Basics of Menstruation
It is the cyclic events that take place in a rhythmic fashion during the reproductive period of a woman’s life.
It’s duration is usually 28 days.
In my view,it is the best marker of female’s reproductive health.
As the cycle is dependent on hormones like LH , FSH ( From anterior pituitary) and estrogen , progesterone ( from ovaries),any factor that disrupts the production or function of these hormones causes changes in the menstrual cycle.
Also there are other factors like genetic abnormalities;anatomical defects of uterus, cervix or vagina;infections , tumors of the genetic tract; systemic disorders like PCOS
disrupt the normal menstrual cycle and hence causes abnormal menstruation.
Types of abnormal menstruation:
•Amenorrhea- absence of menstruation during reproductive period in females.
•Menorrhagia-excessive bleeding during menstruation.
•Oligomenorrhea-reduced bleeding during menses.
•Polymenorrhea-increase in frequency of menstruation.
•Dysmenorrhea-irregular menstruation with pain.
All of the above conditions can be compared with AARTAVA DUSHTI described in Ayurvedic texts.
AARTAVA DUSHTI- Menstrual disorders mentioned in ayurveda.These are of 8 types categorise according to the symptoms.
Symptoms like colour and odour of the menstrual blood or the vaginal discharge.
8 types are:
1.Vataja aartava dushti
2.Pittaja aartava dushti
3.Kaphaja aartava dushti
4.Kunapgandhi or raktaja aartava dushti
5.Granthibhuta aartava dushti
6.Putipuya aartava dushti
7.Ksina aartava dushti
8.Mutrapurisgandhi aartava dushti
These can be related to Oligomenorrhea, Dysmenorrhea, inflammation of reproductive organs like PID, endometritis, cervicitis, endometrial carcinoma, cervical carcinoma.
Treatment protocol -
Treatment with Rasayan (rejuvenating and life prolonging drugs) and Vajikarna(aphrodisiac)
Or with drugs described for urinary disorders is mentioned in the texts.Also doshic shamana chikitsa( to calm the vitiated dosh) is done.
What are the complication of menstrual disorders?
The complication which is mentioned is absence of beej( seed or ovum).That is if menstrual abnormalities are left untreated they lead to infertility.They are the first to show when there is any disturbance in the reproductive system so it is important to attend them at the earliest.
Here with the absence of beej, we conclude there may be Anovulation which could be due to various reasons.
It could be abnormality in the hormones like estrogen progesterone , LH and FSH or due to systemic disorders like PCOS.
Also it can be correlated to premature ovarian failure which is early menopause. The follicular reserve in both the ovaries becomes diminished or gets early exhausted before the menopause.
Physiologically ovaries age and the ovulation ceases as the follicular reserve( no. Of antral follicles) gets exhausted.
The marker of ovarian reserve or the number of eggs which can ovulate is a blood test called AMH or antimullerian hormone. As this is secreted from the growing follicles, it predicts the chances of women getting conceived.