Early Menopause affects approximately 1% of women under the age of 40 years. While Menopause is a natural physiological phenomenon that marks the end of the fertile window; early or premature menopause may expose a woman to several diseases.
It is seen in 10-28% of cases of Primary Amenorrhea and 4-18% of Secondary Amenorrhea. However, the condition is not a rare one.
The average age of menopause is 51 years, but when it appears at the age of 30s or 40s, then it is termed as Early Menopause or Premature Menopause.
Causes of Early Menopause
Ovarian failure: It may be due to premature ovarian failure, damage to ovaries by chemotherapy, radiation etc. Surgical removal of ovaries also causes Premature Menopause.
Physical, Mental and Emotional Stress: Fluctuating emotions, continuous daily stress, and strenuous work overload the body organs and systems. Chronic emotional stress is a leading cause of Early Menopause.
Genetic Disorders: Chromosomal abnormalities are reported in 10-20% of cases involving X sex chromosomes. The commonest abnormality is 45X0 (Turner’s syndrome).
Autoimmune Diseases: They are reported in 30-60% of cases. Women with autoimmune Premature Menopause are at increased risk for adrenal insufficiency, hypothyroidism, diabetes mellitus, myasthenia gravis, rheumatoid arthritis, and systemic lupus erythematosus.
Infections: Mumps is the commonest infection associated with Premature Menopause.
Pelvic tuberculosis can cause secondary amenorrhea and ovarian failure in 3% of cases.
Smoking: Polycyclic hydrocarbons in cigarette smoke are known to induce Early Menopause. It can be due to primary smoking or from secondary smoking (persons who are constantly exposed to cigarette smoke).
Inadequate sleep: Sleep is important for everybody but especially for the women in Perimenopause.
There is a severe imbalance in the levels of reproductive system hormones such as Estrogen, Progesterone, and Testosterone. Ovaries slow down their production of estrogen below 30mIU/ml so levels of FSH get increased up to 40mIU/ ml.
- Less production of Estrogen by ovaries
- Reduced levels of testosterone and estrogen
- Thinner vaginal wall.
- Frequent Urinary Tract Infections (UTI)
- Hot flushes
- Night Sweats
- Reduced libido
- Irregular periods
- Mood swings
- Vaginal dryness
Early Menopause increases the risk of several diseases in women and hence she needs extra medical, physical, emotional, and mental care to help manage the changes she is going through.
Cancer: Ovarian and colorectal cancer
Eyes: Vision loss in the form of Myopia and Byopia, and Cataract.
Teeth: Rapid tooth loss and periodontal diseases.
Osteoporosis: Women with Premature Menopause are at increased risk for lower bone density, earlier onset osteoporosis, and fractures.
Heart disease: Rapid loss of estrogen can lead to Angina and Ischemic heart disease. Estrogen is responsible for increased production of HDL (good cholesterol) and decreased levels of LDL (bad cholesterol), and triglycerides (harmful fatty acids in the bloodstream).
Parkinson’s Disease-like symptoms, Depression, Dementia, and Premature Death.
Early Menopause in Ayurveda
Menopause is the stage of transition from middle age to old age. According to Ayurveda, a woman undergoes a transition from Pitta Aadhikya Kaal (Pitta dominated middle age phase) to Vata Aadhikya Kaal (Vata dominated old age phase). So this change reflects some signs and symptoms on the body.
In Early Menopause, these signs, and symptoms become worse, as women are rapidly and untimely exposed to the predominance of Vata Dosha. This also marks untimely vitiation of Pitta Dosha and Kapha Dosha, which are respectively responsible for metabolism and growth in the body.
Hence, she is exposed to multiple health disorders related to increase of Vata and decrease of Kapha and Pitta Dosha.
Early Menopause Symptoms according to vitiated Dosha
Vata Predominance: Nervousness and affected sleep, vaginal dryness, memory problems, mood swings, dryness of hair and nails, depression, anxiety, and insomnia.
Pitta Predominance: Hot flushes, night sweats, thinner vaginal wall, anger, irritability, skin breakouts and rashes, and hyperacidity.
Kapha Predominance: Weight gain, laziness, listlessness, loss of interest, feeling the mental and physical heaviness.
Management and Prevention of Early Menopause in Ayurveda
Ayurveda focuses on strengthening and rejuvenating the reproductive system through Aahara (Food), Vihara (Physical Activity), and lifestyle modification.
Aahara – Diet and Food
Foods and Practices to Follow
- Women should consume food rich in phytoestrogens. These foods would help to balance the subsiding Estrogen levels and hence prevent related symptoms. Foods such as soya beans, legumes, sprouts, dry fruits, seeds and nuts, berries, and whole grains.
- For healthy bones and to prevent bone density related disorders, following should be consumed:
- Magnesium – whole grain, cereals, nuts, dairy products, bananas, and chlorophyll-rich vegetables.
- Calcium – dried fig, milk, and milk products, beans, pulses, seeds and nuts, cauliflower.
- Vitamin D – Get enough exposure to Sunlight from morning and evening Sun. Consume Vitamin D foods like egg yolk and animal liver.
- Vitamin K – Green vegetables, cereals, and animal food.
- Manganese – cereals, bran, nuts, and tea. Praval Bhasma may be consumed as well.
- Increase the intake of warm foods and drinks.
- Maintain regular meals and follow scheduled timings.
- Use spices as fennel and cumin.
Foods and Practices to Avoid
- Avoid excess salt, chilies, spices, sour foods, and pickles.
- Reduce the use of caffeine, stimulants, refined sugar, and cold drinks.
- Stop consuming junk food, and carbonated drinks.
- Avoid untimely meals, multiple meals, late night foods, and snacks.
- Stop the consumption of processed foods and packaged foods.
Vihara – Lifestyle Practices to manage Early Menopause
- Take sound sleep for at least 6-7 hours. Go to bed early and wake up early. The best bedtime is between 10 pm to 6 am.
- Follow a routine to keep Vata Dosha in balance. Keep regular timings for food and daily activities.
- Avoid excessive use of gadgets. Limit the use of phone 1-2 hours before bedtime.
- Spend time with family and friends.
- Pursue hobbies and interests for mental wellness
- Do bedtime massage with almond oil.
- Go for nature walks, swimming, and relaxing physical activity. Follow this on daily basis.
- Practice yoga, pranayama, and meditation regularly. They can add a better day in the early menopause transition.
Premature Menopause – Ayurvedic Perspective, European Journal of Pharmaceutical and Medical Research.