Women's Health, Fertility and Pregnancy with Dr. Aparna Padmanabhan

Vasudeva sutam devam.

Hello and namaskaram. I am Salila Sukumaran, the founder of Ayurkamaya, an Ayurveda wellness travel concierge based in Mountain View, California. You are listening to the Ayurkamaya podcast. Through these conversations with great karma yogis of Ayurveda, yoga, and other Vedic sciences, I wish to bring to you the treasures of India. If you are a beginner, my mission is to help you develop appreciation. If you are a practitioner, my goal is for you to become confident torchbearers of our immense legacy. May the gods and the gurus Bless you. Today my guest is Dr. Aparna Padmanaban. Dr. Aparna Padmanaban graduated with a PhD in Ayurveda from IPGT and RA, Jamnagar. She was presented with Jeevaka Award for her outstanding academic performance in undergraduate studies. Her PhD was awarded Best Thesis Award. She has presented at many prestigious national and seminars. Her research has been published in several papers and journals. So we welcome Dr. Aparna Padmanathan.

And on today's wonderful day, today's day when we are all thinking about non-violence and Gandhiji's principles, I believe that it is an important topic. As a nation can only be as peaceful as the love and care society shows towards its women. A loved woman becomes a loving woman, a loving mother, a loving head of the family. And only when the children are deeply loved and cherished, then they can become peaceful, peace-loving, and peace-promoting citizens of the world.

Okay, I'll start with a small prayer. Sri Guru Bhyo Namaha. Salutations to all the Masters from this plane and all the planes, and thank you for this opportunity to interact with the Ayurveda student community. So here I'm going to share some of my experiences and a few points to think over in our life and consider those points because it's going to be so much useful. And whatever I have gained from my little experiences till now, I think this will be useful for the, you know, students of Ayurveda. So, you know, while I was a student of Ayurveda, I always wondered why our textbook books, you know, all of those diseases, the chapters on diseases said that mental factors like hurt, hate, anger, loneliness, you know, shoka, bhaya, krodha, karma, all those factors, I always wondered why is it told. And then in every vyadi, the cause of the disease, as such we had like mithya, hara, vihara, that is wrong, food and habits and amla rasapradana yahara, vidahi yahara. So many for us, many of us, it was just a means to pass the exam, you know, to write the common nidana in every answer sheet. And it was, uh, I always wondered why is it everything looking the same. But when I started my practice, I realized how important is our diet and lifestyle and mental health in this, you know, in this cause of— in this, you know, causing— as a causative factor for creating the Vyādhi. So when it is rightly said that when we have experience, then we gain more, you know, with knowledge we gain more. And when we learn more and when we go back to the Shāstras, it is such an eye-opener. So I would like to share some of the experiences with this upcoming practitioners of Ayurveda. When we go through the textbooks of Ayurveda, we always see that there is this, um, sattva, atma, mana, you know, the soul, mind, intellect, and the senses. When they indulge in the positive stimuli like the right contact, right ahara, or the food, and vichara, the lifestyle, we gain health, or it is resultant as health. And when we indulge in the Ashubha Pravritti, or the stressful stimuli, or the wrong ahar and wrong food and habits, then it causes the stress response in the body. That is disease, right? So in the present scenario, when you see the mind-body medicine, it is also very, very much now popular that concept of psychoneuroendocrine immunology. You know, the psych— neurology— the psych nervous system, endocrine system, and immunology, everything is so much connected. So whenever there is a change in the psych, or, you know, whenever we are afflicted with stress or tension and then any of the negative emotions as such, there is a ripple effect in our health. You know, that is why when we are sad or when there is something happening to our dear ones, we don't feel appetite, we feel very sad, and we feel like, you know, our energy level has gone down. Same, that is because there are a lot of chemical reactions taking place in the, in the body. So this is why probably the Acharyas were so specific in considering the mental factors as well as a positive or a Nidana for many of the diseases. The diseases which are told. And then, you know, in the Charaka's 5th chapter, if I'm not wrong, he has rightly said, Adhyatma Dravya Gunas Sangraha, you know, Mano, Mano Artha, Buddhi, So intellect, mind, senses, and the soul, these all should be in harmony to have a very healthy life. You know, so this is so much relevant in today's era because we, we are having a lot of stress. We are living in a competitive world where we are exposed to this stressful stimuli, this negative emotions and the stress response which is causing us diseased or which is causing us sick.

Wonderful, thank you so much.

And you know, this positive stimuli, when I say that is the reason why a lot of Dinacharya, Ritucharya, and all those things are mentioned in our classics, right?

Wow, that was— yeah, that you wrote, you connected the whole thing together. Uh, may I ask, what is the role of Vegadharna in women's health?

So if we want to start with the Vegadharna, we have to go a little, uh, you know, back. So I was talking about the positive stimuli and the negative stimuli, right? So this positive stimuli, when we consider the 3 of the Vayadi, like ahara, nidra, and brahmacharya. So ahara is diet, right? So the right kind of diet is very important. Nidra is, uh, the sleep. So right amount of sleep is very— the quality of sleep is very important. And brahmacharya Brahmacharya is not what is being highlighted, like the sex, the active sexual life, or discipline in sexual life, but it has a deeper meaning, like the brahmachariti brahmacharya. That is what Kamasutra says. That means spiritual and mental health, you know. So that when you are healthy in the spiritual and mental level, then the sexuality transcends, it transcends to another level. So that is This is what probably the acharyas were mentioning, even though it has a, you know, sexual part to it. And when these three pillars of health are well taken care of, it is giving us health. So again, and one of the main cause of VYADI as such, which is said in the classics, is Vega Dharana. So this Vega Dharana, anura anarogyakaranam sreshtham. So Vega Dharana is the best among those which cause disease. Vega is the natural urge, you know. There are 13 urges which are told by our acharyas, and these are very much, very much important in this present scenario because, you know, I have seen many patients saying that, uh, Doctor, I, uh— so when I ask them how many times you poop or how is your poop, you know, how many times you go to the toilet, they say, um, it is very normal, I go once in every 5 days. And they— it, it has become like, you know, a surprise for me, uh, seeing that. And most of the disease they are presenting with is because of the negative effect of of constipation or negative effect of, you know, Veda Dharana or suppressing of these natural urges.

Yeah, thank you so much. I know that you have 3 case studies to share with us, and I am sure the students will gain a lot from listening to your vast experience. If you could begin with Case Study 1 and just elaborate on the patient information. How your treatment plan looked like, an overview, and what was the outcome for the patient?

So see, because I'm practicing in Bali, Indonesia, and we have a variety of cases, variety of nationalities coming to our clinic, you know, our job center, from like, uh, so I was fortunate consult people from 60, almost 60 countries. So, so one thing I have seen is, you know, if I want to present, if I want to summarize the, the dana in 2 or 3, uh, you know, sentences, it would be like, first, when I, when we take the ahara, so the ahara is mostly the, the Western, uh, people are used to they give so much importance to the raw food, and a lot of calories are given more importance than the nutritional side. And a lot of them depend on processed food and precooked food because they don't have time to go and cook because of the work culture. And then, you know, most of them change from one kind of diet to the other kind. Like, for example, paleo diet and vegetarian diet, vegan diet, Mediterranean diet. But one thing which is lacking in most of my patients were they don't know the concept of acne. They are not taking care of acne, and they were eating because they like something, or that because that was popular, you know, that is popular. Like, you know, veganism is a fashion now for most of the people, or a paleo diet is popular, and a lot of people, um, like, you know, it's like, I'm, I'm on my paleo diet, or I'm on my low carb diet, I'm doing intermittent fasting. So, uh, we don't have the awareness on, see, if I eat raw food, um, am I able to digest that food? Is my digestive fire strong enough to assimilate that digestive, you know, that digestive system strong enough to cook that food in the body, that is lacking. So these were the first things which I noticed, the diet. And the second thing was, you know, the veganism, as I said, it's getting popular. So people have this notion that dairy is not good, you know, cow's milk or animal products are not good. They tend to go into this alternatives like, you know, coconut yogurt or almond yogurt, or like things— even cashew cheese. Cashew cheese, that is really abhisyani, and that is really heavy for digestion. So, you know, it is better to take a normal yogurt than having a coconut yogurt, you know. So Actually, finding an alternative is not the solution. It is— the solution is to take care of your acne. It is not that vegan diet is going to make you healthy or raw food is going to be healthy. So the basic understanding about the acne is lacking, basic understanding about the food is lacking in many, many of them. So this is also a main cause of Vyadi. So I'm going through the nidana of the Vyadi for all these cases. So first is diet, as I said. And now coming to the, um, coming to the, uh, ahara, vihara. You know, the vihara— when, when I see this, uh, these patients, most of them are accustomed to vidahi ahara. Vidahi ahara is that which causes a lot of burning in this, like chips and, you know, a lot of, um, like vinegar, pickles. And tikshna, like tikshna is very pungent and very, you know, like wine, you know, like red wine. Most of them are accustomed to wine, smoking. So these are creating a lot of vidaha or paka in the system. Paka means it is cooking you up actually. So the datus, the tissues, and the people are getting cooked in all these things which which they are eating. And a lot of them are— Lavanarasapradana, that is very salty and sour and spicy. Spicy in the mean— not many of them are not accustomed with the hot spice like chili spicy, but it's really vidahi, and it is like really creating a lot of vidaha in the body, like burning sensation in the body. So seafood and eggs— eggs is also a main causative factor for many of us, because in India, you know, people are some somewhat, uh, understand that only one egg a day. And, you know, people are like traditionally and culturally, people understand that it's not very good to have more than one egg. I don't know, like I have seen this education in, uh, in my patients in India. But in the West, you know, when they make an omelette, they put like 3 or 4, 4 eggs and make a big omelette. And That is really too much, right? So this Madhyama Margha, you know, acharyas have told that sarva marghe shu madhyama, of all the parts, Madhyama Margha is the best. So this Madhyama or the concept of Madhyama Margha is lacking in, was lacking in most of my patients. So this was the cause of disease in many of them. And then when you come come to the Bihar, it is a passion to go and get tanned, you know, sunbathe. So they go for sunbathe. So it's again, they are cooking you up. And, uh, you know, it's like you go to sun and then you get tanned, but there is something chemically happening in your system, you know, you are getting cooked in the hot sun. So this is also, um, and most of them, surprisingly, uh, when you see the prakriti or constitution of the patients They were all Pitta prakriti, mostly Pitta dominant people. And so I wonder sometimes whether it is Pitta people I am attracting, those Pitta people here, or most of the Westerners are Pitta prakriti, or whether they are getting sick, or Pitta is more prone to get sick. So this is also my, you know, research topic now, like what kind of people, which prakriti people are getting more are often sick. So sunbath is also one of the more major reasons. And the second most important thing what I felt is the wrong yoga, kind of yoga. When you see in the West, you know, there is vinyasa type of yoga, hatha yoga, ayangar yoga, and you know, hot yoga, and you know, shishasana, doing shishasana is a fashion if you can. So this they are not understanding the basic principles behind it, and they were just like going behind the fashion. So if you are a Pitta Pragati person and you are doing a hot yoga in 45 degrees centigrade temperature, then definitely your Pitta is going to be high. And if I'm a Pitta Pragati person, I should not be doing more than, you know, 3 or 4 rounds of sun salutations or Surya Namaskar. Kara. So this basic understanding, uh, is what is very important when we treat a patient— that what is their lifestyle, what is their diet. So this is the basic thing which gives you an eye-opening or into that person. And Sarika has told that a good physician should be able to go into the antar-atma of the patient, or the soul of the patient. So here I— and what I understand is that we have to really analyze, uh, you know, the diet and lifestyle to, to, you know, get that causative factors, um, from the patient.

Wonderful. Yes, I'm sorry to interrupt you. Continue, continue.

So, um, what I understood is going back to basics is a very important thing, like acne correction Vegadharana correction, Ama elimination, and asking them to do the Dinacharya properly. And, you know, checking whether there is Vata Prakopa Nidana or Pitta Prakopa Nidana. And because when we— when I was a student, I never understood that actually the, you know, the importance of this. But when I started seeing patients, I understand now. I understand how important is is it and why Acharyas have told this, you know, and this is practically visible in most of the cases.

I remember you telling me that you tell people to meditate and about 80% of them get healed.

Yes, you know, I had a patient recently and she had a lot of, you know, anxiety and a lot of panic attacks and then I told, like, before I had to send medicines to her, but before the medicine started, I told, you know, it's very important to meditate and start meditating. And I have sent her some guided meditation, and she, within a week, she said, now I don't get panic attacks anymore. So luckily the courier had, was not sent, so I had to re, you know, re prescribe my medicines because that important is meditation in our life, or, you know, yoga, the yoga and meditation. So when, uh, so, and my PhD thesis was on the role of anxiety, the role of anxiety in, um, and yoga and pranayama, how it is going to affect it and whether medicine is enough or whether anxiety, whether yoga is enough. But yoga is equally important as medicine is what I, you know, I found. So this is very important.

Wonderful, wonderful. If you could share a couple of very interesting cases that you have handled, you know, a few patients, just describe them that stand out to you so the students may learn from it.

Yeah, so I had a patient, a 21-year-old from Austria. So, and she had severe cystitis. So cystitis is like, you know, she had burning micturation and, you know, she pee and it is really painful whenever she urinate. And she was taking less water. And she, when I asked the history, she had been assaulted, like molested in her childhood. So she had this habit of holding her pee for longer time. And when you see this mutra veda dharana of Charaka Samhita or Ashtanga Hridaya, it is, you know, it is clearly said that when you hold your urine for prolonged time, you get severe cystitis or you calculi, stones, and frequent UTIs. So this was very interesting and Then, so it was not just medicine which was important here, but counseling and, you know, sattva vachhe chikilsa is what we say. Psychological counseling was also important, and putting her mind from the bad memories to a positive outlook of life was also very important. So it's a long and slow process, and then finding the right medicine for her, whatever available in a different country. Different country I was practicing was also important. So I don't say that she was totally cured, but, uh, you know, she had severe burning sensation for years, and she was taking antibiotics every 2 or 3 episodes of antibiotic course. She used to have a severe pain abdomen associated with it, and people and doctors could not see anything else. And with our proper panchakarma and for 21 days. And like, um, we were, we, we were giving her, um, different kinds of bastis and, uh, you know, virechana, etc. So with a special Siddha Gru Das and kashayas and tablets, she was able to recover. And it is, it is now the intensity of it is reduced, you know, the intensity of— the problem is reduced. And the frequency, usually she used to get 2 episodes every month, but now it has reduced to 1 episode every 2 or 3 months. So, so, so we are still working on that. But this is very important. See, mudra veludhara or holding of urine, it is not right according to our shastra. And this is what I found, you know, and it is very important to educate educate people that you have to, even if you have a busy work culture, you have to go and pee in between, or you have to drink enough water.

Yes, yes. I have been hearing a lot about fibromyalgia being a very frequently occurring condition in perimenopausal, premenopausal, menopausal women. Is that your experience also?

The fibromyalgia is Especially because when you see the case, we can see that there is ama, lot of ama, or that there is purusha vegadharana. Purusha vegadharana is like with constipation, you know, withholding of poop. So many— I have an interesting case here to share with you. So she was a 42-year-old German patient, and she had a chronic history of a long-standing history of chronic constipation and she had endometritis. And then, uh, so this— what— so when we see, uh, what is happening in that is like, um, there is apana vayu vaygunya, you know, like the apana vayu should be going downwards. It is not proper. So, uh, she was not conceiving. She wanted to get pregnant. And, um, and, and then what I did was just a little bit of diet correction, and then every day I made her to take some herbs to, you know, evacuate our bowels every day, and that was enough. And she was trying to have a baby, she was 42 years old, and within a month or two she conceived. You know, wonderful. This is as simple as that. When the apana, apanavata was corrected by small measures like chronic constipation she was treated, everything went, uh, just like, you know, normal. So this was the importance of Purisha Vegadhara, which I saw in my case, in my practice. And I also had an American lady who was 40 years old, and she was a strong advocate of raw food. You know, she was, I eat salads, and she telling, she came for consultation and she said, Doctor, I'm really healthy, I eat healthy, but I have anxiety, I have gassy distension of the tummy, and I have constipation. But I don't know what am I doing wrong, but I'm, I, I'm very healthy, I eat very healthy, but I have this problem. So when I saw, when I asked for her breakfast, lunch, and dinner, breakfast was raw smoothies. Lunch, lunch was like salads, raw salads. And even night was also like, dinner was also similar. So, so when I said, this is the problem, this is your problem, you know, this is a root cause of your disease, she was really angry because it was such a strong package of raw food.

Was she Vata prakriti?

Pardon?

Was she a Vata prakriti? Do you remember?

She was a bit tough because she was very adamant. It is not really— no, she was really adamant. She told me, this is not the reason why I'm sick because I'm eating healthy. Then I said, you know, for one month, at least one month, listen to me and start having cooked vegetables and cooked soups. And I prescribed her some herbs to reduce her vata and gave couple of meditations for her to practice. And, uh, and she's my Facebook friend now, like, you know, since 2-3 years. And she consulted me in 2017. Now she has a baby, and she, she, you know, she just— simple herbs and then just, you know, going off the raw food diet was enough for her to feel normal.

Wonderful.

Regularly pooping, that's, that's it.

Wonderful. It is so satisfying, isn't it, when you apply Ayurveda and magically things start to move within days, weeks? It is so magical. It must be so satisfying for you to see that. And no side effects. People only get happier, more free, much healthier at the end of it. Wonderful. Would you also say something about the Arthava Vahasrotas Dushti in women?

Yeah, this is a very interesting topic which I saw in my practice. You know, most of the— see, because I'm seeing Western people, you know, Westerners, I would share from those experience. You know, Arthava Vahasrotas is like, you know, Arthava is like their Just as the river is cleansed by its flow, woman is purified by the menstrual flow.

That's beautiful.

So when you do something to block this flow, you know, when you are going to put a blockage to a river, when you build something against the flow, what happens? It will find some other way to go, right? It will overflow, it finds some other ways to go. Same thing is, uh, was happening with many of my patients, you know, they have a history of prolonged use of contraceptive pills. And, you know, 15-20 years of contraceptive pill, like, you know, from the age of 15 they start going on pills. And, and I've seen people— I have, I've asked a couple of patients, why don't you go off the pill? You know, then, then the patient said, I, I get acne. That's why my skin breaks out. That's why I don't go off the pill. So, uh, you know, it's very surprising to see, uh, why women go for so much of chemicals, you know, hormones. It is like menstruation is a normal process in the body, you know. So you are interfering with the physiology of the body. We are actually, uh, it's like deviating from the natural physiology, which is affecting your circadian rhythm. Your biological clock is getting affected. So when the biological clock get affected, when the circadian rhythm get affected, there are a lot of issues like fertility problems, menstrual problems, cancer, sleep issues, whatnot. So there's a lot of problems which comes with along with this hormonal imbalance. PMS, fatigue, um, and fibromyalgia, as you said, anxiety, IBS, skin and hair changes, insomnia, low sex drive. These are all the side effects of a major hormonal imbalance. So when you are stopping hormones to suppress your normal menstruation, these are going to be your side effects, you know. That's what— have to be really, um, careful not to abuse the body You know, just let it flow, let it have this normal course of its, you know, what it is made, meant to. So this is very important. And I would like to share one experience. So this is an Indian patient I had, and so a patient from Kerala, and her husband, you know, wanted to go to Sabarimala. And then when you have a Sharip Swami at house, it's a very common practice in Kerala that women should not be menstruating, you know. So if you are menstruating, you have to go to another house, or it should be clean, all those things. You wanted to keep up with the tradition, and for 45 days she took a Primalute. And Primalute is like a hormone pill to postpone the menstruation. So when she came to my Preeti, she said that I had a lot of burning sensation in my body and I am getting a lot of dryness in my body and I feel like the fire is coming out of my eyes.

Hmm, okay.

So this was the presenting complaint. So I did not understand why this is happening with her. Then slowly when I started analyzing and she— then I said Are you taking any medicines or any, you know? And then she said, ah, doctor, yes, I'm taking Primaluton because my husband is a Swami. And I said, you know, stop, stop this. And then I gave her some Chandanaritalam, Buluchiadi, and Rakshasidha Jalam, etc. And within a week everything went back to normalcy. But then, you know, it takes some time, but the Burning sensation, everything came down. But this is the, this is the havoc these hormones are creating in our body. And most of the headaches and migraines, breast tenderness, yeast infections, big pill challenges, and blood clots, mood swings— I see in most of my patients of prolonged use of hormones. You know, when I talk I told them to go off pill and do a panchakarma to cleanse the system, everything comes back to normal. So this is amazing how these hormones are going to change the course. And also, uh, this is also true in the case of hormone replacement therapy. You might have heard like HRT. People go when they are, uh, you know, then they are in menopausal age, they don't want the hot flushes and they feel uncomfortable, so they start taking the pills, hormone pills. And most, like 90% of my patients or clients who had cancer, the history of cancer, they were on HRT.

Oh no.

So, you know, we have wonderful Ayurveda herbs to postpone or to mitigate the symptom of menopause. So this is very important, like you know, to understand or to propagate that this is such a wonderful science and we have lot to offer. Rather than going for something which is very chemical, which is against the body, go for something very natural. And, and then, and I took one patient out of the, out of the HRT, and then I started giving some herbs, and now she recommends that medicine to her friends, hoping that You know, it will help them also. So this is the role of Arthava Vahasrodhas. And even, um, you know, when I, I get a lot of endometriosis cases in, um, in my practice. And endometriosis, it is really funny that, you know, 1 in every 10 women in the US is suffering from endometriosis. And in India, I have hardly seen a case or 2 of endometriosis because, uh, you Again, this aardhava, you know, we are stopping the aardhava which should be going down, and then it is going to Marga Gamanam. So the Marga Gamanam and going to other places and creating this problem, and it is treating, you know, it is causing a lot of infertility issues and bleeding issues, and then eventually they'll have to go under a hysterectomy. So this is very important that we We let our body to undergo this normal cycle, you know, this moon cycle which, which we are meant to. And, um, I, uh, and there is, uh, and fibroid uterus is also something which is really, um, you know, really bad. And, um, one in every, every 2 or 3, you know, under 10 like every 2 or 3rd person has fibroid uterus. So it is also easily manageable with, with Ayurveda. And I don't say that we can 100% cure, but at least we can stop the, stop the progress of the fibroid uterus and make it shrink and make it really not, you know, when it is in the, in the starting stages, we can really help it to just get scraped off from the body. So these are some of my experiences in treating, uh, you know, patients.

Wonderful, thank you so much. That was so full of information. I have been making notes like crazy here. Would you please speak about a holistic pregnancy care for women, Ayurvedically speaking?

Okay, so Do we take some questions? Yeah, we will take time.

We will— yes, we will speak. If you could speak about holistic pregnancy care for about 4 to 5 minutes, and then we will go to the questions.

My problem is when I start, it's difficult for me to stop. See, for many, for Ayurveda has seen a pregnancy in a very holistic way. It is so beautiful, you know. Pregnancy is not an accident. It is a very planned thing, and both the partners are equally, you know, equally responsible for having a child, right? So the mental, emotional, spiritual, and physical readiness of both the parents are so is so important, right? Right. It's not that, uh, you know, Garbha Samskaras is said only for women, you know, and women are responsible for, uh, you know, upbringing a healthy progeny. No, father is also responsible. That is why Ayurveda has told, uh, Panchakarma should be done for both the parents, like father and mother. They should both undergo a Panchakarma, cleanse your body, and Be mindful and prayerful and invite a divine soul into your body. You know, it's so— it's not like you sleep with someone and you get pregnant. So it's like you're going to invite a healthy soul into your body. So when that spiritual, emotional, mental, physical, physiological readiness, then pregnancy is a very natural process to happen. So when you have And Acharya has very beautifully told that saumanasyam darbhakaranam streshtham. Saumanasya, or the, you know, the pleasant state of mind, is the best among that which can create a new life. Isn't it wonderful? I literally get goosebumps when I say this. You know, that is why, you know, positive stimuli is very important. That is why Having a positive mindset or having an emotional and spiritual balance is so important. So if you have not started meditating, you know, it is right time to get started, you know, and because it's very important and we can prevent a lot of this postnatal, postnatal depression and pregnancy blues and emotional. So this support is very important. And, and one important thing is like, um, I have seen in my practice is that when this both the partners come from that spiritual level, it is very easy to, uh, easy to bring up the child. So it's like positive parenting, and both come from a space of sharing and caring. That is what brings up a very good, you know, child. So mother and father is equally responsible and should take responsibility equally and then try for a child. So that is the holistic approach. And you know, Ritu, Shetra, Ambubija are the 4 factors which is told in Ayurveda. So Ritu, um, Shetra is the body, Ritu is the right time. So it's not just for the female but also for the male. Sheta, the body, and Beeja. So both the female and male should have the best quality of, you know, the gametes, like the ovum and sperm should be in the best form. And so the Shetra is— see, we, when we study the textbooks, we see that, okay, uterus should be healthy, and then, you know, sperm should also be equally healthy, the father should also be equally healthy, and then All these factors, and then you follow dinacharya, ritucharya, and you, when you start meditating and when you have spiritual, uh, you know, playing, then it is a very, very wonderful process.

Thank you so much, Dr. Aparna. That was so beautiful to hear from you. Now we will proceed to all the questions that the students have been leaving you. So I'm going to scroll back up now. But no, they are wonderful, they are wonderful. Okay, let us go up. And Abhishek has the first question. He has a doubt about vipaka. Ma'am, one doubt for vipaka: from where we must consider? Another doubt is, according to Ayurveda, for anyone disease We will consider the same steps of Ayurvedic way for all the disease. Abhishek, I'm not very clear about this, so if you could rephrase that question, Abhishek, we will come back to you. And then the next question is Ayurveda Life Kannada: Where can we reference— we can get the reference of Anushalya. Are Anushalya and Ashastra same? Where can we find the reference of Anushalya? Ashastra and Anushalya. Anushastra, yes. I'm not sure. It says Anushalya and Ashastra.

I'm not very aware of that. I don't know, maybe I just forgot. I think it's too— because, you know, um, I now my memory don't store this. I don't use in practice, so I don't remember the reference. And I, I don't think— if I, if I get to know anything, I can post to this, uh, Ayurveda Nidhi. You know, I have to go back to my textbooks if I have to find— it's Ashtakshatra. Right, Ashtashastram and Anu Chalyam. Okay, yeah, because see, you might be knowing better textbooks than me because I studied in— I studied and, you know, I don't use it anymore. So I am only into the clinical part, and whenever I have a doubt, I go back to the textbook. So I I have— maybe if you have a reference, better reference, maybe you can share in, in the group. So I will ask with it.

Thank you so much. Next question is from Mahesh Chauhan. How much is the size of fibroid that can be treated with Ayurveda? A little bit more details about treatment of fibroids, please.

Okay, so fibroid, um, What I have treated is up to like, in my practice, 6mm to 7mm, up to 10mm is like, you know, treatable. The size is— but it's a slow process. We have to undergo— we have to make them undergo a lot of panchakarma, repeated panchakarma. And if they are bleeding, then we have to give them like kulata kashaya And then we have to give some like rasnas, uh, Saptasarana Kashayam and Rasasinduram, Kanjanara Guggulu, Varanadi Kashayam. These are some of the kashayams and combinations which I use in my practice. And as an Anupana, I give them Kulatha Kashayam because kulatha is having a scraping action, lake in a karma, so it's very good. And there is a preparation in Kerala if you might be— I don't know whether you might be knowing, uh, pulling korimbu. Pulling korimbu is a very wonderful preparation which can really help in, um, you know, reducing the size. But one thing, uh, you have to make sure is you have to repeatedly, uh, be in contact with the patient and keep, uh, taking the USTs every 2 months. And then, you know, uh, so, uh, you have to be really, um, following up regularly with the patient.

Okay, wonderful, thank you.

And that like Vasti, Lakna Vastis, and Vaitarna Vastis are very much useful in treating fibroid. So slowly will come, um, uh, come down, the size will come down. So I have a patient that I've been treating since 5 years, so, um, and she was, uh, posted for surgery, but she didn't want to undergo the hysterectomy. So, uh, she is managing well, you know. So very slowly, the process is very slow, but then we have— we can manage. She is no longer having any bleeding or anything, but— and the size is slowly coming down. So wow, this is how it works.

Yeah, yeah, what a gift that she does not have to go through a painful surgery with so many complications at the end, right? He takes or something. What could be the reason for that?

I think Jalak is in the first year of BAMS, so once you start, you know, once you go to your second year and third year, you will learn then. Wonderful. There are a lot, there are a lot of causes for that. PCOS is one of the cause, and you know, there are a lot of pathology which can, which is associated with that.

Okay, then Sahana is asking, can you please tell us about the symptoms and treatments of PCOD?

Okay, symptoms you can Google, uh, treatments I can say, right? Treatment, uh, when you see in, uh, in the Ayurvedic, uh, this thing, it's like a kapha and rakta, and you know, um, so it's like a water-filled or polycystic ovarian disease, right? So in polycystic ovarian disease, we have to see the lakshana of the patient, uh, what are the presenting complaints, uh, they are coming with. And we can give again kulatha as a food, you know, we can tell them to ask any lekhana or shadhis for this thing. And very good kashayam, we need PCOD, Kaishora Guggulu, Kanjanara Guggulu is very good. And some, uh, some is give— some are giving Saptasarang Kashayam with different anupanas according to different symptoms. And, uh, tilakila laddu, tilka laddu, like sesame balls, are very good. And there is also one concept of, uh, you know, according to the cycle we treat different, uh, according to cycle In the first 14 days, we give some specific set of kashayas, and then the second cycle, we give second set, we give different kind of kashayas and medicine. So according to the avastha, we have to treat. So it's difficult, it's not medicine, you know, if you have fever, you take paracetamol and you will be all right. But in Ayurveda, we have to see the avastha, we have to see the state of disease. Disease. And I was talking about the nidana of the vyadi, like what caused PCOD in them. So it is, it like associated with some other metabolic problems like, you know, DM or— so we have to, we have to do the amsamsa kalpana of the vyadi, like we have to dissect the, the person's disease and see the nidana and see the lakshana and then treat. That is how it is done.

Wonderful, wonderful. Another question from Aksa Ansari: What can be the reason for amenorrhea, endometriosis, if a person is neither taking any pills nor constipated? Meaning probably that, you know, there is no reason, there is no apparent reason. Is there a treatment, and how does Ayurveda work here?

Yeah, so endometriosis, actually, when you see in When you Google it or when you see the Western medicine textbook, you can see that some of the textbooks say that there is— we don't know the reason why it— and I have seen endometriosis is getting treated by like Kashayams and with different Anupanas and things like that. So again, we have to do the Shuddhi, you know, you you have to do the, um, panchakarma, chikilsa, and we have to do the lekhana karma because it's like rakta and pitta dushti along with, uh, you know, the, uh, the endometrium is growing somewhere else and bleeding from there. So we, uh, keep, uh, treating the patients. So 3 to 6 months, uh, it is enough to treat an endometriosis of recent origin, but if it's a chronic one, you will have to treat, keep treating with different panchakarmas, and it takes a little bit, a little while, but surely you will be able to treat it if it's of recent origin.

Thank you. Abhishek is sharing about shukra and shukra ardhva, and the next question is from Ashika Deswal who says, uh, how many patients have shukra dosha and what can be the treatment for that? What, uh, how many patients have Shukra Dosha? Many patients have Shukra Dosha. Okay, she's making an observation. And what can be the treatment for that, for Shukra Dosha?

Okay, so you see, Shukra Dosha, there are— consider whether Shukra, the sperm, is having some pathology, or semen is having pathology, we have to find a specific test for analyzing that, you know, the sperm and semen. So we have to do a quick test and find out which is the problem. And then we have to— if we, we find like there are oligomenorrhea, oligospermia, or azoospermia, so the line of treatment will be different. Different. And if it is something with the seminal fluid, sometimes in seminal fluid there is no enough fructose, you know, no enough sugar for the, for the sperm, uh, to survive. So then we have to treat the seminal fluid. So then again the line of treatment will be different. So according to each condition, uh, you have to treat. So there is no one, uh, formula. As I said, there is one No one formula, or you take this medicine and your sperm problem or semen problem will be, uh, like, okay. It is not like that. And of course, Panchakarma is playing a very important role. So when you learn your textbooks, when you are reading your Panchakarma classes, be very sure that, you know, you learn well and read well. So it will be, it will be your brahmastra in treating such cases.

Thank you so much. So Abhishek ji is making some statements here about the vipaka and every disease consider the same steps. Uh, I think he was just making his— he was just thinking loud. And then Sundariya is talking about PCOD. You've already addressed that. And how can— Arsh Kor wants to know, please give us some knowledge about how can BAMS students frame their future in abroad?

See, uh, okay, see, whether it is in India or abroad, the first and foremost thing is you have to go and learn from good practitioners of Ayurveda. You know, the, uh, see, when you, you have, you have this compulsory internship for 1 year, right? If your college permits, go and do internship good doctors who are practicing real Ayurveda. And then one month here, one, one month with another doctor, then you will gain lot of practical experience. So this is a very important thing what a good vaidya should have. See, how much of a textual knowledge you have, that is not— that is another thing. But when you practically start learning things, you know, that is more important So go and learn with as many as, as many as doctors who are practicing Ayurveda as possible, and then you will be able to come up with your own, your own practice. And this is, this is very important as a student, is what I feel. And then, you know, people will come to you if you are giving your 100% in anything, then people will come to you. There is no other way.

And Dr. Aparna is one of such people, and so please stay in touch with her on Instagram. But she has a small baby, so please also be mindful of her time. And she's very generous, she, she's happy to come back in a little while and give you another lecture if this— you enjoyed this and learned from this. The next question, so I'm going to quickly start wrapping up now because it's 7:30 and all of you, I know, have to do other stuff also. In case of ovarian cyst, Rituja Awad is saying, it is important to do hysterectomy, or is it to manage with removing ovary? What is the treatment for ovarian cyst in Ayurveda?

The ovarian cyst also, we can, we can treat It is like PCOS, same line of treatment we can treat. So it's not like you have to undergo some surgery or something, but you have to obviously see the size of the cyst. And if you can present a case to me, or if you can email the, the right, you know, diagnosis and all, I can tell whether, um, whether I can do it or not. See, one, one important thing about being a a good doctor is we have to be very open. See, if I don't know how to treat a case, I have to refer it to somebody. I cannot say that I can treat everybody and everybody come and I have— I can treat. You have to be very clear, what is my cup of tea? If I cannot, uh, treat something, I have to say no, I don't know, right? So this is also— we have to, um, learn to say no, I don't know, when you are a good doctor.. So if I know, I can, um, I can say I can treat. If I don't know, I can refer to some other Ayurveda doctor who is good in that field, or, you know, definitely we will be able to help.

Wonderful, that is such good philosophy.

You know, sometimes it is, uh, we say that in, in the textbooks, Charaka has said that, okay, this is not treated Charaka line of treatment, like, no, in medicines you have to go to Danvantari, that is surgeons. So sometimes we will have to refer our patients to surgeons.

Wonderful. Anjali wants to know if there is any permanent cure for white or watery discharge.

Yes, we have to see, see whether it is candidiasis or trichomoniasis. Again, it There are a lot of different types of white discharge. It's totally curable.

Okay, Savita is asking a question about PCOD again. I believe Dr. Aparna has already addressed PCOD. So, uh, and then Soundarya has— is saying that if somebody is having PCOD, she will suffer a lifetime or otherwise take pills. Uh, if Ayurveda treatment has been taken, then what?

I believe—

please go ahead.

PCOD is totally treatable according to Ayurveda. If in past it didn't work, that means the amsamsa kalpana of the vyadi was not done properly. So you might have to change your vaidya or you have to change your medicine. That's a good philosophy.

Dr. Sai is giving you thanks. And Prachi is saying, is there a treatment in Ayurveda for erectile dysfunction?

Yeah, uh, there is definitely a good result. And one of my teachers have done his PhD in erectile dysfunction. So if some patient is having, you can refer to the thesis. See, one thing you all can do, start doing If you are students of Ayurveda in the final year or in the first year or in second year, no matter what, just Google some of the research articles and papers and start reading. You know, you will get— see, we— there is always a limitation for a teacher to teach, a lecturer to teach in the classroom because they get like 1 hour a day or 1 hour in, in 2 or 3 days, 2 or, you know, a week of class or 2 or 3 hours. So the real study study starts, you know, after the class. So just Google it and see. There are a lot of research works which is happening in Ayurveda, and you know, you will get an answer for almost all, all things. And if not, then you can ask your senior doctors, or you can, you know, you can PM, DM me, and then I can say whether, you know, who is the best time to go to.

Very nice.

So I'm going to take 2 more questions and then we will wrap up.

So there is a question from Aksan Sari about Tandu Lodak. Tandu Lodak, am I saying that right? In leukorrhea, how useful is it?

Tandu Lodak is given as an Anupana in leukorrhea. So with the different kinds of medicine, we give it as an Anupana. So Tandu Lodak is is nothing but the rice water, you know, the washed water of rice. So typically the red rice is when it is washed with the, you know, we say in Kannivellam in Malayalam, and you know, the wash rice water, washed water. So that actually has a lot of vitamins and minerals, you know, because of the, with the covering of— see, the red rice has its streaks, right? So this is very rich in many of the vitamin B, uh, B, uh, this thing, folates, etc. So, um, this, um, will work as an anupana in most of the 3 rogas.

Very nice, very nice. And then, uh, diet disturb hone pe treatment please.

This is Kuldeep.

Swapna Dosha.

Okay, Swapna Dosha is also related to the sperm. So what he— what, what do he want?

He want to know this, uh, treatment, treatment for Swapna Dosha, if you can briefly.

Yeah, nightfall, right? Okay, so for that, for that also, um, there are a lot of medicines and, uh, there are specific treatments also. And, uh, Virechana, time time taking repeated virechana will be a very good, uh, this thing. Haritaki is a very good, uh, this thing. Haritaki is shreshtha for shukra, um, sukra virechana. In Charaka, fourth chapter, I think it is, uh, it is told Haritaki is, uh, it, um, arrests this, um, nightfall. So it's very good. Haritaki is the drug of choice, and you can repeat it.

Okay, we will take one more question from Savita because she did not— there was a net issue and she could not hear the PCOD treatment that you spoke about. So if you could briefly just go over the PCOD, please.

Yeah, PCOD, uh, again, we have to see what lakshanas is the person presented with. Sometimes the patients are present with kapha pradana lakshana, sometimes the patient present with pitta pradana lakshana. Lakshanas. So we have to see, uh, what, uh, you know, what, uh, Lakshanas the patient is having, and then have to treat accordingly. The mainly given, uh, kashayas and tablets in Ayurveda is Chandraprabha, Varanadi Kashayam, Saptasaram Kashayam, Kanchanara Guggulu. These are the kashayams and gulligas which we— tablets which we give in PCOD. And then diet correction, and then, uh, kulekta is the anupana of choice in this thing. So these are the things which you, you can do. And of course, um, etc., if it is not responding to medicines.

Thank you so much. One last question, because Jyoti has been asking this to me also, and then we will wrap up the session. So Jyoti wants to know about RH incompatibility and how we can manage with Ayurveda?

I don't have experience in treating Rett syndrome reactivity, so I would rather pass that question.

Okay, thank you so much. Well, it has been such a pleasure, Dr. Aparna. Thank you so much for giving us your valuable time. I'm sure the students enjoyed the session and learned a lot. And please stay in touch with us over Instagram, uh, and let us know how we can assist you, help you better in the future. We are happy to bring you more of such programs. Thank you so much and have a wonderful rest of your evening. Bye-bye, everybody.

Thank you. Thank you.

Bye.

Krishnam Vandeh, Krishnam Vandeh, Krishnam Vandeh Jagadguru. Krishnam Vandeh Jagadguru. Devaki Paramananda. Devaki Paramananda. Devaki Paramāṇu, Krishna Vande, Krishna Vande, Krishna Vande Jagadguru.