Premenstrual syndrome (PMS) is characterised by symptoms including mood-disorders, tenderness in the breasts, fatigue, clinical depression, irritable mood and above all, food-cravings. It is estimated that three out of every four women having an active menstrual history, suffer from mild to moderate symptoms associated with Premenstrual syndrome.
The American College of Obstetrics and Gynaecology has coined the definition of premenstrual syndrome. It is defined as “The occurrence of symptoms in cyclic pattern that are severe enough to interfere with some of the aspects of life, and that appear with consistent and predictable relationship to the menses [menstrual period].”
The exact reason behind premenstrual syndrome is still unknown to medical fraternity. As per evidence, there seems to be relation with the fluctuating levels of female-hormones, (oestrogen and progesterone), occurring in preparation for menstruation. Recent evidence is suggestive that premenstrual syndrome is the outcome of the interactions occurring between the levels of sex-hormones and brain chemicals and neurotransmitters.
There seems to be no specific association with specific personality types or any personality factors, as far as premenstrual syndrome is concerned. Similarly, majority of studies have demonstrated that psychological stress has no relation to the severity of symptom of premenstrual syndrome. Yet another theory is suggestive of the fact that a deficiency of magnesium and calcium in the diet results in symptoms of premenstrual syndrome.
Signs and Symptoms of PMS
Common symptoms of premenstrual syndrome include:
- Breast tenderness.
- Food cravings.
- Mood swings.
- Lack of concentration.
- Weight gain.
- Thyroid profile.
- PMS symptom dairy.
Premenstrual syndrome must be differentially diagnosed from other diseases that have a similar clinical picture. It must be differentially diagnosed from dysmenorrhoea.
Premenstrual dysphoric disorder (PMDD)
Premenstrual dysphoric disorder is considered as severe form of premenstrual syndrome. Premenstrual dysphoric disorder strikes in 3% to 8% of menstruating women.
Menstrual diseases as per Ayurveda
- Amenorrhea: Amenorrhea is absence of menstruation after the usual age of puberty and before the menopause. The process can be temporary or permanent. Amenorrhea that occurs during pregnancy and lactation is known as physiological amenorrhea. Diseased state is known as pathological amenorrhea. Pathological amenorrhea can be due to congenital factors or injury to the pelvis. Mostly amenorrhea is due to anaemia, diabetes, starvation, and carcinoma of the sex organs. Sometimes exposure to chill can precipitate amenorrhea. Surgical removal of the ovaries leads to amenorrhea. Certain nervous system diseases like stress, anxiety, and hysteria can lead to the incidence of amenorrhea.
- Dysmenorrhoea: It is of two types, spasmodic and congestive. Spasmodic dysmenorrhoea is characterized by severe pain dating from soon after puberty and the disease has definite cause. Congestive dysmenorrhoea is a form of pre-menstrual or early menstrual pain.
- Leucorrhoea: It is a white or yellow discharge from the vagina. The discharge may contain mucus (mucoid), mucus plus pus (mucopurluent) or pus (purulent). A common form of leucorrhoea occurs in young virgins just before and after menstruation. Leucorrhoea is common in anaemic or malnourished females.
- Menorrhagia: Menstrual bleeding can last more than seven days and amount lost on any or more days is excessive for any particular patient. Fibroids (type of tumour) of the uterus, abnormal position of the uterus, and inflammation (swelling) of the fallopian tubes are some of the specific causes. Endocrinal disorders like hypothyroidism, exophthalmia goitre and constipation are also related to the incidence of menorrhagia.
- Metrorrhagia: Intermenstrual uterine bleeding is referred to as metrorrhagia. It may be encountered as isolated disorder or coexist with menorrhagia. Causes are similar to that of menorrhagia. Constant uterine bleeding is a serious problem.
Allopathic Treatment of PMS
Analgesics, diuretics, oral-contraceptive and drugs suppressing ovarian function are commonly used to curb symptoms of premenstrual syndrome.
Ayurvedic Treatment of PMS and Menstrual Disorders
Ayurveda describes a group of drugs known as uterine tonic for promoting function of the uterus. Various Ayurvedic remedies have been successfully used in managing symptoms associated with PMS.
- Rajapravartini vati is the traditional Ayurvedic remedy for the treatment of amenorrhea. It should be taken under expert Ayurvedic supervision.
- For premenstrual tension, Shatavari mandura is prescibed with lukewarm water in a dose of one tablet, thrice a day.
- Alternatively, standardised extract of Shatavari, two capsules twice a day, with water is ideal for premenstrual syndrome.
- Shankh vati is the best formulation of bloating. In some cases, Mahashankh vati is prescribed. 1-2 tablets of Shankh vati or Mahashankh vati, twice a day, are given with lukewarm water. These formulations are good for painful menstruation.
- Patrangasva, 3-6 teaspoonfuls with equal quantity of water, thrice a day, is helpful in regulating blood flow.
- Lodhrasva, -6 teaspoonfuls with equal quantity of water, thrice a day, is valuable in prevent excessive bleeding.
- Ashokarista, 3-6 teaspoonfuls with equal quantity of Patrangasva or Lodhrasva, is helpful in majority of symptoms of premenstrual syndrome.
- Pradarantaka lauha and, Punarnava mandura are the drugs of choice in treating anaemia. One tablet, twice a day, after meals is very efficacious.
- Dashmularishta, 3-6 teaspoonfuls with equal quantity of water is given in chronic backache associated with premenstrual syndrome.
- Praval Pisti, Praval Bhasma, Shankh Bhasma, Godanti Bhasma, and Karpardaka Bhasma are excellent source of calcium. These are particularly effective as recent evidence of calcium deficiency associated with premenstrual syndrome.
- Haritaki is good remedy for constipation. One teaspoonful (5 g) of the powdered drug with a pinch of Rock-salt (to improve taste) should be taken with lukewarm water.
- Tagara, half teaspoonful with water is good remedy for insomnia.
- Shira-shoola-vjara-rasa is the drug of choice in treating headache. One tablet is given with three teaspoonfuls (15 ml) of Pathyadi quatha, twice a day.
- Jatamansi is the herb used for alleviating symptoms of depression. Masyadi quatha, six teaspoonfuls (30 ml) is helpful in treating depression. It should be continued for six months
- Balances female reproductive hormones
- Reduces PMS
- Promotes energy levels, revitalises and provides strength
- Supports both male and female reproductive health
Premenstrual syndrome has not been described in ancient Ayurvedic texts as independent disease but can be managed as effective cures are available. PMS should not be confused with Post menopausal syndrome.