Dr. L. M. Shah – Alarsin Ayurvedic Products

for the use only of registered medical practitioners

Paper before

2^nd Conference of The Bombay Obstetric

& Gynaecological Society.

Bombay – 16th & 17th December 1972.

HERBAL DRUG “AYAPON” (ALARSIN)IN DYSFUNCTIONAL UTERINE BLEEDING.

Dr. L. M. Shah, MD, FCPS.,

Ghatkopar Maternity & Surgical Hospital, Bombay-86.

Dr. (Mrs.) Sarla Visaria, Ghatkopar, Bombay.

HERBAL DRUG AYAPON (ALARSIN)

I N DYSFUNCTIONAL UTERINE BLEEDING

Dr. L. M. Shah, MD. FCPS.

Ghatkopar Maternity & Surgical Hospital, Bombay – 86. &

Dr. (Mrs.) Sarla Visaria, Ghatkopar, Bombay.

Introduction :

It is becoming increasingly evident now that in a number of diseased conditions, indigenous herbal medicines can offer an equivalent or often better chance of cure as compared to an allopathic formulation. One such striking example is the use of Ayurvedic herbal drugs to treat Dysfunctional Uterine Haemorrhages. The Dysfunctional Uterine Bleed ing may be defined as abno·rmal and excessive uterine bleeding for which a gross organic cause cannot be found.

Moreover, in recent periods, a number of cases come with excessive uterine bleeding where the loop has been inserted as a contraceptive measure.

These days due to various factors incidence of Dysfunctional ‘-(Jterine Haemorrhages is surprisingly high both in general as well as consulting. practice.

Material & Methods :

This study was carried out on 150 cases of Dysfunctional Uterine Haemorrhage and Haemorrhage after abortion, miscarriage or delivery. No apparent case with an organic pathologic condition, such as Flbro myomas, Adenomyosls, Tube-ovarian masses, etc., was selected. 100 cases were used as controls, wherein the usual modes of treatment were employed. The study was carried out over 32- years from July 1968 to December 1971.

The drug used: Tablet AYAPON (ALARSIN) was used in the trial.

Each tablet contains :

1	Ayapan (Eupator ium ayapana)	130 mg
2	Ashoka (Saraca lndlca)	130 mg
3	Godanti (Gypsum)	32 mg

Pharmacology :

AYAPAN : (Eupatorlum ayapana): Is prepared from the dried leaves of Eupatorium ayapana, contains ayapln (6: 7 methylene dioxycoumarln), ayapanin (7-methylene coumarin) and an essential volatile 0·11. Both ayapin and ayapanin possess hemostatic property when applied locally or taken internally. Ayapan has been used effectively to check internal hemorrhage.

ASHOKA (Saraca lndica) : is the bark of the tree possessing strongly astringent and uterine sedative properties. It acts on the muscular fibers of the uterus and exerts a stimulating effect on the endometrium and the ovarian tissue and has been used In uterine affections, especially menorrhagia, due to uterine fibroids and other.

GODANTI (Gypsum):: Is hydrated calcium It has been recommended in Ayurvedic literature for the treatment of menorrhagia.

NAGKESHAR (Mesua ferrea) : It is astringent and hemostatic. It decreases acute bleeding and is therefore useful in Uterine Bleeding.

Ashoka and Nagkeshar combination give pronounced haemosta effect in arresting Functional Uterine Bleeding.

Dosage :

in cases of Functional Uterine Bleeding, Ayapon treatment was started, at the outset with 2 tablets 3 times a day till bleeding was checked. (usually, bleeding was checked within 5-10 days.)

This was followed by 2 tablets of Ayapon twice a day after meals for two months continuously. These patients were also given the usual haematinics simultaneously.

TABLE-I: Age group & Parity

	Below 20	20-30	30 – 40	40-50	Total
Unmarried	18	8			27
Nulliparous	14	8	3		26
With 1-3 children	10	12	30	7	59
With 4 or more children		10	23	5	38
	42	38	57	13	150

TABLE-II: Aetiology

	Ayapon	Control
Menorrhagia after abortion	41	28
Miscarriage or Delivery	109	72
Functional Uterine Haemorrhage	___	___
Total	150	100

RESULTS :

Results were evaluated depending upon the degree of response. They were classified as :

Excellent	___
Good	___
Fair	___
Poor	___	(Little or no response)

TABLE – Ill

	Excellent	Good	Fair	Poor	Total
Ayapon	98(65%)	24(16%)	16(11%)	12( 8% )	150
Control	20(20%)	38(38% )	8(18% )	24(24%)	100

DISCUSSION :

Functional Uterine Haemorrhage has so far been treated with haemostatics and hormones. All three sex hormones have been used by various authors and In varying dosages.

The original and best tried mode of therapy is using Estrogenic preparations, especially in pubertal menorrhagia, while pro·gesterone ls used in premenopausal bleeding; i.e. in cases of metropathia haemor rhagica to induce the medical curettage. Parenteral preparations has been tried time and again, but do not seem to have any major adva take over oral treatment, though premarine Injection is given success fully in some cases. These forms of therapy have certain disadvantages, one of the most discomforting being nausea during the administration of estrogens. Moreover, these drugs must be taken very punctually failing which another bout of withdrawal bleeding results.

Androgens are used mainly parenterally and given in Intramuscular Injections of 25 mg. per day. This Is capable of completely arresting hemorrhage in 48-72 hours. Androgens act by antigonodotropic activity through the hypothalamic hypophyseal effect on the ovary (inhibition of follicle formation), by direct action on the estrogens In the blood and endometrium or by local hemostatic action on the endometrium. Some times androgens are combined with Oestrogens and some times with both Oestrogens and Progesterone.

However, the use of androgens is necessarily restricted because of the ever-present danger of virilization which can never be completely reversed, and so androgens can only be used in women over 35. Recent reports show encouraging results with the use of non-virilising androgens gens which have still to be substantiated.

Progesterone by Itself was some times used in the initial treatment of functional uterine hemorrhage. The advent of the newer progesterones has radically altered this and today the mainstay of treatment is the use of various contraceptive tablets in various doses.

All these drugs however If used for a long time have a number of side effects which are very well known by now like migraine, thromboembolic phenomena, etc. Moreover, menorrhagia recurs as soon as the drugs are withdrawn.

For long term use, therefore, all these drugs do not11aahieve -the maximum safety and effectiveness desired. Here lies the usefulness of an indigenous drug which is both safe and effective either for short or longterm therapy.

Conclusion: In cases of dysfunctional uterine hemorrhages AYAPON (Alarsin) :

Controls Irregular and profuse uterine

Ii. Restores the normal function of the uterus.

Iii. Restores the normal rhythm of the menstrual cycle.

Acknowledgment: I am thankful to M/ s. ALARSIN, Bombay-1 for their continued co-operation for completion of these trials.

REFERENCES :

Ghosh: Pharmacology (1957), Materia Medica and Therapeutics; 20th Edition, Hilton & Co., Calcutta.
R. Jahagirdar (1970) Place of Indigenous drug AYAPON in D. U.B .; Paper before XVI Conference of International College of Surgeons, Hyderabad.
Javeri Veenaben : (1965) Treatment of Functional Uterine Bleeding (A clinical study with AYAPON); Indian Practiticmer, 18 : 783.
Kodkany Kamal B(1968) Use of ‘AYAPON’ in Uterine Bleeding after IUCD; Indian Practitioner, 21 : 901.
Mehta A . (1964) Use of a Eupatorium AYAPAN combination in Functional Uterine Bleeding; Paper before the Scientific session of 40th All India Medical Conference at Kakinada.
Rama Mitra : (1968) Value of Herbal drug in Functional Uterine Bleeding; Mediscope, 11 : 11,
Pandya C.et al : (1963) Value of indigenous drugs in Menorrhagia; Current Medical Practice, 7 : 8,543.
Phadnis N. : (1964) Use of Ayapon Compound in Functional Uterine Haemorrh.ages . Antiseptic, 61 : 1O .683.
Rohatgi Pratibha (1966) Functional Uterine Bleeding: Treatment with an Indigenous Drug AYAPON; Antiseptic , 63 : 11,674.
Shelat Ramesh and Shah Usha (1966) Value of Herbal Drugs in Functional Uterine Bleeding; Indian Practitioner, 19 : 11,697.

ALARSIN Post Box 1 4, Bombay G .P. O., Bombay 400 001