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EFFECT 0F DURVA (Cynodon dactylon Linn) IN MENOPAUSAL SYNDRO0ME

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 Research Article
IAMJ
International Ayurvedic Medical Journal
ISSN:2320 5091
EFFECT 0F DURVA (Cynodon dactylon Linn)
IN MENOPAUSAL SYNDRO0ME
Singh Vandana Oommen Sara Monsy
Dept. of Dravyaguna vijnan, Govt, Ayurveda College, Tripunithura, Ernakulam, Kerala, India

1 ABSTRACcr
There has been extensivc rescarch on Menopause in the West but in India only a few in-
stitutes have recognized the potential of rescarch on this subject. Being an alarming problem it
needs effective and safe treatment. In Modern Medicine management of Menopausal
syndrome
is Hormone Replacement Therapy (H.R.T). Still a high risk exists due to its serious side effects
like Breast Cancer, Uterine Cancer, Venous thromboembolism, Stroke, etc. The medical com-
munity all over the world considers Ayurveda as the last resort for unanswerable questions
whenever their hands are tied up. In perspective of this the present drug of study, Durva with
considerable efficacy is taken for study in order to validate its broad range of efficacy, with
clinical studies and document it. Clinical study was conducted on 30 patients with Dura swa-
rasa in the dose of 15ml twice daily for a period of 1 month. Efficacy of the study drug was
evaluated on the basis of subjective and objective criteria. Drug showed highly significant eff-
cacy in reducing most of the subjective symptoms and not significant in shift of maturation index
of vaginal cytology. Thus the study revealed that Durva is very effective in reducing the Meno

pausal syndrome and did not show any effect on estrogen level.
Keywords: Durva, Cynodon dactylon, Rajonivritti, Menopausal syndrome

INTRODUCTION
changes take place in women. In majority

Menopausal syndrome is the disease apart from cessation of menstruation, no

of modern era. It is probably the important more symptoms are evident while in some.
well symptoms appear like irregular periods
woman health problem in developed as

as developing countries. In India Meno- (Scanty menses, Menorhagia etc.), hot

flushes, night sweating, Atrophic vaginitis,
pausal women about 43 million, projected
figures in 2026 have estimated the meno Recurrent urinary infection, anxiety, head-
mil- ache, insomnia etc. These symptoms in to-
pausal population in India will be 103
been done on gether are grouped as Menopausal
syn-
lion' as very little research has
physicians
Indian context, drome. Some women notice little difference
Menopause in the the
in these symptoms while others find
have begun to recognize Menopause as an bothersome and disrup-
Me- changes extremely
important issue in women's health care.
tive and now in recent years in developed
cessation of menstru-
nopause is permanent countries like India it is
and developing
ation at the end of reproductive life due to
loss of ovarian follicular activity. It is a nat- turning into a major health problem.
In Ayurveda Menopause is similar to
process not an illness. In
this
ural biological as Sushruta mentioned that Ra-
and psychological Rajonivritti
process various physical
 Vandana and ommen: FJfect of Durva in Menopausal Syndrome

norrhagia, Dysmenorrhoca, Ahortion, and

jonivritti is jarapakva
avasthu of the body.
normal Gonorrhea. All these show that the drug may
Ancient Acharyus termed it as a
of S) ycars'
have sone relation with menstrual disorders
physiology occurring at the age and on uterus. On these account an attempt
duc to vata dominance and dhatu kshaya.
is made to assess the efficacy of Durva (Cy
Being an alarming problem Menopausal
cffective and safc man- nodon dactylon Linn. pers) in management
syndrome nceds an

science hormonc re- of Menopausal syndrome (Rajonivritti).

agement. In modern
MATERIALS AND METHODs
placement therapy (HRT) is
one and only
by which Patients: As per incusion and exclusion
altcrnative for this health hazard
achievemcnts in criteria 30 Paticnts with menopausal syn-
one can get spectacular
wide drome were selected for the purpose of
it has
combating the disease but
a

study from OP unit of Dravyaguna vijnanam

health complications like
range of secondary Govn Ayur-
Endometrial cancer, vaginal & Prasoothi tanthra department
Breast cancer,
vedaCollege, Tripunithura, kerala.
bleeding etc. Ayurveda, the science of life, in study was fresh
advocates a holistic treatment for Meno- Study drug: Drug used
of Durva (Juice of Durva)
utilizing various herbs
swarasa

pausal syndrome by Inclusion criteria: Having cardinal symp

reliable option to the conven-
and offers a menstruation were se-
wide tom like cessation of
tional treatment. Therefore there is a
(6month-3years). With menopausal
in Ayurveda to find out a
lected
scope of research excessive sweating.
for its symptoms, hot flushes,
cost effective remedy
safe potent
palpitation, fatigue,
sensation of pin and
to Dhanwanthari
managemnent. According and soles, pain in
needle prick in palm
Kaideva nighantu
nighantu, Raja nighantu, of appetite, constipa-
rasa, sita virya joints, backache, loss
Durva has madhura, kasaya control. Psychological
dahasamaniya, raktapittahara properties tion, loss of urinary
irritability, headache.
symptoms depression,
shamaka drug, due to pitta
and act as pitta Age group
it may be useful in pitta
sleep disturbances, forgetfulness.
shamaka property included.
with Meno- between 40 to 55were
lakshana associated in age group
vishesa
etc. Exclusion criteria: Patient
daha, ratri sweda
pausal syndrome like below 40 years and above
55 years. Known
has been mentioned as
In Raja nighantu it cases of cardiovascular diseases, Diabetes
"Grahabhutashanthidha" it may be related and Hypothy-
mellitus, Hypertension, Hyper
symptoms and renal diseases, ute
in alleviating psychological
may be
roidism, Liver diseases,
due to its jivaniya properties, menopause (oopho
lakshana. Durva
rine fibroid, artificial
w o m a n with
un-
helpful in dhatukshyamaka and Menopausal
rectomy),
Linn. pers) exhibits excuded.
(Cynodon dactylon toward effect of HRT w e r e
Sushruta
raktastambhana action. Acharya The study de-
design and duration:
(Cynodon dactylon
Study Clinical study
mentioned Durva clinical trial.
abortion in 4 month of
sign was open with Durva
Linn.pers) to avoid of was
conducted on 30 patients
traditional healers 15ml twice daily for
Also the
pregnancy. swarasa in the dose of
Allahabad use Durva (Cy-
Chhattisgarh and combina a period of 1
month.

nodon dactylon) as
aphrodisiac in
and in case of Me-
tion with other herbs,
Isue 4; July
-

Aug 2013
IAMJ: Volume 1;
www.iamj.in
2
 Vandana and Oommen:
Criteria of assessment
The results of the reatment were as-
sessed on the basis of Subjective Criteria
(suitable scores were given according to se-
verity) and objective criteria. Assessment
was done on somatic symptoms like hot
flushes, excessive sweating, pain in joints,
backache, palpitations, loss of appetite, sen-
sation of pin and needle prick in palm and
sole, constipation and in loss of urinary
control. In psychological symptoms like
headache. insomnia (sleep disturbance), de-
pression, imitability, forgetfulness. In dha-
tukshayaja lakshanas, like shabdasahatva,
hriddravatva, trishna, twak rukshata, shita
prarthana, katisuptata, Aayasa, sandhi sai-
thilya, asthi toda, bhrama, tamodarshame
daurbalya, rukshata and panduta. Routine
hematological, urine and gynecological ex
amination were carried out to rule out any
systemic disorders if any, in al the regis-
tered cases. Vaginal Cytology study was
also caried out to assess the atrophic
changes of vaginal epithelial cells and hor
monal status especially estrogen level.
Statistical analysis: The obtained results
were statistically analysed by Wilcoxon's
Signed Rank Test for subjective criteria and
for objective criteria.
paired,'T tests
OBSERVATION AND RESULTS
It was observed that 80% were from
the age group 45-50 yrs. Considering the
menstrual history (just prior to menopause)
70 % were having age of menarche between
14-16 years which is the normal age of me-
narche. Majority of the patients were having
of regular menses i.e. 70 %. In
history
46.6% patients' menstruation period was 4-7
daysand also more than 7 days in 46.6% of
patients. 83.3 % of patients got a cycle of
21-30 days. While considering the amount
IAMJ: Volume 1; Issue 4; July-Aug 2013
3 www.amj.in
Effect of Durva in Menopausal Syndrome
of bleeding 83.33% of patients had moderatee
bleeding. Painless type of menstruation was
found in 80% of patients.
Regarding the du-
ration of Menopause majority of the
patients
i.e. 43.33% were
having history of men0
pausal symptoms in a less than 1 year.
Efectiveness of trial on chief somatic
complaints
A. Hot nushes: There is highly
significant
treatment effect in reducing the hot flushes.
Before treatment 26.7% patient had very se
vere complains, 26% severe, 43.3% mod-
erate complain and 3.3% patient had no
complain of hot flushes. It is seen that
87.5% reported a transition from severe to
mild complain, 37.5% reported a shift from
very severe to no complain or mild com-
plain. Results were graphically represented
in figure 1.
Figure 1: Diagram of treatment effect on hot flushes
1.5
B. Excessive sweating: Test of significance
(Wicoxon's test) on effect of therapy on
excessive sweating showed highly signifi-
cant result in excessive sweating. Before
treatment 33.3% patients had very sevee
is
symptoms but after the treatment there
shift of severity of sweating in 100% pa-
complain, in
tients from moderate to no
100% from mild to no complain, in 85.7 %
in
patients from severe to mild complain,
60% from very severe to moderate symp-
toms. Results are graphically represented in
figure 2.
 Vandana and Oommen: Effect of Durva in Menopausal Syndrome

Figure 2: Treatnent effect on excessive Sweating pain in joints shows highly significant result.
Before treatment 43.3% patient had severe
ICO
complain of joints pain but after treatment
there is shift of symptoms in 81.8% patients
from moderate to mild, in 61.5 % from se-
vere to mild complain, in 50% from mild to
no complain, in 18.2% from moderate to no
C. Palpitation: Test of significance (Wil-
therapy
effect of on palpi- complain, in 15.45% from severe to no
coxon's test) on
result in complain. Results are graphically
tations shows highly significant
before treatment represented in figure 5.
palpitation. 26.7% patients Figure 5: Treatment effect on pain in joints
had moderate symptoms and after treatment
from mild
there is shift of symptoms in 80%
from moderate to
to no complain, in 87.5% mader t e no<omplun 132

31
100% very
mild, in 100% severe to mild, in
severe to moderate level symptoms.
Results 154

are graphically represented in figure 3. Test of significance (Wil

of treatment effect on palpitations F. Backache:
Figure 3: Diagram therapy on back-
effect of
coxon's test) on
Before
m d *o <mpiNA
ache shows highly significant result.
treatment 36.7% patient had
modrate mis
severe com-

but after treatment shift of severity of

plain
to no complain,
symptoms in 60% from mild
Test 36.4%
D. Sensation of pin & needle prick: in 45.5% from severe to moderate, in
effect of
of significance (Wilcoxon's test) on from severe to mild complain. Results
are

therapy on sensation of pin and needles graphically represented in figure 6.

shows highly signif Figure 6: Diagram of treatment effect
on backache
prick in palm and sole
cant result. Before treatment 23.3% patient o¢nelan

10
there
had mild complain and after treatment
in 42.9%
is shift of severity of symptoms 34

in
patients from mild to no complain,
33.3%
66.75% from moderate to mild and in G. Loss of appetite: Test of significance
complain. Results are
from severe to no
(Wilcoxon's test) therapy on
on effect of
graphically represented in fig 4. loss of appetite shows highly significant
re-
sensation of had se
Figure 4: Diagram of treatment effect on sult. Before treatment 23.3% patient
pin and needles prick in palm and sole loss appetite but after
vere complain of
nmle naomplan 3.9
treatment shift of severity
of symptoms in
667
moderate, in 50%
n o d e r a t Im'd

100% from very severe to

333

SKYJE u l d from moderate to no complain, in 42.9%

Results are
333
from severe to mild symptoms.

E. Pain in joints: Test of significancee graphicallyrepresented in figure 7.

(Wilcoxon's test) on effect of therapy on
IAMI: Volume 1; Issue 4; July-Aug 2013
www.iamj.in
4
 Vandana and Oommen: Effect of Durva in Menopausal Syndrome
Figure 7: Treatment cffect loss of
on
appetitc Figure 9: Diagram of trcatment cffect on headache

| 43

H. Constipation: Test of significance (Wil- B. Depression: Test of significance (Wil-

coxon's test) on effect of therapy on consti- coxon's test) on effect of therapy on
pation shows highly significant results. Be-
depres-
sion shows highly
significant result. Before
fore treatment 23.3% patient had moderate treatment 43.3% patient had mild complain
complain but after treatment shift of severity but after treatment shift of
severity of
of symptoms in 100% patient from very se- symptoms in 100% from moderate to mild,.
vere to moderate, in 100% from severe to in 66.7%from severe to moderate, in 53.8%
moderate, in 50% from mild to no complain. from mild to no complain, in 46.2% mild
Results are graphically represented in figure complain no change after treatment. Results
8. are graphically represented in figure 10.
Figure 8: Diagram of treatment effect on constipation Figure 10: Diagram of reatment effect on depression

srdd-amgdan
mdd comgdan

mccerrid

| :36

I. Loss of urinary control: Test of signific

C. Insomnia: Test of significance (Wil
coxon's test) on effect of therapy on insom-
ance (Wilcoxon's test) on effect of therapy
nia shows highly significant result. Before
on loss of urinary control shows result is
treatment 26.7% patient had very severe
statistically not significant as in loss of uri- but after treatment
complain of insomnia
nary control no any change noticed before shift of severity of symptoms in 100% from
treatment and after treatment in any type of
severe to mild, in 100% from mild to no
symptoms. 62.5% from very severe to
Effectiveness of trial on chief psychologi- complain, in
moderate, in 60% from moderate to no com-
cal complaints
A. Headache: Test of significance (Wil- plain, in 25% from very severe to severe
complain, in 12.5% very severe to mild
cOxon's test) on therapy on head-
effect of are graphically
complain. Results
ache shows highly significant result. Before represented in figurel1.
treatment 56.7% patient had mild complain insomnia
Diagram of treatment effcct
on
Figure 11:
but after treatment shift of severity of macnalan

severe to
symptoms in 100% from very m o d r h *mid

moderate, in 50% from severe to moderate, wry *virAVVV

in 50% from severe to mild and in 76.5% verywwemdd 15

from mild to complain.

no Results are
(Wil-
9. D. Irritability: Test of significance
graphically represented in figure coxon's test) on effect of therapy
on irita-

result. Before
bility shows highly significant
2013
IAMI: Volume 1; Issue 4; July Aug
-

www.amj.in
 Vandana and Oommen: Effect of Durva in
Menopausal Synárome
ent 26.7 % patient had mild complain
t r e a t m e n t
various somatic and psychological distur
but after treatment shift of severity of bances.
in 87.5 from moderate to mild, Clinical evaluation of observation
mptoms

from very severe to severe. Results and resuls: 80% were from the age group
66.7%

in in
represented figure 12. 45-50 yrs. It shows that climacteric changes
are
graphically
of significant treatment gradually start after an average age of 45
Figure
12: Diagran
effect on irritability years. Considering the menstrual history
just prior to menopause) there is no relation
875 between normal past menstrual history and
13S
Menopausal syndrome. Regarding the dura
66 7
tion of Menopause majority of the patients
393

were having history of menopausal symp

E.Forgetfulness:
Test of significance (Wil- toms n a less than 1 year suggesting of

on effect of therapy on forget hormonal imbalance and psychological

dis-
cOxon's test)
not significant cessation of the
shows statistically turbance immediate after
fulness
noticed before treat- menstruation. Considering gynaecological
results. No any
change
ex-
treatment. examinations inspection, per speculum
ment and after exami-
amination of vagina, per speculum
DISCUSSION
are suggestive
is familiar since
Vedic kala to nation of cervix all findings
Durva which are ob-
era. It is
used in various
ailments
of atrophic genital changes,
the present (lexico w o m e n after
Rajonivritti.
served in the
in various Nighantus of drug. on
as quoted the On evaluating efficacy
For the present study Wilcoxon's
graphic texts). botani- chief somatic complaints
with
selected which was
whole plant was Rank Test; it
showed highly signifi-
(Linn.)
identified as Cynodon detylon Signed hot flushes
cally as follows: cant result
(P<0.01) in reducing
of Durva is sweating (P<0.01),
and
Pers. Rasapanchaka sheeta veeya, (P<0.01),
excessive
used in
madhura, kashaya, tikta, Durva can be
rasa
palpitation (P<0.01). exces-

madhura vipaka. symptom

of hot flushes,
samprapti
ghataka very
severe
There was

n Rajonivritti, and palpitations.

are sapta sive sweating in re
dosha and dushyas result (P<0.01)
significant
vata pitta
are
a r t a v a . The
various also highly and
backache,
while

dhatu including
updhatu duction of pain
in joints loss
are
likely
more
effectiveness
of drug on
Jarawastha
of the
avastha. So, it
and
sensation of pin
symptoms estimating
Rajonivritijanya (P<0.01), and
in the of appetite
is part of
observed (P0.01)
and sole
prick in palm
that Rajonivritti be
can be stated needle found to
female. This Rajonivritti (P<0.01) it was

of aging of constipation these symp-

process
Menopausal syn in
in reducing
condition is
similar to the significant (P>0.05) in
Menopausal syn-
highly not
effective
was
science. But drug There was
modern in
drome in waning toms. control.

of the gradual loss of urinary after

drome is the results es- reducing
for urinary
control

ovaries to
produce noticed
the functions of the consequence
no change
as a
progesterone, treatment.

rogen and
more
becomes

the pituitary
gland FSH
of which, feedback)
and produces
active (positive into
resulting July-Aug 2013
and LH in greater
quantity
Volume 1; Issue 4
IAMI:
www.amj. in

6
 Vandana and Oommen: Effect of Durva in
Menopausal Syndrome
Considering the effectiveness of Probable mode of action of Durva in Me-
Durva in chief psychological complaints nopaual syndrome:
with Wilcoxon's Signed Rank Test; showed Nighantus have explained the
highly significant resut (P<0.01) in reduc- pharmacological properties of Durva as
ing the headache. At the same time it was madhura, kashaya, tikta rasa, sheeta veerya
found highly effective (P<0.01) in reducing and madhura vipaka. Madhura, Thikta rasa
insomnia (sleep disturbance), depression and and Seeta veerya will help in reducing the
irritability. Durva was not effective (P>0.05) pitta associated lakshana like daha (hot
in reducing the symptom of forgetfulness. flushes), ratri sweda (night sweating). Vata
While estimating the effectiveness of associated symptoms like sensation of
needle prick in palm and sole, backache,
drug in dhatukshayatmaka lakshanas with
pain in joints are relieved I madhura rasa
Wilcoxon's Signed Rank Test it was found
in and madhura vipaka of the drug which acts
to be highly significant result (P<0.01)
as vata shamaka. Due to tikta rasa drug may
reducing all rasadhatukshayatmaka laksha-
help in alleviating the agnimandhya and
nas like shabdasahatva (P<0.01), hriddra-
so it will help to
increase the appetite
vatva, trishna (P<0.01). It also showed
ama,

of the patient. Madhura vipaka has proper-

highly significant result (P<0.01) in reduc- faci-
ties of Srushta malamutra which may
ing shita prarthana (wish to take cold
things). Considering the effectiveness of dug litate in reducing the baddha mala (consti-
on asthi, majja and shukra dhatukshaya- pation). In Ayurvedic terminology palpita-
maka lakshanas, it was highly significant tion be co-related with hrid dravatva
can

which is caused by rasa kshaya. Due

to
(P<0.01) in reducing katisuptata (P<0.01),
madhura rasa and madhura vipaka, sheeta
Aayasa (P<0.01), Sandhi saithilya (P<0.0). and by jiva-
ta- virya drugmay act as rasayana
asthi toda (P<0.01), bhrama (P<0.01),
niya property it will enhance the prasastha
modarshama (P<0.01), daurbalya (P<0.01)
found in dhatu formation and prevent the vata
and Significant result (P<0.05) was
of
rukshata (P<0.05) vruddhi due to dhatukshaya. The process
twak rukshata (P<0.05), in de-
formation of proper dhatus will help
and panduta (P<0.05). the symp-
effectiveness of drug lay of aging process. As a result,
Evaluating the can be reduced.
of Rajonivritti
Ac-
toms
maturation indexof vaginal cytology, the
on
to Sushruta it has "vapor-medha-
increased in number cording
superficial cells were bala-buddhi-vivardhana" (increase intelli-
intermediate and para Durva
(MD.33) where as Here,
number (MD.50, gence, strength and wisdom).
basal cells were reduced in due to grahabhuta-
treatment, which
as a Medhya drug, and
MD.16 respectively), after bhutabadhahara properties may
(MI) has shantida,
Suggest that the Maturation Index correct this psychological
distur-
help to
shifted to the right, but these
very slightly bance.
changes are statistically not significant
Various scientific
researches on Cy
ef- that it has anti-
(P>.05). It indicates that the drug has no
nodon dactylon had proved
and on vaginal epi which will favor
in reducing
fect on estrogen level arthritic action
in some
thelial cells. osteoporosis. In study group
risk of

2013
IUMI
Volume 1; Issu 4;July-Aug
uww.amj. tn
 Vandana and Oommen: Effect of Durva in
Menopausal Syndrome
patients Durva has shown good effect in re- REFERENCES
lieving pain in joints and backache. Addi- 1. Third consensus
tional antiarrythmic, cardio protective,
mecting of Indian meno-

polipidemic action will help in reducing

hy pause society 2008; a
summary; http/
www.jmidlifchealth.org
risk, against cardiovascular disorders. Durva 2. Ambikadutta shastri, Susruta samhita,
has shown good effect in reducing total sharira sthana Chaukhamba Sanskrit
cholesterol level in some patients of study sansthan, Varanasi 2005, sha 3/11
group. 3. Ambikadutta shastri, Susruta samhita,
CONCLUSION sharira sthana, Chaukhamba Sanskrit
Due to today's fast life, strain, ten- sansthan, Varanasi 2005, sha 3/11
sion, stress, hurry-worry etc, Menopause, it 4. Indradev Tripathi; Raj Nighantu with
attains "Vyadhisvarupa" which requires Dravyagunaprakashika Hindi commentary
medical interference. Both the term Rajoni- Choukhamba Krisnadas Academy Varanasi
vritti and Menopause literally convey same 2006; page no. 253-255
5. P.V. Sharma and Dr. Guru Prasad
meaning. Clinical study proved that Durva
Sharma; Kaiyadeva nighantu; Choukhamba
is highly effective in treating Menopausal
orientalia, Varanasi 2006; p-227 -228
syndrome. Drug has shown good results, in 6. Chunekark.C; Bhavaprakash nighantu;
somatic complaints like hot flushes, night
like
Chowkamba Bharathi Academy,Varanasi
sweating, in psychological complaints
headache, insomnia and in dhatukshayat 2009, p-384
CORRESPONDING AUTHOR
maka lakshanas like trishna. But
it is not
and Dr. Vandana Singh
effective in loss of urinary complain D/o Shree Virendra singh
estro-
forgetfulness.Drug has no effect on Chaudharipur, Post Thiresapur
-

observed Village -

levels. No adverse effect was Pin- 231304

gen Dist -

Mirzapur, Uttar Pradesh,

therapeutic
during clinical study. It is a new
Email: drvsingh21@gmail.com
menopausal symdrome. Further
option in
population is r e c o m m e n d e d . of support: Nil
study in higher ource
Declared
ACKNOWLEDGEMENT
Conflict of interest: None
sincere thanks
with
Authors express
Oom-
to Dr. Sara Monsy
immense pleasure An-
Professor and Dr. P. Y.
Associate
men, & Associate Profes
H.O.D.
sary, Dravyaguna
vijnan,
Of
sor, Department Tripunithura.
Dr.
College,
Govt. Ayurveda Dravyaguna
Professor, Dept. of
P. Jayasree, Thiruva-
College,
Ayurveda
vijnan, Govt. kumari,
Superiten-
Prasannsa
nanthapuram,
Professor,
Department Of Pra-
HOD& cochi,
dent, Tripunithura,
G.A.C,
soothi tantra,

Kerala. 2013
July-Aug

Volume 1;
Issue 4;
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