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September 20, 2013

Moody, Painful Menstrual Cycle?

Photo: UrbaneWomanMag on Flickr.

My female patients often express concerns about their menstrual cycles.

Many of them are confused. They have gotten the message that it is normal to feel some degree of mood swings and physical discomfort during their periods, but after struggling with these symptoms month after month, year after year, they understandably wonder if there really is no other choice.

From an Ayurvedic perspective, menses do not have to be a time of physical and emotional upheaval. In fact, if they are, it is an indication of imbalance, and seen as an opportunity to do some further digging and find the root cause.

Let’s take a closer look at the Ayurvedic take on the menstrual cycle, as well as some Ayurvedic go-to remedies to ease menstrual discomfort.

An Ayurvedic Take on Menses

Premenstrual and menstrual concerns fall under the general Ayurvedic heading of Yonivyad: concerns of the female genital tract.

Among these are mood swings, nervous tension and emotional disturbances, and it often is accompanied by a set of physical complaints. The symptomatic presentation will be determined in part by the prakriti, “nature” (or body type), of the individual.

The premise of Ayurveda is not based on the removal of symptoms. Rather, it empowers the body’s ability to heal itself. In this regard, the focus of the treatment identifies and addresses the initial cause of the menstrual concern.

The root cause of most cases starts early in the lifestyle of a menstruating young woman. Caraka (an ancient Ayurvedic text) and the other Ayurvedic texts state that the suppression of natural urges, excessive sex, worry, work and excessive physical exercise, along with an improper diet, are linked to female reproductive issues.

Here in the west, the average female strays from following some of the major feminine health guidelines that are taken for granted in the culture of India’s Ayurveda. The causes of our modern health concerns, which did not exist as such in Vedic times, have to be revisited from a modern perspective of lifestyle and behavior.

Honoring the Cleansing Cycle

There is a general consensus among Ayurvedic physicians from India who visit our country as to why the excessive amount of female issues plague the west and not the east, and it has much to do with honoring the cycle itself. In India, the menstrual cycle is a highly respected cycle that is an expression of the female connectedness to the cycles of the moon.

This cycle regulates the tides, migrations, mating times, and, of course, the twenty-eight day cycle of menstruation.

Menses is a time when the female body is providing extra energy to ensure an effective and complete sloughing of waste products. It is a natural time of cleansing and rejuvenation, traditionally accompanied by a time of rest or light duty.

It is understood that in traditional cultures there were extended families which supported women during their monthly cycle and through menstruation.

Here in the West, this is not the case. However, this does not mean that today’s working women cannot respect this time of the month, taking a lighter load or scheduling around their time of the month the best they can.

Basically, the Ayurvedic recommendation is to act in accordance with how one feels. If there is a desire to rest during menstruation and this is not provided, this could be considered a suppression of a natural urge. This resting is not a sign of weakness; it is a time of pulling back the bow so that one can later engage in more dynamic activity. In fact, some Ayurvedic doctors comment that the benefits of the menstrual cycle and monthly cleansing is one of the factors that leads to the generally longer lifespan of women [vs. men].

The Apana and Prana Vatas

The controlling dosha in menstruation is vata.

More specifically, it is the Apana vata that governs the flow of Prana (life force) into the reproductive organs. This Apana vata provides the energy for the birthing process and the monthly cycle of menstruation.

For the Apana vata to do its job effectively, it is necessary for the Apana (downward force of energy) to do so without distractions. If the lifestyle of the woman is such that there is no change in one’s hectic lifestyle, particularly during the menstrual cycle, then the Apana vata will not have available all the energy necessary to perform a complete menstruation.

Often times the physical and mental workload during this time is so great that the Apana vata downward flow of energy turns upwards in an attempt to support the Prana vata in accomplishing the task at hand. This lifestyle stress on a monthly basis for ten to twenty years can create a formidable depletion of the integrity of the Apana vata.

The next stage happens when the depleted Apana vata is called upon to menstruate and there is not enough vitality available to support this process. The Prana vata (mental energy) is called upon to support the Apana vata in order to complete menses. The Prana vata is the main vital upward force of energy that stabilizes moods, emotions, and energy.

When Prana vata is imbalanced, severe stress and emotional issues result.

When this kind of drain in the Prana vata continues for ten to twenty years, with ovulation occurs the demand for Apana vata downward support. This brings the upward moving Prana down to the pelvis, leaving the mind and its emotional stability to suffer. Menstrual concerns result. According to Ayurveda, the litany of concerns associated with the menstrual system is the result of a disturbance to both the Prana and Apana vata.

Beware of the common cures of PMS, such as the recommendation for exercise.

Although it is a proven asset in temporarily removing PMS symptoms, it will often further aggravate the cause over the long run. For example, if the cause of PMS is in fact a depletion in the Apana vata, which then drains Prana vata from the head, exercise will clearly drive the Prana back up into the head—because now the Prana is needed there in order to perform the actual activity of exercise.

This will result in symptoms typically categorized as “of the mind,” i.e., tiredness, mood swings, and emotional sensitivity. These symptoms will further deplete the Apana vata, making the cause of the problem even worse. In an attempt to remove the symptoms, the cause is driven deeper and more permanently into the body.

According to the Doshas:

Menstrual Discomfort—Vata Type

Symptoms of vata imbalance as they manifest in relation to the menstrual cycle include:

Premenstrual and menopausal

  • Nervous tension
  • Mood swings
  • Sleep concerns
  • Forgetfulness/confusion
  • Occasional constipation
  • Light flow

Menstrual

  • Pain/cramps/backache
  • Extended length of period with dark, clotted flow
  • Irregularity of periods or flow

Follow these guidelines for one to three months to reset healthy menstrual function:

Suggested diet: Vata-Pacifying Diet (Generally harvested in fall and available in winter)

  • Avoid coffee, tea, tobacco, and drugs.
  • Favor foods that are warm, heavy, and oily.
  • Minimize foods that are cold, dry, and light (e.g., cold drinks, salads, ice cream, chips, crackers).
  • Favor foods that are sweet (e.g., wheat, milk, rice), sour (e.g., yogurt, tomatoes, citrus fruit), and salty.
  • Minimize foods that are spicy, bitter (e.g., green leafy vegetables), and astringent (e.g., apples, beans).
  • Eat larger quantities of food, but not more than you can digest easily.
  • Dairy: all dairy products pacify vata. Always boil milk before you drink it, and drink it warm. Don’t take milk with a full meal.
  • Sweeteners: all are good for pacifying vata (but don’t overdo).
  • Oils: all oils reduce vata. Choose healthy, unrefined oils such as ghee, olive, and coconut oil.
  • Grains: rice and wheat are very good. Reduce intake of barley, corn, millet, buckwheat, rye, and oats.
  • Fruits: vavor sweet, sour, or heavy fruits, such as oranges, bananas, avocados, grapes, cherries, peaches, melons, berries, plums,
  • Pineapples, mangoes, and papayas. Avoid or reduce dry or light fruits, such as apples, pears, pomegranates, cranberries, and dried fruits.
  • Vegetables: beets, cucumbers, carrots, asparagus, and sweet potatoes are good. They should be cooked, not raw. The following vegetables are acceptable in moderate quantities if they’re cooked, especially with ghee or oil and vata-reducing spices: peas, green leafy vegetables, broccoli, cauliflower, celery, zucchini, and potatoes. It’s better to avoid sprouts and cabbage.
  • Spices: cardamom, cumin, ginger, cinnamon, salt, cloves, mustard seed, and small quantities of black pepper all help reduce vata.
  • Nuts: all nuts and seeds are good.
  • Beans: avoid all beans, except for tofu and mung dahl.
  • Meat and fish (for non-vegetarians): chicken, turkey, and seafoods are fine; beef should be avoided.

Food Supplements:

  • Fennel (Foeniculum vulgare) and licorice (Glycyrrhiza glabra) tea, one to three cups a day.

Specific Herbal Supplements:

For Apana vata, combine:

  • 2 parts Shatavari (Asparagus racemosus)
  • 2 parts Musta (Cyperus rotundus)
  • 1 part Licorice (Glycyrrhiza glabra)
  • 1 part Punarnava (Boerhaavia diffusa)
  • Mix 1 teaspoon of the resulting combination with honey and ghee and take three times a day.

For Prana vata, combine equal parts:

  • Bacopa (Bacopa monnieri)
  • Ashwaganda (Withania somnifera)
  • Guduchi (Tinosporia cordifolia)
  • Mix 1 teaspoon of the resulting combination with water and take three times a day.

Menstrual Discomfort – Pitta Type

Symptoms of pitta imbalance as they manifest in relation to the menstrual cycle include:

Premenstrual and menopausal

  • Irritability/anger
  • Increased appetite
  • Pressure in head
  • Excessive body heat or sweating
  • Increased bowel movements (loose)
  • Skin irritations

Menstrual

  • Heavy bleeding
  • Increased frequency of periods
  • Bright red flow

Follow the following guidelines for one to three months to reset healthy menstrual function:

Suggested Diet: Pitta-Pacifying Diet (Generally Harvested in Summer):

  • Ghee (clarified butter) and raisins daily.
  • Avoid alcohol, coffee, tea, chocolate, and animal products.
  • Avoid delaying or skipping meals when you are hungry.
  • Avoid sour, salty, and pungent foods.
  • Favor foods that are cool and liquid. Minimize foods that are hot and dry (chips and salsa).
  • Favor foods that are sweet, bitter, or astringent. Minimize foods that are spicy, salty or sour.
  • Dairy: milk, butter, and ghee are good for pacifying pitta. Avoid yogurt, cheese, sour cream, and cultured buttermilk—these sour tastes aggravate pitta.
  • Sweeteners: all sweeteners are good in moderation, except for honey and molasses.
  • Oils: olive, sunflower, and coconut oils are best. Reduce sesame, almond, and corn oil—all of which increase pitta.
  • Grains: wheat, white rice, barley. Reduce corn, rye, millet, and brown rice.
  • Fruits: favor sweet fruits such as grapes, cherries, melons, avocado, coconut, pomegranates, mangoes, sweet, fully-ripened oranges, pineapples, and plums. Reduce sour fruits such as grapefruits, olives, papayas and persimmons, and sour, not-yet-ripened oranges, pineapples, and plums.
  • Vegetables: favor asparagus, cucumber, potato, sweet potato, green leafy vegetables, pumpkins, broccoli, cauliflower, celery, okra, lettuce, beans, green beans, and zucchini. Avoid hot peppers, tomatoes, carrots, beets, onions, garlic, radishes, and spinach.
  • Beans: avoid all beans except for soy and mung dahl.
  • Spices: cinnamon, coriander, cardamom, fennel, and small amounts of black pepper are good, but the following spices strongly increase pitta and should be taken in moderation: ginger, cumin, fenugreek, clove, celery seed, salt, and mustard seed.
  • Chili peppers and cayenne should be avoided.
  • Meat and Fisf (for non-vegetarians): chicken, pheasant, and turkey are preferable; but beef, seafood, and egg yolk increase pitta.

Food Supplements:

  • Fennel (Foeniculum vulgare) and/or coriander (Coriandrum sativum) tea. Drink 1-3 cups a day.

Specific Herbal Supplements:

For both Prana and Apana vata, combine:

  • 2 parts Shatavari (Asparagus racemosus)
  • 1 part Turmeric (Curcuma longa)
  • 1 part Bacopa (Bacopa monnieri)
  • Take 1 teaspoon, with water, three times a day.

To decrease pitta and Apana vata:

  • Take 2 capsules Manjistha three times a day, after meals.

Menstrual Discomfort – Kapha Type

Symptoms of kapha imbalance as they manifest in relation to the menstrual cycle include:

Premenstrual and menopausal

  • Weight gain
  • Fluid retention
  • Breast enlargement
  • Abdominal bloating
  • Blemishes
  • Menstrual
  • Stiffness in back, joints, etc.
  • Pale, mucousy menstrual flow

Follow the following guidelines for one to three months to reset healthy menstrual function:

Suggested Diet: Kapha-Pacifying Diet (Same as Spring Diet):

  • Avoid salt, cheese, yogurt, chocolate, and refined sugars and flours for one week before and during the period.
  • Lassi (1⁄2 cup yogurt, 1⁄2 cup water) and hot boiled milk are okay.
  • Avoid overeating, especially at night.
  • Do not eat when you are not hungry.
  • A primarily vegetarian diet is highly recommended.
  • Include ginger in your daily diet: take a pinch of fresh ginger root with a few drops of lemon juice before each meal.
  • Favor foods that are light, dry, and warm. Minimize foods that are heavy, oily, and cold.
  • Favor foods that are spicy, bitter, and astringent. Minimize foods that are sweet, salty, and sour.
  • Dairy: low-fat milk is better. Always boil milk before you drink it (making it easier to digest) and take it warm. Do not take milk with a full meal, or with sour or salty food.
  • You might add one or two pinches of turmeric or ginger to whole milk before boiling it to help reduce any kapha-creating properties in the milk.
  • Fruits: lighter fruits, such as apples and pears, are better. Reduce heavy or sour fruits such as oranges, bananas, pineapples, figs, dates, avocados, coconuts, and melons, as these fruits increase kapha.
  • Sweeteners: honey is excellent for reducing kapha. Reduce sugar products, as these increase kapha.
  • Beans: all beans are fine, except soy.
  • Nuts: reduce all nuts. Seeds are ok.
  • Grains: most grains are fine, especially barley and millet. Do not take too much wheat, rice, or oats, as they increase kapha.
  • Spices: all are fine, except for salt. Salt increases kapha.
  • Vegetables: all are fine, except tomatoes, cucumbers, sweet potatoes, and zucchini, all of which increase kapha.
  • Meat and fish (for non-vegetarians): white meat from chicken or turkey is fine, as is seafood. Avoid or reduce red meat.

Food Supplements:

  • Spice food with turmeric, ginger, black pepper, and cinnamon.

Specific Herbal Supplements

For Apana vata, combine equal parts:

  • Shatavari (Asparagus racemosus)
  • Ashwaganda (Withania somnifera)
  • Trikatu (Zingiber officinalis, Piper longum, Piper nigrum)
  • Mix with honey into a paste and take one teaspoon three times a day.

At-Home Treatments for All Body Types

  • Daily Abhyanga massage with herbalized sesame oil such as tri-doshic or lymphatic massage oil.
  • Seven to ten days before your period, one hour after your abhyanga, take a hot tub bath. Massage the abdomen in a clockwise motion during the bath. Then take the following laxative therapy: On an empty stomach, take 1 tablespoon Epsom salt with 1 cup warm water, 1 tablespoon of olive oil and 1 tablespoon of lemon juice. Do not eat until the majority of the laxative action has occurred (4 to 6 hours). Usually this procedure results in 2 to 3 bowel movements. You may repeat this monthly for up to 6 months.
  • For pain or discomfort during the period, application of heat externally to the lower abdomen is advised. This may be accomplished by rubbing herbalized sesame oil on the abdomen followed by the application of a hot water bottle directly to the oiled skin. You can also try placing a hot water bottle on top of a cotton cloth soaked in fresh ginger juice, or on top of a paste made from ginger powder and warm water.

For Apana and Prana Vata: For All Body Types

  • Mix 1 teaspoon Dashamula in 2 cups water and boil down to 1⁄2 cup; drink 1⁄2 cup twice a day. Dashamula, a.k.a. dashamoola or ten roots, is a compounded formula containing the following, although this formula may be modified by some practitioners: salaparni (Gmelina arborea), agnimantha (Premna obtusifolia), brhati (Solanum indicum), kantakari (Solanum xanthocarpum), praniparni, gokshura (Tribulus terrestris), patala (Clerodendron phlomoides), syvnajka, bilua (Aegle marmelos), gambarai.

 

References

1. Sharma, P.V. Cakradatta, Chaukhambha Orientalia. New Delhi, India. 1994.

2. Atha Vale, V.B. Basic Principles of Ayurveda. Bombay, India Town Pinery. 1980.

3. Bhishagratna, K.L. Shushruta Samhita, Vol 1 and 2. Varanasi, India. Chowkhamba Sanscrit series. 1981.

4. Sharma, P.V. Caraka Samhita, Vols. 1 and 2. Varanasi, India. Chaukhanbha. 1981.

5. Devaraj, T.L. The Panchakarma Treatment of Ayurveda. Dwanwantari Orientalia Publications, Bangalore India. 1986.

 

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Ed: Catherine Monkman

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