In a woman's life, the point of entry of a girl into womanhood is marked by the onset of menstrual cycle called as menarche. A girl experiences lots of physical as well as emotional changes during this period of life, which generally starts at the age of 12-13 years.
Physical changes in the body during menarche
On the onset of puberty, a girl experiences a lot of physical changes such as feminization of voice, growth of hair on vulva, and armpits, enlargement of the breasts, the broadening of buttocks and chest, imparting the particular shape to the body of the woman, which takes place to ensure easy pregnancy and normal child birth in future. The main change that takes place is the monthly menstrual flow marked by the passage of blood flow for the period of 4-5 days per vagina, which is occasionally accompanied by mild to severe backache or cramps in legs and spasmodic pain in the abdomen known commonly as the menstrual cramps.
As the girl enters the first step of the womanhood, the first emotional change is the physical as well as emotional attraction towards men. This is also the part of nature's planning to forward the meeting of the two sexes in order to continue the existence of the human race by means of reproduction.
Another emotional fluctuation that an adolescent girl experiences is the otherwise unexplainable emotional stress, 4-5 days before the expected monthly periods, known as the premenstrual syndrome (PMS). This happens due to the sudden changes in the blood levels of the female hormones, viz., estrogen as well as progesterone. The main symptoms are headache, nausea, gain in weight, and tenderness of breasts, associated with mood fluctuations such as irritability, depression, or hyper excitation.
If the emotional disturbance preceding the periods remains limited to the mood fluctuations, it can be controlled with proper diet such as low fats and carbohydrates and restriction of salt and water intake, taking adequate rest along with psychological counseling. Some times the syndrome is accompanied by episodes of epileptic fit, and lowered blood sugar, causing physical damage. Such cases should be treated with appropriate hormone replacement therapy under the specialist's guidance.
It is advisable to follow certain rules of diet and deeds in order to avoid a painful menstrual cycle.
• During the premenstrual period, i.e., during 4-5 days before the expected periods, one should avoid eating very spicy and deep fried food items. This helps in keeping the Vata Dosha in a balanced position and hence in avoiding severe spasmodic abdominal pain (menstrual cramps).
• Personal hygiene is of prime importance especially during the menstrual periods.
• In case of constipation, mild laxative such as powder of three myrobalans (Triphala powder) should be taken in the dose of 1 tsp. At night along with warm water.
• Excessive physical stress such as exercises, or any other heavy work should be avoided to avoid excessive bleeding and pain during the periods.
• In case of severe pain in abdomen or back, hot water fomentation should be taken along with the home remedies like asafetida powder in the dose of 125 -250 mg. Along with warm water.
Some women experience mild to moderate lower abdominal pain during the 13th - 15th day of the menstrual cycle, some times accompanied by blood spotting. This is because of the liberation of the egg into peritoneal cavity and no treatment is required for this condition.
Description of normal menstrual cycle as per Ayurveda
Ayurveda describes these hormones, the entire physiological system of woman and the menstrual flow with different terms like Artava, Shonita, and Rajah. The monthly menstrual cycle starts at around the age of 12-13 years marking the onset of fertility period of the woman's life, which goes on till the menopause taking place around the age of 50-55 years. The period of maximum fertility each month is marked by rupture of the egg from either of the ovaries (this process is known as ovulation), during the 12-18th day of each menstrual cycle. The egg remains alive for 48 hours and if not fertilized during this period, degenerates.
Ayurveda also describes that some women, inspite of having regular menstrual cycles, might be infertile as their cycles are devoid of Antah-pushpa, i.e. formation of the egg. When the bleeding per vagina during each menstrual cycle is normal is bright red in color and is free of foul smell. The total quantity of blood lost during each normal cycle is around 50 to 60 ml. When a woman conceives, this monthly flow stops and starts again after delivery. When menstrual blood flow is altered either in quality or quantity, it is considered as abnormal and needs investigation and treatment. For example, absence of monthly periods is known as amenorrhoea, excessive bleeding and irregularity of periods as menometrorrhagia and painful menses as dysmenorrhoea, all of which require thorough investigation and treatment.
Disorders during puberty and menstruation
The normal menarche (onset of menstruation) starts at the age of 13-14 years. This happens because of the timely release of various hormones from the pituitary gland and from the ovaries.
• If, due to some congenital (present at birth) or acquired cause, this hormonal secretion is inadequate, it might cause a delay in the onset of menstrual periods. The hormonal imbalance can be treated in most of the cases by supplying the patient with artificial hormones in the form of tablets or injectable medicine.
• Sometimes, there is some structural defect in the genital tract, such as congenital absence of ovaries or uterus, which causes delayed menarche. These are not treatable. However secondary sex characters (like breasts and feminization of voice) in these patients can be developed by artificial hormone therapy. Such patients suffer from life long sterility (incapable of conception).
• Another important cause of the delay of menarche is congenital genetic defect giving rise to complex conditions like inter sex, which have limited remedy, even after complicated medical and surgical therapies.
• As all the above-mentioned disorders are of different etiology (origin) and present themselves with different clinical features, the line of treatment also differs in different types and in different persons.
• Ayurveda offers purification therapy or Panchakarma as main line of treatment in congenital diseases. This includes enemata with various medicated oils, or with medicinal infusions and decoctions.
• Vaginal douche is also advised using decoctions and cold infusions of medicinal herbs to cleanse the infected uterus and vagina.
• Internal medicines comprise of the rejuvenators like Shatavari (Asparagus recemosus), Ashwagandha (Withania somnifera), Bala (Sida cordifolia) and herbs, which specifically act on female reproductive system, such as Ashoka (Saraca indica), and Lodhra (Symplocos recemosa).