Ayurveda, a prehistoric healing system, to live a healthy life,  advises us to modify our activities which will be in rhythm with the nature. The body is subjected to the  purification process through panchakarma therapy by cleaning the body, improving  digestion and the metabolic processes hence the health is restored,

Poorva Karma (Pre care )  - prepares the body for main therapy of panchakarma
a) Paachan (Digestion) – A unique preparation of ghee is being administered, which helps in cleansing the  digestive process which makes the impurities softer and lubricates the body tissues.
b) Snehan ( oleation) – An oil massage is applied to the entire body, which opens the channels and moves the toxins towards the gastro intestinal tract and also makes the deep tissues softer.
c)  Swedan (Fomentation) – It involves heat to make the patient sweat. A herbal concoction may also be added to the steam which  dilutes the toxins and increases it movement to the GI tract.
After a week of above process, the doshas are expected to be ripened and now  the main panchakarma  treatment which suits the individual body constitution and the disorder is advised..

Panchakarma (Pradan Karma) :
a) Vamana Karma – induced vomiting -  Here the toxins due to the vitiated doshas are expelled out through the oral route. It purifies respiratory tract and upper part of the body.
b) Virechana Karma – induced purgation -  Here a proper bowel movement is brought about by flushing out the toxins which are flushed out through the anal passage. It usually expels pitta from stomach and  upper part of the small intestine.
c) Basti Karma – Medicated  Enema –  Involves the introduction of either medicatedwater or oils in the rectum  passage and expels the toxins.
d) Nasya – elimination of the toxins through the nose  - Oil or medicated milk is administered in to the nostrils thereby expelling toxins from the forehead and head thereby rejunevating the sense organs.
e) Rakta Mokshan (Artificial bloodletting)-  A  small amount of blood is extracted from a vein which  relieves the tension created by the pittagenic toxins found in the blood.

Paschat Karma (Post care)
f) After the main purification process the body functions are reestablished and slowly only has to start his normal diet from the special diet and also some rejuvenating therapies are to be done.

Kalari Massage :
 This type of massage combines the chavutti thirummu and synchronized massage, Here the therapist uses one feet to massage and for balancing himself he uses the string. Also synchronized, a whole body  massage is done by two therapist who are experts in the kalari, a martial art of Kerala. It relieves one out of the body pain and rejuvenates the whole body.

Kathakali Massage :
Kathakali is one of the traditional dance in Kerala. The teachers massages the students by themselves at the morning hours as the kathakali dancers need to keep the body supple and flexible. Here the oil is applied from the head to toe and massaged with feet.

Marma massage :
It is a full body hand massage with warm medicated oil and marma points on the body are massaged.  This generates the own energy and removes blockages found at these marma points  and improves the functions of the connecting organs.
 

Ayurveda, an age old system of Indian medicine, in its Garbhini Paricharya recommends the following advise about the ahara (diet), Vihara(lifestyle) and vichara(thought process) to be followed by the pregnant women.

** On a regular basis drink milk as it is a chief source of calcium, lactose and butter fat.

** During the first three months of pregnancy the foetus is nourished by percolation hence a lot of liquid diet like fruit juice, coconut water, milk to be included in diet. From the seventh month onwards take care to reduce the fat, salt and water in the diet and instead take a lot of rice kanji with ghee.

** Cereals are a must - wheat, oats, rye, dried peas, bean sprouts, whole meal bread, lentils, dried peas, chickpeas, soya-beans have an adequate amounts of protein. Fresh vegetables like spinach lettuce, potatoes, celery are must Fruits like apple, banana, and juices of lemon, orange, pineapple to be consumed. Dried fruits like dates, figs, almonds, grapes are good. Take rice, butter, ghee, food prepared with urad dal and amla, fish and egg are to be included in diet. Avoid fried or over salty and greasy foods.

** Sleep in a secured place. don’t travel outside house often, don’t indulge in talking to strangers, don’t subject yourself to any situation that creates fear in you mind, wear loose clothes so that you are comfortable, do not indulge in a strenuous physical activities, avoid smoking, alcohol and keep yourself away from sex.

** Take care to eat lightly i.e, you may eat 6 meals instead of heavy four meals, But you should eat only when you feel hungry and take only home made preparations, avoid any artificial chemicals, preservatives.

Keep yourself cool, calm and collected as it has direct effect on your baby. Use this time to be grateful to GOD for what all things he has given you in your life and Meditation helps you to be in touch with your real self and travel through the journey of pregnancy which is the very basic craving and enjoyment for every women.

Ayurveda,  a holistic way of living, discusses the details of pregnancy under Garbhini Vyakaran. Father to be’s health too to be taken care as the reproductive tissues are to be nourished well and toxins are flushed out, so that an optimum fertilization can  occur. Pregnant women has to be more careful during the first three months, as it is formative stage and after seventh month i.e, last stage of her pregnancy. 

Foetus and mother are attached by a cord called rasvaha nadi (matenal part of the placenta) which helps in carrying the  ahararasa-virya (nutrition) from the mother to the foetus  It gets nourished by  rasa by the process of attracting moisture (upasneha) and  osmosis (upasweda)  The food intake gets refined until it is  transformed to the nutritional eggs and sperms.

Doshas control the mensuration cycle, which should be 26-30 days cycle, 5 days, moderate flow and colour without any clots or discomfort.

Kapha phase is from the end of bleeding until the ovulation, and it builds the endometrium and also restore ths health to body and prepares it for conception.

Pitta phase is from ovulation till period starts. This prepares endometrium for implantation of the egg to be fertilsed and breasts to secrete milk. It is in this phase one under goes a high emotional overload.

Vata phase occurs throughout the period, is. apna vayu regulates the downward movements in the body and it helps in the flow during mensration and also helps during the delivery.

Above ayurvedic concepts clearly explains that if one has to ensure a fertililty, then the doshas are to be balanced and normalised. Any imbalance in doshas will lead to problem in conceiving. It recommends  yogic practice and a nutritious diet  to calm the doshas thereby  strengthening the  body and relaxing  the mother and thereby indirectly benefiting the baby.

Ayurveda, an oldest medication in the world, strikes at the very base of the ailments, eradicating the cause at the root level and aims at preventng it from reoccurring in future. It operates on the following concept :

a) Individual constitution (prakriti) is made of unique combination of three doshas pitta, vata and kapha.
b) Vitamins, minerals, carbohydrates and fats that are taken by us are being bio transformed by kaya (agni) to an energy that is being used by our cells present in our body.
c) Consitution is also affected by kostha which is bowel function.
c) It believes that the physical body and a network of channels that circulate fluids around the body is made up of dhatus (seven tissues) and their malas (waste products).
d) Apart from all the above three gunas viz - purity (sattva), activity (rajas) and solidity (tamas)  also plays an important role in mental and physical health of an individual.

In this stress filled modern era, everybody is tend to lead an improper lifestyle, and unwholesome diet, by which an imbalance in one or more of the above mentioned components occurs thereby creating body ailments. And  present generation more and more accept Ayurvedic medicine to restore the balance as they find it more transparent in its concept and its results speak for themselves.

** Naturally grown herbs are pure and has an innate power of nature in it and cures the chronic ailments by providing balance to the body. It believes that vegetables, animals, mineral origins, metals have some medicinal value. Ayurvedic medicaments are made from herbs or mixtures of herbs with alone or in mixture of above and they are purified before being used.
** Ayurvedic medicines which is prepared based on the natural ingredients like plants, animals, metals, minerals ensures a physical and mental health and has not side effect at all.
** It is non toxic and non invasive and can be used safely as an alternative alongside of the other conventional therapy.
** Rasayanas  improves the metabolic activites and provides one with an improved memory power, strong body, a glowing skin, youthfulness etc.,
** Basically it aims in health preserving, promoting the health, curing the diseases. It treats all types of ailments like stress, metabolic related or chronic conditions.
** There are evidences where it has treated nervous disorders, skin problems, ulcers, acne, allergies, asthma, diabetes, hypertension etc. it has also helped in fighting insomnia and depression.

World Health organization has accepted Ayurvedic medicines, known as herbal medicines,   as an alternative medicine, whose raw materials are taken from plant, minerals, animal sources. It is now a statutory, and a recognised medical system of health care in many countries like India.
 

Ayurveda defines Health as Purity of body, mind and soul, which has become so dark because of negative thoughts and actions and it is here Yoga that comes in handy to treat this state of mankind. With its regular practice one is able to eradicate all the impurities both in mind and body and regulate the self towards GOD.

According to the ancient hindu philosophy, Yoga is the union of body and mind  which helps one to attain oneness with the “Supreme Being”, the ultimate aim of our birth.

Regular yogic practice  helps to acquire a balanced body and mind which  naturally trains him to be in present moment and with a minimum input of energy/time,  he can achieve a maximum output of work. Is it not a greater benefit in this fast pace world where one lacks time.

Yoga is  a combination of asanas (postures), pranayama (breathing techniques) and dhyana (meditation).  Its benefits can be cited as below :

At Physical Level –

** Provides strength and flexibility, body awareness and energy level increases, heals the injuries very quickly, helps to fight the pain caused by various ailments, immunity increases, blood circulation to brain, digestive system and skin is increased, skin glows, aids in the overall efficient functioning of the internal organs. Gives relief from the  muscular pain , open constricted air passages, aging process is delayed, toxins in the body are flushed out.

It is also highly therapeutic ie.. it treats various ailments like digestive disorders, headaches, irritable bowel syndrome, asthma, skin problem, nervous tension etc, thyroid function is improved hence the weight is controlled, knee cartilage is made strong, it helps to fight pain of  arthritis and rheumatism, leg muscles are toned up, flexibility of spine is increased, also controls autonomic or involuntary functions, such as temperature, heartbeat and blood pressure
 
At Mental Level -

Helps one to  let go of emotional blockages and negativity hence –  helps to lead a  relaxed state of living, helps one to face the stressed situation more enthusiastically,  provides strength to fight depression, frustration and anxiety, you feel that you are in control of your own self,  you are able to look life always on its positive side, you will have an internal harmony and  a great sense of balance,

Also concentration increases,  provides courage and a hopefulness, creates a consistent sense of well being, brings harmony in relationship, deals with mood swings, intellect develops, regulates all the senses,  will power increases, increases mental clarity, gives a peace of mind.

At  Spiritual Level -

It helps one to realize that you are more than this body and mind and  helps in awakening the divinity, it also enhance the movements of energy through ajna (the centre of intuition). helps the soul to flourish and helps to understand his  true nature.

It also softens the rough edges in our character and dissolves the solid crust of your heart region which is important in our ultimate journey towards the ultimate God.
 

For the convience, the ayurveda has been divided in to eight branches. The different aspects of the life are well addressed by these branches. The wholistic approach of the ancient wisdom is well appreciated in this division. Kayachikitsa, Shalya Tantra, Shalakya Tantra, Kaumara-Bhritya, Bhuta-vidya, Agada – tantra, Rasayana-tantra and Vajikarana are the eight divisions.

Vajikarana is the science dealing with the promotion of sexual health and the management of seminal disorders and male sexual disorders. It also describes the means for health progeny.
Basic aim of the therapy is to procreate healthy progeny and to increase sexual potency in man. Specific drugs are mentioned to improve sexual vigour, sperm motility and sperm count. Generally all kapha increasing drugs act as vajikarna. Examples
Yasti madhu (Glycyrrhiza glabra),Atma gupta (Mucuna pruriens),Jati phala (Myristica fragrans), Masha (Phaseolus mungo),Aswagandha (Withania somnifera),Satavari (Asparagus racemosus). Abhayanga (oil massage), satvavajaya (positive mind) can also act like Vajikarana.
Functions of Sukra dhatu ( Sperm)
1. Beejartham/Garbhothpadanam – Fertility/ to initiate conception.
2. Harsha – Libido or sexual desire.
3. Deha balam – Strength of the body to withstand adverse extrinsic and intrinsic conditions.
4. Preethi – Fondness or Attraction towards opposite sex.
5. Cyavana – Sensation of proper ejaculation and orgasm.
6. Dhairya – Boldness.
7. Sukra Niskramana – Ejaculation.

Eight factors mentioned by Charaka acharya, which contribute to the process of ejaculation, are:
Harsha (Libido), Tarsha (patio or desire for ladies), Saratva (mobility of sukra), Dravatva (fluidity of sukra), Paicchillya (Slimness or viscidity of sukra), Gaurava (heaviness or gravity of sukra), Anu pravana bhava (Tendency to flow down due to property of atomicity), Mruta drutatva – propulsion by apanavayu.
Infertility
Definition:
 A condition in which  couple have problems in conceiving, or getting pregnant, after one year of regular sexual intercourse without using any birth control methods. Infertility can be caused by a problem with the man or the woman, or both.

Male infertility

Causes of male infertility

It can be studied under following heads.
Bija upa tapa ( Congenital abnormalities ), Sukra dosha ( Diseases of sperm), Klaibya ( Loss of libido).

a. Bija upa tapa – Defects in the gamete, leading to development and structural anomalies of reproductive system. Chromosomal disorders, various developmental disorders can be considered in this group.

b. Sukra dosha (Seminal morbidity)

Causes of seminal morbidity
Food factors
 Habitual and excessive uses of dry, bitter, astringent, salty, acidic and hot food. Foods which are at variance with place, time, power of digestion, quantity, habit, doshas and mode of preparation

Behavioural factors
Excessive sexual indulgence, untimely sexual congress, sexual abuse, absolute sexual abstinence, bodily exertion in excess, suppression of natural urges and  sexual congress with an unresponsive woman.

Psychological factors
Grief, anxiety, fear, anger and lack of mutual love and confidence.

Pathological factors
Emaciation due to diseases, vitiation of body elements, injury with surgical instruments,
improper application of cautery and caustics and other casues like trauma, weak poisons, age.

c. Klaibya – Impotence and other anomalies which impede effective insemination
Causes:
Psychic, dietary, exhaustion of sukra, old age, mental worries, debilitating diseases (like T.B, Diabetes mellitus), over strain, malnutrition, excessive indulgence in sex are considered as contributory factors of quantitative and qualitative diminution of sukra.

Management of Male Infertility

Purvakarma (Preliminary treatment)
Snehana (Oleation)
Swedana (Sudation)

Pradhanakarma (Main treatment)
Virechana (purgation) (Castor oil with milk)
Sneha vasti (oil enema)
Vasti (Decoction enema)
Yapana vasti (rejuvenating enema which can be used for a long time without any adverse effect.)
Uttara vasti (enema given through the urethral orifice)

Pascatkarma (Management after main treatment)
Vajikarnam (specific infertility management with Vajikarna drugs)

Medicines commonly used in Vajikarana
Sukumara ghritam, Amritaprasam, Asvagandhadi ghritam, Mamsa sarpis, Kusmanda ghritam, Vastyamayantakam ghritm, Kalyanaka ghrtam, Asvagandhadi lehyam, Satavari lehyam, Madana kameswari, Chyavanaprasam, Silajit rasayanam, Dasamularistam, Draksaristam, Asvagandharistam, Chandra prabha Vati, Kalyana gulam, Abhraka bhasma, Swarna bhasma.

Sukra sodhana gana (drugs which help in purification of semen or sperm)
 Kustha, elavaluka, katphala, samudra phena, kadamba niryasa, iksu, kanda iksu, iksuraka, vasuka, usira
Sukra janana gana (drugs which help in formation of semen or sperm)
 Jivaka, rsabhaka, kakoli, ksirakakoli, mudgaparni, masaparni, meda, vrksaruha, jatila, kulinga

Female Infertility
The descriptions about female reproductive disorders have been dealt in the chapters of Stri roga in Ashtanga hridaya, Charak samhita, Susrutha samhita, Sarnghadhara samhita and Ashtang samgraha.
 Acarya Susruta describes the psychological changes that occur during the act of sexual intercourse. During contact, teja (fire) is produced. This teja stimulates vatodirana (movement of air element). Teja along with vata causes secretion of sukra. Sukra( sperm) travels to yoni and unites with artava (ovum). The resulting product of union of Agni and Soma (zygote) then travels to garbhasaya and grows as garbha.

Factors of conception
Ritu, kshetra, ambu, bija are the chief factors of conception
Ritu – phase of kapha denoting proliferative phase in the uterus followed by ovulation.
Kshetra – denotes healthy female genital tract which will facilitate the entry of sperm.
Ambu – nutritional elements and hormones.
Bija – Ovum and sperm.

Disorders of conception factors
Disorders of Ritukala
Rtukala is a period of kapha pitta predominance. If it is affected by vata or pitta, sub fertility may result.
Disorders of kshetra (female genital tract)
Margavarodha (Obstruction in fallopian tubes), Vyapanna yoni / garbhasaya (Uterine, cervical or vaginal pathology causing hostility to spermatozoa).
Disorders of Ambu (nutritional fluids)
Garbhasravi or amniotic fluid problems, nutritional insufficiency
Disorders of Bija (Ovum or sperm)
Artava dosa or sukra dosa can cause sub fertility
Disorders of maithuna (Intercourse)
Maithuna asahatva (Dyspareunia – painful intercourse), Maithuna aniccha (Psychological disturbances causing frigidity), Asamyak maithuna (Improper intercourse).

Management of Female infertility
1. Sodhana (Purification therapy).
2.  Samana (Pacification therapy).
3.  Utility of specific medicines.
4.  Medicated ghees and oils.
Narayana tailam, satapuspa tailam, phala sarpis, kalyanaka ghrta, dadimadi ghrta, kalyana gulam are commonly used. Ushna, kaphavatahara treatment is given for cystic ovarian disease (PCOS).