Menstruation is one of the hallmark events of womanhood- a glorious dismantling of a delicately designed architecture, and sweeping the debris off the womb. It is a physiological process just like breathing or excreting, and should not cause severe discomfort. But for some of us, menstruation is more of a brutal bloodshed, with actual pain involved. Recurrent obnoxious cramps that last for days, drastic fatigue, abdominal distress, nausea, vomiting, pain radiating to thigh and calf from lower back, pelvic ache, muscle soreness, and more- if you are experiencing this, dysmenorrhea could be the problem.
In simple terms, dysmenorrhea is a painful period. It is usually accompanied by heavy menstrual bleeding, and the symptoms can last up to 72 hours. While primary dysmenorrhea has no known cause, secondary dysmenorrhea is sure to have an underlying pathology, mostly related to reproductive organs. The former appears gradually after the menarche, and the latter appears suddenly. Primary dysmenorrhea is caused by uterine muscle contractions stimulated by prostaglandins. Uterine fibroids, endometriosis, adenomyosis, polycystic ovarian syndrome, certain IUDs and medications, cancer, and pelvic inflammation can get your body to give into secondary dysmenorrhea. Demographics say that about 15% of the global women population from age 15-30 suffer from dysmenorrhea.
Ayurveda explains dysmenorrhea under the term kashtartava. Though exact references cannot be seen in classical literature, kashtartava is described as a symptom of various diseases. Vata is the main culprit here, with pitta and kapha as the assisting doshas.
Pain in the pelvis, abdomen, and lower back is the main symptom. It can be throbbing or shooting or pulsating or even dull, depending on the affected person. Pain is usually radiating in nature, and can spread to the thighs and calf regions. This is usually accompanied by nausea, vomiting, diarrhea, mental confusion, dizziness, headache, fatigue, and in severe cases, fainting. Heavy menstrual bleeding is another sidekick to dysmenorrhea. The symptoms can last for 2-3 days and interfere with the quality of life. Smoking, alcoholism, precocious puberty, and obesity can contribute to it.
Ayurveda correlates dysmenorrhea to Kashtartava, kashta meaning difficult, and artava meaning menstruation. It is considered a vata pradhana tridoshaja vyadhi, or a disease that involves all three doshas with a predominance in vata. Vata dosha is a prominent factor in every menstrual disease, and the other two doshas will always be anubandhi (supporting) to it. Vata is the sole cause of pains, aches, and cramps. Vyana vayu and Apana vayu, the two variants of vata that control circulation and the activities in the lower body are said to be responsible here. The obstruction and faulty activity of artavavaha srotas (the channels that carry menstrual blood) due to these vitiated doshas can be taken as the etiology of kashtartava.
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Pacifying vata is of utmost priority when it comes to gynecological disorders. Balancing vata dosha through a properly curated vata-friendly diet, regimen, and therapies can go a long way in curing kashtartava.
Once the vata is fixed, the associated doshas can be cured likewise. Panchakarma therapy is of big use in all gynecological disorders. The purificatory measures such as Vamana (emesis), virechana (purgation), nasya (nasal drops), vasti (enema), and raktamoksha (bloodletting) done after proper snehana (oleation) and swedana (sudation) will clear the upper and lower body and remove the morbid toxins. Uttara vasti is proven to be effective in all vata-predominant yoni rogas. Oily, hot, salty, and sour food items and medicines will help curb the vata while sweet, astringent, and cold things alleviate pitta. For kapha, these should be of hot, astringent, pungent, and bitter taste.