A Single Case Study on Menstrual Disorder and with Yoga Therapy

 

P. Shanthi*, Dr. (Prof.) Nalini Jeyavanthasantha

1Research Scholar, CSI  Jeyaraj Annapackiam College of Nursing, Pasumalai, Madurai Tamil Nadu

2Guide, Principal, Sacred Heart College of Nursing, Madurai Tamil Nadu

*Corresponding author Email: shanthiilango@yahoo.com

 

ABSTRACT:

Ms. X is a MSc(N) student with 23 years of age, facing difficulties due to dysmenorrhea and  has the complaint of  amenorrhea since 4 months. She states that her menstrual cycle has been irregular. Her symptoms make her difficult to concentrate at work. She feels tired most of the day, due to lack of sleep and also she expressed that she is not able to reproduce in her future. She needs effective treatment but she is confused about the right therapy for her symptoms. She is also anxious about her irregular menstruation and the effect of complementary therapy (yoga therapy). Her friends suggested that complementary therapy could be useful.

 

She has put on 6 Kg weight (92 to 98kgs) within 4 months. She was experiencing of pain in lower abdomen, low back pain and intolerant pain in both the thighs and knees. Pain character was twisting and sharp over two days during menstruation, she has attended 2 weeks yoga class, there after she started practicing yoga since six months with the duration of 15 - 30 mts twice in a day, such as Baddhakonasana (Butterfly Pose), Viparita Karani (Legs Up the Wall Pose and on lying pose), Bhujangasana, Pranayma, Dhanurasana, Paschimottanasana,Vajrasana and yoga nidtra.

 

After practicing yoga for 6 months, she had better results in her menstrual cycle, followed by continuous menstruation for 3/28 days regularly with in minimal difficulties.  Now the pain location is only on the lower abdomen and character of pain is twisting. She experiences pain only on the first day of menstruation and absence pain on 2nd day onwards. She felt that yoga is very effective and useful for her in all the aspects such as reduction of weight from 98 to 95 kgs along with hip, thighs and abdominal circumference and also reduced stress. If the women practice regularly one or two above said yoga from the adolescent period onwards, definitely they will feel comfortable during menstruation, pregnancy, postpartum period and menopausal period. In olden days women use to do all kind of house hold activities, now a days which are replaced by technology.

 

KEY WORDS: Menstrual Cycle, Dysmenorrhea, Amenorrhea, Yoga Therapy.

 

 

INTRODUCTION:

Common causes of irregular periods (Menstrual)

1.      Heavy or less workout

2.      Stress

3.      High or less body weight

4.      Infection in reproductive organ

5.      Change of life style eg - diet

6.      Hormonal imbalance

7.      Breastfeeding

8.      Miscarriage

9.      Birth control pills

 

 

Yoga Therapy for Irregular Menstruation

Adolescence is the transition period from childhood to adulthood and is characterized by a spurt in physical, endocrinal, emotional and mental growth. One of the major physiological changes that take place in the adolescent girls is the onset of menarche. It is often associated with the problem of irregular menstruation, excessive bleeding and dysmenorrhea. Generally, women’s problems are neglected in our society, particularly gynecological problems such as menstrual irregularities like excess or scanty flow etc. Menstrual dysfunction is a common problem in the population of the reproductive age group. Incarcerated women have high rates of amenorrhea (9%) and menstrual irregularity (33%), psychological factors, stress and deprivation were found to be associated with menstrual irregularities.

 

Khushbu Rani et.al. conducted a study on yogic relaxation therapy (Yoga Nidra), total of 150 female subjects suffering from menstrual irregularities were diagnosed by a senior consultant in the Department of Obstetrics and Gynecology, Chatrapati Shivaji Maharaj Medical University Lucknow, Uttar Pradesh, India. Participants were aged between 18 to 45 years with current menstrual irregularities persisting for more than six months. Women older than 18 years of age having menstrual irregularities (pathological amenorrhea, dysmenorrhoea, oligomenorrhoea, polymenorrhoea, hypomenorrhoea, menorrhagia and metrorrhagia) were included.

 

A total of 150 female subjects were randomly divided into two groups group (1) of 75 subjects (with yogic intervention) and a control group (2) of 75 subjects (without yogic intervention). Assessment of psychological general wellbeing (tool) was used for all the subjects (Cases and controls). This assessment was done twice first time in the beginning (baseline) and then after six months.

 

Anxiety decreased significantly (P<0.003) and depression (P<0.01) in the yoga group. Positive wellbeing and general health improved significantly (P<0.02) and vitality improved significantly (P<0.01) after six months of yoga therapy (Yoga Nidra) in the yoga group compared with the control group. The current findings suggest that patients with menstrual irregularities, having psychological problems significantly in the areas of their wellbeing, anxiety and depression by learning and applying a program based on yogic intervention (Yoga Nidra).

 

The socio-demographic data, details of personal history and menstrual history (last menstrual period, duration of menstrual cycle, amount of bleeding and dysmenorrhoea) and pervious treatments such as physical therapy and yoga therapy were inquired and recorded. The protocol (yoga classes) consisted of 35 min per day, five days a week intervention. Patients were subjected to Yoga Nidra intervention a deep relaxation technique, difference in score with Standard Deviation (SD) of pre-and post-treatment values improvement in psychological symptoms, significant changes in anxiety (P<0.003), depression (P<0.01), positive wellbeing and general health (P<0.02) and vitality (P<0.01) in the case group after six months of yogic intervention with comparison to the control group1.

 

There are several types of menstrual cycle problems related to irregular periods that affect the frequency of menstruation like polymenorrhoea (frequent periods - with intervals of 21 days or less), oligomenorrhoea (infrequent menstrual periods - interval between menstruation exceeds 35 days), Amenorrhea (absence of periods for more than 60 days in a woman of reproductive age, physiologically occurs during pregnancy and breastfeeding).

 

There are some other conditions which are related to pain during menstruation such as Dysmenorrhea (cramps or painful menstruation, Involves menstrual periods that are accompanied by either sharp, intermittent pain or dull aching pain, usually in the pelvis or lower abdomen)Many female also complain of pain, anxiety, depression, fatigue and vomiting during the menstrual cycle throughout their reproductive life.

 

Alternative and complementary therapy is widely accepted and advisable. Yoga helps to relieve menstrual discomfort through increased vasodilatation and subsequent decreased ischemia, release of endogenous opiates, suppression of prostaglandins and shunting of blood away from viscera thus decreasing pelvic congestion2.

 

Yoga therapy for irregular periods

a.       Baddha Konasana (Butterfly Pose)

b.      Viparita Karani (Legs Up the Wall Pose)

c.       Bhujangasana

d.      Pranayma

e.       Dhanurasana

f.       Paschimottanasana

g.      Vajrasana

h.      Badhhakonasana

i.        Yoga Nidra

 

Baddha Konasana (Butterfly Pose)

 

1.      This asana is very beneficial for pregnant women in easy and smooth delivery.

2.      Stimulate and improve the function of reproductive system.

3.      Improves blood circulation.

4.      It helps to stimulate the abdominal organs, bladder and kidneys.

5.      It acts as a stress reliever.

6.      It helps in regulating menstruation.

7.      Improve flexibility in the groin and in the hip region and gives a good stretch for inner thighs, groins and knees.

 

Steps for Baddha konasana Butterfly Pose

1.      Sit straight on the floor with erect spine and bend knees by bringing feet as close as possible. Try to touch the soles of feet each other.

2.      Hold   feet tightly with hands.

3.      Inhale deeply. While exhaling press the thighs and knees downward toward the floor by pressing elbows on thighs or on the knees. Keep breathing normally and start flapping like a butter fly by bringing thighs up and down.

 

Precautions

1.      A person suffering from groin and knee injury should not perform this asana. Can perform with blanket under thighs for support.

2.      Avoid Baddha Konasna during menstruation days.

 

ViparitaKarani (Legs Up the Wall Pose)

 

The restorative nature of this posture gets blood flowing to parts of the body that need it, making it good for most any ailment including arthritis, high or low blood pressure, respiratory ailments and menopause.

 

Which ideally includes a yoga mat, yoga block and two small towels. Lie on the floor near a wall and practice deep, steady breathing. Exhale and swing the legs up onto the wall so that the heels and sitting bones are supported against it. If there is any discomfort in lower back, adjust the body slightly back from the wall so that sitting bones are not touching it. Rest the head on the mat or floor, keeping the spine straight and bend the knees a little so the kneecaps won’t lock.

 

Rest the arms out to sides. Open the shoulder blades away from the spine, relaxing the hands and wrists. Keep the legs held vertically in place, but only partially flexed.

 

Release the weight of the belly toward the back of the pelvis, deeply into the torso. Soften the eyes and turn them down towards the heart. After that come out of this restorative pose, be sure to lie on side for a few breaths before sitting upright with back against the wall, then slowly rising the feet.

 

Benefits of Legs Up the Wall Pose

·        Regulates blood flow to the pelvic regions.

·        Alleviates menstrual cramps

·        Relieves swollen ankles and varicose veins

·        Helps testicular, semen and ovarian problems in men and women respectively

·        Restores tired feet or legs

·        Stretches the back of the neck, front torso and back of the legs

·        Improves from the eyes and ears problems

·        Relieves mild backache

·        Provides migraine and headache relief, especially when done with a bandage wrapped tightly around the forehead and back of the skull

·        Helps keep young and vital or active

·        Calms the person from anxiety

·        Relieves symptoms of mild depression and insomnia2

 

Yoga poses (exercises) benefits for menstrual disorder

1.      Yoga helps to reduce stress.

2.      Regular practice reduces the upper and lower abdominal fat.

3.      Help to relax body and mind.

4.      Relieve menstrual pain.

5.      Improve the function of abdominal organs.

 

 

Bhujangasana (cobra pose)

 

 

Pranayama

 

 

Dhanurasana

 

 

Paschimottanasana

 

Vajrasana

 

Yoganidra

 

 

Yoga Nidra is a deep relaxation technique which through relaxing the mind and body reduces the effects of stress. It is a simple yet profound practice that induces deep relaxation into the whole body-mind system in a conscious way. It is often called psychic sleep because it’s as though sleeping, yet remain aware at a subtle level.

 

The main feature of Yoga Nidra is the systematic rotation of consciousness through different parts of the body. It may also involve visualizations, awareness of feelings and awareness of breath. Practice of yoga nidra is a simply scanning(keep in mind to concentrate)through the different body parts, in comfortable. Become aware of natural breath, natural incoming and outgoing breath. Repeat this for 3 times with feeling and awareness.

 

  Then begin by bringing the attention to right hand, right hand thumb, second finger, third finger, fourth finger, fifth finger, palm of the hand, back of the hand, wrist, elbow, shoulder, armpit, right waist, right hip, right thigh, knee cap, calf muscle, ankle, heel, sole of the foot, top of the foot, right big toe, second toe, third toe, fourth toe, fifth toe. Breathing comfortably feel the whole right side of the body.

 

And then become aware of the left hand, left hand thumb, second finger, third finger, fourth finger, fifth finger, palm of the hand, back of the hand, wrist, elbow, shoulder, armpit, left waist, left hip, left thigh, knee cap, calf muscle, ankle, heel, sole of the foot, top of the foot, left big toe, second toe, third toe, fourth toe, fifth toe, Breathing easily become aware of the whole left side of  body the whole right side and the whole left side and then left and right together, the whole body aware of the whole body breathing easily3.

 

General instructions

■     Avoid hot places and wear lighter clothes

■     Avoid spicy and fast foods

■     Try to avoid stress in life, stress activation of both the sympathetic nervous system.

        cause constriction of the arterioles of the vascular systems, may induce sweating and

        lack of blood supply to the body parts.

■     Do regular house hold activities and specific activities such as pelvic floor exercise.

■     Can have iron and vitamin rich diet such as groundnut candy, seesam seed candy, lemon, ginger juice or  tea with honey or jaggery and green leafy vegetables - mint juice, protein rich diet, regular consumption of fenugreek and black gram mix porridge with palm jaggery(karupatti), papaya and pomegranate fruit.

■     Keeping the body weight in normal limit.

■     Quitting smoking

■     Drinking alcohol to be avoided

■     Limiting caffeine, spicy and hot and avoid fast food4.

 

CONCLUSION:

The yoga therapy is a simple, cost effective and easy to practice and should practice twice a dayat least. This practice is helpful today’s life style because high level of stress and goal oriented life. These therapy yoga causes difficult like body pain and discomfort for few days for the beginners. But which will be habituated within 7 to 15 days. One can realize the effect within a couple of week. Yoga helps to minimize the menstrual problems and the postmenopausal symptoms in future and women can lead their life without gynecological problems.

 

REFERENCES:

1        Khushbu Rani, SC Int J Yogav. 4(1); Jan-Jun 2011   PMC3099097 Logo of jyogaInt . J Yoga. 2011 Jan-Jun; 4(1): 20–25.

2        ABC of Yoga 2003-2008, Maxlifestyle International, 11th October 2009, http://www.abc-of-yoga.com/yoga-and-health/yoga-lifestyle.asp.

3        Swami NishchalanandaSaraswati, 2004, A Systematic Course in the Ancient Tantric Techniques of Yoga and Kriyayoga, Yoga Publications Trust, Ganga Darshan, Munger, Bihar, India.

4        ShanthiP., Dr.(Prof).NaliniJeyavanthasantha, Int. J. Adv. Nur. Management 2(3): July -Sept.,2014; Page 166 -170

 

 

 

Received on 27.11.2014           Modified on 07.12.2014

Accepted on 07.01.2015           © A&V Publication all right reserved

Int. J. Nur. Edu. and Research 3(1): Jan.-March, 2015; Page 64-69

DOI: