Dysmenorrhoea is a common gynecological condition of pain during menstruation that affects normal activities. It is not a fatal disease but forces patients to keep away from work for at least couple of days. Nearly fifty percent of adolescent girls and menstruating women are affected by this. Prevalence is more among teenagers and stressful working women. Modern stressful and unhealthy lifestyle which includes lack of exercise, abnormal sexual activities, food habits etc contribute to this situation. Pregnancy and normal delivery increases the vascular supply and uterine muscle development which decreases sensitivity of nerve endings of uterus which has a major role in spasmodic pain of dysmenorrhoea. It is thus observed that dysmenorrhoea improve after pregnancy or after normal delivery. It is broadly divided in to two, primary dysmenorrh0ea and secondary dysmenorrhoea. Primary dysmenorrhoea is menstrual pain without any underlying pelvic disorders. This is more prevalent type in young age. Adolescent girls have low threshold of pain that is also a cause of pain during menstruation. Secondary dysmenorrhoea is caused by gynecological diseases or diseases of pelvic origin. Endometriosis, cyst, fibroid, inflammatory pelvic diseases are some of these causes. Ayurveda consider dysmenorrhoea as Krichrartava or Kashtarthava. This condition is caused by Apana Vatha vitiation caused by lack of nutritional food, excess mental strain resulting from lifestyle.
Chances of dysmenorrhoea increases with:
- Family with history of dysmenorrhoea
- Stressful life
- Lack of exercise
- Excess use of coffee ,alcoholic beverages
- Fibroid, Cyst and Pelvic inflammatory disease.
Signs and symptoms
- Pain in the lower abdomen starting just prior to the menstruation
- Relief of pain within a few hours up to one or two days
- Radiating pain to back and inner thigh
- Head ache
- Highly sensitive to sound and light
Ayurvedic approach – Dysmenorrhoea
Dysmenorrhoea is considered under Krichrartava or Kashtarthava by Ayurveda. This is a Vatha predominant condition and occasionally Pitha and Kapha may also participate in the pathology. Factors such as excess physical and mental strain, lack of nutritious food, lack of good sleep, physical activities without keeping body parts in comfortable position cause Vatha humor vitiation. Other etiological factor specifically significant in this disorder is suppression of natural urges such as defecation, urination, coughing, sneezing affect Apana Vatha, the sub division of Vatha humor which control neuro-muscular and hormonal control behind urogenital physiological and excretory functions. Transportation of body factors along normal pathway is done by Vatha in equilibrium. When Apana Vatha is vitiated, normal route of menstrual blood is blocked this result in spasmodic pain in lower abdomen.
Correction of Apana Vatha vitiation is the main objective of the treatment. Site of Apana Vatha is last part of the intestines. Apana Vatha acting in abnormal route has to be pacified. Etiological factors which lead to Apana Vatha provocation need to be strictly avoided and this help to prevent further worsening of the clinical situation.
Generally snehana or oleation is done with medicated oil or ghee. It may be administered orally or externally.
Oleation help in pacifying vitiated Apana Vatha.
Purgatives or laxatives with oiliness are useful here. Any procedure which will induce dryness will aggravate Apana Vatha.
Enema with medicated oils is useful to pacify Apana Vatha and correcting Krichrartava.
Virechana and Vasthi procedures remove all blocks caused by feces and flatulence. Relief of stress in the lower abdomen helps in allowing menstrual blood to flow in the normal path .It enable relief from spasmodic pain and Apana Vatha now start to function properly .
Yoga, Pranayama and meditation
Stress is a main factor contributing to this disease and hence pranayama and meditative techniques are proved to be effective in relieving the condition and prevent further recurrence.
Yoga postures which give stretching to pelvic muscles such as maarjarasana or Cat stretch, Sun salute -Surya namaskara are useful.
- Easily digestible and nutritive food in regular intervals.
- Avoid food which may induce constipation
- Papaya and drum stick are good.
- Use of Asa foetida is advised.
- Warm water for drinking
- Avoid preserved, refrigerated, fried and sour food.
- Avoid day time sleeping
Ginger-Zingiber officinale, Eranda (Ricinus communis), Holy basil-Ocimum sanctum, Hingu-Asafoetida, Kumari-Aloe vera, Thila-Sesame seed, Asoka-Saraca asoka, Sathavari-Asparagus racemosus, Lodhra-Symplocos racemoses etc are some of the useful herbs.
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