Case Series on the Ayurvedic Management of Pubertal Menorrhagia Using Ficus racemosa Nasya

Aim

Pubertal menorrhagia is characterized by abnormal uterine bleeding in adolescent girls, primarily due to the immaturity of the Hypothalamic-Pituitary-Ovarian (HPO) axis rather than any identifiable pelvic pathology. In Ayurvedic literature, this condition corresponds to Asrigdara, attributed to vitiation of Pitta and Rakta Doshas. Nasya Karma (nasal administration of medicated substances) is traditionally recommended for managing neuroendocrine dysfunctions.

Objectives

Two adolescent females, aged 13 and 15, presented with excessive and prolonged menstrual bleeding, shortened intermenstrual intervals, and dysmenorrhea. Menarche had occurred 1-2 years earlier. Based on Ayurvedic assessment, both were diagnosed with Asrigdara. Modern investigations, including pelvic ultrasound, complete blood count, and coagulation profiles, excluding structural or systemic abnormalities. Hormonal profiles revealed elevated or borderline LH/FSH levels, indicating an immature HPO axis.

Materials and Methods

Both patients were administered an aqueous extract of Udumbara (Ficus racemosa) fruit-4 nasal drops per nostril daily for 7 days post-menstruation-over two menstrual cycles. No oral medications were given, minimizing systemic exposure in this pediatric group. Follow-up and Outcomes: Significant clinical improvement was noted in both cases, with reductions in menstrual blood loss, improved cycle regularity, and relief from dysmenorrhea. Hormonal assays post-treatment showed normalization trends in LH and FSH. No adverse reactions were reported.

Results

These findings suggest that Udumbara Phala Nasya may exert beneficial effects on the neuroendocrine axis, potentially through olfactory-mediated pathways. The non-invasive and localized nature of the therapy aligns with Ayurvedic practices and is well-suited for adolescent patients.

Conclusion

Udumbara Phala Nasya demonstrates promise as a safe and effective integrative therapy for managing pubertal menorrhagia. Further large-scale clinical studies are needed to substantiate its efficacy and elucidate its underlying mechanisms.