Menstruation is a normal process in every woman’s life, but it becomes horrible when it cause Severe Pain and Discomfort. This condition is known as Dysmenorrhoea. It can feature different kinds of pain including Sharp, Throbbing or Dull and other associated symptoms Nausea, Vomiting, Headaches, Anxiety, Fainting etc. This condition significantly interferes & incapacitates with everyday activities for several days each month.
Dysmenorrhoea refers to the symptoms of painful menstruation or literally translated as difficult monthly flow. It describes the presence of painful lower abdominal cramps, often accompanied by lower back and upper thigh pain which occurs monthly with menstruation. It is one of the most frequently encountered gynaecological complaint amongst adolescents or young women and one of most common complaint in women of reproductive age. While it is not life threatening, but it can have a considerable impact on the patient's quality of life.
It is classified into 2 Types -
Primary Dysmenorrhoea also called True Dysmenorrhoea refers to pain which has no obvious cause. It tends to occur in younger women with no pelvic abnormality, particularly in the first few years after menarche. It mostly affecting more than 50% of women and quite severe in about 10%.
Secondary Dysmenorrhoea refers to pain which arises as a result of underlying conditions. It usually begins in older women in the third or fourth decade. It may be caused by a number of conditions including-
- Adenomyosis, Endometriosis
- Sexually Transmitted Infections
- Pelvic Inflammatory Disease
- Ovarian Cyst or Tumour
- Use of an Intrauterine Device
It can also be classified as -
1. Congestive Dysmenorrhoea- due to congestion of pelvis (due to Pre Menstrual Syndrome, Pelvic Diseases etc.)
2. Spasmodic Dysmenorrhoea - occurs mostly during periods due to narrowing of cervix with stricture or hormonal problem. Clots in menses also cause this type of pain.
3. Membranous Dysmenorrhoea - extreme case of dysmenorrhoea where patient can see the disintegrated membranes of uterus in bleeding which may be due to chronic inflammation.
4. Psychogenic Dysmenorrhoea - usually occurs after an unpleasant sexual activity or painful condition or fear of sex with lack of sexual knowledge.
Symptoms of Dysmenorrhoea include -
- Pain in Lower Abdomen spreads to the Hips, Lower Back & Inner Thighs.
- Pain that is gripping or Constant Ache or a combination of both.
- Typically, the pain starts when the period starts or earlier
- The first 24 hours is most painful
- Clots are passed in the menstrual blood.
And Associated Symptoms include Nausea, Vomiting, Headaches, Digestive Problems such as diarrhoea or Constipation, Dizziness, Fainting, Fatigue, Hypersensitivity to Sound, Light, Smell and Touch, Pre Menstrual Symptoms such as Tender Breasts and a Swollen Abdomen which may continue throughout the Period, Pain continuing after the first 24 hours.
AYURVEDIC CONCEPT OF DYSMENORRHOEA:
In Ayurveda Dysmenorrhoea can be considered as Kashtartava. Due to movement of Apana Vayu in opposite direction or disturbance, obstruction in the flow of vayu may cause severe pain during menstruation called as Kashtartava. It is not separately described as a disease anywhere in Ayurvedic classics, but there are many other diseases in which Kashtartava is considered and described as a symptoms like - Vataja Rajo Dushti, Udavarta or Udavartini, Antarmukhi & Suchi Mukhi Yoni Vyapad etc.
Kashtartava is a disease of reproductive tract situated in the pelvic region and this region is considered as the one of the main place of Vata dosha. All the gynaecological diseases arise with affliction of aggravated Vata. It shows strong relationship of Kashtartava with Vata dosha by its origin and the system belongs to it. It is also well known that without association of Vata there cannot be pain. Vata is the main responsible factor though other dosha only be present as anubandhi or associated with it. So pain is produced due to vitiation of only Vata dosha or in combination with other doshas.
Ayurvedic Management of Dysmenorrhoea:
As Kashtartava can be considered as a type of Artava Dushti and a symptom of various Yoni and Artava Vyapad. So General principles of Treatment given by all Acharyas can be drawn as follows-
- All Five Purifying Measures - Panchakarma Procedures should be given after proper Snehana (Oleation) & Swedana (Sudation).
- The purifying Measures should be used in proper sequence and in Mridu (soft) form and Drugs used in these procedures should be according to vitiation of doshas.
- After proper cleansing or Oleation other measures i.e. Uttar Vasti (Considered as best among all Shodhana Chikitsa. In this procedure medicines are administered inside uterus, which helps in removal of blockages of channels and provide nutrition to uterus), Anuvasana Vasti (Oil Enema) and Abhyanga (Massage) - both are beneficial in normalizing the flow and direction of Apana Vayu, Parisheka (Irrigation), Pralepa (Anointments) and Pichu (Tampons) etc. should be used.
- The Treatment prescribed for disorders of Vata (Vatahara Chikitsa) should be used. Because it do not occurs without vitiation of Vata, thus first of all Vata should be normalized and then other doshas.
- Use of Milk and Virechana (Purgatives) is beneficial.
- Ayurveda recommends Rutucharya and Dinacharya, Diet Modification and Yoga in the form of Asanas, Pranayama & Meditation on a regular basis so as to alleviate Dysmenorrhoea effectively.