Menarche and the monthly menstrual cycle (artava) are indicators of female fertility and health. As mentioned in a previous article, artava is the subsidiary tissue of rasa dhatu (plasma-lymphatic tissue). Therefore, the strength of the menstrual channels is a reflection of rasa dhatu and overall immunity. Menstrual complaints often begin showing up soon after menarche simply because of poor diet and lifestyle patterns that are inherent in the stressful, fast-paced Western world. I experienced this firsthand in the school cafeteria in our hometown.
Not too long ago, I volunteered during the lunch period at my daughter’s elementary school. It was ‘Rainbow Lunch’ day, which meant students who had a colorful plate of food earned a rainbow wristband. I was appalled when I saw the sad salad bar made of pre-made bags of dry lettuce and purple cabbage with a few strands of carrots here and there, sliced cucumbers, and ranch dressing to douse it in. All refrigerated, cold, and very un-Ayurvedic! The hot lunch that day was an even sadder looking pizza with burned cheese on top of thick, stale bread. I felt like a fraud as I congratulated the children and handed out bracelets to those with pizza and salad on their plate!
I thought about my daughter, who often brought home-cooked Indian food (rice with veggies and spices or a bread called chapatti with a side of vegetable curry). One of the ‘hot lunch’ kids had teased her one day, so she started throwing out her homemade lunch and buying hot lunch just to fit in with the other kids. Beyond the heartache I felt for my daughter, I was angry at the injustice of a school culture which encourages kids to partake in poor eating habits just to “fit in”.
The gut-brain axis is at the heart of the thousands-of-years-old Ayurvedic practices, as Dr. Vaidya fervently teaches his students. The Standard American Diet, for which the acronym “SAD” is all too fitting, is high in fats, carbs, and government-subsidized corn, wheat, and soy and low in veggies, fruits, vitamins, and nutrients. It’s the reason why obesity is a pandemic, leading to chronic diseases like diabetes, heart attacks, strokes, and arthritis. It’s also why adolescent mental disorders, such as anxiety, depression, attention deficit hyperactivity disorder, and teen suicide, are increasing at alarming rates. Menstrual disorders, starting at an early age, are also rooted in unwholesome foods and way of living.
So, I was very distraught that day and daunted by the task that lay ahead: to ensure my daughter would have a healthy menstrual cycle in the not too-far-off-future by eating the right foods, at the same time helping her feel a sense of ease and belonging among her friends. By and by, I am grateful to have the teachings of Ayurveda to lean on. Let’s take a closer look now at some common early menstrual disorders through the lens of Ayurveda and how Ayurveda can promote a healthy outcome.
According to the Ayurvedic texts, Yoni Vyapad describes disorders of the female reproductive tract and are twenty in number. They are grouped by the predominant dosha derangement, which are vata (air + space elements), pitta (fire element), kapha (water + earth elements), or sannipata (tridosha – vata, pitta, and kapha) types. However, vata dosha is involved to the greatest extent in all of them, due to the main seat of vata being below the navel in the reproductive tract area, and apana vayu overseeing the elimination processes of the body including the outflow of menstrual fluid.
Vata also manages the sensory perceptions of the mind and the emotional regulation of the nervous system. So, mental disorders are directly related to physiologic distress. The female reproductive system is a storage receptacle for suppressed emotions including childhood trauma, tension, and stress which are seen as hormone dysregulation, dysfunctional sexual relationships, infertility, and more. As stated in Charaka Samhita, “The body and the mind are the abodes of diseases as well as health. Proper body-mind interaction is the cause for happiness”.
For these twenty Yoni Vyapad, Charaka Samhita gives four main causes which are shown in the chart below.
The contribution of the Standard American Diet to reproductive disorders in females undergoing puberty was previously addressed. The remaining three categories of Yoni Vyapad can be summarized as modern day living in the material age of ‘Kali Yuga’, involving all manners of activity that distract us from the spiritual path. Similar reasons for abnormal menstrual cycles are well documented in scientific literature. For example, the average age at menarche continues to trend to a younger and younger age, from 15 years one hundred years ago to 12.4 years. Research shows socioeconomic conditions, general health and nutritional status, exercise, seasonal changes, and genetics all play key roles.
A large body of evidence also points toward bio hormone chemicals, or endocrine-disrupting xenobiotics, which the mother is exposed to during gestation, are decreasing the age of menarche in their babies. These chemicals mimic female hormones and unnaturally speed up reproductive growth in children; they’re also linked to more female cancers later in life. The burden of these environment toxins has increased dramatically after the Industrial Revolution, and they are found everywhere – in foods (pesticides), consumer products (phthalates, BPA in plastics), manufacturing industries, vehicle exhaust, pharmaceuticals, furniture, children’s toys, and even the very water supply!
All of these are causes for the common, early menstrual disorders that occur in adolescent girls soon after menarche, which are listed below, followed by Ayurvedic recommendations for managing them.
Irregular periods are quite common in young girls whose hormones have not quite regulated and comes in a variety of forms. Metrorrhagia, or breakthrough bleeding, refers to spotting or light bleeding between periods and is common during the early ovulating years. In general, treatment is not needed per Ayurveda. Similarly, an imbalance in estrogen and progesterone levels around menarche can also lead to menorrhagia or heavy menstrual bleeding (asrigdara), which in turn can cause anemia due to excessive loss of blood. For this, the use of ayurvedic formulations which slow menstrual blood flow (stambhana), pacify the heat of pitta, and herbo-minerals containing iron are beneficial.
Abnormal uterine bleeding refers to excessive blood flow caused by lack of ovulation which affects hormone levels; it’s most common soon after menarche and before menopause. As per Ayurveda, ovulation is the result of pitta, in the form of hormones, and vata, because it involves expulsion of the ovum from the follicle due to the action of hormones. Therefore, vata and pitta pacifying diet and lifestyle are recommended.
Primary amenorrhea (prathamika anartava), which is when the girl has not begun to menstruate by age 16 years, along with the lack of signs of sexual development (such as breasts and pubic hair), requires consultation by a gynecologist. Per Ayurveda, the cause is considered to be congenital abnormalities (Sahaja vikruti) and is treated with herbs and mantras.
Oligomenorrhea, or infrequent menstrual cycles occurring more than 35 days apart, is common in early teenage females, as is scanty flow. Weight loss and eating disorders in adolescent girls lead to reduced reproductive hormones and can also cause hypothyroidism. Elevated stress increases cortisol levels, which can also lower reproductive hormone levels. Excessive athletic training is associated with amenorrhea or oligomenorrhea. Ashokarishta and Rajah pravartani are both herbs which strengthen and improve the function of the reproductive system and pacify aggravated doshas and are useful along with vata and pitta lowering diet and lifestyle.
Girls who start menstruating before age 11 years are at higher risk for premenstrual syndrome and have severe pain, longer periods, and longer menstrual cycles. Being overweight can also increase the risk for painful periods and cramps, also called dysmenorrhea. Dysmenorrhea is generally a disorder of vata, so oiling (abhyanga) and enema (basti) are beneficial after cleansing the channels.
In summary, menstrual disorders can affect an adolescent’s quality of life, ability to be productive, and social activities. Modern medicine recommends eating a healthy diet of whole grains, fresh fruits and vegetables, avoiding saturated fats and junk foods, and keeping well hydrated starting about two weeks before menses. If that fails, then estrogen and progestin are given to regulate the cycle. But these are dangerous ways of messing with Mother Nature and can have unwanted side effects. Ayurvedic recommendations start by following a proper diet and cleansing plasma (rasa dhatu), because menstruation is its secondary tissue. Enhancing digestion of food and removing toxins from the body are the first step toward achieving hormone balance. Practicing yoga, breathwork, and meditation go a long way towards regulating emotions and releasing stress. Finally, specific herbal remedies are used depending on the symptoms, such as pitta-pacifying herbs for heavy periods, and strengthening herbs for scanty or irregular periods. Ayurveda offers a holistic way to nurture adolescent girls into a healthy menstrual cycle.
Uma Hingorani
Advanced Ayurvedic Practitioner
References:
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3.Menstrual disorders Information | Mount Sinai – New York
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