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| ORIGINAL ARTICLES |
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| Year : 2019 | Volume
: 7
| Issue : 4 | Page : 212-216 |
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Correlation of signs and symptoms at menarche in Kapha-dominant Prakruti
Raksha G Kanoje, Amol M Deshpande
Department of Rachana Sharir, Mahatma Gandhi Ayurved College Hospital and Research Centre, Datta Meghe Institute of Medical Sciences (DMIMS [DU]), Wardha, Maharashtra, India
| Date of Submission | 29-Jan-2020 |
| Date of Decision | 03-Mar-2020 |
| Date of Acceptance | 12-Mar-2020 |
| Date of Web Publication | 14-Apr-2020 |
Correspondence Address:
Dr. Amol M Deshpande
Department of Rachana Sharir, Mahatma Gandhi Ayurved College Hospital and Research Centre, Datta Meghe Institute of Medical Sciences (DMIMS [DU]), Salod, Wardha 442001, Maharashtra.
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/JISM.JISM_7_20
Background: Menarche (Rajohdarshana) is one of the milestone of womanhood. However, very concise literature of Rajohdarshana (menarche) is available in the compendia. Ayurveda stands on the fundamentals of Prakruti (physical and mental temperament). The Ahara (food), Vihar (walking for pleasure), and Chikitsa (treatment) are more specific in relation to the Prakruti. Menarche can also be associated with Prakruti. However, no published evidences in regard to relation of menarche and Prakruti were found. Hence, this study will be helpful to assess the symptoms occurring during menarche in context to the Kapha (physiological humors)-dominant Prakruti. The specific symptoms if found can be prevented or treated by advising appropriate Ahara, Vihar, and medications, if any. Materials and Methods: A total of 673 girls were included in the study from the age group 9–15 years, of which 300 girls were excluded as they do not have their menses. Other participants were assessed on the basis of Prakruti Parikshan (physical and mental temperament examination). A total of 100 Kapha-dominant girls were selected for the study. Status of the current menstruation and signs and symptoms were assessed by the questioner. Results and Conclusion: There is direct association between Kapha-dominant Prakruti and menarche, along with premenstrual symptoms. In Kapha-dominant Prakruti, the average age of the menarche is found at 12 years, which mostly starts in between the month of May and November, and also have moderate quantity of blood flow for which is consistent for 5 days at the interval of 28–30 days without any kind of premenstrual symptoms. Keywords: Kapha Dosha, menarche, menstrual cycle, Prakruti, premenstrual symptoms, Rajohdarshana
How to cite this article:
Kanoje RG, Deshpande AM. Correlation of signs and symptoms at menarche in Kapha-dominant Prakruti. J Indian Sys Medicine 2019;7:212-6 |
| Introduction | |  |
Menarche is the initiation of menstrual cycle in women’s life, which is a momentous incident as it denotes the start of reproductive capacity. In various studies, the age of onset of menarche has decreased day by day; the adolescent growth has occurred at younger ages and also with that height growth velocity of the girls has increased. Today, in different countries menarche is seen in between the age of 12 and 13 years.[1] Also there are several studies in modern science regarding the factors that are affecting the menarche such as genetic inheritance, race, ecological situation, diet, physical activity, geographic place, urban or rural habitat, emotional factors, body mass index, family unit, financial status, educational qualification of the parents, profession of parents, orphan children, child sexual abuse, mental and physical stress, duration and quantity of the tea consumption, and smoking.[2] But it is still an unexplored topic in Ayurveda.
In modern science, common premenstrual symptoms include irritability, malaise, headache, acne, and abdominal pain, which usually occur before 7–10 days before the timing of the bleeding.[3] But in Ayurveda, such symptoms are not mentioned by any Acharyas in their text.
The menstrual cycle occurring in females has been termed in Ayurveda as Rutuchakra (menstruation cycle). The word “chakra” signifies its regular onset at regular intervals, just like a cycle. A single Rutuchakra cover a period of one Chandramasa (28 days) and it has been divided into three phases: the Rajahsravakala, (menstrual flow period), the Rutukala (menstrual period), and the Rutuvyatita kala (post-menstrual period).[4]
In Ayurveda, body is formed by three basic constituents: Vata, Pitta, and Kapha (physiological humors), and predominance of it is already decided at the time of conception, which is called as Prakruti.[5] The signs and symptoms of each disease and condition are different in different Doshas (basic constitution). In Ayurveda, there is a very sparse literature regarding the relation between the Prakruti and Menarche. Also no research work is published regarding onset of menarche in different types of Prakruti. Therefore, in this study we are trying to explore the signs and the symptoms of the menarche and the onset of menarche in Kapha-dominant Prakruti as Kapha Dosha is predominant in Balyavastha (childhood).
Aim
The aim of this study was to find the correlation of signs and symptoms at menarche in Kapha-dominant Prakruti.
Objectives
The objectives of this study are to:
- (1) to assess the age at the onset of menarche, and
- (2) to study the signs and symptoms at the onset of menarche.
| Materials and Methods | | |
Participants: A total of 673 girls were included in the study from the age group 9–15 years, of which 300 girls were excluded as they do not have their menses. Of the remaining 373 girls, 123 girls were having Vata-dominant Prakruti in which 53 were of Vatapittaj and 70 were of Vatakaphaj, and 150 were having Pitta-dominant Prakruti in which 99 were of Pittakapha and 51 were of Pittavataj. So they are also excluded from the study. A total of 100 Kapha-dominant girls were selected for the study of which 45 were of Kaphavataj Prakruti and 55 were of Kaphapittaj Prakruti.
Methodology
Prakruti Parikshan pro forma was prepared for the assessment of Prakruti and case record pro forma was prepared for the assessment of status of menarche and current status of menarche.
The study was completed under the following steps:
- (1) Assessment of Kapha-dominant Prakruti
- (2) Observation regarding the status of the menarche
- (3) Observations regarding the status of the current menstrual cycle
- (4) Descriptive statistical analysis to find out correlation between Kapha-dominant Prakruti and Menarche
- (a) Place of work: school going girls from Wardha district
- (b) Sample size: 100
- (c) Study type: observational study
- (d) Study design: Cross-sectional study
- (e) Inclusion criteria:
- (i) Females who had their menarche age group 9–15 years
- (ii) Kaphavataj and Kaphapittaj
- (f) Exclusion criteria:
- (i) Hypothyroidism
- (ii) Polycystic ovary disease
- (g) Assessment criteria:
- (i) PrakrutiParikshan questionnaire and case record form
| Observation and Results | | |
The results according to the data obtained by Prakruti and pattern of menarche and current status of the menarche of 100 participants are as follows.
Of the 100 participants, 51% had their menarche at the age of 12 years, 26% had at the age of 13 years, 17% had at the age of 11 years, 4% had at the age of 14 years, and 2% had at age of 10 years [Figure 1].
Of the 100 participants, the occurrence of the next menstrual cycle was found regular in 75% participants and 25% had irregular menses [Figure 2].
In this study, of the 100 participants, 64% of girls had moderate type of blood flow, 24% had scanty, and 12% had excessive blood flow at the time of their first menstrual cycle [Figure 3].
In relation with the consistency of the menstrual flow during first menstrual flow, it was found that in the 100 participants, 51% girls had watery consistency, 30% had viscid type of blood flow, and 19% participants had presence of clot in their first blood flow [Figure 4].
Regarding the smell of the flow, in this study, it was found that 86% girls had normal smell, whereas 14% had faced the problem regarding foul smell from their first menstrual flow [Figure 5].
Duration of the first menstrual flow in the menarche was found 5 days in 48% girls, 4 days in 17% girls, 6 days in 16% girls, 3 days in 11% girls, 7 days in 4% girls, 9 days in 2% girls, and 2 and 8 days flow in 1% girls [Figure 6].
Of the 100 participants, 35% of girls had 30 days of interval in their next cycle after menarche, 28% had an interval of 28 days, 12% had 25 days of interval in their next cycle, 7% had 29 days of interval, 5% had 60 days of interval, 3% had 22 and 45 days of interval, 2% had 27 and 43 days of interval, and 1% had 20, 32, and 40 days of interval in between their next cycle [Figure 7].
In relation with the symptoms during the first menstrual cycle, of the 100 participants, 45% of girls had normal menses without any kind of symptoms during the menstrual flow, whereas 35% had abdominal pain, 10% had weakness during the flow, 6% had backache, 4% had pain in legs, 2% had pain in hands, and 1% had complete body pain and loose motion [Figure 8].
In current menstruation, of the 100 participants, 48% of girls had 5 days of menstrual flow in their menstrual cycle, 17% had 4 days of flow, 16% had 6 days of flow, 11% had 3 days of menstrual flow, 4% had 7 days of flow, 2% had 9 days of flow, and 1% had 2 and 8 days of menstrual flow [Figure 9].
In relation with the quantity of blood flow in the current status of menstrual cycle, of the 100 participants, 66% of girls had moderate type of flow in their menses, 22% had scanty type of flow, and 12% had heavy flow during their menses [Figure 10].
In relation between dysmenorrhea and current menstrual status, of 100 participants, 57% of girls were facing the dysmenorrhea and 43% were normal [Figure 11].
In the current menstrual cycle, of the 100 participants, 49% of girls do not had any kind of symptoms during menstrual cycle, 27% had abdominal pain, 20% were suffering from weakness, 12% had cramps in their legs, 6% were facing problems such as high temperature during each menses, 3% had breast tenderness and constipation, and only 2% had vomiting and abdominal blotting [Figure 12].
| Discussion | | |
As per Ayurveda, Vata, Pitta, and Kapha are the basic constituents of the body. Dominance of these Doshas decided the character of the body called as Prakruti.[5] If the body is having dominance of the Kaphavata Doshas and Kaphapitta Doshas, the body is called as Kapha-dominant Prakruti.[6] Such type of 100 Kapha-dominant participants were studied in this study.
In this study, 51% of girls had their menarche at the age of 12 years. In various studies conducted in Kalamboli, the average age of menarche was found to be 13.32 years, and in Turkey it was 12.81 years. Also in a similar study conducted in West Bengal, the mean age was 12.8 years (Dasgupta and Sarkar[7]).
In this study, the month of the onset of menarche is studied in relation with Rutu (season) and Mahabhoot (basic elements) mentioned in Ayurveda [Table 1].[8] A total of 35% participants were found in the months of September to November, that is, Sahrad Rutu (autumn) where Jal (water) and Agni (fire) Mahabhoot are dominant. As all participants belong to Kapha Prakruti, Jal Mahabhoot[9] is predominantly present in it, and as mentioned in Acharya Shushruta, Aartva (menstruation) is related with Agni Mahabhoot.[10] Also 84% of the participants were having menarche when there is Agni predominance, that is, in the months from May to November.
Of the girls who had participated in the study, 75% said that they had regular menstrual cycle. Also 64% of the girls were reported with moderate quantity of blood loss during their first menses, which was changed to 66% moderate quantity of blood loss in the regular menstrual cycle. In the study conducted in Gujjar adolescent girls, 45.04% of participants had normal quantity of blood flow during menstruation (Rajni et al.[11]). It can be due to the Sthirya Guna of Kapha.[12]
Of the girls, 51% had water consistency in Kapha-dominant Prakruti and 86% had normal smell from the menstruation flow. It is also due to the dominance of Jal Mahabhoot.[8]
In this study, the duration of menstrual flow was found about 5 days in 48% of participants, and which is all most same in the present condition of the menstrual cycle in all participants. The study that was conducted in Turkey concluded that the menstrual flow in adolescent was present for more than 8 days (Sule et al.[13]).
In this study, the interval between two successive menstrual cycles was found to be 28–30 days in 70% of participants. Whereas the study conducted in tribal (Gujjar) adolescent girls, 70.23% had their menstrual cycle between 30 and 45 days after, which is near about similar to the findings of this study (Rajni et al.).[11]
Of the participants, 45% did not have any kind of symptoms in first menstrual flow, whereas 35% had experienced abdominal pain during their first menstrual flow. After first menstrual cycle, 49% of girls did not have any kind of symptoms during menstrual flow and 27% had abdominal pain. In this study, 57% of girls had dysmenorrhea and 43% were normal in present menstrual status. So it was seen that as the age progresses, the symptoms that are present during the menstrual flow are gradually decreased in Kapha-dominant Prakruti.
| Conclusion | | |
From the aforementioned study of 100 participants, we can conclude that there is direct association of Kapha-dominant Prakruti and signs and symptoms of menarche and menstrual cycle. Most of the participants had menarche at the age of 12 years and mostly in the months from May to November and had a regular menstrual cycle, which indicates the quality of the Kapha. Also the consistency of the menstrual flow is watery as there is dominance of the Jal Mahabhoot in it. The menstrual flow in Kapha-dominant Prakruti was about 5 days and was of in moderate quantity in menarche and regular menstrual cycle, and the interval between the cycle was 28–30 days after first cycle as well as in their regular menstrual cycle.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | De Sanctis V, Bernasconi S, Bianchin L, Bona G, Bozzola M, Buzi F, et al. Onset of menstrual cycle and menses features among secondary school girls in Italy: A questionnaire study on 3,783 students. Indian J Endocrinol Metab 2014;18:S84-92.  |
| 2. | Ramezani Tehrani F, Mirmiran P, Gholami R, Moslehi N, Azizi F. Factors influencing menarcheal age: Results from the cohort of tehran lipid and glucose study. Int J Endocrinol Metab 2014;12:e16130. |
| 3. | Dambhare DG, Wagh SV, Dudhe JY. Age at menarche and menstrual cycle pattern among school adolescent girls in Central India. Glob J Health Sci 2012;4:105-11. |
| 4. | Shankar S. Menstrual cycle: An ayurvedic prospective. IAMJ 2015;3:2991-9. |
| 5. | Vagbhata . Ayushkamiya sutra sthana: chapter 1, verse 9. In: Arundatta , Moreshwar K, editors. Astangahridya Sarvanga Sundara. Varanasi, India: Chaukhamba Oraiantiali; 2005. p. 9. Reprint edition. |
| 6. | Vagbhata . Ayushkamiya sutra sthana: chapter 1, verse 10. In: Arundatta , Moreshwar K, editors. Astangahridya Ayurveda Rasayana. Varanasi, India: Chaukhamba Oraiantiali; 2005. p. 10. Reprint edition. |
| 7. | Dasgupta A, Sarkar M. Menstrual hygiene: How hygienic is the adolescent girl? Indian J Community Med 2008;33:77-80. [ PUBMED] [Full text] |
| 8. | Patrikar V. Swasthavritta Vidyana, part I. Chapter 4, Rutucharya. In: Patrikar V, editor. 4th ed. Nagpur, India: Godawari Publishers and Book Promoters; 2010. p. 62. Reprint edition. |
| 9. | Vagbhat, Sushruta. Astangasangraha sutra sthana: chapter 20, verse 1. In: Murthy KRS, editor. Vrudhhavagbhaat Doshbhediya Adhyaya. Varanasi, India: Chaukhamba Orientalia; 2009. p. 367. Reprint edition. |
| 10. | Sushruta . Susrutasamhita nimbandha sangraha: chapter 14, verse 7. In: Dalhan , Sharam PV, editors. Shonitvarniya Adhyaya. 9th ed. Varanasi, India: Chaukhamba Orientalia; 2007. p. 59. Reprint edition. |
| 11. | Rajni D, Anil K, Manpreet K. Knowledge and practices related to menstruation among tribal (Gujjar) adolescent girls. Studies on Ethno-Medicine 2009;3:43-8. |
| 12. | Vagbhat Ayushkamiya sutra sthana: chapter 1, verse 12. In: Arundatta , Moreshwar K, editors. Astangahridya Sarvanga Sundara. Varanasi, India: Chaukhamba Oraiantiali; 2005. p. 10. Reprint edition. |
| 13. | Sule ST, Umar HS, Madugu NH. Premenstrual symptoms and dysmenorrhoea among Muslim women in Zaria, Nigeria. Ann Afr Med 2007;6:68-72. [ PUBMED] [Full text] |
[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9], [Figure 10], [Figure 11], [Figure 12]
[Table 1]
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