DYSMENORRHEA - PERIOD CRAMPS ACCORDING TO AYURVEDA

✧Udavartini is one among the 20 gynaecological disorders. It is caused due to aggravated apana vata which throws the menstrual blood in an upward direction causing painful menstruation. It is called by the name Udavrutta by both Vagbhatas. In Madhava Nidana treatise, the same condition is named as Udavarta

Causative factor

Vega udavarta – movement of natural urges for flatus, feces, urine etc in a reverse / upward movement (other than the normal course of movement)

Pathogenesis

✧When the natural urges like that for flatus etc moves in a reverse direction / upward course, the apana vata gets 

aggravated. This aggravated vata moving in reverse / upward direction  fills up the vagina and uterus, contaminates them and causes abnormalities i.e. painful conditions.

Sign and symptoms

✧ Saa rugarta rajah krichchrena udavruttam vimunchati – the uterus seized with severe pain caused by vitiated vata, initially throws the menstrual blood in an upward direction and later discharges it with great difficulty

✧ Aartave saa vimukte tu tat kshanam labhate sukham – once the menstrual blood is discharged, the woman feels relieved

✧ Sa phena rajah – frothy menstruation (Sushruta)

✧ Anila vedanah – other painful conditions of vitiated vata, like body ache, malaise etc. (Sushruta)

✧ Baddha raktam – discharge of clotted blood (Indu, commentator of Ashtanga Hridayam)

✧ Phenila raja kruchchrena munchati, kaphena evam artavam –discharge of frothy, menstrual blood or menstrual blood associated with kapha, with difficulty 

Kashtaaartava

✧Kashtartava (dysmenorrhea) is not separately described as a disease. But there are many diseases in which Kashtartava is considered and described as a symptom.

Nirukti

✧The term Kashtartava is made of two words- Kashta and Artava

✧Kashta: Painful, Difficult, troublesome, ill, forced, wrong, unnatural, a bad state of Thing.

✧Artava: Belonging to reasons, period of time, menstruation.

✧Kashtena - with great difficulty

✧Thus the word Kashtartava can be expressed as-

“Kashthenamuchyatiiti kashtartava” i.e. the condition where Artava is shaded with great difficulty and pain is termed as “Kashtartava”.

Pathogenesis

✧When Vata dosha aggravating diet and behavior is followed by woman then Vata dosha is aggravated which created obstruction in functioning of Vata Dosha. It vitiates Rasa Dhatu and Artavavaha srotasa (Reproductive system). Apana vata moves in upward direction influences menstrual Bleeding by causing Pain. 

TYPES

According to association of Dosha three types can be observed, viz. Vata-pitta-kaphaja (congestive Dysmenorrhoea), Vata-kaphaja (Mem- branous dysmenorrhoea) and Vataja (spasmodic dysmenorrhoea).

Sampraptighataka 

✧ Dosha :- vatapradhan Tridosha Vata:- as Anubandhita dosha 

✧Dhatu:-Rasa, Rakta, Artava 

✧Upadhatu:- Artava 

✧Agni:- Jatharagni, Rasagni, Raktagni 

✧Strotasa:- Rasa, Rakta and Artavavahastrotasa 

✧Strotodushti:- Sanga and Vimargagamana 

✧Udbhavasthana:- Ampakvashaya 

✧Rogamarga:- Abyantara 

✧SthanaSamshraya:- Garbhashaya

✧ Vyaktisthana:- Garbhashaya

✧Bheda (types): 

Vataja (Spasmodic Dysmenorrhoea) 

Vata-kaphaja (Membranous Dysmenorrhoea) 

Vata-Pitta-kaphaja (Congestive Dysmenorrhoea)

Chikitsa sutra

✧Disorders of Yoni never take place without vitiation of Vata, hence first Vata should be regularized then Management for other Dosha should be done .

Ayurvedic Treatment:

 Our Ancient Acharayas has mentioned Several Classical Ayurvedic Formulations for the cure of Dysmenorrhoea. Ayurvedic herbal, classical time tested medicines cures by establishing the equilibrium of Tridosha (vatta, Pitta, kapha) and Saptdhatus. In Treatment of Dysmenorrhoea balancing of Vata is most important. The treatment Modalities includes Panchakarma, external therapies, internal medication, and activities advice of food and lifestyle

Treatment

 Life-style changes

✧ Exercise regularly-minimum thrice a week Ensure sound sleep of at least 6-8 hours Avoid smoking and alcohol

✧ Reduce caffeine

Diet

✧ Eat healthy, warm and fresh foods Eat 5-6 small meals

✧ Have fresh fruits like plums, dark grapes, apples, pomegranates.

✧ Eat more leafy vegetables

✧ Regularly use ginger in food preparations Avoid high fat and sugar

✧ Take supplements like calcium, magnesium, vitamin E, B6, B12

 Yoga: Yoga activities can help to reduce and prevent the severity of many ailments that specifically women’s health and give strength, stability, and suppleness. Yogasanas are considered as the most  convenient, drugless, and inexpensive method. Yoga is also found to have encouraging effect on increasing the pain threshold capacity in individuals. In Yoga, various types of Asanas have been mentioned. Among them Ushtrasana, Bhadrasana, Gomukhasana, and Vajrasana have a pain relieving effect.

✧ Our Ancient Acharayas has mentioned Several Classical Ayurvedic Formulations for the cure of Dysmenorrhoea. Ayurvedic herbal, classical time tested medicines cures by establishing the equilibrium of Tridosha (vatta, Pitta, kapha) and Saptdhatus. In Treatment of Dysmenorrhoea balancing of Vata is most important. The treatment Modalities includes Panchakarma,external therapies, internal medication, and activities ad- vice of food and lifestyle changes. 

✧ Panchkarma- 

✧ Sneha karma (Oleation) with Traivrita sneha. 

✧ SwedanKarma (Hot fomentation). 

✧ Oral use of Dashamoola ksheera. 

✧ Anuvasana basti (oil enema), Uttarbasti (Intra uterine oil instillation) with Traivrita Sneha. 

✧ Swedan with Milk. 

✧ Intake of sneha in oral form.

✧Sneha is in the form of Anuvasan and Uttarbasti. Anuvasan basti (Oil enema) is beneficial in normal- izing the flow and direction of Apana Vayu (vata). A series of oil and decoction enema are administered to patients, due to which there is a significant reduction in pain and discomfort. Therapy including massage is used to relieve any obstructions in the passage, relieve any spasm, facilitate free movement of vata in the Proper direction, and enhance a proper menstrual flow. Uttar basti is a procedure where in medicines are 

administered inside uterus. This helps in removal of blockages of channels (which provides nutrition to uterus) also it helps to give more nutri- tion (Poshan) to the Garbhashay (Uterus) Beneficial therapy: 

✧Basti 

✧Uttar basti 

✧Virechan 

✧Picchu

✧ Some Simple Yogasanas to relieve Menstrual Cramps.

✧ Yogasanas useful in Dysmenorrhoe

✧ Eka Pada Raja Kapotasana:–It Stretches the entire lower part of the body, stimulates the abdominal organs and relieves the body from menstrual discomfort.

✧ Matsyasana:-It also stretches and stimulates the belly muscles. It is also known to relieve menstrual pain.

✧ Janu Shirsasana:- Massages the abdominal organs, thus give relief from menstrual cramps.

✧ Dhanurasana:-It strengthens abdominal muscles and stimulates the  reproductive organs. It alleviates menstrual discomfort and constipation.

✧ Bhujangasana:-It stretches and tones the abdomen, relieving the body from Dysmenorrhoea. It also reduces Fatigue and Stress.

✧ Ustrasana:-It helps the body to get rid of Lower back Ache and menstrual discomfort.

✧ Utthita Trikonasana:- It improves the flexibility of the spine, alleviates backache, reduces dicomfort during Menstruation.

✧ Virbhadrasana1:- It relieves backache, strengthens back muscle, relieves menstrual pain and reduces heavy menstruation.

✧ Yogasanas, meditation, regular exercises help in maintaining weight. Walking for half an hour daily for 5 days is sufficient to maintain weight.

✧ Supta virasana:- Stretches the

abdomen back and waist, reduces menstrual pain. 

AYURVED TREATMENT

 Snehana – oleation with Trivrit sneha i.e. mixture of ghee, oil and muscle fat 

 Swedana – sudation 

 Mamsarasa – use of meat soup of animals and birds living in forests, marshy lands and water 

 Dashamula ksheera pana – milk medicated with dashamula should be given to drink 

 Dashamula ksheera basti – enema should be given with milk processed with dashamula 

 Anuvasana vasti – unctuous enema given with traivruta sneha 

 Uttara vasti – uterine / vaginal enema given with traivruta sneha

 Vatahara krama – all measures capable of mitigating the vitiated vata should be adopted 

 Utkarika – poultice prepared with barley, wheat, yeast, Saussurea lappa, dill seeds, Sida cordifolia, Callicarpa macrophylla and Ipomea reniformis should be done, introduced inside the vagina 

 Ksheera sweda – sudation with hot milk 

 Dashamula-trivrut siddha sneha  fats i.e. ghee or oil medicated with dashamula and Operculina turpethum should be administered either for oral consumption or enema. This medicament shall be used to administer both, unctuous enema and also vaginal / uterine enema.