Abstract

Background: Abnormal uterine bleeding (AUB) is one of the most frequent gynaecological complaints, accounting for nearly 30% of outpatient consultations. In Ayurveda, this condition is conceptualised as Asrigdara, primarily attributed to pitta and rakta vitiation, with vata facilitating excessive expulsion. Charaka has recommended Shonitasthapana Mahakashaya, a group of ten agents, for managing bleeding disorders. Methodology: This review critically evaluated Shonitasthapana Mahakashaya through classical Ayurvedic texts and modern biomedical literature. Each drug was assessed for Ayurvedic pharmacodynamics (rasa, guna, veerya, vipaka) and correlated with reported pharmacological actions relevant to haemostasis, antiinflammatory activity, and uterine regulation. Review Results: The ten agents, Madhu, Madhuka, Rudhira, Mocharasa, Mrutkapala, Lodhra, Gairika, Priyangu, Sharkara, and Laja, demonstrated significant stambhana (haemostatic) and pitta-shamaka activity. Contemporary research substantiates their bioactive effects: tannin-rich herbs (Lodhra, Mocharasa, Priyangu) showed antihaemorrhagic and vascular-stabilising properties; saffron (Rudhira) and liquorice (Madhuka) exerted antioxidant, phytoestrogenic, and uterine-modulatory effects; mineral Gairika demonstrated styptic and hematinic activity. Collectively, these align with the Ayurvedic rationale of pacifying pitta-rakta imbalance and restoring haemostatic balance. Evidence supports the integration of Shonitasthapana Mahakashaya as adjuvant therapy in AUB management. While pharmacological studies affirm their mechanistic potential, robust clinical trials remain scarce. Conclusion: Shonitasthapana Mahakashaya demonstrate promising therapeutic relevance for Asrigdara. Rigorous clinical validation could position them as integrative strategies in gynaecological care.

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