Interpretation of LH, FSH and AMH according to #Ayurveda and its management.

Views shared by several ayurveda professionals and non-ayurveda people in discussion group:

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Next topic for discussion:  Interpretation of  LH, FSH and AMH according to #Ayurveda and its management.

Ayulink: Very high value of LH, and FSH at young age and forcefully acceptance of menopause at very young age is becoming major issue these days.

Anartav, nashtartava, rasa dhatu dushti, vata disturbance are commonly used terms by vaidyas.

But it is very difficult to understand all hormone system and / or endocrine system according to Ayurveda.

USA Gary Yuen: Agree psychology and hormones have a large effect. An ancient Greek gynaecogist says sex should begin when menopause begins. Our changes in sexual morality also has large effects on hormone balance, just like teenage acne and other skin problems also due to pitta from forced morality and customs.

Dr. Ronak Rathod: In kids In central precocious puberty LH AND FSH levels are too raised that affects whole body's growth system ....  generally hypothalamic hematoma is the etiology factor of it . Such cases are missed in early diagnosis.

USA Gary Yuen: It may be difficult to prescribe antidotes for larger societal changes but likely pitta rasayanas such as amalaki shatavari and jatamamsi could help. In Greek medicine, herbs such as flax are used as sort of an abhyanga interernally in the uterus. I don't know if ayurveda does such things but sounds good.

Ayulink: Yes. May be you are mentioning about Uttarbasti treatment mentioned in Ayurvedic texts, where medicine are introduced directly in uterus.

USA Gary Yuen: Yes. I am curious where that is discussed. Maybe there are no studies of how they effects hormone studies but it seems like it should have effect and might even be good to maintain health just like abhyanga.

Dr. Bhadresh Naik: According to ayurved hormones correlate is difficult. Consider the dhatu and strotas we can correlate something different.

Example - Pcod is artvav xay, Sign and symptoms relleted with

Ras, Sukra or stribeej, Artvahvah strotas. As morden fsh and lh thyroid poor function, High insulin production. We treat according to Ayurveda we consider as above etiology patients get benefit. Even hormones profile are change that's suggests it's indirectly effects on hormone. Shatavari, Gudhchi, Krina jirak, Suva nasya- Uttter basti- Nakstra puspantakras- Puspadhavaras in female- Vasarista- Brugrajarist Is best line of treatment.

USA Gary Yuen: Yes. Direct observation of all external parts such as skin eye tongue hair and pulse are enough. No need to follow modern medicine methods of measurement without knowing etiology.

Dr. Bhadresh Naik: Not even lifestyle, Stress, Anxiety, Poor hygiene, Poor nutrients intake. Important  not to follow the rule of during menstrual period according to ayurved is majjor cause of irregular menstrual period. Lack of excercise is major causative factor.

USA Gary Yuen: Our modern way of life is very harmful for everyone. Here is a study of ayurvedic treatment of PCOS with successful changes in LH & FSH. After 1 year, 85-90+ percent cured, 85% successful conception and healthy babies. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3215317/

Dr. Bhavesh Modh: Overall effect of the therapy

In allopathic medicine oral contraceptives, progestin’s, anti androgens and ovulation induction agents remain standard therapies.

Aartava-kshaya, which can be correlated with PCOS has been described as deficiency or loss of artava, artava dose not appears in time or is delayed, is scanty and dose not last for three days. Pain in vagina also can be seen. According to Ayurveda, Aartava-kshaya is a disorder involving Pitta and Kapha doshas, Medas, Ambu/Rasa, Shukra/Artava Dhatu and Rasa, Rakta, Artava Vaha Srotas Therefore Poly Cystic Ovarian Syndrome can also be described with same involvement of Dosha, Dhatu and Upadhatu Kapha predominance manifests as increased weight, subfertility, hirsutium, diabetic tendencies and coldness. Pitta predominance manifests as hair loss, acne, painful menses, clots and heart problems. Vata predominance manifests with painful menses, scanty or less menstrual blood and severe menstrual irregularity. The pathology is an obstruction in the pelvic cavity (Apana Kshetra) causing disorders in the flow of Vata. This in turn leads to an accumulation of Kapha and Pitta. The treatment principle is to clear obstruction in the pelvis, normalize metabolism and regulate the menstrual system (Aartava Dhatu). Kapha reducing, insulin enhancing and hormone rebalancing drugs help to the relieve symptoms of Poly Cystic Ovarian Syndrome.

Triphala Kwatha, Chandraprabha Vati and Manibhadra Choorna help to clear obstruction and normalize the srotas. Especially Triphala and Guggulu are very useful for reducing excess weight. Powder of A. racemosus brings balance and strength to the menstrual system and it helps to regulate Aartva Dhatu. Properties of Powder of seeds of P. graveloens, oil of Krishna Jeeraka (Nigella sativa) and oil of Sahachara (Barleria prionits) were helped to destroy cysts on ovaries and stimulate the follicular maturity. Properties of Deepana and Pachana of above drugs they elevate the Jatharagni, Dhatvagni as well as Aartavagni. Powder of Guduchchadiya enhances the overall immunity and powder of Atibala has properties of Prajasthapana, Garbhasya DaurbalyAhara, Balya, Brunhanaand Ojo Vardhana. Therefore it helps to get conceived and avoid miscarriage.

Uttara Vasti is the most effective treatment in gynaecological disorders. It helps to purification and clears the Aartava Vaha Srotas, pacifies vitiated Apana Vayu and improve follicular maturity.

Due to Samprapti Vighatana Kriya of this Ayurveda treatment regimen the symptoms of Poly Cystic Ovarian Syndrome get reduced. The effect of therapy show highly significant result on all above symptoms of Poly Cystic Ovarian Syndrome. When considering irregular menstruation most of the patients had 2 - 4 months duration. At the end of the treatment .

USA Gary Yuen: Looking at a book on chinese medicine and infertility, it recommends these acupuncture points. Finding where they match with marma and abhyanga could prove helpful.

KI-13 Qixue, KI-3 Taixi, BL-23 Shenshu, BL-52 Zhishi, Ren-4 Guanyuan, Du-4 Mingmen, LU-7 Lieque (on the right) and KI-6 Zhaohai (on the left), Ren-8 Shenque-Baomen, Zihu..

Dr. Bhavesh Modh: In  mammals, AMH prevents the development of the Müllerian ducts into the uterus and other Müllerian structures. The effect is ipsilateral, that is each testis suppresses Müllerian development only on its own side. In humans, this action takes place during the first 8 weeks of gestation.( Responsible  for. पिंड, पेशी, अर्बुद )  If no hormone is produced from the gonads, the Müllerian ducts automatically develop, while the Wolffian ducts, which are responsible for male reproductive parts, automatically die.

Its ability to inhibit growth of tissue derived from the Müllerian ducts has raised hopes of usefulness in the treatment of a variety of medical conditions including endometriosis, adenomyosis, and uterine cancer. Research is underway in several laboratories. If there were more standardized AMH assays, it could potentially be used as a biomarker of polycystic ovary syndrome.

USA Gary Yuen: Is there yet info about cause of hormone levels?

Vd.  Mahavir Vora: Manibhadra churna is it of manibhadra leha or some other combination.

USA Irene CCA: A Patient had her last period one year and a half and after that she had her period again But it was two month having shatavari/guduchi and aswhagandha. she wonder if that is something to do with having  period again? She is waiting if next month come again. Doctor told her than after one year without period should not come again.

Dr. Bhadresh Naik: Consider age.

USA Irene CCA: 49

Dr. Supratim Bir: The 45-55 yrs are considered to have menopause. she had a long gap, so I would suggest her an USG of lower abdomen to screen out her uterus n adnexa.

USA Irene CCA: USG?

Slovenia Anoop S. Anand: Ultra Sound

Dr. Bhadresh Naik: Is she undergone menopausal stage she might have a perspiration, Hot flashes, Dry vaginal, Depression, Pain in breast. Occ menstrual cycle I advised usg, Pep smear. If painless vaginal bleeding y must aware about it. It's common Don't frusted Take it easy normal..

USA Irene CCA: pep smear?

Dr. Bhadresh Naik: Continue Shatavari granules, Pit shamak drugs. Pep smear test is performed by gynecologist. Smear taken from ext vaginal To rule out ca uterus It's common test but very important.

Dr. Supratim Bir: Yes Indicated for screening.

Dr. Gaurav Makan: Irene, the foremost step to go with will be USG Pelvis. After its results and keeping in mind the clinical picture.

USA Gary Yuen: If we are discussing what is the best possible health if one strictly studies and follows the original texts of Ayurveda, I think one should be able to still have regular menstruations and give birth long after age 50. likely after age 80 or more. but it would take great knowledge of diet and rasayanas. and effort to reach samadhi and not have the sexual moraltiies of our age, and become comfortable in ones body.

Dr. Bhadresh Naik: In western countries menarche and menopausal age are different from Indian so it's possible in western countries.

USA Gary Yuen: Possible in India and Asia, possible everywhere. We are very very far from the health, beliefs, customs, diet, spirtual health and practices, etc from ancient times. So now it is very difficult but not impossible.

Dr. Gaurav Makan: I agree sir! Environmental factors and dietary factors being the main cause.

USA Gary Yuen: Comparing the diet recommended in Caraka and astanga hrdyam, and strictly following rasayanas in Caraka, few people try. The vegetables recommended in astanga are far better than most people know of but still eaten and used in some parts of India. That is one of many factors that could help avoid all modern diseases including PCOS. Plus all hominid relatives such as chimps, they do not get menopause til past age 90. They live a natural life like we did long long ago, around maybe even before Vedic age.

Dr. Madhuri Patil Chaudhari: Menopause is cessation of menses as well as fullstop of  ovulation. A woman i know, never had menstruation, still gave birth 2 normal  kids. (Inspite of Extreme Ras and Aartav kshay).  Its not always necessary that Shukra dhatu is also dushit in such cases. PCOS is not entirely reproductive system disorder.. but also overall Ras dhatu and med dhatu dushti, not of shukravah strotas, but may b affected ultimately , if left untreated. Menstruation and ovulation are not always co-dependent. Without ovulation, there is no LH. facotrs to b kept in mind while dd of female hormonal disorders. Ayurved  says Rajodarshan or Rajonivrutii. Rajodarshan  is menstruation and Artav is ovulation. Artav khay is not same as Rajonivrutii.  Menopause is rajonivrutii. Artav khay is Relative term , never came across Artavnivrutti. or cessasion of ovulation.

Shri Minoo parabia: Pause - cessation - of menstruation. May I say?

Dr. Madhuri Patil Chaudhari: yes thats popular meaning.There is nothing like cessation of ovulation  only artav kshay,  not artav nivrutti.

Croatia Branko Markovic: Food causing hormonal changes is biggest problem then life style. Food products are stuffed with hormones, allergens etc. Yes in Vedic time a lot of things wore possible and people wore mostly conscious about them self and environment and people today live and they are not aware that they are living even.. With investigation what average people in the west eat they could be happy they are still alive.

Dr. Madhuri Patil Chaudhari: yes , Endocrine disruptors. food additives.

Vd. Dhruti Nirav Bhatt: According to Ayurved Apan Vayu has main role in Genitourinary system and also Vayu has main role on Nervous system and Endocrine system so We should Control Vayu. Constipation cause Apan Vayu dusti and it may cause menstrual disturbance. Stress cause Endocrine disturbance and effect on Pituitary gland and also Ovary. sometimes Obesity ,High Insulin level cause PCOD. Now a days Lifestyle,Food habits,Stress are main causative factors for Menstrual disturbance.

Dr. Madhuri Patil Chaudhari: HPO axis, hypothalamus- pitutary- ovary axis, goes out of tune because abnormal or nomal but induced (like in medicinal ovulation suppression)  negative feedback. Mechanism main cause of Hormonal disturbances.

USA Gary Yuen: There is a also a study of using multiple grains together becomes a better prebiotics. In the study, they use barley and rice, the same as recommended in Sutrashana I.5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3744518/

Eating a variety of dal and grains, such as panchranga increases gut diversity and reduces CRP. Higher CRP is also liked with obesity and changes in LH/FSH levels.

For infertility treatment, I found bhringaraj is used. There is a review of common Chinese formulas in Taiwan, and the 2nd most popular treatment is bhringaraj combined with a member of the olive family: Ligustrum lucidum. It seems that except for the common olive, there might not be any historical use of the family.

Dr. Ravindra Upadhyay:

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Compiled by : Dr. Dhruti Kagrana