By, Dr. Aarti Kulkarni, Ayurveda
According to The American College of Obstetrics and Gynecology, it is defined as the occurrence of symptoms in ‘the cyclic pattern that are severe enough to interfere with some of the aspects of life, and that appear with consistent and predictable relationship to the menses.’
Premenstrual syndrome (PMS) is characterized by symptoms including mood-disorders, tenderness in the breasts, fatigue, clinical depression, irritable mood and food-cravings. Three out of every four women having an active menstrual history suffer from mild to moderate symptoms associated with the premenstrual syndrome. These symptoms arise 1-2 weeks before menses starts and usually end with the onset of menstrual flow.
The exact reason behind premenstrual syndrome is still unknown. As per research, there seems to be a relation between the fluctuating levels of female hormones, (estrogen and progesterone), occurring in preparation for menstruation. Recent evidence is suggestive that premenstrual syndrome is the outcome of the interactions occurring between the levels of sex hormones and brain chemicals and neurotransmitters.
Excessive intake of oily and spicy foods, sedentary lifestyle, poor nutrition, lack of exercise, unhygienic living conditions and psychological factors play a part in causing symptoms of PMS.
Signs and Symptoms of PMS
- Breast tenderness
- Food cravings
- Mood swings
- Abdominal pain
- Fatigue and troubled sleep
- Upset stomach
- Constipation or diarrhea
- Body ache and/or headache
- Pain in the pubic region
- Appetite changes
- Joint or muscle pain
- Crying spells
- Water retention and swelling
- Lack of concentration
- Weight gain
Treatment of PMS
- Analgesics, diuretics, oral-contraceptive and drugs suppressing ovarian function are commonly used to curb symptoms of premenstrual syndrome.
- Reducing salt, caffeine, and stress along with increasing exercise is recommended. Calcium and vitamin D supplementation may be useful in some. Anti-inflammatories may help with physical symptoms.
Antidepressants can be used to treat severe PMS.
- Tentative evidence supports vitamin B6. Evidence does not support the use of soy, vitamin E. Evening primrose oil may be useful.
Ayurvedic Premenstrual Syndrome(PMS) Treatment
In Ayurveda, PMS can be correlated with Krichhraartava (Krichhra means ‘difficult’ and aartava means ‘menses’). There is impairment of Apana Vayu (a sub-dosha of Vata or Air) as well as Pitta (Fire). Apana Vayu is located in the lower pelvic region and is responsible for the elimination of menstrual blood, stool and urine. Impaired Apana Vata and Pitta circulate in different channels of the body which can cause symptoms of PMS.
Additionally, Apana Vata might also aggravate vitiation of Prana Vayu, another sub-dosha of Vata which is linked to anxiety, mood swings and depression like problems.
Ayurvedic treatment For PMS:
Following Rajaswala Paricharya (lifestyle during menstruation), Diancharya (Daily regimen as per body constitution), Rutucharya (lifestyle according to seasonal variations) is an essential remedy.
- Use of nasya (inhalations), swedana (sudation) and vamana(emesis) are contraindicated during menstruation.
- In order to get the body slightly emaciated and digestive system purified, she should take less quantity of meals.
- She should avoid pungent, hot and salty substances; always concentrate on thinking good or auspicious things
- After the fourth day, she should wash her head during the bath.
- Have freshly prepared, warm and easily digestible meals.
- Include cumin seeds, cloves, fenugreek, asafetida, black pepper, coriander, and mint in cooking.
- Avoid heavy, oily, sour, fried, and indigestible foods that can cause constipation and flatulence.
- Yoga and exercise
- Whole body Massage and steam
- Padabhyang (foot massage)
- Shirodhara (Continuous pouring of lukewarm oil or decoction on forehead)
- Head massage
- Basti (Medicated oil or decoction or milk enema)
- Seasonwise detoxification vaman (induced vomiting) virechan (induced loose motions)
Yograj Guggul, Sutshekhar, Shatavari kalpa, Sukshma Triphala, Sukhsarak vati, Chandraprabha Vati, dashmularishta, shankhvati, gokshuradi guggul, Jatamansi, brahmi, Amalaki, Guduchi, Punarnava, Gokshur, ashwagandha etc are very useful when taken under proper guidance.
Premenstrual dysphoric disorder (PMDD)
It is a severe and disabling form of the premenstrual syndrome affecting 3–8% of menstruating women. The disorder consists of a “cluster of affective, behavioral and somatic symptoms” occurring during the luteal phase of the menstrual cycle. The exact pathogenesis of the disorder is still unclear. Treatment of PMDD relies largely on antidepressants.
The symptoms in PMDD can be both physical and emotional with mood symptom being dominant. The emotional symptoms include anxiety, fatigue, irritability, depression, mood lability, feelings of ‘loss of control’ and difficulty in concentrating. These physical symptoms include a headache, abdominal bloating, breast tenderness, and generalized aches.
Cognitive behavioral therapy (CBT) is an evidence-based treatment approach for treating depression and focuses on the link between mood, thoughts, and actions to help patients address current issues and symptoms. CBT has been shown to be effective in PMS.