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Introduction: Menorrhagia, defined as excessive or prolonged uterine bleeding during menstruation, significantly impacts women’s health worldwide. In Ayurveda, the condition is described as Asrigdara, a disorder of excessive menstrual bleeding caused by Vata–Pitta imbalance and uterine dysfunction. This condition not only leads to anemia, fatigue, and poor quality of life but also contributes to long-term reproductive morbidity if not properly managed. Methods: A systematic review was conducted by analyzing Ayurvedic classical texts (Charaka Samhita, Sushruta Samhita, Ashtanga Hridaya, Kashyapa Samhita) and their commentaries to understand the etiology, pathogenesis, and treatment modalities of Asrigdara. Contemporary databases such as PubMed, Scopus, Web of Science, and Google Scholar were searched for the terms “Asrigdara,” “menorrhagia,” “Ayurveda management of heavy menstrual bleeding,” and “herbal therapy in menorrhagia.” Clinical trials, observational studies, and review articles published between 2000 and 2025 were included. Results: Ayurveda describes Asrigdara under Yonivyapad and associates it with aggravated Vata and Pitta doshas, impaired Rasa and Rakta dhatus, and uterine dysfunction. Management strategies include Shamana (palliative therapies with hemostatic herbs such as Lodhra, Ashoka, Nagakeshara, Shatavari), Shodhana (panchakarma procedures like Virechana), and lifestyle modifications. Modern evidence demonstrates that plant-derived hemostatic drugs, yoga, and stress management effectively reduce heavy bleeding and improve quality of life. Integration of Ayurvedic formulations with evidence-based medical management shows promise in reducing the burden of menorrhagia. Discussion: Ayurvedic understanding of Asrigdara correlates with modern pathophysiology of menorrhagia, including hormonal imbalance, uterine pathology, and systemic disorders. However, rigorous randomized controlled trials are required to validate the efficacy of Ayurvedic therapies.

KEYWORDS: Asrigdara, Ayurveda, Hemostatic herbs, Menorrhagia, Women’s health