Efficacy and Safety of Utpaladi Churna with Tandulambu in the Management of Asṛgdara (Abnormal Uterine Bleeding due to Ovulatory Dysfunction): Clinical Case Study

Authors

  • Bhappil Sharma
  • Tanuja Bharti

Keywords:

(MeSH compatible), 1. Abnormal Uterine Bleeding, 2. Asṛgdara, 3. Ayurvedic Medicine, 4. Utpaladi Churna, 5. N-of-1 Trial, 6. Menorrhagia, 7. Ovulatory Dysfunction, 8. Tandulambu

Abstract

Background: Asṛgdara, correlated with Abnormal Uterine Bleeding (AUB) due to ovulatory dysfunction, is a prevalent gynecological disorder causing significant morbidity. Current hormonal management often presents adverse effects, necessitating safe, effective, and non-hormonal alternatives. Utpaladi Churna, a classical Ayurvedic formulation with astringent (Kashaya) and cooling (Shita Virya) properties, has been traditionally indicated for hemorrhagic disorders, yet lacks modern clinical validation.

Case Summary: This N-of-1 study reports the efficacy of Utpaladi Churna (3g twice daily) administered with Tandulambu (rice water) as an adjuvant in a 28-year-old female diagnosed with AUB due to anovulatory cycles (WHO Type I), presenting with a Pictorial Blood Loss Assessment Chart (PBAC) score of 310, severe anemia (Hb: 8.9 gm%), and a symptom score of 28. The intervention was given over three consecutive menstrual cycles.

Results: The primary endpoint showed a marked reduction in PBAC score to 60 by Cycle 3 (80.6% reduction; p < 0.05 on Reliable Change Index). Hemoglobin improved to 12.1 gm% (+35.9%). Menstrual duration normalized from 9 days to 4 days, and cycle length regulated to 28 days. The Ayurvedic symptom score declined to 5 (82.1% reduction). The C-statistic trend analysis confirmed a significant downward trend in bleeding scores over time (p < 0.05). Safety parameters (LFT, RFT) remained within normal limits, and no adverse events were reported.

Conclusion: This single case demonstrates that Utpaladi Churna with Tandulambu is a clinically effective, safe, and well-tolerated non-hormonal intervention for managing AUB due to ovulatory dysfunction. These promising findings warrant larger, randomized controlled trials to corroborate the results

 

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References

1. Munro MG, Critchley HOD, Fraser IS. The FIGO classification of causes of abnormal uterine bleeding. Int J Gynaecol Obstet. 2011;113(1):3-13.

2. Fraser IS, Langham S, Uhl-Hochgraeber K. Health-related quality of life and economic burden of abnormal uterine bleeding. Expert Rev Pharmacoecon Outcomes Res. 2009;9(5):413-23.

3. Munro MG, Critchley HOD, Fraser IS. The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years. Am J Obstet Gynecol. 2018;219(5):454-68.

4. Practice Committee of the American Society for Reproductive Medicine. Management of abnormal uterine bleeding associated with ovulatory dysfunction. Fertil Steril. 2013;99(4):987-94.

5. Liu Z, Doan QV, Blumenthal P, Dubois RW. A systematic review evaluating health-related quality of life, work impairment, and health-care costs and utilization in abnormal uterine bleeding. Value Health. 2007;10(3):183-94.

6. Rigsby CK, Rosen MW, Sridhar A, et al. Use of hormonal contraceptives and risk of venous thromboembolism. Am J Obstet Gynecol. 2022;226(5):700-12.

7. Bradley LD, Gueye NA. The medical management of abnormal uterine bleeding in reproductive-aged women. Am J Obstet Gynecol. 2016;214(1):31-44.

8. Shapley M, Jordan K, Croft PR. A systematic review of postcoital bleeding and risk of cervical cancer. Br J Gen Pract. 2006;56(527):453-60.

9. Sushruta. Sushruta Samhita, Nidana Sthana. Vol 1. Varanasi: Chaukhambha Sanskrit Sansthan; 2019. p. 456.

10. Charaka. Charaka Samhita, Chikitsa Sthana. Vol 4. Varanasi: Chaukhambha Orientalia; 2020.

11. Govindadas. Bhaishajya Ratnavali (Pradara Rogadhikara). Varanasi: Chaukhambha Prakashan; 2019.

12. Higham JM, O'Brien PM, Shaw RW. Assessment of menstrual blood loss using a pictorial chart. Br J Obstet Gynaecol. 1990;97(8):734-9.

13. Jacobson NS, Truax P. Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. J Consult Clin Psychol. 1991;59(1):12-9.

14. Turner BJ, Verplanken B, Hall PA. C-Statistic for evaluating single-case data. Behav Ther. 2016;47(3):397-407.

15. Wise EA. Methods for analyzing psychotherapy outcomes: a review of clinical significance, reliable change, and recommendations for future directions. J Pers Assess. 2004;82(1):50-9.

16. Kumar D, Sharma A, Gupta A. Evaluation of phytochemicals and procoagulant activity of Symplocos racemosa bark. J Ethnopharmacol. 2020;250:112455.

17. Dhiman KS, Sharma R. Review on the artava janana and artava sthambana drugs in Ayurveda. Int J Ayurveda Res. 2021;7(2):34-42.

18. Charaka. Charaka Samhita, Sutra Sthana. (Anupana Khanda). Varanasi: Chaukhambha Sanskrit Sansthan; 2020.

19. Pandey G, Sharma R. Role of rice water (Tandulambu) in management of anemia: a review. Ayu. 2022;43(1):45-9.

20. Savrikar SS, Ravishankar B. Introduction to 'Rasa Shastra' - the Iatrochemistry of Ayurveda. Afr J Tradit Complement Altern Med. 2011;8(5 Suppl):66-82.

21. Joshi YK, Wagh R. Pharmacognostic and phytochemical studies of Woodfordia fruticosa flowers. Pharmacogn J. 2018;10(6):1192-6.

22. Singh N, Singh A. Phytochemical analysis and uterine contractile activity of Mesua ferrea. J Herb Med. 2019;18:100291.

23. Verma S, Singh SP. Anti-inflammatory activity of Nymphaea nouchali rhizome extracts. Int J Pharm Sci Res. 2020;11(4):1789-95.

24. Patel S, Patel R. Phytoestrogenic activity of Callicarpa macrophylla in ovariectomized rats. Phytother Res. 2021;35(8):4450-9

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Published

2025-04-25

How to Cite

1.
Sharma B, Bharti T. Efficacy and Safety of Utpaladi Churna with Tandulambu in the Management of Asṛgdara (Abnormal Uterine Bleeding due to Ovulatory Dysfunction): Clinical Case Study. J Neonatal Surg [Internet]. 2025 Apr. 25 [cited 2026 Sep. 20];14(4S):1544-52. Available from: https://jneonatalsurg.com/index.php/jns/article/view/10481

Issue

Vol. 14 No. 4S (2025): Journal of Neonatal Surgery

Section

Original Article

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