“Mommy, my tummy hurts…. I can’t bear it.”
Said twelve-year-old Naira holding her abdomen.
“You are on your periods dear…All girls have that pain. Its normal.”
Retorted back her mother.
“No mommy, I don’t want to go to school today. I can’t even walk.”
Naira’s eyes got filled with tears.
“It is all your excuse to skip your school, Naira. Get ready soon. You are going to school today.”
said the mother with an angry face.
You might have heard this conversation going on between your friends and family. Most of the people consider pain during the time of menstruation as normal. Though a mild pain will be present over the abdomen, lower back, and thigh regions, if it becomes unbearable affecting the day-to-day activities, must be taken care of. This pain is scientifically known as Dysmenorrhea. There are two types of Dysmenorrhea. Primary and Secondary. Primary dysmenorrhea is defined as spasmodic and painful cramps in the lower abdomen that begin shortly before or at the onset of menses in the absence of any pelvic pathology. Dysmenorrhea pain has a clear and cyclic pattern, which is typically severe during the first day of menses and lasts up to 72 hours. Usually, the pain subsides by itself once the menstrual blood flow is established. This type of pain is often seen in adolescents. It is almost always confined to ovulatory cycles. The pain is cured after following pregnancy and vaginal delivery. The pain is related to the contractions of the uterus that happens dysrhythmically. Psychosomatic factors have also known to contribute towards primary dysmenorrhea.
Secondary dysmenorrhea originates from a pathological disorder, such as endometriosis, chronic pelvic inflammatory disease, adenomyosis, endometrial polyps, ovarian cyst, congenital anomalies, and complications of intrauterine contraceptive devices. It is associated with diffused or constant pain, that does not necessarily occur during menstruation. The pain is often due to the elevating tension in the pelvic tissues due to premenstrual pelvic congestion or increased vascularity in the pelvic organs.
Almost 70% of the female population in India suffers from Primary dysmenorrhea. Among them, 50% have reported absenteeism from their workplace or study environment. Most of them suffer from unbearable pain along with various symptoms like nausea, vomiting, diarrhoea, fatigue, and in severe cases can result in even chills. The intensity of the pain may differ depending upon the mental pain threshold a person holds. Usually, when a patient comes to OPD, we try to rate their pain using a Visual Analogue Scale (VAS). The highest VAS score of a patient is 10; with 10 being the most intense pain suffered by the patient ever in her life. The least score is zero, where the patient feels no pain. This method gives the physician an overall idea about the pain intensity and the effect of treatment.
Almost 90% of the females, try to tolerate their pain through over the counter medications without knowing the ill effects of its long-term usage. Certain Non-Steroidal Anti-inflammatory drugs without the prescription of a doctor can lead to headache, allergy, liver disorders, anaemia, stroke, heart diseases and even gastrointestinal complaints like ulcer, nausea, and vomiting.
In Ayurveda, the common medication prescribed are as follows.
Abhayarishta is often given twice daily after food. Those who already have gastrointestinal irritations and ulcers need to be cautious before the intake of this medicine and should add ample amount of water to the arishta before consumption. Kumaryasava is also a physician’s choice for the dysmenorrhea. Rajapravartani vati and Dhanwantaram Gulika can also be given in such patients which regulates the Vata dosha and help in controlling the pain by making the menstrual flow without any difficulties. Among Kashaya preparations, Saptasaram Kashaya shows good results. As emergency home remedies, one can always rely upon drinking a glass of water in which fenugreek seeds were kept soaked overnight. Patients can also drink the water boiled with cumin seeds which can drastically reduce the abdominal pain. Hot water bag application on the painful areas have also been providing good results.
Regarding the diet of the patient, the patients are asked to avoid tuberous food items like tapioca and potato, which is known to increase Vata in the human body. Other food items which are often termed as incompatible foods specially those which falls under the umbrella term junk foods are to be avoided. Oily and spicy food items are also to be avoided by such patients. Discontinuing them have shown to decrease pain on the consequent cycles. Such patients are also advised to do Yogasana and Pranayama except on the days of menstruation, which can reduce both the mental and physical turmoil of pain.
Above all one should always try to give an emotional support to the female, especially during the time of menstruation. Sometimes, knowing that she is not alone in this painful journey can also act as a medicine. Proper awareness must be given to the adolescent girls about menstruation and its abnormalities so that they themselves can recognise the diseases earlier. This can help in early diagnosis of the menstrual related disorders which can in turn help in the easy treatment of the same.
Dysmenorrhea is not always a tantrum for the little girls to skip school, it necessarily need not be the office drama of your co-worker to skip their daily tasks, it might not be excuse of your wife to avoid the kitchen works… It is a disease, which needs proper diagnosis and treatment. Next time you meet a female with dysmenorrhea, lend an ear out, extend a helping hand and direct her to consult a qualified doctor.
