Premenstrual Syndrome (PMS)-krichhartava- causes, Symptoms, management through Ayurveda

Premenstrual syndrome (PMS) is a group of symptoms that may include body ache, back ache, headache, nausea, vomiting , loose stools or constipation, and mood swing,


Authors: Dr. Ranjeet Singh
Dr Kavita Sharma


Premenstrual syndrome (PMS) is a group of symptoms that may include body ache, back ache, headache, nausea, vomiting , loose stools or constipation, and mood swing, which recur in the same phase of menstrual cycle. The symptoms generally make their appearance 2-7 days before the onset of menstruation and end with the onset of menstrual flow. The symptoms differ for different females and at different age group. In Ayurveda, premenstrual syndrome (PMS) is known as Krichhartava. Here, ‘krichha‘ means difficult and ‘artava’ means menses.

Approximately, 40% women of reproductive age are suffer from premenstrual tension and it occurs mostly in women over 30 years of age. In some women, the onset of symptoms seems to be coincide with ovulation and may then persist until menstruation commences. In some rare cases relief from the premenstrual syndrome may be obtained only with the cessation of the menstrual flow.

What are the causes of Premenstrual Syndrome ( PMS)?

According to Ayurveda, premenstrual syndrome related to vitiated Apana Vayu which governs the functioning of the pelvic area and Pitta dosha. vitiated apana vayu and pitra dosha circulated in the different channels of the body causing various symptoms of the premenstrual syndrome. Poor nutrition, unhygienic living conditions, improper diet, and psychological factors can also play a part.

Some authorities believe that deficiency of the hormone progesterone may results in premenstrual syndrome but this not yet been satisfactorily proved.

A team of researchers at Sinai Hospital in Baltimore and Johu Hopkins University School of Medicine, London, through carefully controlled studies, conducted that dietary deficiency , particularly that of vitamin E and Vitamin B6 are the most common cause of premenstrual syndrome.

What are the symptoms of Premenstrual Syndrome?

The symptoms differ from person to person. There may be pain in the pubic region and thigh, body ache. The onset of this syndrome is abrupt, generally with a headache which is after accompanies by vomiting. A general feeling of depression and irritability permeate the entire experience.

The other symptoms include-

  • Swelling and tenderness in the breast (which is sometimes so severe that it is almost unbearable).
  • Constipation or diarrhea
  • Flatulence
  • Fatigue
  • Acne
  • Disturbed sleep
  • Appetite changes
  • Mood swings
  • Migraine attacks ( occur with severe pain and vomiting)

Patient suffering from premenstrual tension show a weight gain of 1 kilogram or more in later part of the menstrual cycle due to, Salt and water retention. The retention of fluid is partly due to ovarian cyst, but there is also an increased output of antidiuretic hormone from posterior pituitary gland.

In Ayurveda, Premenstrual Syndrome is classified in three types as- Vata, pitta, and kapha. Each type of PMS have different symptoms, which are listed below. If you’re an Ayurveda physician, you must be find out the type of PMS ( Vata, pitta, and kapha) and the, prescribe treatment plan to your patient accordingly.

Vata type PMS symptoms include:

  • Low backache
  • Lower abdominal pain
  • Distention
  • Anxiety
  • Insomnia
  • Mood swings

Pitta type PMS symptoms include:

  • Breast tenderness
  • Urethritis
  • Hives
  • Hot flashes
  • Irritability
  • Sometime burning sensation when passing urine

Kapha type PMS symptoms include:

  • Water retention ( breast become enlarged and tendor)
  • Drowsiness

Diagnosis of Premenstrual Syndrome?

There is no specific laboratory diagnosis of the premenstrual syndrome. The problem can be diagnosed on the basis of past history showing a clear, recurrent relationship between stage of the menstrual cycle and the onset of symptoms as well as a coincidence of relief with the start or cessation of menstruation. Patient may maintain a personal diary about her symptoms and feelings during those days. The record should be kept for at least 3 cycles.

How to treat Premenstrual Syndrome?

Treatment of premenstrual syndrome depends on the severity of the symptoms. Where only mild symptoms are experienced, the problem can be alleviated by a change of routine. Extra work and stressful situations should be avoided. fluids should be moderately restricted and care should be taken not to add extra salt to the food. The patient’s partner and family members should be educated about all the facets of the PMS. The patient should not take any oral contraceptives as these may cause fluid retention and lowering of Plasma levels. Hormonal imbalance and infections of the uterus can be helped by a natural diet regimen.

As most women feel tension arising from chronic constipation, it is essential to treat this condition first. In constipation, the putrefying fecal matter may be reabsorbed into the bloodstream, and the same blood, if supply to the Brain, will cause gradual enervation. Constipation can be relieved by a luke warm water enema and liberal intake of seasonal fruits and vegetables and simple fibrous meals.

Simple home remedies for all body type ( Vata-Pitta-Kapha):

  1. Warm ghee nose drops stimulate natural hormones and help regulate balance of the system.
  2. When there is abdominal bloating and cramps, all body constitutional types can put a warm castor oil pack on the lower abdomen. One of the quality of castor oil is that it produces a slow, and sustained heat that is soothing and healing. A warm castor oil packs will also help relieve the congestion and discomfort of endometriosis.
  3. Fill a tub with warm water. Sit in the tub with the pubic region submerged. This relaxes the muscles and relieves pain before the onset of menses.

Diet plays a significant role in preventing premenstrual syndrome. The patient should avoid refined carbohydrates, Sugars, coffee, tea, tobacco and other stimulants oily, fried or a spicy food and all meats.

Mental poise is an important factor. Negative mental attitudes like fear, worry, anger, jealousy, tension and inferiority Complex should be eliminated by Positive Thinking, meditation and good company.

For Prevention:

Be sure to get regular exercise during the month, including half an hour of walking or other aerobic exercise at least 5 days a week. Yoga stretching is also helpful. However, Ayurveda recommends no exercise or yoga during the actual menstrual period as much as possible, rest, read, and relax.