Premenstrual Symptoms: An Ayurvedic Perspective on Pathogenesis and Holistic Management

Premenstrual symptoms (PMS) represent a spectrum of recurrent physical, emotional, and behavioral disturbances that occur during the luteal phase of the menstrual cycle and subside with the onset of menstruation. Affecting a significant proportion of women of reproductive age, PMS can impair quality of life and daily functioning. In modern medicine, its etiology is considered multifactorial, involving hormonal fluctuations, neurotransmitter imbalance, and lifestyle factors. Ayurveda does not describe PMS as a single disease entity; however, its symptomatology can be understood under the concepts of Artava Vyapad, Ritucharya, and imbalance of Doshas, predominantly Vata and Pitta. The vitiation of Apana Vata, along with associated Pitta and Kapha disturbances, plays a central role in the manifestation of symptoms such as mood swings, irritability, abdominal pain, breast tenderness, and fatigue. The Ayurvedic approach emphasizes a holistic management strategy including Ahara (dietary modifications), Vihara (lifestyle regulation), and Aushadhi (herbal medications). Therapeutic measures such as Snehana, Swedana, and Vata-pacifying therapies, along with the use of herbs like Ashoka (Saraca indica), Shatavari (Asparagus racemosus), and Lodhra (Symplocos racemosa), have shown potential in alleviating symptoms. Additionally, practices like Yoga, meditation, and adherence to Ritucharya contribute to hormonal balance and mental well-being. Thus, Ayurveda offers a safe, individualized, and preventive approach in the management of premenstrual symptoms by addressing the root cause through Dosha equilibrium and lifestyle correction, thereby improving overall reproductive health. 491-500