Article by Dr Manasa S, B.A.M.S & Dr Raghuram Y.S. MD (Ay)
Menstrual Related Headaches (MRH) affecting women are also called by the names ‘Menstrual Migraine’ and ‘Hormonal Headaches’.
They occur during the menstrual cycle and are closely linked to hormonal fluctuations, mainly decline in oestrogen levels.
Related Reading – Menstrual Related Headaches
Menstrual Headaches / Menstrual Migraine – Understanding and management from Ayurveda Perspective
The Vata and Vataja Shirashula / Shiroroga Link
Quoting Senior Professor and renowned Ayurveda physician and grand-master Lt Shri SN Ojha sir – ‘Hormones are Vata Dharmiya’ i.e. their actions are similar to those of vata and symptoms of imbalance are similar to vata disturbance.
This also includes the oestrogen and progesterone hormone play in the menstrual cycle of a woman and everything which controls and balances them.
Hormone Headaches can be studied in parallel with Vataja Shiroroga / Vataja Shirashula.
Artava Nishkramana Karma
Regular and balanced menstrual cycles in women and the physiology of menstruation is under the control of vata, mainly apana vata. If apana vata is disturbed or put into a state of imbalance, menstrual irregularities occur in women.
Artava Vega Dharana
Ayurveda advocates that the body’s natural urges should not be withheld forcibly. Artava Vega Dharana i.e. forcibly withholding the menstrual cycles or meddling with its cycles can cause a wide array of problems. Though not mentioned, it shall be considered and inferred in place of shukra vega dharana – forcibly withholding the ejaculatory reflex or urge in men, in women. Vega Dharana of any sort will cause udavarta i.e. retrograde or upward movements of vata. This vata will produce many disorders, including headache. Women should not meddle with or tamper with the normal menstrual cycles.
Pureesha Vega Dharana Link
Shiroruja – headache – is mentioned amongst the symptoms caused by ‘forcible withholding of defecation urge / reflex’. Defecation is also controlled by apana vata, the same subtype of vata which controls menstruation. Similarly, obstruction or problems in the cycles of menstruation can cause headaches. On the other hand, weak apana vata will not enable normal and healthy menstruation. It may lead to deficit or excess menstruation. Both can cause headaches or menstrual migraines. Many times, a course of Virechana given for some purpose would rectify the functions of apana vata, menstrual irregularities and has been found to be an effective remedy for menstrual migraine or hormonal headaches. Similarly, Vasti or Uttara Vasti will have a similar impact. Many times, an external therapy like Shirodhara, Shirovasti or Abhyanga or Sarvangadhara will magically relieve menstrual headaches. Similarly, women who are used to withholding natural defecation reflexes or have chronic constipation are seen to have menstrual irregularities and also menstrual migraine.
Ardhavabhedaka Link
This kind of headache i.e. Menstrual Related Headaches are also called Menstrual Migraine. Migraine is compared to Ardhavabhedaka Shiroroga / Shirashula in Ayurveda. Vataja Shiroroga and Ardhavabhedaka Shiroroga have almost similar symptoms of presentation.
Rakta Kshaya and Raktaja Shiroroga / Shirashula
Hormone Headache / Menstrual Headaches can also be considered as Raktaja Shiroroga / Shirashula. The symptoms of pittaja shirashula along with tenderness in the head are the features of this type of headache. Increase in rasa or rakta (lymph and blood) may lead to excessive production of blood leading to excessive discharge of menstrual blood.
Rakta Kshaya i.e. excess loss of blood can lead to vata increase and vataja type of headache. Here, these headaches bridge between Vataja and Raktaja Headaches and are dealt with as per their predominance.
Raktavruta Vata and Vatarakta
Menstrual Migraine may also be treated on the lines of Raktavruta Vata – vata obstructed by vitiated rakta or Vatarakta – vicious amalgamation of vata and rakta causing systemic disorder with predominant symptoms of bones, joints and soft tissues – popularly compared with gout or gouty arthritis. Asrugdhara – excessive menstrual bleeding / dysmenorrhea and Vatarakta – both are rakta pradoshaja vikaras i.e. diseases taking origin from contamination of blood tissue and both can cause both, and both are related to vata imbalances.
Kshayaja Shiroroga / Kshayaja Shirashula
This is a type of headache which is caused by abnormal decrease of rakta – blood, meda – fat tissue, kapha and vata. Headache is severe and intolerable and is difficult to cure. This type of headache increases by administration of swedana – sudation, vamana – emesis, dhumapana – herbal or medicated smoking and nasya – strong errhines / instillation of nasal drops and raktamokshana – bloodletting.
In this condition, we can see that decrease in blood is one of the causes for the headache. This decrease in blood tissue may happen due to excessive and uncontrolled menstruation.
Principles of Management of Hormonal / Menstrual Headache
Basically, these headaches shall be managed on the lines of treatment of vataja shiroroga and ardhavabhedaka. Since menstrual migraine or hormonal headache falls under different conditions explained in Ayurveda, the physician should use his skills and knowledge to pick up a suitable and most comprehensive line of treatment as per his or her understanding of the disease. I have given various perspectives of understanding the disease through the Ayurveda lens in the above paragraphs. Maintaining good menstrual health is the key to prevent menstrual headaches and other conditions associated with menstrual irregularities.
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