Menstrual Disorder

Menstrual Disorder – An Ayurvedic Perspective

Ayurvedic Treatment for Menstrual Disorder

Today we are going to talk about a common problem faced by women i.e. menstrual disorder. It actually refers to an irregularity in women’s menstrual cycle.

Menstrual disorder refers to a condition of irregularity in menstrual cycle of women i.e. having it before or after theexpected time. A menstrual cycle normally has a period of 21 days. Any variation in this period of menstrual cycle by more than 7 days is counted as a menstrual disease. It also constitutes painful menstruation and heavy menstrual discharge.

To have a detailed discussion on the topic, as always we have our Ayurvedic expert Dr. Parmeshwar Arora in our studio. Welcome to our show doctor.

Q. First of all, how would you define the condition of Menstrual Disorder?

As we all know, the standard period of a menstrual cycle is of 28 days. Sometimes there could be a variation of 2-3 days and if a woman carries a cycle of even 30 days then we consider it as normal cycle. Apart from this, generally the bleeding phase varies between 4-6 days and this phase has to be painless. So, if there is a major variation seen in this cycle of 28-30 days or there is a variation in the bleeding phase or the bleeding is quite painful or there is massive bleeding either in terms of quantity or number of days then these conditions fall under Menstrual Disorder.

Q. What could be the different types of Menstrual Disorders?

As I said, the first condition which we generally observe is delayed menses wherein the cycle which should normally complete in 28-30 days gets completed in 40 days or more ( sometimes 2-3 months). Contrary to this, sometimes patient has a much smaller cycle of 15 days or so. So, either a considerable reduction in this cycle (i.e. having menstruation more frequently) or a considerable increment in this cycle (i.e. having delayed menstruation) are both considered to be abnormal conditions. Similarly, the variation in bleeding phase i.e. having bleeding for just 1-2 days or having it for 7-8 days could also be a pathological condition which cannot be termed as normal. Apart from this, the bleeding during menstruation should be almost painless. It has to be a normal process which should be spontaneous. But as you would have observed, most of the women have a painful menstruation specially the young girls, who have a great difficulty in the initial stage. The women with such difficulty have problem in performing even their day-to- day work (during this time). They sometimes even have to take an off from studies or work. So, this condition of dismenorrea is also a pathological condition.

Q. What could be the reasons behind an early or a delayed menstrual cycle?

First of all, I would like to tell you that this whole menstrual cycle is entirely a hormonal process. A woman has four types of hormones : Gonadotropin Releasing Hormone (GRH) which is released from hypothalamus, Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH) and Estrogen Hormone. A normal coordination, a normal quantity and a normal activity of these four hormones is important to have a normal menstrual cycle. A surge or a variation in a particular hormone brings a specific change in the uterus. Generally, during a proliferation phase the wall of uterus becomes thick and there is thickening of endometrium. At the time of ovulation, the graafian follicles or matured follicles get converted into corpus luteum which initiates the secretion of progesterone. If a particular ovulation doesn’t meet a sperm (i.e there is no fertilization) then again under a hormonal impact, the corpus luteum undergoes destruction during which the endometrium is shed off and the menstruation begins. If there is any disturbance in this natural process then there are chances of having a disturbed menses.

If the hormones are normal but still there is disturbance in menstruation then as per the concept of Ayurveda, the reason could be increased vayu (air). Vayu or air has a property of drying up so, it dries up the blood, dries up the uterus and thus the menses gets affected. Apart from this, if you have normal hormones but you have an inclination towards pitta aggravating diet and lifestyle i.e. you eat hot things (things which have property of heat) or too much of sour things, too much peppery and spicy things then you will have early menstruation. For this particular reason we give hot things to the women who have delayed menses or reduced menstrual flow. We make them eat things like ajwain (i.e. carom seeds), methi seeds (i.e. Fenugreek seeds), gajar (i.e. carrot) seeds, kalonji (i.e. onion seeds) etc. as they are known to have a property of heat. So to conclude, while an increased vata in the body will delay menses, an aggravated pitta in the body will induce an early menses.

Q. You had mentioned a term called dismenorrea. The young girls often face this problem because of which they are not able to concentrate on their work. They have to go through acute pain which interferes with their routine work too. I would like you to tell us about the reason behind this problem of dismenorrea?

Hormones have a major role to play here. Dismenorrea refers to a condition of painful bleeding during menstruation. If we look at this problem with an Ayurvedic perspective then there can be no pain without an involvement of vayu (air). Here is a direct indication that if you have an aggravated vayu in your body i.e. if you have a tendency of gas formation then there is a probability of having a painful menstruation i.e. there are chances that you may fall a victim to dismenorrea.

Q. Sometimes there in no problem with the menstrual cycle as such i.e. the menstrual cycle is of 28 days but the problem is in terms of the menstrual flow which is sometimes very heavy and sometimes too scanty. Why does it happen?

Let’s take them one by one. In the first case, as you said a women has significantly heavy menstrual bleeding. This problem could either be of menorrhagia or of metrorrhagia. When a woman has a longer bleeding phase (i.e. her bleeding continues for 8 days or more) as well as heavy menstrual flow then we term this condition as menorrhagia. And, when a woman has a normal bleeding phase (i.e. duration of bleeding remains normal i.e. 4-6 days) but she has a heavy menstrual flow then this condition is termed as metrorrhagia. In contrary to these, some women have a normal cycle, a normal bleeding phase but the blood flow is too little. Such a condition is termed as oligomenorrea.

All these three conditions depend upon the hormones. You would have probably heard of a term PCOD which is quite commonly seen condition these days. PCOD is responsible for such irregularities in menses. Generally, due to PCOD we observe delayed menses and oligomenorrea. Contrary to this, if the uterus has some fibroid or a nodule, or there is some irritating material lying out there (it could be contraceptive tissue) then that would stimulate bleeding. To resolve this problem, we initially use medicines but sometimes the patient has to go through hysterectomy of uterus and sometimes the uterus has to be completely removed. This is because the fibroid acts as an irritant and induces excessive bleeding. So I would say that hormonal imbalance and certain pathological conditions can become a reason for the conditions like menorrhagia, metrorrhagia and oligomenorrea. For an exact diagnosis, we get an ultrasound or hormonal assessment done for the patient. Once the diagnosis is made, an appropriate course of treatment can be followed thereafter.

Q. Sometimes there is another situation where a woman has two bleeding phases in a duration of one month. What kind of condition is this?

Having two bleeding phases in a period of one month directly indicates that their menstrual cycle has shortened. You can also say that instead of having menstrual bleeding after 1 month they have it every 15 days. This condition obviously is not normal and is termed as DUB (Dysfunctional Uterine Bleeding). Any condition wherein a woman is bleeding more than the normal bleeding in menstrual cycle falls under the category of DUB. Menorrhagia, metrorrhagia etc. all can be put under DUB.

Q. If a woman is struggling a lot with the problem of Menstrual Disorder, how can she get rid of this problem?

First of all, we need to understand the problem well. If there is less bleeding, it could mean that the patient is anemic. If some patient is having oligomenorrea because of deficiency in blood in her body then we need not worry about her menstruation. Instead we should work on her anemia. If some patient has aggravated vayu (we can find out the same by checking her pulse) and this is responsible for her scanty menstrual flow then instead of treating her menstruation problem, we need to give her vatnashaka medicines (i.e. the medicines which can suppress vata in her body). Similarly, if we observe that less bleeding in a patient is due to lower temperature of her body then we have to make her consume things with hot property like ajwain (i.e. carom seeds), methi dane (i.e. fenugreek seeds) etc.. So depending upon the nature of irregularity i.e the kind of disturbance, we should find the relevant cause. If a patient has PCOD then we don’t have to do anything about menses instead we need to treat her ovarian cyst. If we talk about medicines then a woman who has a heavy bleeding can take lodhrasava and patrangasava. These can easily be procured from any Ayurvedic store. These medicines can be taken without any confusion as they are very safe yet extremely effective. These can be taken in case of heavy bleeding (whether it is in terms of flow or bleeding phase) as 4 teaspoons each after lunch and dinner. This will surely bring down the quantity of blood flow during menstruation as well as it will also control the duration of bleeding.