Dysmenorrhea in Ayurveda

In Ayurveda all the gynecological disorders are well explained in a separate chapter called Yoni Vyapath which consists of 20 gynecological diseases. Dysmenorrhea is termed as Kashta Artava in Ayurveda texts and mentioned not as a disease but as a symptom in many of the gynecological disorders.

DERIVATION (NIRUKTI)

Kashtartava can be expressed as "kashtena muchyati iti kashtaartava" i.e. the condition in which Artava (menstrual blood) is shredded with great difficulty and causes pain.

Aggravated Vata Dosha is the cause for all types of pain in the body. Apana Vata (subtype of Vata) which is responsible for normal regulation of menstruation gets disturbed due to some causative factors and Vata gets vitiated. This causes painful menstruation.

SAMANYA NIDANA (ETIOLOGY)

1. Mithya Ahara (Improper diet) Excessive intake of food which aggravates Vata Dosha like Rooksha (dry), Sheeta (cold), Khara (hard) and Guna (qualities) with Katu rasa (pungent taste), Tikta (bitter) and Kashaya (astringent) predominant food. Anashana (inadequate intake of food) and Vishamashana (improper diet).

2. Mithya Vihara (Improper activities) Excessive Vyayama (excessive exercise, running, etc.) Faulty sexual practices Vegodharana (suppression of natural urges like flatus, micturition, sneezing etc.)

3. Pradushta Artava: It can be correlated to any fault in reproductive hormones.

4. Bija Dosha (genetic factors)

5. Abnormalities in the genes which can affect the function of the reproductive organs.

6. Daiva (idiopathic): It can be known as an unknown causative factor.

7. Manasika Hetu : Vata vitiating chintha (thinking), shoka (grief), etc. that causes psychological stress.

UPASHAYA (PACIFYING FACTORS)

1. Hot bag fomentation on the lower abdomen during the pain.

2. Hot water shower after application of warm oil all over the body.

3. Intake of warm and unctuous food and drinks.

4. Intake of food which are sweet, sour and salty predominant.

5. Daily practice of pranayama and yoga.

ANUPASHAYA (NON PACIFYING FACTOR)

1. Exposure to cold weather.

2. Skipping meals.

3. Consuming food which is cold and dry.

4. Intake of food which has a spicy, bitter, astringent predominant taste.

5. Excessive stress.

6. Daytime sleeping.

7. Keeping awake at night.

CHIKITSA SUTRA (PRINCIPLE LINE OF TREATMENT)

As Vata Dosha is the main cause for all Yonivyapad, the treatment should be directed towards the vitiated Vata and eradication of the cause. The principles of treatment can be subdivided into:-

SHODANA (PURIFICATION THERAPY)

1. Snehana (Oleation therapy)

• Bahya Snehana: External oil massage with Vata pacifying oil

• Abyantara Snehana: Intake of Sneha (Like medicated oils/Ghee/Fats) followed by the below:

2. Swedana (Fomentation) : Swedana (fomentation) with Ksheera (milk).

3. Virechana (Purgation)

• Mild purgation is beneficial for all Yonivyapad because it has Vata-Anulomana (downward passage of Vata) and Sukha Rechaka (mild purgation)

4. Vamana (Emesis)

5. Basti (enema)

A series of decoction enema and medicated oil enema is given after proper and swedana. It is most effective to normalize the Apana Vata localized in the abdomen by entering the srotas (channels) by removing the spasm.

• Kashaya Vasti like Dashamooladi Niruha Vasti is the best.

• Uttara basti is a procedure for administration of medicines inside of the uterus. This helps to remove the blockage and gives nutrition to the uterus.

HOME REMEDIES

1. Sip 2 cups per day of chamomile tea few days prior to menstruation Grate a small piece of ginger into warm water .

2. Intake of 5 ml of castor oil in warm milk at bed time,. This helps with immediate relief from menstrual cramps.

3. Prepare a dessert with black sesame seeds (1/3rd teaspoon), cumin seeds (1/3rd teaspoon) mixed with jaggery (1teaspoon) and Ghee(1/2 teaspoon) and make small balls out of it. Consume it frequently.

4. Take Ajwain Tea for relief from muscular cramps. Add 2 pinches of Ajwain in 2 cups of water and boil it until it reduces to half. Strain, and drink two to three times a day.

5. Soak a teaspoon of Methi seeds in a glass of water and leave it for overnight. Next morning, drink it whole with the seeds if possible, or you may choose to strain the seeds out..

6. Jaggery is a great Vata pacifier. Substitute sugar with jaggery. A great way to combine Methi (Fenugreek seeds powder : 2gms) -Ajwain (Carrom seeds powder : 2grams) and Gur(Jaggery 5-6grams) is to make small sized balls (like pills) with these three ingredients. You can take 2-3 of these on an empty stomach with a sip of warm water.

7. Aloe is a woman’s best friend. One of its vast range of health applications is pain relief in period cramps. Drink a glass of Aloe Vera juice on an empty stomach every morning and you will see your health improving drastically. If you can’t take it daily, then consider drinking it 3 to 5 days before cramps set it. You can continue drinking it throughout your periods.

8. Massage the lower abdomen, thigh with warm sesame oil/castor oil and apply hot bag fomentation. For best results, you may want to slightly warm the oil, and then apply a little warmth with a hot water bag over a light blanket.

9. Avoid Vata increasing factors such as travelling, stress, drinking caffeine etc. a few days prior to menstruation.

10. Always consume food which is warm and easy to digest.

AROMATHERAPY

1. Lavender essential oil

2. Clary sage

3. Marjoram Mixed with carrier oil such as sweet almond oil or grapeseed oil.

4. A safe concentration is one drop of essential oil to 1 tsp. of carrier oil.

These remedies are generalized in nature. For the personalized treatment of irregular menses or other gynecological problems, please consult a doctor instead of self-medicating.

NOTE: It is strongly recommended that you consult an Ayurvedic Physician before using these herbs.

Modern Overview

Menstrual cramps (dysmenorrhea) are throbbing or cramping pains in the lower abdomen. Many women have menstrual cramps just before and during their menstrual periods.

For some women, the discomfort is merely annoying. For others, menstrual cramps can be severe enough to interfere with everyday activities for a few days every month.

Conditions such as endometriosis or uterine fibroids can cause menstrual cramps. Treating the cause is key to reducing the pain. Menstrual cramps that aren't caused by another condition tend to lessen with age and often improve after giving birth.

Menstrual cramps can be caused by: -

1. Endometriosis. The tissue that lines your uterus becomes implanted outside your uterus, most commonly on your fallopian tubes, ovaries or the tissue lining your pelvis.

2. Uterine fibroids. These noncancerous growths in the wall of the uterus can cause pain.

3. Adenomyosis. The tissue that lines your uterus begins to grow into the muscular walls of the uterus.

4. Pelvic inflammatory disease. This infection of the female reproductive organs is usually caused by sexually transmitted bacteria.

5. Cervical stenosis. In some women, the opening of the cervix is small enough to impede menstrual flow, causing a painful increase of pressure within the uterus.

Complications

Menstrual cramps don't cause other medical complications, but they can interfere with school, work and social activities.