Menopause is the stage in a woman’s life when the menstrual cycle stops. When a woman is not menstruating for twelve consecutive months, then she has entered into the phase of menopause.  Menses is called as Raja in Ayurveda. For this reason, the stoppage of the menses flow permanently, i.e. menopause is called as Raja Nivrutti, which literally means retirement of menses. 

According to Ayurveda, this is not a disease; rather it is a natural process in a woman’s life that occurs at the age of 45-55 years. With ageing, out of three Doshas, Vata dosh increases significantly with considerable decline in pitta and kapha dosha, so menopausal symptoms occurring due to the vitiation of mainly Vata dosha. Every woman is born with definite number of oocytes (ovarian reserve). The natural depletion of the reserve and ageing of ovaries cause decrease in feminine hormones and hence menopause occurs. 

Premature ovarian Failure: Premature ovarian failure (POF) is the cessation of the ovarian function before the age of 40 year. It is confirmed by high blood levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH). 

Causes of premature ovarian failure

  • Autoimmune disorders
  • Thyroid disease
  • Women who have a functional disorder affecting the reproductive system (e.g., endometriosis, polycystic ovary syndrome, cancer of the reproductive organs) can go into menopause at a younger age.
  • Cigarette smoking
  • Higher body mass index
  • Racial and ethnic factors
  • Chronic Illnesses 
  • Surgical Menopause Stoppage of menses as a result of removal of the ovaries is called "surgical menopause"

Symptoms of Menopausal Syndrome

1) GYNECOLOGICAL

  • Dry skin or mucous membranes (including the vagina) 
  • Scanty bleeding during perimenopause 
  • Heavy bleeding during perimenopause 
  • Irregular bleeding 
  • Vaginal dryness 
  • Painful Intercourse 

2) PHYSICAL

  • Constipation or irritable bowel 
  • Insomnia 
  • Bone loss (Osteoporosis) 
  • Hot flushes 
  • High blood pressure and heart disease 
  • Weight gain - Overweight 
  • Fluid retention, edema 
  • High cholesterol or triglycerides
  • Lack of energy 
  • Joint soreness stiffness
  • Back pain
  • Breast pain
  • Heart palpitations
  • Headache
  • Dizziness
  • Dry itchy skin
  • Urinary incontinence, increased urgency
  • Heavy night sweats 

3) PSYCHOLOGICAL

  • Mood swings 
  • Irritability 
  • Anxiety
  • Worry
  • Fear 
  • Reduced libido 
  • Anger
  • Depression
  • Sadness 
  • Decreased concentration due to dullness 

An Ayurvedic approach for managing Menopause

Ayurvedic Management consist of mainly Rasayana (rejuvenation) therapy, Specific dietary guidelines, Lifestyle modification, Medicinal supplements, Panchakarma (detoxification) and Yoga. 

Rasayana (rejuvenation) therapy: It is an Important therapy for this period which leads to an overall improvement in the formation and maintenance of the living tissues and helps in the prevention of aging, improving resistance against diseases, bodily strength and mental health. 

It can be done in 4 ways:

  1. Achar Rasayan (lifestyle modification)
  2. Ahar Rasayan (Diet Modification)
  3. Dravya Rasayan (Medicine) 
  4. Panchakarma

Achar Rasayana (Lifestyle modification)

According to Ayurveda, by following Dinacharya, Ritucharya and Ratricharya aging process can be delayed and symptoms related to menopause can be minimized. Exercise should be inevitable part of lifestyle. Yoga and Pranayama for specific condition like backache/ knee pain/ stress/ obesity should be learned from an experienced teacher and should be followed REGULARLY. 

Ahar Rasayan (Diet Modification)

  • Diet can be a crucial tool in menopause management. 

Pitta related symptoms

  • If you are prone to Pitta-based problems, such as hot flushes or excessive irritability, follow a Pitta-pacifying diet: avoid foods that are spicy, such as chilies, black mustard seed. 
  • Salty foods and sour foods such as ketchup,chips, etc. Favor foods that are bitter, astringent and sweet, as these are cooling to Pitta dosha. 
  • Sweet foods include rice, milk and Ghee which pacify Pitta dosha. 
  • Cook with Pitta-reducing spices, such as cinnamon, coriander, cardamom and small amounts of cumin seeds.

Vata related symptoms

  • If you experience Vata-related symptoms of menopause such as bloating or vaginal dryness, then eat foods that are sweet, sour and salty as this balances Vata dosha. 
  • Avoid Processed sweet food as cakes Pastries,tetra pack juices and processed salty food like chips and biscuits. 

For both Pitta and Vata related symptoms

  • Milk and Ghee plays important role. It is also important to keep your digestion strong and free of ama (Product of indigestion). 
  • Avoid eating foods that are packaged, processed, frozen, canned or left over. 
  • Eat organic foods that are cooked fresh. Your diet should consist of whole grains, fresh fruits and vegetables, and legumes Avoid heavy foods such as meat, cheese and ice cream and curd especially at night. 

Dravya Rasayan (Medicinal Supplements)

Shatavari, Ashwagandha, Chandrashur, Shankhpushpi, Bala, Ardrak, Shatapushpa , Blackgrams etc can be taken under proper guidance

Panchkarma

  • Basti- As menopausal period is under influence of Vata dosha and Mainly Apan Vayu, Basti is the best treatment for vitiated Apan vayu and eventually for disturbed menstrual cycle or heavy bleeding. 
  • Intrauterine instillation (Uttarbasti) of sterile medicine (oil or Ghee) is helpful in heavy bleeding. 
  • Panchatikta shiroBasti is also helpful in the condition of osteoporosis
  • Local Treatments Like Janu Basti, Manyabasti and Katibasti (Holding Oil over Knee, neck and back respectively) for Knee, neck and back pain are also helpful.
  • Recurrent vaginitis, dryness or inflammatory conditions in Pap’s smear can be treated by local irrigation of lukewarm herbal decoctions (Yoni Prakshalan) and keeping oil soaked tampon in vagina is also helpful in the conditions of vaginal dryness, cervicitis and first degree uterine prolapse.
  • Shirodhara: Shirodhara is continuous pouring of lukewarm oil or decoction or milk or buttermilk on forehead (in between both eyebrows). This procedure helps to reduce stress, sleeplessness, anxiety, irritability, hypertension, hair problems etc. It relaxes body and mind as well. 
  • Abhyang:· Abhyang and Sweden (whole body massage and steam) are one of the traditional measures to relieve stress. This procedure helps to get rid of vitiated vata and hence we get pain relief and relaxation. 
  • According to Ayurveda we should practice Abhyang routinely on head, ear and foot/sole.
  • Oletion by medicinal leaves pack (Patra Pinda Sweda) is also helpful in knee/back/neck pain.