Dysmenorrhoea(Painful periods)




The term dysmenorrhoea refers to severe painful cramping sensation in the lower abdomen during menstruation. It is commonly called as ‘difficult monthly flow’.


  • Aching pain in your belly
  • Pain in the hips, lower back and inner thighs

Severe symptoms may include:

  • Stomach upset, bloating , sometimes with nausea or vomiting.
  • Headaches and breast tenderness or pain.
  • Fainting.


Types of Dysmenorrhoea

Primary Dysmenorrhoea

Primary dysmenorrhoea is defined as a cyclic pain associated with menses.

No pelvic or structural abnormalities are found as causes, and no abnormalities are present in the physical examination. The diagnosis is made by the patient’s history.

Secondary Dysmenorrhoea

Secondary dysmenorrhoea is a cyclic pain associated with structural abnormalities and organic pathology.


Causes for Secondary Dysmenorrhoea

  • Endometriosis
  • Pelvic inflammatory disease (PID)
  • Stenosis (narrowing) of the cervix
  • Uterine fibroids (growths)
  • Adenomyosis
  • Sexually transmitted infection (STI)
  • An ovarian cyst or tumour
  • Using of an intrauterine device (IUD), a birth control method.



Menstrual cramps can range from mild to severe. They usually happen for the first time a year or two after a girl first gets her period. With age, they usually become less painful and may stop entirely after you have your first baby. When the symptoms are severe it is recommended to consult your Gynaecologist.

You may have to undergo a pelvic examination, and your blood and urine may be tested.

Ultrasonography (USG) is used to get a picture of your internal organs or even the technique of laparoscopy for a direct look into your uterus.


How are menstrual cramps caused?

Period pain can be caused by a build-up of hormone-like substances called prostaglandins, which are produced by the uterus, leading to cramping pain in your lower abdomen and stomach.

Menstrual cramps happen because of contractions in the uterine muscles. If it contracts too strongly during your menstrual cycle, it can press against nearby blood vessels. This briefly cuts off the supply of oxygen to the uterus. It’s this lack of oxygen causes pain and cramping.


Medications or other remedies are prescribed depending on the cause of the dysmenorrhoea.

Primary dysmenorrhoea is usually treated by medication such as an analgesic medication. Many women find relief with nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, and acetylsalicylic acid (ASA).

Women who do not respond after three months of treatment with NSAIDs and hormonal contraceptives may have secondary dysmenorrhoea. Treatment for secondary dysmenorrhoea will vary with the underlying cause.

Hormone medications and Oral contraceptives may also help to reduce the severity of the symptoms. (Strictly under medical supervision)

Diagnostic laparoscopy, other hormonal treatments, or trial of transcutaneous electrical nerve stimulation (TENS) are potential next steps.

Surgery can be done to remove fibroids and to widening of the cervical canal if it is too narrow.


Ayurvedic management of Dysmenorrhoea or Painful periods

  1. Panchakarma chikitsa- Ayurvedic internal treatments to regularise menstrual cycles.
  2. Ayurvedic herbal preparations useful in this condition: (should be taken under medical supervision)
  • Ashokarishta
  • Kumaryasava
  • Rajah pravartini vati
  • Lodhrasava
  1. Ayurvedic herbal preparation in the form of Tea is highly recommended in Primary Dysmenorrhoea or Painful periods without organic pathology:

Ayurvedic Tee

Required herbs:

  • Anise seed                 – Pimpinella anisum           – छोटी सौंफ़       – ಚಿಕ್ಕ ಸೋಂಪು
  • Bitter Fennel seed   – Foeniculum vulgare         – कड़वी सौंप       – ಕಹಿಸೋಂಪು
  • Coriander seed         – Coriandrum sativum       – धनिया            – ಕೊತ್ತುಂಬರಿ ಬೀಜ
  • Caraway seed            – Carum carvi                      – शाहजीरा         – ಕರಿಜೀರಿಗೆ
  • Valerian powder      – Valeriana wallichii            – तगर               – ಮುಷ್ಕಬಾಲ ಬೇರಿನ ಚೂರ್ಣ
  • Monk’s pepper          – Vitex negundo                  – इंद्राणी            – ಲಕ್ಕಿ ಗಿಡದ ಬೀಜ

Preparation method:

Collect equal quantity of each of the below said dry herbs/seeds and take ¼ Teaspoon Each of the following and boil it with 300ml water for 5 minutes and drink 2 -3 times a day during painful days.


Useful health tips to reduce the pain during dysmenorrhoea

  • Lying on your back, supporting your knees with a pillow.
  • Holding a heating pad or hot water bottle on your abdomen or lower back.
  • Taking a warm bath
  • Gently massaging your abdomen
  • Doing mild exercises like stretching or walking may improve blood flow and reduce pelvic pain.
  • Take adequate rest and avoid stressful situations as your period approaches.
  • Yogasana




Dr. Keerthi Shetty

Indian Ayurveda Doctor

Panchakarma Expert

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