Dysmenorrhea 

Dysmenorrhea:

Painful Menstruation. It is a very common problem observed in women due to forceful contraction of the uterus. Dysmenorrhea is of two types – Primary Dysmenorrhea and Secondary Dysmenorrhea. 

Etiology of Primary Dysmenorrhea: Excess of prostaglandins is released from secretory endometrium to cause spasms of uterine muscles during menses. 

Meaning of Prostaglandins: Prostaglandins (any of various oxygenated unsaturated cyclic fatty acids of animals that have a variety of hormone-like actions like smooth muscle contraction). These Prostaglandins cause muscle contractions, resulting in pain. They also decrease blood flow and oxygen to the uterus. Pain increases when the Prostaglandin level increases in the uterus's lining.

Girls with anxiety are more prone to pain.

Cause of Primary Dysmenorrhea:

Dysmenorrhea is called ‘Primary’ when there is no specific abnormality. In such conditions, painful menstruation occurs without any recognized physical cause. This type of Dysmenorrhea is associated with a normal menstrual cycle. Mostly, it is observed in adolescent girls.

Cause of Secondary Dysmenorrhea:

• Fibroid: a benign tumor, especially of the uterine wall, that consists of fibrous and muscular tissue
• PID: Pelvic inflammatory Disease: Inflammation of the female reproductive tract and especially the fallopian tubes that is caused especially by sexually transmitted diseases, occurs more often in women using intrauterine devices
• Endometriosis: the presence and growth of functioning endometrial tissues in places other than the uterus that often results in severe pain and infertility
• Adenomyosis: (When the endometrial tissues invade the myometrium) means in this condition, the inner lining of the uterus breaks through the muscle wall of the uterus.

Symptoms of Primary Dysmenorrhea:

The patient is young, usually 18-24 years old, rare after 30 years. Pain is colicky and cramp-like at the hypogastric region and radiates to the thighs. There may be low backache, nausea, vomiting, diarrhea, burning sensation in hands and feet, fatigue, stomachache, dizziness, disorientation, hypersensitivity to light and sound. The main symptom of Dysmenorrhea is pain in the lower abdomen or in the umbilical region. headache, irritation, anxiety. 

The patient may be in a poor state of health, often thin and anxious. Ref: Textbook of Gynaecology Contraception and Demography – Dawn Books.

In Primary Dysmenorrhea, pain occurs when the menstrual cycle starts. If the level of prostaglandin increases, the pain gets increased, most probably it is high on the 1st day and when the lining of the uterus sheds, the level of Prostaglandin decreases, resulting in decreased pain.

The pain in Secondary Dysmenorrhea often lasts for a longer period than the pain occurs in normal menstrual cramps. Pain starts 3-5 days before the start of menses, persists during menses, and lasts for days after menses. In endometriosis, pain can be at times severe and cannot be relieved by analgesics. In adenomyosis, there can be menstrual pain with menorrhagia.

Fibroid can also cause pelvic pain during menses. In the case of PID, pain occurs before and during menses in the lower abdomen. Ref: Textbook of Gynaecology Contraception and Demography – Dawn Books.

The most common and popular choice to treat Dysmenorrhea is “Nonsteroidal anti-inflammatory drugs. These include Aspirin, Ibuprofen, Naproxen. But there are certain side effects of NSAID drugs like diarrhea, epigastric discomfort. Herbal remedies have negligible side effects; hence, they are preferred.

Herbs Useful To Treat Dysmenorrhea:

• Saraca indica (Ashok): The bark is useful to treat uterine disorders especially Dysmenorrhea Ref: Bhavprakash. Database on Medicinal Plants Used In Ayurveda Vol 3. Symplocus racemosa (Lodhra) Remedy for Menstrual problems. Acts as a uterine tonic.
• Nagarmotha (Cyperus scariosus): Nagarmotha is an excellent natural remedy for treating dysmenorrhea. Ref: Database on Medicinal Plants Used In Ayurveda Vol 3.
• Aambhingi (Mangifera indica): Green fruits are considered antidysmenorrheic.

Natural Home Remedies:

Take the powder of Ashwagandha, Shatavari, Vidara, and Tagar, once a day, (For the quantity, contact the author). Mix mustard oil and castor oil in equal proportion and then apply it on the lower abdomen.

Magnesium is useful to relieve menstrual cramps. Sources – Nuts, Green leafy vegetables, and whole grains, Spinach, Yogurt, Peas. Take a piece of ginger, boil it in a cup of water. Filter it and drink it once a day or you can increase the amount of ginger while cooking.

Omega-3 fatty acids are also useful in reducing menstrual cramps.

Sources – Flaxseed oil, cod liver oil. Fresh green vegetables, especially cabbage and spinach, help to reduce menstrual cramps.

Studies show that Vitamin B is effective when taken at 100mg daily. Meditation and yoga are techniques useful to relieve the symptoms of Dysmenorrhea. Take dietary fiber – Orange pulp, raw carrot, broccoli. Bromelain juice is advisable. Sprinkle cinnamon powder on your breakfast, and vegetables, or use it in tea, as it is useful to relieve the pain of Dysmenorrhea. The application of a hot water bottle/bag on the hypogastrium gives relief from pain in menses.

Granthokta Preparation: Ashokarishtha.

Avoid:

Working in a stressful atmosphere. Do not do strenuous exercise during Period (Menstruation).

Examinations To Be Done: Ultrasound, PV.

Take all these aforementioned Natural/Home Remedies with the consultation of an Ayurvedic Physician Doctor.