Naturopath Ann Vlass explains how to rectify common menstrual symptoms using a holistic, natural approach to healing.

Your menstrual cycle is a good barometer of overall health. A balanced cycle is uneventful, regular, lasting about 28 to 34 days without spotting. Bleeding should be continuous, lasting between three and seven days, with the blood a slightly translucent red that washes out of fabrics without staining. However, when internal and external factors disrupt the cycle, problems manifest. Classical Ayurveda describes menstruation as a time of reflecting and going inward while the body sheds metabolic wastes and toxins (ama).

This cleansing – menstruation – begins with an inflammatory cascade of prostaglandins. Synchronised with the right balance of hormones, the prostaglandins instruct the uterus muscle to contract and expel its lining and menses fluid. During this process, we should regulate the body's energy force, nourish the blood, and minimise toxin load. Helpful foods include beets, eggplant, celery, coriander, leafy greens; mung and adzuki beans; seaweeds; figs; green apples; lemons; warming ginger and chamomile teas; and apple cider vinegar taken with raw honey to assist digestion while alkalising the body.

Ayurveda classifies body types – or doshas – as vata, pitta and kapha, which are nature’s biological energies derived from the five elements: air, ether, fire, water, earth. When I work with menstrual issues, I observe the patient’s dosha, their constitution and body signs to select appropriate remedies and therapies. For example, the amount and location of ama - caused by an accumulation of toxins and blockage of circulation arising from improper diet, poor digestion, stress, irregularity, inadequate sleep-wake rhythms and toxic emotions - influences menstrual symptoms and cycle imbalances. If you feel and look better after your period ends, then ama is behind those symptoms, and toxin-cleansing is necessary.

Pre-menstrual syndrome

PMS can begin in the vata phase: any time after ovulation until menstruation. Experienced by 40 percent of women, PMS manifests in many forms; the more toxins present, the stronger the symptoms. Vata symptoms are predominant: lower-back-ache, nausea, headache, bloating, constipation, anxiety, insomnia, mood swings, and difficulty concentrating. The fire and water elements of pitta play out as breast tenderness, painful urination, high histamine signs (hives; night sweats; smelly loose stools), irritability, anger, hostility, and hypersensitivity. Kapha’s earth and water elements lead to fluid retention and tender, swollen breasts, caffeine cravings, sleepiness, crying, lethargy, and depressive tendencies.

Painful periods

Once menstruation commences, mild-to-severe pain can 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. The pain experienced by vata imbalance is erratic with intermittent cramping; pitta pain is sharp, intense and burning; kapha pain is dull and constant.

Heavy bleeding, clots

Further involvement of hormones, such as oestrogens over-stimulating the uterine lining, initiates heavy bleeding. Menstrual blood naturally releases anticoagulants to keep blood thin and fluid. Clotting is another sign of imbalance. It can be the body’s natural way of controlling excess bleeding (menorrhagia). Vata imbalance is evidenced in dark brown clots that 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.

Managing perimenopause

After age 40 when the body moves towards vata time – perimenopause – 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, and has insufficient quality oils and fats and sweet foods such as fig and mango, will aggravate vata in blood and body. She becomes more prone to dry skin, vaginal dryness, joint pain, 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, while 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 is easily disrupted. Vata energy needs warmth, salt, sour, and sweetness. The energy in vata comes in bursts, like 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 with warming spices encourage this wind in the mind and body to move with intelligence, focus and ease.
* Ghee lubricates the body and nourishes blood and reproductive tissues.
* Oleocanthal, a polyphenol in extra virgin olive oil, suppresses production of inflammatory prostaglandins involved in pain – an effect shown to be cumulative.
* Saffron and turmeric have been used for millennia in Ayurveda to treat cramping and scanty flow.
* Fresh basil, chewed or juiced as a tea, contains caffeic acid, a great menstrual-pain reliever.
* Magnesium citrate, activated B6 and zinc, vitamin C and one teaspoon of flaxseed soaked in water overnight, taken daily for six to 12 weeks, alleviate many symptoms and balance hormones.
* Sprinkle unrefined mineral-rich sea salt, rock salt or Himalayan salt on food. Add umeboshi vinegar and sauerkraut as condiments.
* Rest, routine and meditation are essential. Turn inward, limit commitments, and avoid upsets. Indulge in activities you enjoy. The warmth and water element of a hot water bottle is perfect for 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 most effective.

ATMS member Ann Vlass BSc(Hons), BHSc(Nat) is a medical scientist, natural medicine practitioner and clinic director at Helping Nature Heal.