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Background: Abnormal uterine bleeding, and heavy menstrual bleeding in particular, is common, under-reported and a major contributor to iron deficiency and anaemia in women of reproductive age. Ayurveda describes excessive or prolonged uterine bleeding under Asrigdara (also called Pradara) and has a long tradition of haemostatic formulations based on astringent and Pitta-pacifying drugs such as Ashoka, Lodhra and Dhataki. Objective: To review the classical Ayurvedic understanding of Asrigdara, relate it to the current FIGO framework for abnormal uterine bleeding, and summarise the clinical and experimental evidence for commonly used Ayurvedic haemostatic drugs and formulations. Methods: Classical texts (Charaka Samhita, Sushruta Samhita, Bhaishajya Ratnavali, Bhavaprakasha Nighantu) were reviewed for the description and management of Asrigdara. PubMed was searched for reviews, clinical trials, protocols, case reports and experimental studies on Ayurvedic interventions for heavy menstrual bleeding and on Saraca asoca, Symplocos racemosa and related drugs. Findings were synthesised narratively. Results: The classical account of Asrigdara as excessive menstrual flow caused by Pitta-aggravated Rakta carried by Vata corresponds broadly to the symptom of heavy menstrual bleeding, but not to a single diagnosis; the FIGO PALM-COEIN system is therefore required alongside Ayurvedic assessment. Experimental studies of Saraca asoca and Ashokarishta show anti-inflammatory and endometrial anti-proliferative effects, although findings on oestrogenic activity conflict. The only recent clinical study of an Ashoka-based formulation is open-label and uncontrolled, and a randomised trial of Ashokarishta against tranexamic acid has not yet reported. No controlled clinical evidence was found for Pushyanuga churna. Widespread adulteration of Ashoka bark is a major quality concern. Conclusion: Ayurvedic haemostatic formulations are biologically plausible and widely used for Asrigdara, but controlled clinical evidence is very limited. Structural and coagulation causes must be excluded first, and authenticated, standardised products should be tested in randomised trials using validated blood-loss measures.