One of the major causes of absenteeism from work , decreasing efficiency and quality of life amongst women is Dysmenorrhoea , also called Menstrual cramps . The word Dysmenorrhoea is derived from Greek word : Dys – difficulty , Menorrhoea – monthly flow . Thus it is defined as pain associated with menstruation . It is the commonest gynecological disorder affecting women in reproductive age group .
In Ayurveda , the diseases in women are described under ‘ Yonivyapad ’ where Yoni means genital organs and Vyapad means diseases . One of them having similarity with dysmenorrhoea is Udavartini Yonivyapad . The cause of painful menstruation is Vata . The pain is before onset of menses which is relieved with start of menses .
Classification of Dysmenorrhoea :
a) Primary or Spasmodic : It is the painful menstruation in the absence of pelvic pathology . It is essentially a first day pain .
b) Secondary or Congestive : It is the painful menstruation secondary to underlying organic disease of the pelvic organs . Pain may continue throughout flow.
Risk Factors :
a) Menstrual Factors : Early menarche ; long and heavy menstrual cycles.
b) Cigarette smoking
c) Behaviourial & Psychological Factors :
Just before and during menstruation , most women are less efficient physically and more unstable emotionally – these factors lower the pain threshold .
Expectation of pain can be fostered by overanxious parents and by curtailment of normal physical activities during menses .
Unhappiness at home or work .
d) Uterine hyperactivity and incoordinate muscle action of the uterus .
e) Hormonal Imbalance : It has been observed that progesterone induces high tone to the uterus .
f) Prostaglandins : They increase the sensitivity of the nerve endings to pain .
Sign & Symptoms :
Primary Dysmenorrhoea :
Pain is experienced a few hours before and after the onset of menstruation and rarely lasts for longer than 12 hours .
It is colicky in type and causes her to double up .
Pain is felt in lower abdomen , inner and front aspects of the thighs .
Some low backache may be present .
During severe attack , woman looks drawn , pale and may sweat . Nausea , vomiting are common . There may be diarrhea and rectal and bladder tenesmus .
In 50 % of cases the pain does not arise until 6 – 12 months after menarche .
It usually develops after a phase of painless menstrual cycles and is seen at older age .
Pain is worst premenstrually and relieved during menses .
It is diffuse , dull ache in the pelvis often accompanied by backache .
Most common causes are Pelvic inflammatory disease ( PID ) , endometriosis , IUCD etc .
a) General Measures :
i) Counselling : Explaining young girls regarding the condition and reassurance should be an essential component in the treatment plan . Girls should be taught to have a proper outlook on menstruation and health in general .
ii) Improvement in nutritional status and dietary changes .
b) Physical Activity : It can be in the form of yoga , walk , exercise , aerobics etc . The yogasanas which are helpful in dysmenorrhoea are pavanmuktasana , bhujangasana , paschimottanasana , katichakrasana , Pranayam etc .