Painful menstruation, also known as dysmenorrhoea, is a common problem of women in the reproductive age group. There are several causes attributed to this condition; such as congenital malformation of the genital tract, mechanical obstruction, infection, vascular congestion and sometimes psychogenic causes. The nature, severity and time of pain vary from individual to individual depending on the underlying cause, tolerance capacity and the individual’s perception of the condition.

Pain may occur before, during and after menstrual flow. Sometimes, it may occur between the menstrual periods. The pain can be dull and continuous with a sense of heaviness in the pelvic region and not infrequently intermittent and spasmodic. Anxiety, stress and unsatisfied sexual stimulation contribute significantly to induce or aggravate dysmenorrhoea without any structural or pathologic cause.

Primary dysmenorrhoea is present from the time of menarche, i.e. from the onset of menstruation and is also termed as congenital or essential, while secondary dysmenorrhoea results from congestive, inflammatory, obstructive and functional conditions of the genital tract.

Painful menstruation without pathologic conditions can be successfully managed with simple remedies such as powder of Shatpushpa and observing certain do’s and don’ts:

• (1) Food intake around menstual period should be light, soft and easy to digest. Heavy meals, overeating and dry, spicy, and cold foods should be avoided. If the appetite is weak, switch over to liquid or semi-solid diet.
• (2) Women should maintain a relaxed state of mind before and during menstrual days keeping away aggression, anger, frustration and irritation. Proper sleep and deep breathing with relaxed mind help to improve tolerance and alleviate pain.
• (3) Suppression of defecation and urination urges should be avoided.
• (4) Sipping of warm water and hot water fomentation over lower abdomen give relief from pain.
• (5) Excessive physical or mental exertion, dietary irregularities and mental irritation should be avoided and due care should be taken to have proper meals and rest.

Shatpushpa (Anethum sowa Roxb. ex Flem.)

Tribal communities use dried ripe fruits of Shatpushpa in the form of a decoction or powder or boiled with milk alone or mixed with other herbs for female health problems resulting during menstruation and after child birth. The formulation is listed with given indications in the Ayurvedic Pharmacopoeia of India. The plant is cultivated in tropical and subtropical regions and its fruits are collected near the end of winter, dried in the shade and kept in dry conditions. Properly preserved fruits are dark brown and rich in essential oil with a faintly aromatic odour, warm and slightly sharp taste resembling that of caraway. Optimal potency of the herb and its powder lasts for about one year.

Composition

The formulation consists of powdered dry fruits of Shatpushpa.

English name	Dill
Latin name	Anethum sowa Roxb. ex Flem.
Family	Apiaceae
Parts used	Dried ripe fruits

Main chemical constituents

Essential oil, aromatic glycosides, monoterpenoid, ketodiols.

Quality standards

Foreign matter	Not more than 5%
Total ash	Not more than 14%
Acid-insoluble ash	Not more than 1.5%
Alcohol-soluble extractive	Not less than 4%
Water-soluble extractive	Not less than 15%
Volatile oil	Not less than 3%

Method of preparation

• (1) Clean Shatpushpa dried fruits by removing dust and other foreign particles.
• (2) Grind fruits in a dry grinder or pulverizer.
• (3) Filter the powder through sieve with mesh size 85.
• (4) Store the powder in an air-tight glass or food-grade plastic container and store in a dry, cool place away from direct sunlight.
• (5) Soft decoction or infusion is prepared by boiling 2 to 3 grams of Shatpushpa in 50 ml of water until half of it remains. Or, soak Shatpushpa fruits in 25 to 30 ml of hot water for half an hour and then filter the contents to obtain infusion.

Dosage form

Brownish powder and decoction is light brown liquid.

Therapeutic properties

The preparation has anti-spasmodic, stomachic, carminative, antiflatulent and emmenagogue properties.

Dose and mode of administration

Two to three grams of the powder is to be taken twice a day with warm water, preferably after meals. The powder can be mixed with an equal amount of honey and swallowed with warm water or milk.

Or, 25 to 30 ml of decoction or infusion can be taken twice or thrice daily. For continous pain or heaviness use of 2-3 teaspoonsful (10-15 ml) infusion is recommended at hourly intervals.

Indications and uses

• (1) Painful menstruation with or without abdominal symptoms.
• (2) Shatpushpa is also indicated for improving menstrual flow and lactation after delivery.
• (3) It is also used as a household remedy for first-hand management of common ailments like diarrhoea, flatulence, indigestion, acute abdominal pain and fever.

Precautions and safety aspects

• (1) Hot (pungent) spicy and sour food items should be avoided during menstruation and medication with Shatpushpa powder. In summer either the dose of Shatpushpa should be reduced or should be taken with some cooling, soft and soothing liquid.
• (2) Use of Shatpushpa may be discontinued if menstrual blood flow increases and symptoms of giddiness, heat, burning, excessive thirst and dryness appear. These symptoms usually appear in women with hot body-mind constitution, i.e. Paittik constitution and can be negated by consuming soft, lubricating, soothing, semisolid and juicy food items.
• (3) Toxic or adverse effects of Shatpushpa are not reported in the literature.
• (4) Deep-fried, oily foods that may cause abdominal heaviness, indigestion and constipation, etc. should be avoided.
• (5) Cold water bath, dry massage, night awakening, irregularity in sleep, excessive walking, excessive coitus, strenuous exertion and mental stress, etc. should be avoided.

References

• (1) India, Ministry of Health and Family Welfare. The Ayurvedic pharmacopoeia of India. Part I. Vol. II. New Delhi: Department of Indian Systems of Medicine and Homeopathy, 1999. p. 153-154.
• (2) Lavekar GS et al. Database on medicinal plants used in Ayurveda. Vol. 8. New Delhi: Central Council for Research in Ayurveda and Siddha, 2007. p. 360.
• (3) India, Ministry of Health and Family Welfare. The Ayurvedic pharmacopoeia of India. Part I. Vol. II. New Delhi: Department of Indian Systems of Medicine and Homeopathy, 1999. p. 154.
• (4) Lavekar GS et al. Database on medicinal plants used in Ayurveda. Vol. 8. New Delhi: Central Council for Research in Ayurveda and Siddha, 2007. p. 357.
• (5) Bhavamishra. Bhavaprakasha Nighantu. Edited by Dr G.S. Pandey. Varanasi: Chaukhamba Bharati Academy, 1999. p. 35-36.

Further reading

• (1) India, Ministry of Health and Family Welfare. The Ayurvedic pharmacopoeia of India. Part I. Vol. II. New Delhi: Department of Indian Systems of Medicine and Homeopathy, 1999.
• (2) Khare CP. Indian medicinal plants. New Delhi: Springer (India) Pvt. Ltd., 2007.
• (3) Sharma PV. Dravyaguna vijnana. Vol. II. Varanasi: Chaukhamba Bharati Academy, 2001.
• (4) National Academy of Ayurveda. Medicinal plants used in Ayurveda. New Delhi: INAA, 1998.
• (5) Bhavamishra. Bhavaprakasha Nighantu. Edited by Dr GS Pandey. Varanasi: Chaukhamba Bharati Academy, 1999.

Source: Traditional Herbal Remedies for Primary Health Care - WHO