Abstract

DYSMENORRHOEA AND UDAVARTINI YONIVYAPAD: NEUROINFLAMMATION, APANA VATA, AND INTEGRATIVE PAIN MANAGEMENT

Prachi Adwait Gujarathi*

Abstract

Dysmenorrhoea is often normalized as an unavoidable part of menstruation, even when pain repeatedly interrupts education, work, sleep, mobility, and emotional well-being. Contemporary evidence explains primary dysmenorrhoea mainly through progesterone withdrawal, increased endometrial prostaglandin production, uterine hypercontractility, vasoconstriction, and transient ischaemia. The emerging picture is broader: inflammatory cytokines, oxidative stress, peripheral nociceptor activation, altered descending pain modulation, and central sensitization may help explain why pain severity differs markedly between individuals and why recurrent menstrual pain may persist beyond a purely uterine event. In Ayurveda, painful and difficult menstruation with relief after the establishment of menstrual flow is described under Udavartini Yonivyapad. Its pathogenesis centres on aggravated Vata, especially disturbed or upward-moving Apana Vata, resulting in Rajahkrichhrata and Yoni Shoola. Although Apana Vata cannot be equated directly with a single neuroendocrine pathway, it provides a functional framework for understanding disordered pelvic movement, pain, and elimination. This narrative review examines dysmenorrhoea through biomedical and Ayurvedic perspectives and proposes a safe, layered model of integrative pain management. Evidence-based pharmacological care, appropriate screening for secondary causes, heat, physical activity, yoga, sleep and stress regulation may be combined with individualized Ayurvedic measures under qualified supervision. Published Ayurvedic trials are encouraging but are generally small and methodologically limited. Integration should therefore complement—not delay—diagnosis or established treatment. Future research should use rigorous randomized designs, standardized outcomes, adverse-event reporting, and mechanistic biomarkers to determine whether Ayurvedic interventions influence inflammation, uterine contractility, pain sensitization, or functional recovery.

Keywords: dysmenorrhoea; Udavartini Yonivyapad; Apana Vata; neuroinflammation; menstrual pain; central sensitization; integrative medicine; Ayurveda.