Menopause is a biological state that marks the end of the fertile window in a woman’s life. It is a natural and inevitable process, which also often entails multiple health issues for a woman. Menopause is clinically declared when a female has not had menses for 12 consecutive months.
The end of the monthly cycles brings big changes in the functioning of body systems and the health of a woman. Her body starts to prepare for these changes several years ahead, a time period termed as perimenopause. The average age of Menopause is described to be 51 years in modern scientific texts and in the Ayurvedic texts.
As a woman approaches the late 40s, fewer follicles grow during each cycle. This leads to irregular ovulation or anovulation (absence of ovulation) and subsequently irregular menstrual cycles and vaginal bleeding. Eventually, a state is reached where the supply of follicles is depleted, and ovulation doesn’t occur anymore.
A regular menstrual cycle and changes in the menstrual cycle, until a complete stop are orchestrated by the hormones gonadotrophins, steroids, and inhibins.
Menopause in Ayurveda
According to Ayurveda, Menopause marks the beginning of the Vata stage of life. Vata Dosha accompanies several attributes, which have both positive and negative effects on the physical and psychological functioning of our body systems. To avoid any imbalances and hence diseases, one needs to carefully incorporate changes in diet and lifestyle.
Menopausal symptoms are due to the imbalance of the Doshas (Vata, Pitta, and Kapha) which occurs as a natural and gradual consequence of aging. Menopause is termed as Rajonivritti or absence of bleeding. Following are termed as reasons for Menopause:
- Nature – Swabhava – Due to hereditary factors. In the absence of any nutritional deficiency, women will have menopause almost at the same age as their mothers and sisters have had.
- Jarapakvasharira – Aging is one of the primary reasons for decreased activity and strength of reproductive organs.
- Dhatukshaya – Loss of reproductive tissues.
- Effect of dosha – Aggravation of Vata Dosha, often leads to Amenorrhea and may trigger early menopause in some.
- Abhighata – Approaching menopause age. This falls in the same line as that of Swabhava.
Relationship of Menopause with Dosha
In Ayurveda, the symptoms of Rajonivritti are due to the dominant Dosha during the perimenopause and menopause stage. A woman would fare through the transition without any health issues if all the Doshas are balanced by adopting modifications in diet and lifestyle.
However, exposure to stress, environmental pollutants, lack of routine, faulty diet, and sedentary life lead to aggravation of Dosha, causing health issues specific to each Dosha as listed below.
Symptoms of Vata aggravation in Menopause
- Dryness in vagina
- Extremities get cold
- Insomnia – Difficulty in getting sleep
- Mild to variable hot flashes (Invariable)
- Mood swings
- Dry and wrinkled skin
Symptoms of Pitta aggravation in Menopause
- Excessive hot flashes
- Night sweats
- Extremely heavy periods with a burning sensation
- Skin rashes
- Associated complaints such as UTI (urinary tract infection).
Symptoms of Kapha aggravation in Menopause
- Weight gain
- Feeling of heaviness
- Lethargy, depression
- Lack of motivation
- Hormonal changes such as Thyroid malfunction
- Fibrocystic changes in the uterus or in the breast
- Excessive fluid retention
- Sentimental and Highly emotional
- Lack of Interest
General Management of Menopause with Ayurveda
Aahara – Dietary Guidelines
Food items to be Eaten
- Whole foods such as grains, fruits, and vegetables
- Vitamin E – nuts, eggs, olive oil
- Vitamin D – egg yolk, fish liver oils
- Calcium Foods – milk and milk products, green leafy vegetables, cereals, fruits like custard apple and dates
- Phosphorus – milk, dry fruits, guava
- Sweet juicy fruits like grapes, pears, plums, mango, melons, and apples also serve the purpose to alleviate hot flashes.
- Summer vegetables like yellow squash and cucumber are also advised as good options.
- Stay hydrated with warm water and herbal teas.
- Phytoestrogens to naturally balance the declining levels of Estrogen.
- Herbal teas made from lemongrass, fennel, cumin, carom seeds, and fenugreek to balance the hormones and also for micronutrients.
Food items to be avoided
- Spicy food, extremely hot, and fried foods
- White flour-based products
- Refined and processed foods
- Chocolate, Coffee, and Black Tea
- Unhealthy and burnt fats like vanaspati and refined vegetable oil
- Sugary foods
- Excessive salt. Avoid table salt and replace with little amounts of rock salt
- Alcohol should not be taken as it aggravates Vata Dosha, promotes constipation, and leads to dryness of the body
Vihara – Lifestyle Guidelines
- Eat regular meals at about the same time of day
- Get enough sleep of at least 6-8 hours. Go to bed early and rise with the Sun.
- Engage in relaxing activities, go for walks, swimming, spend time in nature.
- Avoid eating during the period of nervousness and worries.
- Do weight-bearing exercises such as hiking in nature, brisk walking, and swimming.
- Avoid staying up late at night.
- Avoid eating till late in the night.
- Quit or avoid smoking specifically if you are suffering from hot flashes.
- Women should avoid the suppression of natural urges and excessive physical activity.
Yoga also plays an important role in alleviating menopausal symptoms. Yoga helps to make the body more flexible, improve posture, and ease many menopausal problems.
- Yoga and breathing meditation techniques like Anuloma Viloma and Kapalbhati may help to reduce anxiety and psychological disturbances.
- Asanas like Trikonasana, Tadasana, Padmasana, Matsyasana, and Shalabhasana strengthens abdominal muscles and pelvic floor. Yoga exercises have positive benefits for both the physical and mental health of menopausal women.
Panchkarma chikitsha or therapy involves physical therapies that thoroughly cleanse and purify the physical and mental impurities from the body and mind.
The general purpose of the Panchakarma therapies is to loosen, liquefy and remove the vitiated substances and Doshas from their abnormal sites in peripheral tissues via their natural pathway of elimination.
- Snehan, Swedana is very beneficial in curing various ailments of Menopause.
- Abhyanga followed by light Swedana helps to pacify Vata and improves circulation.
- Shirodhara particularly is very effective in hot flushes and psychological disorders like mood swings, anxiety, and depression, etc.
- Hrid Basti and Dhara also helps to alleviate these symptoms.
It is the method which retards the aging process, increases longevity, talent, and vitality and makes the body fit to overcome the factors causing ailments.
Triphala: It consists of Haritaki, Vibhitaki, and Amalaki. It pacifies all the three Doshas. Also, it is an excellent Vayasthapana (anti-aging agent).
Ashwagandha: It is a powerful antioxidant & immune modulator. It improves muscle mass and relieves stress. In Menopause, it controls effectively the vasomotor symptoms (Hot flushes, night sweats, palpitation).
Ayurvedic Management of Dosha Imbalance
For Vata Dominant Menopause
- Increase warm food and drinks, regular meals.
- Decrease caffeine and other stimulants, refined sugar, cold drinks, salads.
- Early bedtime, meditation, and yoga.
- Oil massages using almond and olive oil.
- Regular exercise like walking
- Ashwagandha, Arjuna, Cardamom, Garlic, and Sandalwood.
- Use spices such as fennel and cumin.
For Pitta Dominant Menopause
- Increase cooling foods, water intake, sweet juicy fruits (grapes, pears, plums, mango, melons, apples,) zucchini, yellow squash, cucumber, organic foods.
- Avoid hot spicy foods, hot drinks, and alcohol.
- Oil massage using coconut and sesame oil.
- Use Meditation and other techniques to reduce anger, hatred, and resentment.
- Exercise and exposure to the sun are limited.
- Arjuna, Amla, Saffron, and Sandalwood.
- Use spices such as cinnamon, cardamom, and fennel.
For Kapha Dominant Menopause
- Prefer light, dry and warm food, Consume fruits, whole grains, legumes, vegetables.
- Avoid meat, cheese, sugar, cold foods, and drinks.
- Weekly fasting is helpful.
- Most, or all of the daily food should be consumed before 6 p.m.
- Get up early.
- Do self-massage or Abhyanga with Mustard oil and linseed oil.
- Cinnamon, Guggulu, Mustard, Haritki, and Nagarmotha.
- Use spices such as black pepper, turmeric, and ginger.