Ayurveda
 
Hindu View of Menstruation- V: Menstruation in Ayurveda

Fifth part of the series to present the Hindu view on menstruation. It deals with how Ayurveda perceives menstruation.

@nkgrock
Indology | 25-07-2016

In the previous articles, we successively saw how Hinduism associates menstruation with Ashaucha, austerity, self-purification, rest, and sacred celebration. We also saw about how Yoga philosophy perceives menstruation. In this article, we will deal with what Ayurveda speaks about menstruation.

Ayurveda is a health and medicine system, which is prevalent across India for many thousand years. This indigenous health and medicine system, similar to other indigenous knowledge systems, is intrinsically connected to Hindu philosophy, religion, and culture. Thus, the roots of Ayurveda is in Sanatana Dharma and it is considered as one of the Upaveda- supplementary systems of knowledge attached to the four Vedas.

Ayurveda recognizes menstruation as a physiological process and like other physiological process, it is also governed by the actions of the Doshas.

According to Ayurveda, each individual has a particular temperament and constitution (Prakriti), which is formed during the union of sperm and ovum itself. The Prakriti of an individual depends upon the working of these Doshas and Ayurveda classifies people into different Prakriti categories based on the Dosha, which is predominant in a person. Doshas are three in number: Vata (related to movement), Pitta (related to digestion), and Kapha (related to cumulation) and their mutual action causes various physiological functions within the human body. Based upon, which Dosha is predominant in an individual, people are classified into three categories of Prakriti– Vata, Pitta and Kapha. Ayurveda defines health and illness of a person based on whether there is a balance or imbalance in the working of the Doshas, and whether the workings of Doshas in an individual at any given time are in sync with his Prakriti or not.

Now, coming to the process of menstruation, Ayurveda divides the entire monthly cycle into three phases: Ritu-Kala, Ritu-Vyateeta-Kala, and Rajahsrava-Kala and each of these phases are predominated by a different Dosha. Ritu-Kala refers to the proliferative phase during which follicles inside the ovaries develop and mature in preparation for ovulation. This phase is considered to be of a duration of 12-16 days and is dominated by Kapha Dosha, which governs regeneration and growth. Ritu-Vyateeta-Kala refers to the Secretory Phase, wherein various hormones and nutrients are secreted in anticipation of nourishing the conceptus (the embryo) if conception were to take place. This phase will exist for a duration of 9-13 days and is dominated by Pitta Dosha, which governs all secretion activities in the body. Rajahsrava-Kala is the actual phase of menstruation, wherein the menstrual blood along with the endometrium is shed from the body. This phase exists for a duration of 3-5 days and is predominated by Vata Dosha (and the Apana vayu), which governs all movement within the body [1].

The workings of these three Doshas will determine whether a woman will undergo normal menstruation process or abnormal menstruation process. Ayurvedic texts define normal menstruation [2] as one which is not associated with pain or burning sensation, excreted blood is not unctuous, not very scanty or excessive in amount, and the color of the blood resembles the red juice of lac, rabbit’s blood. This normal menstruation occurs when the three Doshas exist in a proper balanced state and any imbalance in them will cause abnormal menstruation.

A Vatika menstrual flow, for example, will be accompanied by pain. This is so because, the presence of Vata in excess, will result in its Sheetha and Khara qualities to cause constriction of blood vessels, which in turn will result in very less menstrual discharge and will also obstruct the free flow of Vata, thus causing pain. On the other hand, a Paittika menstrual flow will result in heavy bleeding and the Pitta Dosha will cause swollen breasts, acne, etc.  Kapha Dosha is by nature dull, heavy and sticky and hence a Khaphaja menstrual flow will cause heavier flow with clots in the menstrual blood. It is to be noted that all these external symptoms of pain, scanty flow, excess flow, etc. are considered signs of abnormal flow.

Sushruta Samhita (Sharirasthana 2.4) says that disturbed Arthavam (i.e. abnormal menstruation) caused by the disturbed Vayu (i.e. Vata), Pittam, Khapha, and blood, either severally or in combination of two or more Doshas, will hamper the ability of a woman to conceive. It classifies abnormal menstrual flow into those in which flow is excessive (Asrigdara) and those in which the flow is suppressed (Amenorrhoe) and suggests treatment for both conditions (Sharirasthana 2.19-23). It further states that among the various kinds of abnormal menstruation, those which “smell like a putrid corpse or fetid pus, or which is clotted, or is thin, or emits the smell of urine or fecal matter, should be deemed as being beyond remedy, and the rest being amenable (Sharirasthana 2.4).” [3]

Further, as mentioned before, each person will have his own Prakriti depending upon the predominance of the Doshas and as a result, each woman is susceptible to develop different abnormal conditions due to imbalance of Doshas. Thus, a woman with Vata Prakruti is more likely to develop pain during menstruation. Similarly, a woman with Pitta Prakruti is more susceptible to mood variations and a woman with Kapha Prakriti is likely to have more clots in their menstrual blood. [4]

From the above, it is clear that an imbalance in the Doshas will lead to an imbalance in the menstruation process, which would in turn affect the health of a woman, including her capacity to conceive. Add to this the fact that the drastic physiological and psychic changes that a menstruating woman experiences, makes her more vulnerable to various diseases during her periods. Further, the imbalance of the Doshas may affect the health of the child conceived during Ritu-Kala. Considering all these factors, Ayurveda has prescribed a mode of life to be adopted by menstruating women –a series of Do’s and Don’ts– called as ‘Rajaswala Paricharya’, which aims to protect the health of the menstruating woman and prevent any health defects in the child, in case any conception happens.

Charaka Samhita (Sharirasthana 8.4) says: “After the onset of menstruation, for 3 days and nights, the woman should observe celibacy, should sleep on the ground, take food with hands from an unbroken utensil and should not cleanse her body in any way [5].”

Similarly, Sushruta Samhita (Sharirasthana 2/25) says: “A woman in her menses should lie down on a mattress made of Kusha blades (during the first three days), should take her food from her own blended palms or from earthen sauces, or from trays made of leaves. She should live on a course of Habishya diet and forswear during the time, even the sight of her husband. After this period, on the fourth day she should take a ceremonial ablution, put on a new (untorn) garment and ornaments and then visit her husband after having uttered the words of necessary benediction [6].”

The Ayurvedic texts stress that intercourse during menses should be avoided, because if a child is conceived (its possible, though less likely) from such an intercourse, then such a child may suffer intra-uterine death or death within few days of the birth, or if alive, then suffer from some deformity [7]. Ayurveda further elaborates on Do’s and Don’ts that must be followed during menstruation and how the long-term practice of prohibited elements of Paricharya, may have harmful effect on the child, which may be conceived during Ritu-Kala. Here is a Table-1, which summarizes various Do’s and Don’ts of the Rajaswala Paricharya, along with the harmful effect on the conceived child, if prohibited elements are practiced for a long time [8]:

SI NO Do’s during menstruation Don’ts during menstruation Abnormalities in Child if Don’ts are performed
1. To observe celibacy during the first three days of menstruation Sleeping during day time Over Sleepy
Use of Collyrium Blind
Weeping, Crying Visual Disturbances
2. Sleep on Kusha Mattress Bathing and Annointment Miserable
Massage Skin disorders
3. Should eat meal made of ghee, Shali rice, and milk; or meal made of barley Nail Pairing Deformity in nails
Running Reckless, indecisive
4. To eat food directly taking over palm, or in clay utensils, leaves Laughing Discoloration of teeth, lips and tongue
Indulging in long conversations Over talkative
5 To take food in less quantity Listening to various topics Deaf
Combing Bald
6 Concentrate on auspicious things Nasal instillation of medicine Menstrual abnormalities in female child
Exposure to wind, Fatigue work Mental illness

Table-1: Do’s and Don’ts prescribed in Ayurvedic Rajaswala Paricharya, along with abnormalities in child if prohibitions are not implemented by menstruating women over long period.

Some of these restrictions may seem odd and we may wonder whether there a scientific basis for these Do’s and Don’ts. Later on we will also look at a scientific study, which examines the practical usage of Rajaswala Paricharya and how it alleviates menstruation-related problems. But, first, to properly understand what the Ayurveda says about the relevance of practicing Rajaswala Paricharya and how it helps a menstruating woman, as well as her child, which she may conceive in future, it is very vital to understand the physiological process of menstruation in the context of Paricharya. [9]

A comparison of Rajaswala Paricharya with Do’s and Don’ts prescribed during different medical conditions reveals that menstruation is first and foremost a naturally occurring purification (Shodhan) process, which helps to purify the body and restore health by removing impurities from the body. Thus, the mode of life prescribed for menstruating women is more or less same as those prescribed for people who have undergone Shodhan procedure as mentioned in Ashta-Mahadoshkar-Bhava. The Ashta-Mahadoshkar-Bhava are the eight activities, which are to be avoided during any Shodhan procedure performed in Ayurveda. The eight activities include: Talking in a loud voice, travelling in vehicles, excessive walking, sitting in one place for a long time, having food in ajeerna awastha, having non-prescribed food, sleeping during the day, and sexual intercourse. These prohibitions will help in preventing the vitiation of Vata and Kapha Dosha, restoring the strength of the body, and nourishing the Agni (digestive capacity) of the person. These eight prohibited activities during Shodhan process is similar to the prohibited activities prescribed for menstruating women (as given in Table-1), and hence they play a similar function in the case of menstruation as well. Therefore, it can be concluded that Paricharya prescribed for menstruating women will assist in the natural Shodhan process and will restore health to the menstruating women by preventing any imbalance in the Doshas and by nourishing the Agni.

Secondly, menstruation is a state of Agnimandya- a state of weakened internal fire- as a result of which menstruating woman experiences decrease in appetite. This state is common during all Shodhan procedures. To remedy this and rekindle the digestive fire, certain diets, which are simple and easily digestible, are prescribed to be maintained during Shodhana procedure. The diet mentioned during menstruation (meal made of ghee, Shali rice, etc.) is one such diet. Sticking to this diet along with other elements of Rajaswala Paricharya like not sleeping during day time, not doing exercises and activities of physical exertion, not anointing the body, etc. will help in rekindling the digestive Agni of the menstruating women and thus prevent unpleasant physiological conditions that may arise due to weakened digestive fire.

Thirdly, a menstruating woman is perceived as a person with a wound. This is because, the body sheds the lining of the uterus during menstruation, and thus indicating an active wound. As a result, the Paricharya prescribed for menstruating women includes elements that are prescribed during injury of a person (or during a surgery), so as to assist in fast and uninterrupted healing of the wound. Both menstruating women and injured persons are advised to consume light and easily digestible food, avoid intercourse, avoid sleeping during daytime, and avoid physical exertion.

From above, it is very clear that the purpose of various Do’s and Don’ts of Rajaswala Paricharya is to protect the menstruating women (who are susceptible to various diseases) by preventing the vitiation of various Doshas, by re-kindling the internal digestive fire, and by healing the internal injury. If Rajaswala Paricharya is not followed over a long period of time, then the imbalance in the Doshas, as well as the conditions like Agnimandya, may become a permanent condition, thus seriously affecting the health of the woman. This in-turn may also have harmful effects on the children she conceives.

There is a cause and effect relationship between factors like vitiation of Doshas, Agnimandya, etc. and various unpleasant symptoms experienced by women during menstruation. For example, pain in abdomen is clearly due to the hindrances to the free flow of Apana Vayu (i.e. Vata), thus causing the uterus to apply more pressure for expelling menstrual blood. This obstruction to flow of Vata, also causes cramps in calf muscles. Also, physical exertion leads to vitiation of Vata, which in-turn leads to weakness. Agnimandya causes increased frequency of motions. Vitiation of Kapha, Vata, and blood causes pimples. Similarly, abnormality in Rasa-Dhatu causes irritation, mood swings, and depression during menstruation. [9]

This cause-effect relationship also exists between vitiation of Doshas, etc. in the menstruating women and the deformity that one may observe in child conceived by such women. For, example, Rajaswala Paricharya advices menstruating women to not run, laugh loudly, or talk too much and says if these Don’ts are not followed, then the conceived child will be unsteady, have discolored teeth, or will be over talkative. This is so because, running, laughing, and talking too much during menstruation will result in vitiation of the Vata Dosha and if women persist with these activities during monthly period after period, then the vitiation of Vata Dosha may become a permanent condition, which will in-turn affect the health of the conceived child, when it is in the mother’s womb.  Similarly, if menstruating women sleep during day time, it will cause vitiation of Kapha and Pitta Dosha, which in-turn may result in her child developing characteristics like sleepiness, laziness, etc.; if they listen to loud music, it will vitiate Vata Dosha, and if persisted over long periods of time, it may affect the hearing capacity of the child conceived by such women; and if they apply bodily cream, oil, etc. which are contraindicated in Agnimandya, then such women may be hurting their internal Agni, which is persists, may cause skin disorders in children born to such women. [9] But, this does not mean that each and every woman, who does not follow Rajaswala Paricharya will end up having children who are either deaf, lazy, or have skin disorder. Instead, the gist is, the children born to such women are more susceptible to developing those unsavory conditions, because of their exposure to the vitiated Doshas, while they were in their mother’s womb.

The usefulness of the mode of life prescribed by the Ayurvedic Rajaswala Paricharya in protecting the health of the menstruating women and in ensuring that they undergo normal menstruation, without any pain and other unpleasant symptoms, has been scientifically established by at least one study conducted by Dr. Pallavi Pai, Dr. Sarita Bhutada, and Dr. Prasad Pandkar. Their study titled: ‘Rajaswala Paricharya: Effect on Menstrual Cycle and Its Associated Symptoms’ was published in IOSR Journal of Dental and Medical Sciences in February 2015 (Volume 14, Issue 2 Ver. II).

For the study, a sample of 30 unmarried females between 18 years and 24 years of age having regular menstrual cycle were selected. They were asked to practice Rajaswala Paricharya during the 3-days of their menstruation over six consecutive cycles and the effect of the practice on the menstrual symptoms experienced by them was noted and appropriate statistical tests were carried out. At the end of six months, the study found that there was not only a drastic reduction in the number of menstrual symptoms experienced by each woman, but there was also a drastic reduction in the number of women who experienced any given symptom.

The evaluation was carried out with respect to thirteen menstrual symptoms: Pain in lower abdomen (28, 3), Lower back ache (24, 2), Pimples (20, 5), Breast tenderness (1, 0), Cramps in calf muscles (13, 1), Loss of appetite (17, 6), Hot flushes (12, 5), Nausea/Vomiting (7, 1), Constipation/Increased bowel movements (8, 2), Increased frequency of micturition (6, 1), Weakness (25, 8), Headache/Migraine (11, 1), Excitability/Irritability/Depression (21, 2). The figures in the bracket denotes the number of people who experienced these symptoms before the study and at the end of the study, respectively.

The above figures clearly show how except for the symptom of breast tenderness, in the case of all other symptoms, there was a drastic reduction in the number of people who experienced those symptoms. The greatest reduction was observed with respect to lower abdomen pain, lower back ache, Cramps in calf muscles, depression, weakness, and pimples.

Similarly, each subject in the study experienced drastic reductions in the number of symptoms, they were afflicted with. The number of symptoms experienced by a single person before beginning of the study ranged from four to nine. At the end of the study, the maximum number of symptoms experienced by a single subject stood at four. At least 11 out of the 30 females reported zero symptom at the end of the study. Similarly, nine students reported experiencing one symptom, four students experiencing two and three symptoms, and just two students experiencing four symptoms.

Thus, a clear relief from menstrual symptoms was experienced by those women in the study within six months of practice of Rajaswala Paricharya. The fact that Paricharya was beneficial to these women can also be gauged by the fact that the compliance to various tenets of Paricharya among these women increased from an average of 76.10% to 86.66% during the study period.

An interesting point to be noted here is the fact that many of these tenets regarding menstruation practices prescribed in Ayurvedic texts, have also been prescribed in various Shruti and Smriti texts, thus establishing how health and medical considerations formed an inseparable aspect of Dharmic practices. It also goes to show how Ayurveda is integral to Sanatana Dharma as an Upaveda, with it highlighting the health aspect, whereas texts like Smriti highlights the Dharmic and social aspect.

In the next concluding part, we will look into Menstruation restrictions and attitudes.

References:

  1. Shweta V. Dabhade, A.A.Hawale, A conceptual study of rutuchakra, Ayurlog: National Journal of Research in Ayurved Science, Vol3, Special issue (16th Feb. 2015). [http://ayurlog.com/Archive/january_march/ssac/201502S060.pdf]. Also see: Jain Nishi, Joshi Anil Kumar, Analysis of Artava (Menstruation) in Context of Sharira Rachana, Ayushdhara, Vol 2, Issue 3 (May-June 2015)
  2. Shweta V. Dabhade, A.A.Hawale, A conceptual study of rutuchakra, Ayurlog: National Journal of Research in Ayurved Science, Vol3, Special issue (16th Feb. 2015). [http://ayurlog.com/Archive/january_march/ssac/201502S060.pdf]
  3. An English Translation of Sushruta Samhita, Vol2, Edited by Kaviraj Kunjalal Bhishagratna [https://archive.org/details/englishtranslati00susruoft]
  4. Amrutha.B.L, Menstrual Health And Ayurveda, International Ayurvedic medical Journal {online} 2016 {cited 2016 April} [http://www.iamj.in/posts/images/upload/602_605.pdf]
  5. Charaka Samhita: Handbook on Ayurveda, Vol1, Edited by Gabriel Van Loon [http://yousigma.com/biographies/Charaka%20Samhita%20%28Acharya%20Charaka%29.pdf]
  6. An English Translation of Sushruta Samhita, Vol2, Edited by Kaviraj Kunjalal Bhishagratna [https://archive.org/details/englishtranslati00susruoft]
  7. Sushruta Samhita (Sharirasthana 2.31), Kashyapa Samhita (Sharirasthana 5.5)
  8. The Table-1 has been compiled using information present in various Ayurvedic texts, especially Sushruta Samhita. The table has been reproduced with minor changes from: Dr. Jasmine Gujarathi,Dr. Dilip Jani and Dr. ARV Murthy, ‘Prevalence of Menstrual Related Taboos in Special Context with Ayurvedic Rajaswala Paricharya in Young Girls’, Rasamruta, 6:4, February 2014 [https://www.researchgate.net/publication/260267973_Prevalence_of_Menstrual_Related_Taboos_in_Special_Context_with_Ayurvedic_Rajaswala_Paricharya_in_Young_Girls]
  9. The comparison between Rajaswala Paricharya and do’s and don’ts during Shodhana, Agnimandya and injury conditions have been taken from: Dr. Pallavi Pai, Dr. Sarita Bhutada, Dr. Prasad Pandkar, ‘Rajaswala Paricharya: Effect on Menstrual Cycle and Its Associated Symptoms’, IOSR Journal of Dental and Medical Sciences, Volume 14, Issue 2 Ver. II (Feb. 2015). [http://www.iosrjournals.org/iosr-jdms/papers/Vol14-issue2/Version-2/R014228287.pdf]

Image Credit- ayurvedatrip.com

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