Ann Vlass discusses how she views common menstrual symptoms and syndromes as imbalances from our natural flow, and how she rectifies and treats the cause using remedies and therapies of opposite qualities.

Life, with its continual spiral of change, is a delicate balancing act where everything is trying to flow in relation to all other things. Ayurveda medicine describes this equilibrium as a co-existence of opposites, where we are capable of being dynamically active and in the flow of calm at the same time. This flow is simply being in harmony with nature’s balancing act – and nothing showcases this better than the female menstrual cycle which, when in its healthy state, fluctuates in a delicate, cyclical and harmonious flow alongside nature’s cycles.

Embracing change

The most important and empowering aspect to the menstrual cycle I try to explain to my clients is that embracing our capacity to change is empowering and healthy, especially as a menstruating female where change is constant and inevitable.

The menstrual cycle is a beautiful cascade of endocrine and neurotransmitter events that effect physiological, emotional and spiritual change. Its central controller is the hypothalamus and pituitary gland, while the liver and gastrointestinal tract process and eliminate excess hormones and metabolites. When these events occur according to the endocrine blueprint, the cycle should progress without any major discomfort or problems. Changes are not the cause of the imbalance: instead, it’s our resistance to make necessary adjustments to the changes, and acting against our natural equilibrium

Your menstrual cycle is a good barometer of your overall health. A healthy, balanced cycle is uneventful, regular, lasting about 28 to 34 days without any spotting of blood. The bleeding should be a slightly translucent red, continuous flow lasting between three and seven days, that washes easily out of fabrics without staining. When internal and external factors disrupt the cycle, problems such as PMS, period pain, heavy periods, clotting, or scanty bleeds manifest.

Turning inward

Menstruation is a regenerative and fertility-enhancing cycle, which may have evolved as a means to protect the endometrium against sperm-borne pathogens and pelvic infections. The menses is composed of remnants of tissue and secretions, and other structures and products in the uterus and endometrium.

Classical Ayurveda states that menstruation removes the body’s metabolic wastes and toxins (ama) and is a time of reflecting and going inward. Traditional Chinese Medicine (TCM) takes a similar view, saying the energy of the body, mind, and spirit is turned inward while going through a cleansing process. Cleansing begins with an inflammatory cascade of prostaglandins, body chemicals that cause contractions of the uterus, bowel and blood vessels. Synchronised with the right balance of hormones, the prostaglandins tell the uterus muscle to contract and expel its lining and menses fluid.
During this time, we should regulate the energy force of the body, nourish the blood, support the cleansing and minimise any toxin load. Helpful foods include fresh vegetables like beets, eggplant, celery, cilantro, leafy greens; small beans like mung and adzuki beans; seaweed; figs; green apples; lemons; and warming ginger and chamomile teas to support the digestion. Apple cider vinegar taken with raw honey also assists digestion and alkalises the body.

Dosha power

Ayurveda classifies the body types, or doshas, as vata, pitta and kapha, which are nature’s biological energies made up from the five elements of air, ether, fire, water, earth. Each of us has a unique combination of these elements. When I work with menstrual and fertility issues, I observe the patient’s dosha, their constitution makeup, current body signs, and other information to select the appropriate advice, remedies, and food and spice therapies.

Each phase of the menstrual cycle is governed by a different dosha, each with its own set of symptoms. Kapha rules the first half of the cycle until ovulation, as the lining of the uterus thickens to prepare for a possible pregnancy. Pitta rules during the phase after ovulation, when the blood supply to the lining of the uterus increases. Vata increases if no egg is fertilised and implanted, prompting the uterus to shed its lining.

The amount and location of ama influences symptoms and menstrual cycle imbalances. This is caused by an accumulation of toxins and blockage of circulation arising from an improper diet, poor digestion, stress, irregularity, inadequate sleep-wake rhythms and toxic emotions. High levels of accumulated ama can cause fatigue and lethargy. Ama in the breast area can lead to breast tenderness, while its presence in the skin can cause blemishes and irritation. If you feel and look better after your period finishes, then ama is behind those symptoms, and a period of toxin-cleansing is necessary. The combination of symptoms varies for each woman, and from cycle to cycle.

Premenstrual syndrome (PMS)

PMS is an alteration in a woman’s physiology and emotional biology and can begin in the vata phase: any time after ovulation until menstruation. Experienced by 40 percent of women, PMS manifests in many forms such as anxiety, irritability, anger, depression, uncontrolled cravings, bloating, constipation, fatigue and fluid retention. Many theories attempt to explain the multifactorial causes of the disrupting fluctuations with oestrogen and progesterone. Some believe PMS mood swings may be related to vitamin B6 and magnesium. The more toxins present in the body, the stronger the symptoms.

Vata symptoms are the predominant PMS symptoms: lower-back ache; nausea; headache; bloating; constipation; anxiety; insomnia; fear; nervousness; mood swings; and difficulty concentrating. The fire and water elements of pitta play out as breast tenderness; painful urination; high histamine signs such as hives; night sweats; smelly loose stools; irritability, anger, hostility, and hypersensitivity. Kapha’s earth and water elements lead to fluid retention and swelling; breast enlargement with tenderness; caffeine cravings; sleepiness; melancholy, crying, lethargy, and depressive tendencies.

Painful periods

Once menstruation commences, mild-to-severe pain symptoms can also occur, although pain is not a normal sign. Higher levels of prostaglandins produced in the endometrium may be the cause. Smooth muscle contracts in other muscles too, causing nausea, bloating, vomiting, headaches and constipation in those susceptible.

The pain experienced by vata imbalance is erratic with intermittent cramping. Pitta pain is sharp, intense and burning.  The pain of kapha is dull and constant.

Heavy bleeding

Further involvement of hormones, such as oestrogens over-stimulating the uterine lining, initiates heavy bleeding with the pain. Menstrual blood naturally releases anticoagulants to keep the blood thin and fluid.


The presence of clots is another sign of imbalance. They can be the body’s natural way of controlling excess bleeding (menorrhagia) as in the heavy flow of kapha and pitta imbalance. Vata imbalance is evidenced in dark brown clots that may indicate lack of uterine strength, and lack of free flow. Pitta develops red clots. Kapha has heavy clots.

Scanty flow

A blood-flow duration of less than two days is considered scanty (hypomenorrhoea). This is usually associated with the extremes of reproductive life, when ovulation is irregular and the endometrial lining fails to develop normally. Vata aggravations are most common here.


After age 40 when the body begins to move towards vata time – the perimenopausal years – another set of symptoms manifests. During this phase, a vata-type woman who does not sleep well; who over-works; eats mostly cold and dry foods; has insufficient quality oils and fats and sweet foods such as fig and mango, will aggravate vata in both blood and body. She becomes more prone to dry skin, vaginal dryness, joint pain during menstruation and irregular cycles. PMS symptoms such as bloating, constipation, foggy brain and insomnia become more extreme.


I think in terms of qualities and treat with the appropriate remedies of opposites, whilst supporting digestion, eliminating toxins and regulating hormonal imbalance and nutritional deficiencies. When trying to balance hormones, the over-riding influence is pacifying vata as its movement affects all other doshas. In our busy world, vata energy vata is very easily disrupted.

Vata energy needs warmth, salt, sour, and sweetness. The energy in vata comes in bursts like a wind moving through a tunnel, which is why vata types crave refined sugars. However, this energy needs stability after a burst. Warm, light, soft, foods cooked in good-quality oils (ghee, coconut, extra virgin olive) with warming spices (turmeric, ginger, saffron, garlic, cumin, cinnamon, cloves) encourage the wind in the mind and body to move with intelligence, focus and ease.

Ghee lubricates the body and helps to nourish the blood and reproductive tissues. Oleocanthal, a polyphenol found in extra virgin olive oil, suppresses the production of an inflammatory prostaglandin molecule involved in pain – and this effect has been shown to be cumulative. Saffron and turmeric have been used for millennia in Ayurveda to treat female and mood-related and reproductive issues such as cramping and scanty flow issues. A handful of fresh basil leaves, chewed or juiced as a tea, can be a great menstrual-pain reliever as it contains a natural painkiller called caffeic acid. Magnesium citrate, activated B6 and zinc, vitamin C and one teaspoon of flaxseeds soaked in water overnight, taken daily for six to 12 weeks, can help alleviate many symptoms and balance hormones and neurotransmitters. Unrefined and mineral-rich sea salt, rock salt or Himalayan salt can be sprinkled on food. Add a splash of umeboshi vinegar and some sauerkraut as a condiment to your meal.

Rest, routine and meditation are essential. Turn inward, try to limit commitments and avoid situations upsets. Indulge in activities you enjoy. The warmth and water element of a hot water bottle is perfect for the vata cramping. Those with a pitta imbalance respond best to monthly internal cleansing with cool foods, while those with a kapha imbalance find stimulating herbal supplements, sweating in a steam room and a diet that reduces congestion and impurities are most effective.
By knowing your true nature, you can plan and practise daily routines to allow your menstrual cycle and hormones to flow intelligently and harmoniously with nature’s rhythms. With this simple effort, the body will maintain its balance act of continuous and intelligent flow of the doshas, and this is considered the healthy state of being human.

Ann Vlass B.Sc (Hons), B.HSc (Nat) is a Member of the Australian Traditional medicine Society (ATM), medical scientist, natural medicine practitioner, and clinic director at Helping Nature Heal.