Vaazhai Vadagam in the Management of Perumbadu (Menorrhagia) - Systematic Drug Review

Abstract

Menorrhagia, known as Perumbadu in the Siddha system of medicine, is a common gynecological disorder characterized by excessive menstrual bleeding. Vaazhai Vadagam, a classical Siddha formulation prepared mainly from Musa paradisiaca flower along with other medicinal ingredients, has been traditionally used for Perumbadu, but scientific validation of its pharmacological basis is still limited. Objective: This systematic review aimed to compile and analyse Siddha textual references and modern scientific evidence regarding the phytochemical constituents and pharmacological activities of Vaazhai Vadagam and its ingredients in relation to the pathophysiology of menorrhagia. Methods: A comprehensive literature search was carried out in electronic databases including PubMed, Google Scholar, Science Direct, Springer Link, Wiley, Embase, and Semantic Scholar. Studies were selected based on their relevance to the ingredients of Vaazhai Vadagam, pharmacological activities, and therapeutic implications for menorrhagia. In vitro, in vivo, clinical, and review studies were included, while irrelevant or methodologically inadequate studies were excluded using predefined inclusion and exclusion criteria. Results: The constituents exhibit pharmacological activities relevant to menorrhagia, including hemostatic, anti-inflammatory, antioxidant, hormonal modulatory, anti-angiogenic, uterotonic, and hematinic effects. Buffalo buttermilk used in processing may enhance phytochemical bioavailability. The formulation targets key pathogenic mechanisms such as impaired endometrial hemostasis, inflammation, oxidative stress, hormonal imbalance, abnormal angiogenesis, and anemia. Conclusion: Vaazhai Vadagam shows a multi-targeted pharmacological potential that supports its traditional use in the management of Perumbadu. Nevertheless, further well-designed preclinical and clinical studies are required to establish its safety, efficacy, and standardization for evidence-based clinical application.