Menstrual disorders are unfortunately quite common among women in the modern age. The reasons can be varied. Stress, pollution of air, soil and water, food adulteration and poor lifestyle being the major culprits, it seems like menstrual disorders are almost inescapable these days. It sounds quite tragic, yeah?
We take up this matter in our second yoga therapy series. We realize the importance of preserving the good health of women. As Swami Vivekananda once said “Can you better the condition of your women? Then there will be hope for your well-being. Otherwise you will remain as backwards as you are now” Enough said.
First, let’s try to understand menstruation.
Menstruation can be defined as cyclical discharge of blood, mucus and certain other substances from the uterus in the reproductive life of the females, at an average interval of 28 days. It occurs every month from puberty to menopause.
A baby girl is actually born with eggs stored in sacs called follicles inside her ovaries. At puberty, her body releases hormones that cause the eggs to mature. The process that leads to maturity of eggs is pretty interesting. Firstly, a gland in the brain called hypothalamus instructs another gland called pituitary gland to secrete Follicle Stimulating Hormone (FSH) and a little of Luteinizing Hormone (LH) into the bloodstream. When these hormones reach the follicles, they begin to mature.
The maturing follicles release another hormone called estrogen. Estrogen is responsible for the thickening of the uterus lining. When it reaches a certain level in the bloodstream, the pituitary gland releases LH in large amounts. This sudden rise of LH causes one of the most mature follicles to burst open and release an egg. The egg finds it’s way to the fallopian tube as the ligaments contract. Inside the uterus, fertilization occurs if sperms are present. Otherwise, the spiral arteries of the lining close off, stopping blood flow to the surface of the lining. The blood pools into “venous lakes” which, once full, burst and, with the endometrial lining, form the menstrual flow. The bleeding generally lasts for 4 – 6 days.
With this, I think we’ve a basic understanding of how menstruation happens.
Common disorders related to menstruation
1. Dysmenorrhea (Menstrual cramps)
Dysmenorrhea means painful menstruation that disturbs or incapacitates day-to-day activities. It is the most common of menstrual disorders that affects more than 50% of the young women (it’s usually known to recede after pregnancy).
Symptoms of Dysmenorrhea are varied:
-Concentrated pain in the lower abdomen/pelvis
-The pain may radiate to thighs and lower back
-Nausea or vomiting
Causes of Dysmenorrhea:
The uterus contractions occur throughout a woman’s menstrual cycle. This contractions or tightening occur due to the secretion of a lipid compound called prostaglandin. During menstruation, the uterus contracts are stronger and hence it presses against nearby blood vessels, cutting off the supply of oxygen to the muscle tissue of the uterus. When this happens, the woman experiences pain.
Dysmenorrhea may be primary or secondary.
In this case there is no identifiable pelvic pathology. It is mostly confined to adolescents. The pain is usually cured following pregnancy and vaginal delivery. Pain is either due to psychosomatic reasons due to tension and anxiety during adolescence. Pain threshold level may be low at this age, so it may disappear with the advancing age. There may be functional disturbances such as strong uterine contractions where the cervix may fail to dilate when uterus contacts to expel the menstrual fluid or there may be an imbalance in the autonomic nervous control of uterus muscle.
Pain begins a few hours before or just with onset of menstruation. The severity of pain usually lasts for few hours to 48 hours. The pain is spasmodic and confined to lower abdomen, may radiate to the back and medial aspect of thighs. Systemic discomforts like nausea, vomiting, fatigue diarrhea and headache may be associated. There may be pallorness, cold sweats and occasional fainting. Rarely syncope and collapse in severe cases may be associated.
This condition is the painful menstruation occurring in the presence of pelvic pathology such as pelvic infections, endometriosis, adenomyosis, fibroid, and endometrial polyp, Intra Uterine Contraceptive Devices.
Pain is dull, situated in the back and in front without any radiation. It usually appears 3 to 5 days prior to period and relieves with the start of bleeding. Individuals with secondary dysmenorrhea may have some discomfort even in between periods.
Sheetali Pranayama (Cooling)
Technique: Sit in any comfortable meditative position with spine uplifted. Hands in Chin or Jnana mudrā. Eyes gently closed. Take a few natural breaths. Open the mouth, stick the tongue out and roll the edges to make a tube. Inhale a full yogic breath through the tongue. Take the tongue into the mouth and close the mouth, hold as long as possible. Exhale through the nose.
Variation: For those who cannot roll their tongue, they can fold the tongue instead and inhale through the sides.
Avoid if you have:
Supta Baddha Konāsana
Supta Baddha Konāsana can bring great relief to women suffering from Dysmenorrhea/ Menstrual cramps. Practice regularly and also when you’re experiencing the cramps.
Technique: Begin with Daṇḍāsana. Bend both knees out to the side, bringing the soles of your feet together. Place the heels in front of the pelvis, about a fist distance from the groin. To gain lift & length in the back you can bring the hands behind you. Then take hold of your feet with your hands, opening your feet “like a book”. After this position is comfortable, slowly lie down on your back by keeping your hands on the floor on either side. Hold the position for 5 – 10 minutes. To come back, keep breathing and come to the sitting position. Return to Dandāsana by releasing your legs.
Work carefully in case of:
Shanmukhi mudra appeared in the yoga therapy series for Migraine as well.
It is of excellent help to Dysmenorrhea sufferers too.
-Sit in any comfortable meditation asana.
-Hold the head and spine straight. Close the eyes and place the hands on the knees. Relax the whole body.
-Raise the arms in front of the face with the elbows pointing sideways.
-Close the ears with the thumbs, the eyes with index fingers, the nostrils with the middle fingers and the mouth by placing the ring and little fingers above and below the lips.
-Release the pressure of the middle fingers and open the nostrils.
-Inhale slowly and deeply, using full yogic breathing. At the end of inhalation close the nostrils with the middle fingers. Retain the breath inside for as long as is comfortable.
-Try to hear any manifestation of sound in the region of bindu, ajna or Anahata chakras. There may be many sounds or none at all; just listen. After some time, release the pressure of the middle fingers and slowly breathe out. This is one round.
-Breathe in again immediately to start another round. Continue in this way throughout the practice.
-To end the practice, lower the hands to the knees, keeping the eye closed and slowly begins to externalize the mind by becoming aware of external sounds and the physical body.
Duration: Practice for 5 to 10 minutes to begin with. Then, gradually building up over a period of a few months, increase to 30 minutes.
Note: Expert guidance advised.
Bhramari Pranayama (Humming Bee)
One of the really effective methods one can use in case of Dysmenorrhea is Bhramari Pranayama. This technique helps reduce anxiety, improves sleep and even strengthens the nerves. It is helpful in reducing pain during menstrual cramps.
Avoid if you suffer from
Avoid practicing while lying down.
Technique: Sit in any comfortable meditative position with spine uplifted. Do natural breathing and bring the awareness to the breath. Gradually bring the awareness to the throat. Watch the breath there. Inhale a full yogic breath through both nostrils. Lift the arms and insert the index or middle fingers into the ear holes, or leave hands in Chin mudrā. Exhale and make a humming sound, slowly increasing the volume and lengthening the exhalation. Afterward, recognize the resonance throughout the head, face, etc.
Vipareeta Karani Mudra
Vipareeta = inverted;
Karani = one who does
Women are the biggest benefiters of this mudra. It helps one manage stress and menstruation related problems. Women suffering from Dysmenorrhea should practice it, as they will see tremendous improvement in their condition.
Regular practice is advised. However, it should be avoided during menstruation.
-Assume the inverted posture of vipareeta karani asana. Keep the legs straight and together; tilt them slightly over the head so that the eyes look straight up at the feet.
-Close the eyes and relax the whole body. Fix the awareness at Manipura chakra in the spine, directly behind the navel. This is the starting position.
-Inhale slowly and deeply with Ujjayi Pranayama. Feel the breath and consciousness moving from Manipura to vishuddhi chakra situated in the spine, behind the throat pit.
-While exhaling, maintain the awareness at vishuddhi.
-At the end of the exhalation, immediately bring the awareness back to manipura and repeat the same process.
-Continue for as long as the asana can be comfortably maintained.
Practice 5 to 7 rounds or until discomfort arises. If pressure builds up in the head, end the practice. Gradually increase the number of rounds up to 21 over a period of months. The length of the inhalation and exhalation will increase spontaneously over time as the practice becomes more comfortable.
In case of difficulty in assuming the Vipareeta Karani asana, you may take the support of a wall.
People suffering from high blood pressure, heart disease, enlarged thyroid or excessive toxins in the body should not perform this practice.
With this, we end the yoga therapy series for Dysmenorrhea.