8% and Significant p value (p>0.005). As
Group B was found with better result with Average % Uttara Basti is a local treatment, the drug is
of relief 70.6% and Significant p value (p>0.005). The administered locally in the Cervix which is directly
Emmenagogue and Fibrolytic action of most of the absorbed by the cervical epithelium because of the
contents of Jeevantyadi Yamaka Uttara Basti may be Sukshma property of the drug and thus directly acts on
the responsible factor for the increase of flow days. Cervical mucous. Due to the Laghu and Ushna Guna of
Effect of Therapy on Interval between two cycles: contents of Jeevantyadi Yamaka, it decreases the
Picchilata of Kapha and increases thinness (fluidity) of
Group B was found with better result with Average % mucus, thus, the viscosity decreases and hence
of relief 76.9% and Significant p value (p>0.005). spinbarkeit increases.
Ushna, Tikshna, Lekhana, Pachana etc. properties of
contents of Jeevantyadi Yamaka increases the Agneya Overall Effect of Therapy
guna of Pitta which is responsible for decreasing In the present study, in 21.2% of patients Ovulation
interval. This effect is also supported by Vatanulomana occurred, 12.1% of patients reported marked
property of Uttara Basti. improvement in the size of follicles i.e., 19-23 mm,

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57.6% of patients reported moderate improvement in Endometrial thickness as well as quality of cervical
the size of follicles i.e., 12-19 mm and 9.1% of patients mucous and may increase the muscular strength of
reported mild improvement or no growth in the size of Reproductive system
follicles i.e., <12 mm.
▪ Some drugs like Shatapushpa, Pippali,
No patient got conceived during and after the trial. Gorakhmundi, have Deepana-Pachana and Ama-
dosha nashaka properties so it regulates
Average % of relief was higher in Group B i.e., 65.9%
Jatharagni, Dhatvagni and Bhutagni by the action
followed by Group A i.e., 48%.
of Samana Vata which corrects metabolism at
Overall, Group B had a higher percentage of individuals cellular lever which result in proper formation of
achieving Ovulation and marked improvement. On the Dhatus and Upadhatus (Artava) and
other hand, Group A had a higher percentage of Srotoshodhana by removing Ama.
individuals experiencing moderate improvement. Both
▪ By Ushna Virya, Katu Vipaka, Tikta Rasa and Katu
groups had a relatively small number of individuals
Guna of Madan, Gorakhmundi, Shatapushpa,
showing mild improvement.
Karkatshringi, Shati and Vacha, it clears the
Discussion on Drug Srotosanga and Stimulates the Srotasa, thus
making the proper function of Artavagni by which
Probable mode of action of Jeevantyadi Yamaka
Ovulation may occur and Menstrual cycle is
▪ Jeevantyadi Yamaka contains 16 ingredients i.e., regulated.
Jeevanti, Madan, Meda, Gorakhmundi, Madhuka,
▪ Because of Madhura Vipaka and Sheeta Virya of
Bala, Shatapushpa, Rishibhaka, Pippali, Kaknasa,
Jeevanti, Madhuka, Vidari, Kaknasa, Shatavari, Go-
Shatavari, Kaunch, Ksheerakakoli, Karkatshringi,
Ghrita and Go-Ksheera, it does the Poshana and
Shati, Vacha, along with Go dugdha, Moorchita Go
Brihana of Yoni. Thus, may enhance the follicular
ghrita and Tila taila.
growth by increasing the blood supply and
▪ Due to the non-availability of Rishibhaka, Meda regularising the function of Beejotsarga.
and Ksheerakakoli, Pratinidhi dravyas Vidarikanda,
▪ The Emmenagogue and the fibrolytic action of
Shatavari and Ashwagandha were used which
Madana, Shatapushpa, and Shati may be the
resulted in double quantity of Shatavari and
responsible factor for the increase of flow days.
ultimately increased the Rasayana property of the
drug. ▪ Bala, Gorakhmundi, Vidari, Kapikacchu,
Ashwagandha have Anti-oxidant property which
▪ Majority of the drugs having Vata-Kapha shamaka,
decreases oxidative stress.
Deepana-Pachana, Vatanulomaka, Vrishya,
Rasayana, Shothahara, Balya, Yonidoshahara, ▪ Shatavari is Garbhaposhaka. It nourishes the
Garbhasthapaka properties mostly with Laghu, Uterus and Ovum and prepares the female organ
Ushna, Teekshna guna. These may remove for pregnancy and prevents threatened
Avarana of Kapha and might have restored the miscarriage.
normal functioning of Vata and Follicular
▪ The Hypoglycaemic property of Shatavari and
development.
Jeevanti decreases androgen production and
▪ Ingredients like Jeevanti, Madhuyashti, Bala, stimulates the hepatic production of S.HBG, thus
Ashwagandha, Vidarikanda, Shatavari, Kaknasa, relieving the symptoms of PCOS.
Kaunch have Madhura rasa and qualities like
▪ Shatavari, Shatapushpa, Jeevanti, Bala, Vidari,
Rasayana, Balya, Brimhana which is responsible
Kapikacchu, Ashwagandha, Karkatshringi contains
for Upchaya (Kapha Dosha) thereby improves the

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β-Sitosterol (phytoestrogens), the precursor of complication are also less, if Vatanulomana is done
Estrogen. Due to their Phyto-estrogenic effect prior to procedure. Other than it, Abhyanga and
increases amount of cervical mucous, spinbarkeit, Swedana just prior to Matra Basti, relaxes abdominal
ferning, motility and density of sperm in cervical muscles, increases metabolism and blood circulation
mucous. Phyto-estrogenic effect may also help in because of vasodilation.
regulating the HPO axis and thus regulates
Flowchart 1: Showing Mode of Action of Jeevantyadi
menstrual cycle and Ovulation.
Yamaka
▪ Stigmasterol present in Jeevanti and Vidari, is a
precursor of progesterone, acts as intermediate in
the biosynthesis of androgens, estrogens,
and corticoids.[13]
▪ According to Modern Science, Sneha is Lipophilic in
nature. Thus, it diffuses rapidly across the cell
membrane which is also composed of bimolecular
lipid matrix and Sneha can cross blood brain barrier
and act on CNS i.e., Hypothalamus and Pituitary
gland and may correct hormonal imbalance. Ghrita
contains Beta-carotene and Vitamin E which itself
are anti-oxidant. Ghrita and Taila contains
cholesterol which is responsible for the synthesis
of steroid hormones i.e., Estrogen & Progesterone.
▪ The Causative factor of Bandhyatva is mainly
vitiation of Vata. Acharya Charaka says that all the
gynaecological disorders are due to vitiation of
Vata and maximum drugs of Jeevantyadi Yamaka
are having Vatashamaka and Vatanulomaka
actions. By keeping Doshas in Samyavastha, it may
ensure proper functioning of Dhatus.
▪ Thus, we can say that by Katu and Tikta Rasa,
Laghu, Snigdha guna, Ushna Veerya, Anulomana,
Deepana and Pachana Karma, Jeevantyadi Yamaka
Mode of action of Pradhana Karma
digests the Ama at the cellular level and pacify the
vitiated Vata and Kapha Dosha. Due to the Ama- ▪ When lukewarm Sneha is given through rectum it
pachana and Kapha-vatashamana, Avarana and reaches instantly into systematic circulation thus
Sanga of Vata-Kapha dosha is removed and Apana has faster absorption and quick results. Mild
Vayu get normalised and do its normal function Temperature of Sneha enhances its diffusion.
(Beejotsarga). ▪ ENS controls the motility, exocrine and endocrine
Discussion on probable mode of action of Matra Basti secretions and microcirculation of the G.I. tract.
on Ovulation ENS closely resembles CNS. Endogenous opioids
Mode of action of Purvakarma are mainly present in G.I.T and in Brain
(Hypothalamus, Pituitary).
Sthanika Abhyanga and Swedana prior to Matra Basti
do its Anulomana and thus, Basti becomes more ▪ β endorphin has a role in regulation of normal
efficacious. Besides this, chances of any type of menstrual cycle. The essence of Matra Basti

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 Rupali Purohit et al. Evaluation of Jeevantyadi Yamaka Matra Basti and Uttara Basti in Bandhyatva

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stimulates endogenous opioids which are usually Probable Mode of Action of Uttara Basti on Ovulation
present in GIT.
Probable Mode of action of Purvakarma
▪ These endogenous opioids (β endorphin) may
▪ Haritaki Churna given one night prior to Uttara
influence GnRH release and aids to regulate
Basti, helps to alleviate constipation and thus may
Hypothalamo-pituitary ovarian axis and thus
be helpful in bringing Pratimola Apana Vayu back
regulates the ovarian cycle.
to normalcy.
▪ Thus, Matra Basti stimulates the ENS, generates
▪ Sthanika Abhyanga and Swedana prior to Uttara
the stimulatory signals for CNS, causes stimulation
Basti do its Anulomana and thus, Uttara Basti
of Hypothalamus for GnRH and Pituitary for FSH
becomes more efficacious. Besides this, chances of
and LH with the help of Neurotransmitters.
any type of complication are also less, if
Flowchart 2: Showing Mode of Action of Matra Basti Vatanulomana is done prior to procedure. Other
on Ovulation than it, Abhyanga and Swedana just prior to Uttara
Basti, relaxes abdominal muscles, increases
metabolism and blood circulation because of
vasodilation.
▪ Yoniprakshalana done prior to Uttara Basti with
Panchavalkal Kwatha nullifies the possibility of any
type of infection as a complication.
Probable Mode of action of Pradhana Karma
▪ When lukewarm Sneha enters into the Uterine
Cavity, network of Srotasa carry the Sneha towards
the Artavaha Srotasa. Mild Temperature of Sneha
enhances its diffusion.
▪ Uttara Basti, which is given in Garbhashaya, i.e.,
Artavaha Srotasa stimulates the Srotasa as well as
Beejagranthi. By the stimulation of Ovary, the
Sanga in the Beejagranthi is removed and Vata
performs its two functions properly i.e., Vibhajana
(reduction division in oocyte, proliferation of
granulosa cells and responsible for development of
follicle along with Kapha) and Pravartana (rupture
of follicle i.e., Ovulation).
▪ Uterus is the Mulasthana of Artavavaha Srotasa.
The drug directly being instilled in the Uterus gives
direct access to the seat of Sroto vaigunya and
Dosha-Dushya-Sammurchana and hence acts on
the Vikrita Vayu thereby disintegrating the
Samprapti. In condition of anovulation, Uttar Basti
removes the Srotosangha and corrects the
Artavagni which regulates the menstrual cycle,
thus resulting in ovulation. Uttara Basti causes

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ISSN: 2456-3110 ORIGINAL ARTICLE January 2024

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