Understanding menstrual health
In Ayurveda the menstrual cycle is a window into the state of human body giving great insight into health. All three doshas play a role in menstruation with the menstrual cycle showing imbalances in the doshas long before they show up in other systems (1).
| Dosha | Elements | Responsibility |
|---|---|---|
| Vata | Air and water | Movement |
| Pitta | Fire and water | Transformation and metabolism |
| Kapha | Water and earth | Nourishment and structure |
According to Ayurveda the body is composed of seven dhatus (tissues layers) whose function is to provide support and nourishment (1).
After food and water is consumed, provided that agni (digestive fire) is strong, it is digested and transformed into a very fine nourishing essence called ahara rasa. If agni is weak food is unable to be digested properly so ama (toxins) may form (3).
The first dhatu, Rasa (plasma), is formed from this essence. Rasa dhatu doesn’t just build itself but also provides nourishment for the succeeding dhatu. This process is repeated by each dhatu with the essence become more refined and potent as it passes through the layers (6).
The last layer is shukra, the reproductive tissues. Shukra is considered the highest, most refined product of the body. Shukra is the sperm and ovum. Shukra is used as the name for sperm and Artava for the ovum. When shukra is healthy it produces ojas (immunity). Ojas then nourishes all the other dhatus forming a dynamic circle (6).
The seven Dhatus listed in order of nutrient metabolism (3)
- Rasa – plasma
- Rakta – blood
- Mamsa – muscle, skeletal, visceral
- Medas – fat or adipose
- Ashti – bone
- Majja – marrow and nerve
- Shukra – reproductive
Rasa dhatu is composed of plasma, lymph and white blood cells. It Is the nutrient transport system of the body delivering nourishment and energy to every cell in the body and removing wastes. As rasa dhatu is formed it produces Upadhatus (by-products) of stanya (lactating tissue) and rajah (menstruation) (6).
Rakta dhatu, the blood layer is also part of the menstrual flow which helps to release excess pitta (6).
Being the first two dhatus, Rasa and Rakta are the first to be vitiated by imbalances within the doshas and are easily weakened by wrong food, incorrect lifestyle and stress (7). As a result, they can quickly change in consistency and quality which is why a woman’s menstrual cycle can reveal so much about her health (11).
How does menstruation work?
In Ayurveda the menstrual cycle is Rutuchakra. A single rutuchakra covers one period of 28 days and is divided into three phases. Rajas (menstrual flow) last for 3-5 days every month from around age 12 to menopause (1).
Rutukala: Follicular phase
This is the first phase of the cycle dominated by kapha dosha. Straight after menstruation kapha governs regeneration and growth as the endometrium starts to thicken. During this phase kapha’s levels increase to its peak of aggravation called Kapha prakopa. Pitta starts to increase in the latter half of rutukala while vata remains at a normal level (1).
During this phase woman feel the essence of kapha with the juiciness, glow and feeling at peace. Rutukala finishes with ovulation (1).
Rutavateta kala: Luteal phase
This stage is dominated by pitta. As pitta increases to pitta prakopa, kapha decreases. Pitta acts mainly through the rakta dhatu (blood tissue layer) within the endometrium which becomes more enlarged with blood vessels in preparation for a fertilized egg. As this phase comes to an end, vata starts to increase (1).
Rajakala: Menstrual phase
This is the last phase which occurs if there isn’t a fertilized egg. Vata increase to its aggravating level, Vata prakopa, triggering the menstrual flow to begin (1).
Apana vayu, a sub-dosha of vata governs downward movement and elimination. The downward movement of this force is what enables the free flow of menstrual blood (6).
If vata is out of balance, then the flow of apana vayu will be disturbed. Without the grounding of apana vayu many disturbances can occur in the pelvic region such as pain, scanty flow and constipation (6).
Understanding the root
According to the classical texts on Ayurveda, a healthy cycle has the following qualities (4)
- Occurs once a month
- Is free of pain
- Is free of bloating
- Is free of irritability, depression or mood swings
- Does not stain clothing (sign of ama)
- Does not have a foul odour
- Has an amount of four anjalees (one anjalee is the amount of liquid that fits in to one cupped hand)
- Has a free flow without spotting before the full flow, and with little spotting afterwards
Most menstrual issues are related to a dysfunction of vata dosha usually from the sub-dosha apana vayu that coordinates the release of menstruation (9). As vata is the dosha that moves it can cause pitta and kapha to become imbalanced (3).
Vata vitiated menstrual flow
Vata’s qualities are dry, light, cold, rough, subtle and mobile (3).
When vata increases and penetrates the artava vaha srota (menstrual channel) and uterus, its cold, dry and rough qualities cause the blood vessels to constrict. Vata’s dryness depletes rasa and rakta dhatu which reduces the nourishment received by the endometrial lining. This results in lighter flow with even cessation of menstrual flow (1).
In Ayurveda the cause of udavartini (painful periods) is due to vitiated vata or blockages in the free flow of apana vayu due to the suppression of natural urges. As a result, apana vayu moves upwards instead of downwards causing severe pain. The pain subsides after discharge of menstrual blood (8).
Pitta vitiated flow
Pitta’s qualities are oily, sharp, hot, light, foul smelling, mobile and fluid (3).
Pitta resides in the blood bringing heat and fluidity to the blood so that it flows with ease. In excess, pitta seeks to be released through the blood which can cause heavy bleeding. The excess heat brings irritation and swelling in the body such as tender, swollen breasts, increased body temperature and headaches (1).
Kapha vitiated flow
Kapha’s qualities are oily, cold, heavy, slimy, slow, smooth, and stable (6).
These qualities in excess contribute towards stagnation. As stagnation builds up, blockages and obstruction occur especially in the rasa dhatu. This gives rise to feelings of bloating and water retention during the pre-menstrual and menstrual period. As the blockage gets stronger the tissues start to overgrow so require more blood vessels to supply this growth. This causes a heavier and abundant flow (1).
Signs and symptoms
| Vata | Pitta | Kapha | |
|---|---|---|---|
| Discomfort | Sharp, spasmodic pain often in lower abdomen or back | Burning sensation | Dull discomfort |
| Emotions | Anxiety, nervousness, fear | Anger, irritability | Depression, emotional eating |
| Menstruation | Frothy, thin, dry (absence of mucus), dark in colour, light flow | Hot, profuse, fleshy or foul smelling, heavy flow | Mucoid, unctuous, heavier and longer flow |
| Other potential imbalances | Stiffness | Increased body temperature, acne, headache, nausea, vomiting, diarrhoea | Water retention, bloating, increased sleep |
Herbal solutions
Ashoka (Saraca indica): Known as the ‘Queen of Herbs’ for the female reproductive system. Ashoka is an excellent uterine tonic, particularly for reducing heavy bleeding. It strengthens the uterine muscles and clears congestion. Ashoka removes physical as well as psychological pain (10).
Shatavari (Asparagus racemosus): Shatavari translates as, ‘she who possesses a thousand husbands’. It is an excellent nourishing tonic and the most important rejuvenate for women with a particular affinity for the female reproductive system. Shatavari reduces pitta and is a wonderful adaptogen helping to increase resilience to stress. Avoid if there is high kapha (3).
Kumari (Aloe vera): Kumari means, ‘like a young girl’, highlighting its power as a uterine tonic and in helping to impart female energy in general. Kumari exerts a special action on the blood and pitta organs. It is very cooling and cleansing removing ama from the digestive system and rekindling agni. The longer the use of kumari the more the dhatu-agni are rekindled. Kumari is often used with other herbs as anupana, the vehicle to direct the herbs to the reproductive system (11).
Ashwaganda (Withania somniferum): Ashwaganda is the best regulator of apana vayu, which governs the lower abdomen, ensuring its downward movement. It is excellent for menstrual issues associated with excess vata such as painful periods, scanty and irregular periods. It is a wonderfully nourishing nerve tonic for vata improving resilience to emotional and physical stress. Care should be taken with pitta conditions as it can increase pitta (3).
Tulsi (Ocimum sanctum): Tulsi lifts the mood and helps in mild depression associated with menstruation. It is warming to the digestion helping to stimulate agni and absorption. It helps relieve spasms and bloating (3). Tulsi is a builder and nourisher of the rasa dhatu making it a lovely herb for nourishment or rajas flow (12).
Sariva (Hemidesmus indicus): Sariva balances all three doshas. It is a good cooling and cleansing remedy for excess pitta in the body and mind (calms irritable emotions). It stimulates agni also helping to remove ama/toxins. Sariva is a rasayana/rejuvenating tonic that nourishes rasa dhatu (3).
Manjishta (Rubia cordifolia): Manjishta rejuvenates the rakta dhatu (blood tissues) by removing excess pitta, cleansing and building the blood gently. As it cleanses the blood it is also able to remove any stagnation or constriction within the shukra vaha srota (reproductive channel). It is an excellent herb for delayed or painful menstruation or heavy flow (11). It is useful for endometriosis related to excess pitta and kapha (3).
Ginger (Zingiber officinale): Sunthi (dry ginger) is hotter and dryer than ardrak (fresh ginger) which makes it superior for reducing kapha and stimulating agni. Ardrak is better for vata problems as it is wet (11). Ginger is one of the best herbs to open and clear channels blocked by apana vayu therefore relieving delayed, painful, scanty periods or clots. Avoid if there is excess pitta (3).
Cumin (Cuminum cyminum): Cumin enhances appetite, digestion and absorption without aggravating pitta. It helps to clear ama, relieves bloating and poor digestion from excess kapha and vata. Cumin helps to regulate apana vayu (3).
Coriander (Coriandrum sativum): Coriander seeds ease abdominal pain and heavy periods by helping to redirect the flow of apana vayu downwards, by clearing heat and ama from the rasa and raktu dhatus. It also helps to stimulate agni and absorption without increasing pitta (14).
Fennel (Foeniculum vulgare): Fennel clears ama from rakta dhatu, redirects the flow of apana vayu downwards, improves agni and relieves muscle tension that restricts the flow of vata. Fennel also reduces kapha congestion and vata obstructions to help bring on menstruation and reduce period pain (14).
Kanchanar guggulu: A traditional Ayurvedic formula used for addressing deep seated kapha imbalances. It is an astringent herb that counters the moist, stagnant qualities of kapha. Mixed with triphala, trikatu and guggulu, it becomes a powerful detoxifier removing excess kapha from the tissues. It also enkindles the digestive fire and helps with healthy elimination (7).
Holistic solutions
Diet
During menstruation eat simple, warm, freshly cooked foods with digestive spices such as ginger, cardamon, cumin and fennel to avoid over burdening the digestive system, free up this energy for cleansing.
Throughout the rest of the month, it is important to implement a dosha pacifying diet for any vitiated doshas.
Vitiated vata should include plenty of ghee to counteract vata’s dryness.
Vitiated pitta should avoid spicy food, oil and include more cooling foods.
Vitiated kapha should stimulate agni with ginger, cardamon and cinnamon whilst avoid heavy foods.
CCF Tea
The inability to properly digest food and absorb nutrients is one of the most common modern disorders. This is a popular Ayurvedic tea to help improve agni and assimilation. (11)
Ingredients:
- ½ teaspoon cumin seeds
- ½ teaspoon coriander seeds
- ½ teaspoon fennel seeds
- 6 cups of water
Bring to boil and then simmer for 10 minutes. Keep in a thermos to sip throughout the day.
Rest
Menstruation is a time of cleansing. Wastes are moving down and out of the body which requires a lot of energy. It is also important to rest as apana vayu becomes imbalanced by upwards movements of things such as excessive talking or thinking, excessive movement, sex and even pranayama and yoga. These are best left to non-menstruating days (11).
Reflection
Taking time while resting to reflect on the menstrual cycle to identify any imbalances and to start correcting these will prevent imbalances from moving deeper into the physiology.
Castor oil pack
Castor oil packs break up kapha accumulations and help drive out toxins. It also has a calming effect on vata. A warm castor oil pack placed on the abdomen is very effective at balancing apana vayu. For excess pitta castor oil can be replaced with coconut oil as it is cooling. Do not do a castor oil pack during menstruation (9). After starting castor oil packs, it is common for the next menstruation or two to be heavier and more painful as stagnation is cleared from the uterus. Subsequent cycles will become less painful than before the use of castor oil packs (13).
Abhyanga
Regular practice of abhyanga oil massage, quickly calms the nervous system. The skin is the largest organ of the body. Massaging with warm oil stimulates the dhatu layers to prevent toxins from accumulating and helps toxins drain to the gut for elimination. The warm oil calms the nervous system. Sesame seed oil is one of the best remedies for balancing vata and is beneficial to all seven dhatus. Sesame seed oil is wonderful for reducing stress and tension. Regular use can help prevent period pain. Abhyanga should not be carried out during menstruation (3).
Nasya
Nasya is the administration of herbal oils though the nose which help to clear accumulated toxins in the head and neck region. This is useful for pitta premenstrual headaches (3).
Meditation
Meditation helps to clear mental and emotional ama and prevent the build-up of more. There are many forms of meditation whether it is sitting peacefully and quietening the mind, visualisation, mantra chanting, walking meditations in nature or pranayama breath exercises.
Yoga
Yoga is good for the spine, digestive organs and helps to move stagnation out of the body. It also helps to clear the mind and feel grounded (3).
Hydrate
During menstruation, just like any cleanse, hydration is very important to help with the elimination of wastes. Sipping warm water throughout the day helps the body to flush out wastes. Including good oils daily such as ghee or flaxseed oil throughout the menstrual cycle helps to counteract vata’s dryness and helps keep rasa dhatu nourished (1).
Don’t suppress natural urges
The body is constantly working to keep us in a state of balance. Suppressing natural urges, which are often a way for the body to eliminate wastes, results in vitiated vata and upward flowing apana vayu. Natural urges are sneezing, urinating, coughing, crying, defecating, feeling hungry or thirsty, yawning, burping, sleeping, vomiting, expelling wind and breathing.
References
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