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Dysmenorrhoea, a medical term for painful periods, or menstrual cramps, pertaining to pain during menstruation. This, the most common menstrual disorder, occurs in 20% to 90% of women of reproductive age.

Symptoms of Dysmenorrhoea Pain

Symptoms of dysmenorrhea often begin immediately after ovulation and can last until the end of menstruation because it is often associated with changes in hormonal levels in the body that occur with ovulation.The cramping and pain usually start a day or two before the period begins with the most severe discomfort occurring on the first day of menstruation.

The main symptoms often co-occurring with menstrual pain include:

• Throbbing pain in the lower abdomen or pelvis, and radiate pain to the lower back and thighs.
• Nausea and vomiting
• Diarrhoea or constipation
• Headache, dizziness, disorientation
• fainting and fatigue
• Hypersensitivity to sound, light, touch and smell
• Angry outbursts
• Menstrual migraines
• Social withdrawal
• Frequent urination
• Altered bowel habits like diarrhoea or constipation
• Heart palpitation and sweating can also occur due to anxiety and hormonal changes.
• Heavy bleeding periods

Symptoms like heaviness, fullness and painfulness of breasts or/and abdomen may occur before and during the periods.

Causes of Dysmenorrhoea:

• Excess oestrogen level in blood
• Fluid retention. Vitamin B6 deficiency
• Progesterone hormone deficiency
• Thyroid abnormality
• Hypoglycaemia (reduction of blood glucose level)
• Serotonin deficiency
• Endometriosis
• Ovarian cyst
• Scoliosis
• Adenomyosis

One can experience relief by restricting alcohol and caffeine consumption, since alcohol is a depressant and diuretic that can worsen PMS headaches and fatigue and can accentuate depression. Caffeine, on the other hand, is a stimulant, and can contribute to anxiety, irritability and painful breast tenderness. Diet rich in calcium and vitamin B6 during PMS may also help reduce water retention and alleviate bad moods. The highest sources of calcium are milk and milk products like yogurt, ice cream and cheese. But make sure you choose low-fat options. Also, one can get calcium from vegetables such as broccoli, dark greens (like turnip greens), green or red cabbage (raw). Foods rich in vitamin B6 include bananas; baked potatoes; legumes such as soybeans and lentils.

Many women have food cravings during PMS, and the cravings usually focus on sweets and snacks such as ice cream, chocolate and potato chips. Eating complex carbohydrates is probably the best way to ward off those food cravings. These foods are a good source of fibre, which helps to clear excess oestrogen from your body. High levels of oestrogen have been shown to contribute to PMS. Also high-carbohydrate foods relieve the psychological symptoms of tension, anxiety and mood swings that accompany PMS.

Home remedies-

• Applying heat on the lower abdomen is the easiest way to control menstrual cramps and relaxing the contracting muscles in the uterus. It can be done either using a regular plastic bottle filled with hot water or taking a hot shower.

Natural home remedy using flaxseeds

• Eat 2 tbsp of flaxseeds every day during periods
• This reduces prostaglandin levels in the body

Using ginger, honey, lemon and tea

• Prepare black tea
• Add to it ½ tsp of crushed ginger
• Add 2 tsp lemon juice
• Add 1 tsp honey
• Drink this tea at regular intervals during the day

Basil leaves

• Crush a handful of basil leaves
• Press the paste on a sieve to extract juice
• Take 1 glass hot water
• Add 2 tsp basil leave juicee
• Mix well
• Drink thrice everyday

Cinnamon

• Make cinnamon tea by stirring one-fourth teaspoon of cinnamon powder into a cup of hot water.
• Let it sit for up to five minutes, add a little honey and then sip it slowly.
• Drink 2-3 cups of cinnamon tea one to two days before your period starts to prevent cramps

Fennel

• Add one teaspoon of fennel seeds to a cup of boiling water.
• Simmer the mixture on low heat for five minutes.
• Remove from heat and strain the tea.
• Add one teaspoon of honey and mix well.
• Drink this herbal tea 2 times daily beginning three days before the expected start date of your cycle.

Papaya

• A potent anti-inflammatory agent, papaya is very helpful in treating menstrual cramps.
• Also, it has nutrients like carotene, iron, calcium and vitamins A and C that help soothe the uterine walls and ease muscle contractions.

Ayurvedic cure –

• Rajah pravartanivati
• Ashokarishta
• Kumaari-aasava

“There is no better feeling that the movement of life inside of you”–let’s make pregnancy easy together.
Pregnancy and motherhood are the most eulogized concepts of all times, and in all cultures universally. Women have always been looked up to with awe because of this wonder of being able to bring another being into this world. The practice of yoga can help you prepare your mind and body for labour and birth as this helps you focus, concentrate and keep you healthy. Doing yoga postures is a gentle way of keeping your body active and supple and minimize common pregnancy symptoms like morning sickness and constipation. It can also help in ensuring easier labour and smooth delivery by relieving tension around the cervix and birth canal and by opening the pelvis.

12 Yoga poses for ladies during pregnancy -

The following Yoga poses can help you deal with symptoms of pregnancy, ensuring smoother and easier delivery, and faster recovery after childbirth.

• Sukhasana
• Marjariasana
• Vajrasana with ujjayi breath (Adamantine pose with Victory breath)
• Tadasana (Mountain pose)
• Konasana - 1 (Standing sideways & bending one arm)
• Konasana- 1 (sideways bending using both arms)
• Trikonasana
• Veerbhadrasana
• Paschimottanasana
• Badhakonasana
• Viparitakarni
• Shavasana

Some of the benefits of practicing yoga during pregnancy include-

• Develops stamina and strength- As baby grows within our body, more energy and strength is needed to be able to carry the weight. Yoga poses strengthen our hips, back, arms and shoulders.
• Balance - Our balance is challenged physically as the foetus grows within our body. Emotionally we are drained due to the increases in progesterone & estrogen levels. As we try to focus on holding and breathing through each yoga pose, we are able to fine tune our balance, physically and emotionally.
• Relieves tension of lower back, hips, chest, upper back, neck and shoulders - As baby grows, more stress is put upon these specific muscle groups in our bodies. We tend to have more of a lordtic/lower back curve due to the increased size of bellies. Our hips get tighter due to the added pressure of baby's weight in our bellies. As our breasts increase in size, our upper back and chest have more tension, along with our neck and shoulders.
• Calms the nervous system – Through deep breathing, the nervous system goes into parasympathetic mode, which is responsible for relaxation. When our bodies are in that mode, our digestions operate properly, we tend to sleep better, and our immune system is at its optimal.
• Preparation for Labor - You are working with conscious breathing during each yoga pose, which may sometimes be challenging. This transfers into the time of labor, allowing one to practice being "comfortable with the uncomfortable" through our breathwork. As you inhale, you acknowledge the tension that is felt. As you deeply exhale, you let go of it more and more with each breath.
• Connection with baby - A prenatal yoga practice allows us to slow down and focus attention on what is going on within our bodies. Through working with our breath and doing each pose, you become more aware of what is going on within.
• Increases circulation - Circulation is enhanced within our joints and our muscles are elongated during practice. Upon circulation of the blood within our bodies, swelling is decreased and our immunity is enhanced, creating a healthy environment for a thriving baby.
• Breathwork practice - This is a good tool for labor during contractions. If we are consciously breathing, our blood pressure and heart rate is regulated keeping us in parasympathetic/relaxation mode. Calm mama equals calm baby.
• Sense of community/sisterhood - It can be very comforting to be with a group of women who understand what we are going through.
• Nurturing time - This time allows us to stop and slowdown from our busy days. Through the practice of yoga, you are setting intention in taking care of not only yourself, but of baby.

Yoga precautions for pregnant women -

• Poses that put pressure on the abdomen and other difficult poses should not be done during advanced stages of pregnancy.
• For the first trimester, standing Yoga poses are advised as this will help strengthen the legs, enhance circulation, generate energy, and may reduce leg cramps. During the second and third trimester, you may reduce your time spent for practicing the asanas to prevent fatigue and overwork. Instead, focus more on breathing and meditation.
• Also, it is not advised to practice from the tenth through the fourteenth week of pregnancy since these are crucial times.
• Do not overstretch the abdomen; the emphasis of your twisting poses should be on the shoulders and the upper back and not on the abdomen. Avoid doing inversion poses.
• Konasana - 1 (Standing sideways & bending one arm)
• You do not have to do all these asanas and remember to listen to your body and just do as much as you easily can.

Healthy Food and lifestyle

Follow a healthy and balanced diet:

• During pregnancy it is important to continue to eat a healthy balanced diet. Aim to eat a healthy diet(which everyone should be eating, not just pregnant women). Briefly, a third of most meals should be starch-based foods (such as bread, cereals, potatoes, rice, and pasta), with fruit and vegetables. Eat plenty of fibre, which can be found in wholegrain breads as well as fruit and vegetables. Eat some protein foods such as meat, fish, pulses, chicken, etc, every day. Choose lean meat, cut the fat off red meat and the skin off chicken. Try to avoid adding fat - for example, by not frying food where possible.
• Include foods with plenty of iron, calcium and folic acid - a growing baby needs these nutrients right from the start of the pregnancy:
  1. Iron is mainly in red meat, pulses, dried fruit, green vegetables and fortified cereals.
  2. Calcium is mainly in dairy products such as milk, cheese, and yoghurt. (Low-fat milk, cheeses and yoghurts usually contain just as much calcium as the full-fat varieties.)
  3. Folic acid is mainly in green vegetables, brown rice, and fortified cereals.

Vitamins and supplements

• Folic acid - You should take folic acid tablets (supplements). Ideally, start taking folic acid tablets before becoming pregnant. The common advice is to start from the time you stop using contraception. If the pregnancy is unplanned then start taking folic acid tablets as soon as you know that you are pregnant.
• Food Sources :- found in spinach, sprouts, broccoli, green beans and potatoes. Some bread and breakfast cereals are fortified with folic acid.
  Vitamin D: - is needed for growth and supplements are recommended for all pregnant women, breast-feeding women and breast-fed babies.Best source is sunlight.
  Iodine - Iodine is known to be important for the healthy development of the brain of the foetus. A woman who is pregnant needs more iodine than usual to supply the developing foetus. If they do not have enough iodine, the baby may end up less intelligent than they otherwise would. Sources:milk, yogurt, eggs and fish,Iodised salt, etc.

Exercise

For most women, it is important to do some regular physical activity during pregnancy as part of living a healthy lifestyle. In most cases, moderate physical activity during pregnancy is safe and can have benefits for both you and your baby and should not harm either of you.You should aim to do a mixture of both aerobic physical activity and muscle-strengthening physical activity everyday at least 30 minutes is recommended.

Precautions which should be taken during pregnancy - You should not eat the following if you are pregnant:

• Anything with a lot of vitamin A-So, avoid liver and liver products and vitamin tablets/supplements.
• Food which may have high levels of listeria(like Undercooked meats and eggs, mould-ripened and soft cheeses and pasteurised milk), which may cause miscarriage, stillbirth or infections in the baby after birth.
• Limit the amount of caffeine to no more than 300 mg per day.Having a lot of caffeine increases your risk of having a miscarriage and a baby with low birth weight.

Medication

The effects of some prescribed medicines are safe in pregnancy.However, for many medicines, we do not know for sure if they are safe or unsafe. So if you are pregnant, you should minimise your use of medication. Always tell a doctor or dentist who prescribes medication for you that you are pregnant.

• Paracetamol at normal dose is safe and useful for headaches, backache and other aches and pains that may occur during pregnancy.
• Anti-inflammatory painkillers such as ibuprofen should not be taken normally during pregnancy as it can affect the large blood vessels of the developing baby.
• Laxatives - Constipation is common in pregnancy and you may need a laxative.It is best to try increasing the fibre in your diet and increasing the amount of non-alcoholic fluids that you drink.
• Antihistamines: Advised to avoid antihistamines because there are no trials to show they are safe.
• Decongestants such as pseudoephedrine and xylometazoline often bought for symptoms of the common cold should be avoided in pregnancy.

Recreational (illicit) drugs -

It is safe to assume that if you use recreational drugs, it is likely to pose a risk to the unborn child. If you intend to become pregnant you should aim to stop taking or using recreational drugs.

Smoking :- Smoking when you are pregnant gives a higher risk of:

1. Having a miscarriage
2. Having a pregnancy which does not develop in the normal place (ectopic pregnancy)
3. Slow growth of the baby leading to a low birth weight.
4. Premature labour
5. Bleeding towards the end of pregnancy due to placental abruption.
6. Stillbirth.
7. Abnormalities such as a cleft lip or palate
8. Even after the birth, children of smoking parents have an increased risk of:
   • Chest infections.
   • Asthma.
   • Glue ear.
   • Cot death (sudden infant death syndrome).
   • Doing less well at school.
   • Behavioural problems such as attention deficit hyperactivity disorder (ADHD).

Alcohol

Women who are pregnant should not drink alcohol because it can cause damage to a developing baby. Alcohol gets to a baby through the placenta if a pregnant woman drinks alcohol. A baby cannot process alcohol very well. So, any alcohol in your baby stays in its body much longer than in you. This is known to be a risk for causing serious problems. At worst, babies can develop a syndrome of severe abnormalities, called foetal alcohol syndrome(poor growth, premature labour and physical and mental disability).

Sex

Sex is safe for most couples during pregnancy. Later in pregnancy, sex and orgasm may provoke contractions known as Braxton-Hicks contractions. These make your bump feel hard. They can be uncomfortable but are quite normal. They usually pass after a few minutes. Your doctor or midwife may advise you to avoid sex if any problem occurs.

Working during pregnancy

If you think that your job may pose a risk to a pregnancy, then ideally you should discuss this with your employer before you become pregnant or as soon as you become pregnant.

Animals

Avoid contact with sheep and lambs at lambing time. This is because some lambs are born carrying the germs that cause listeriosis, toxoplasmosis and chlamydia. Toxoplasma is also found in cat poo. You should always wash your hands after handling cats and kittens and ask someone else to wash out cat litter trays.

Travel

In general, it is safe to travel during pregnancy. When in a car, wear the seat belt so that the straps go above and below your bump, not across it. Flying is not known to be harmful. (Most airlines will not allow you to fly in the late stages of pregnancy). Don't travel to anywhere too remote and far from medical assistance, particularly in the early or later stages of pregnancy.

Understanding PMS

Highlights -

• Common symptoms of PMS include anxiety, depression, acne, fatigue, and headaches.
• Premenstrual dysphoric disorder (PMDD) causes severe symptoms, such as suicidal thoughts and insomnia.

Premenstrual syndrome (PMS) is a condition that affects a woman’s emotions, physical health, and behaviour during certain days of the menstrual cycle, generally just before her menses. Are you one of those women for whom having a period is almost torture?And this happens on a regular basis. Your head aches, your stomach cramps, your tummy feels bloated, you feel like crying for no apparent reason, and you bite everyone’s head off at the slightest provocation. Most of all, you hate it when people shrug and patronizingly mouth, “PMS!”.

The onset of menstruation signifies that a girl has stepped across a biological threshold into puberty. For some women, menstruation is merely an inconvenience. Others really dread “that time of month.” The latter are usually women who are plagued by premenstrual syndrome (PMS). For these women it is not the five days of actual menstruation that bothers them so much as the symptoms of PMS that manifest themselves any time from two to ten days before menstruation begins.

Many researchers believe that it’s related to a change in both sex hormone and serotonin levels at the beginning of the menstrual cycle. Levels of estrogen and progesterone increase during certain times of the month. An increase in these hormones can cause mood swings, anxiety, and irritability. Ovarian steroids also modulate activity in parts of your brain associated with premenstrual symptoms. Serotonin levels affect mood. Serotonin is a chemical in your brain and gut that affects your moods, emotions, and thoughts.

The symptoms of PMS include: -

• abdominal bloating & pain
• sore breasts
• acne
• food cravings, especially for sweets
• constipation
• diarrhoea
• headaches & sensitivity to light or sound
• fatigue
• irritability & changes in sleep patterns
• anxiety
• depression
• sadness & emotional outbursts

Aadness & Emotional Outbursts -

If you have a mild or moderate form of premenstrual syndrome, the treatment options include:

• Drinking plenty of fluids to ease abdominal bloating.
• Eating a balanced diet to improve your overall health and energy level, which means eating plenty of fruits and vegetables and reducing your intake of sugar, salt, caffeine, and alcohol.
• Taking supplements, such as folic acid, vitamin B-6, calcium, and magnesium to reduce cramps and mood swings. Vitamin B6 also helps in reducing premenstrual tension and water retention.
• Taking vitamin D to reduce symptoms.
• Sleeping at least eight hours per night to reduce fatigue.
• Exercising to decrease bloating and improve your mental health.
• Try to avoid stressful situations.
• Going to cognitive behavioural therapy, which has been shown to be effective.

Severe PMS: premenstrual dysphoric disorder -

Severe PMS symptoms are rare.PMDD affects between 3 and 8 percent of women. This is characterized in the new edition of the Diagnostic and Statistical Manual of Mental Disorders.

Symptoms include –

• Depression
• Thoughts of suicide
• Panic attacks
• Extreme anxiety
• Anger with severe mood swings
• Crying spells
• headaches & sensitivity to light or sound
• A lack of interest in daily activities
• Insomnia
• Trouble thinking or focusing
• Binge eating
• Painful cramping
• Bloating

Long-term outlook -

PMS and PMDD symptoms can recur, but they typically go away after the start of menstruation. A healthy lifestyle and a comprehensive treatment plan can reduce or eliminate the symptoms for most women.

Ayurvedic Supplements –

• Shatavari
• RajapravartiniBati