Vol. 2, Issue 2, Part A (2025)

Background: Primary dysmenorrhea is highly prevalent among adolescents and young women and is a major cause of functional limitation, absenteeism and reduced quality of life. Conventional management relies predominantly on non-steroidal anti-inflammatory drugs (NSAIDs), which may be associated with incomplete relief and potential adverse effects on long-term cyclic use. In Ayurveda, primary dysmenorrhea closely corresponds to Kashta Artava, wherein vitiated Apana Vayu, Agni-dushti, Ama formation and Srotorodha are addressed through Vata-shamana, Shoolaprashamana, Dipana-Pachana and Artava-janana measures, along with dietary and lifestyle regulation.

Objectives: To clinically assess the efficacy and safety of a standardized Ayurvedic regimen in comparison with standard NSAID-based therapy in the management of primary dysmenorrhea (Kashta Artava), with particular reference to pain intensity, associated symptoms, functional limitation and rescue analgesic use.

Materials and Methods: In this prospective, randomized, controlled, parallel-group trial, 90 women aged 16-30 years with confirmed primary dysmenorrhea were allocated to receive either a multi-component Ayurvedic regimen (Group A; n=45) or standard therapy (NSAIDs as needed with routine advice; Group B; n=45) over two consecutive treatment cycles following a baseline observation cycle. The Ayurvedic protocol combined internal Vata-shamaka, Shoolaprashamana, Dipana-Pachana and Artava-janana formulations with menstrual diet-lifestyle counselling. Primary outcome was change in dysmenorrhea pain intensity on a 10-cm visual analogue scale (VAS). Secondary outcomes included composite dysmenorrhea symptom score, hours of functional limitation/absenteeism per cycle, rescue NSAID consumption and adverse events. Data were analysed on an intention-to-treat basis.

Results: Baseline characteristics were comparable between groups. Both groups showed significant within-group reductions in VAS scores (p<0.001), but the decrease was greater in Group A (mean change −4.3±1.4) than Group B (−2.4±1.5; p<0.001), with 68.9% versus 37.8% participants achieving ≥50% pain reduction, respectively. Composite symptom scores, hours of functional limitation and mean rescue NSAID tablets per cycle all improved significantly in both groups, with consistently greater changes in the Ayurvedic group. No serious adverse events occurred; mild gastrointestinal complaints were more frequent with NSAID use.

Conclusion: The standardized Ayurvedic regimen produced superior reduction in menstrual pain, associated symptoms, functional impairment and rescue NSAID consumption compared with standard NSAID-based therapy alone, with good tolerability, in women with primary dysmenorrhea (Kashta Artava). These findings support the integration of evidence-based Ayurvedic approaches as a safe, effective and NSAID-sparing option in the holistic management of primary dysmenorrhea, and justify larger, multi-centric trials and implementation research.