What is the pathogenesis (Samprapti) of menorrhagia described here?

• A. Pitta pushing vata causes decreased vascularization of endometrium.
• B. Kapha vitiation leads to dampness of endometrium.
• C. Vata causes endometrial atrophy.
• D. Vata pushing pitta in artava causes increased vascularization of endometrial lining.

Answer: (D)

The main idea is that a specific dosha interplay in artava can drive changes in the endometrium that lead to heavy bleeding. When vata pushes pitta into artava, the pitta activity within the menstrual tissue increases heat and metabolic drive, which promotes increased vascularization of the endometrial lining. With more blood vessels and blood flow in the lining, menstruation can become heavier, causing menorrhagia.

The other scenarios describe outcomes that would not produce heavier flow: decreased vascularization reduces bleeding; Kapha vitiation leading to dampness would tend to slow or stagnate the tissue rather than increase bleed; endometrial atrophy implies thinning and less bleeding. Therefore, the described pathway—vata driving pitta into artava, increasing endometrial vascularity—best explains the heavy flow.