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Background: Infrequent and scanty menstruation are common complaints in young women, often reflecting ovulatory dysfunction, most frequently polycystic ovary syndrome (PCOS). Ayurveda describes diminished menstruation as Artavakshaya and recommends Agneya (heat-generating) Artavajanana (menstruation-inducing) drugs, together with purification therapies, for its treatment. Objective: To review the classical description and pathogenesis (Samprapti) of Artavakshaya, relate it to the contemporary evaluation of oligomenorrhoea and hypomenorrhoea, and summarise the clinical and experimental evidence for Artavajanana drugs and related Ayurvedic interventions. Methods: Classical texts (Sushruta Samhita, Charaka Samhita, Kashyapa Samhita and Bhavaprakasha Nighantu) were reviewed for the definition, causes, pathogenesis and treatment of Artavakshaya. PubMed was searched for clinical studies, systematic and scoping reviews, randomised trials, case reports and experimental studies on Ayurvedic and herbal interventions for oligomenorrhoea, hypomenorrhoea and PCOS. Findings were synthesised narratively. Results: Sushruta defines Artavakshaya as delayed or absent menstruation, scanty flow and vaginal pain, arising from obstruction of the channels of Artava by Vata and Kapha, and prescribes purification and Agneya drugs. Most clinical evidence concerns Shatapushpa (Anethum sowa), for which two uncontrolled studies reported shorter menstrual intervals, one also with reduced ovarian volume in PCOS. Small studies of Vamana followed by Shatapushpadi ghanavati, and of Krishna tila decoction with Arkapushpa taila Uttara basti, reported benefit but had major methodological limitations. A randomised trial of Nigella sativa in adolescents with PCOS and a 2026 systematic review of herbal compounds provide supportive but heterogeneous evidence. Conclusion: The classical Samprapti of Artavakshaya offers a coherent framework that maps closely onto ovulatory dysfunction. Artavajanana drugs, particularly Shatapushpa, are promising, but randomised, controlled trials with objective ovulation and hormonal outcomes are required.