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Menopause Natural Support with Ayurveda

Author : Gurnam Saini  

MENOPAUSE

 

 

 

Menopause is known as Rajonivritti in Ayurveda. Rajonivritti is a combination of two words – Rajas meaning Menstrual blood and Nivritti means Stoppage or permanent cessation. Acharya Susrutha mentioned 50 years of age as ideal for menopause. But the present day fast paced lifestyle and unhealthy food habits aggravates Vata Dosha in our body leading to early menopause. 

 

Three stages of life

 

Life span of individual is divided into three stages – Bala (Childhood), Madhya (Middle age) and Vriddha (Old age). Kapha, Pitta and Vata Dosha dominates during childhood, middle age and old age respectively. 

 

In Menopause, Vata and Pitta Doshas are dominant whereas Kapha Dosha is reduced, hence there is degeneration of tissues, especially the reproductive tissues. 

 

What is Menopause?

 

The absence of menses for 12 consecutive months is called menopause. Menopause is a natural aging process however more recently it has become a health problem. Ayurveda has explained the different problems faces by the menopausal women and its treatments too. Diet and lifestyle during menopausal period are also explained in Ayurveda classics. Primarily the ovarian function becomes inactive during menopause which also causes somatic and psychological changes in the body. Although it is a normal physiological process, it can cause discomfort to the body and mind leading to a group of symptoms known as ‘Menopausal Syndrome’ that will need treatment.

 

Menstrual blood is the by-product of the first tissue, Rasa Dhatu (Lymph / Plasma). The functioning of menstrual cycle and health of reproductive tissue are dependent on the health and quality of Rasa Dhatu. As Rasa Dhatu’s function and health is good during adulthood and decreases during old age, menstruation also gradually decreases and finally stops in old age. Ayurveda classics describe the age of menarche as 12 years and age of menopause as 50 years. The menstrual blood is Agneya, that is it has the properties of fire because the foetus has the qualities of both fire and water. (Reference 1)

 

Causes of Menopause 

 

Ageing and menopause both occur because of the progressive reduction in functions of Agni (Digestive and Metabolic fire) and Srotas (Channels of circulation) resulting in inadequate nutrition of the tissues. In the universe, nothing is eternal. According to the theory of natural destruction postulated by SwabhavaparamVada, destruction is caused by the absence of factors responsible for production. 

 

Passage of time - Time is a major factor behind any process. Time is the reason for the characteristics of a particular age and specific changes that take place in different stages if life. Acharya Charaka mentions that a child becomes young and old due to the passage of time.

 

Natural Phenomenon - Ageing and menopause are natural phenomenon that take place during one’s life in a generalised manner. Birth, degradation of the body and death are natural phenomenon. Menstruation and reproduction are also physiological entities that degrades, ultimately leading to Menopause. Menstrual fluid and reproductive capability begin during the natural course of life, they will also bound to naturally deteriorate over the period of time and ultimately get vanished by nature.

 

Involvement of Vata Dosha - Vata is the controller of all activities in the body as well as in the universe. Vata is responsible for initiation, progression and destruction of any activity. There are five subtypes of Vata, two (Apana and Vyana Vata) of which are responsible for the functions related to uterus, which initiates the menstrual cycle. Ageing causes degeneration of the tissue health leading to dryness and emaciation in the body which in turn aggravates Vata Dosha. This in turn causes vicious cycle which affects the normal functioning of Vata Dosha leading to hampered formation and discharge of menses thus causing Menopause. Hence it can be understood that increased Vata is the cause of Menopause. 

 

Diminution in the tissue health - Tissue health is important for body health. Tissues are the functional units of the body. Maturation of tissues is necessary for production of menstruation. In childhood, as the tissues are immature, they are incapable of producing menses or reproduction. But in teenage and adulthood, the tissues are fully mature, hence menstrual cycle begins at menarche and gradually reproductive age of the women starts too. However, as age advances, tissue health deteriorates gradually leading to quantitative and qualitative decrease of Rasa Dhatu because of which menstruation is not produced in the normal way and gradually stops, so is the quality of reproduction. 

 

How does Menopause occur? - Nutrition from diet leads to nourishment if bodily tissues including Rasa Dhatu, the by-product of which is menstrual fluid. As we age, Vata Dosha increases in the body naturally. The properties of Vata Dosha mainly lightness and dryness qualities are opposite to the unctuousness and nourishing qualities of Rasa Dhatu. Because of aggravation of Vata, the liquid or fluid nature of all the body tissues which is responsible for cellular nutrition gets reduced hence they become incapable to nourish the cells and the cells become under nourished and senile leading to Menopause.

 

Timely Menopause - Menopause is a natural phenomenon and Acharya Charaka says menopause has no treatment, meaning it cannot be stopped or prevented. However, the discomforts caused due to menopause because of improper diet, lifestyle and increase of Doshas can be managed effectively through Ayurveda. Menopause that which occurs around the age of 50 years is called Kalaja Rajonivritti or Timely Menopause.

 

Untimely menopause - If menopause occurs before the age of 50 years it is called Akalaja Rajonivritti or untimely menopause and it can lead to health problems too. Due to Abhigata (indirect trauma) to the uterus or arteries) will lead to cessation of menses which manifests as untimely menopause. Also, unfavourable environment such as constant exposure to high stress conditions or malnourishment causes early ageing, thereby leading to early or untimely menopause.

 

Factors involved in Menopause

 

Doshas vitiated – Vata, mainly Apana Vata

Dushya / Tissue vitiated – Rasa (Plasma) and Rakta Dhatu (Blood tissue)

Status of Agni / Digestive and Metabolic Fire – Manda or Low

Srotas / Channels of circulation involved - Artavavaha (Menses carrying channels)

Seat of Manifestation – Uterus

 

Ayurveda Approach of Menopause

 

Ageing is inevitable but early ageing or untimely aging can be prevented by adopting healthy diet, lifestyle and Ayurveda treatment. Rasayana or Rejuvenation is a branch of Ayurveda which treats diseases and slows down ageing process or helps in healthy ageing. There are two goals of Ayurveda treatment – First is to improve the health of the healthy and second is to treat diseases. Treatment of menopause comes under the first goal. Cells suffer from stress due to constant wear and tear off the body leading to compromised cellular health causing deterioration of the bodily functions. Ayurveda treatments have rejuvenation and revitalisation benefits that increase body’s immunity and slows down the ageing process. Rasayana can be administered to the healthy as well as diseased because it helps in adaptation and survival by inducing secretion of hormones and enzymes needed by the body. Thus, we can say that Rasayana helps to maintain health, prevent diseases and slows down ageing process. 

 

The three types of Rasayana for management of menopause explained in Ayurveda texts are 

 

Achara Rasayana – These are lifestyle and habits which when adopted gives Rasayana benefits. Following daily and seasonal regimen mentioned in Ayurveda texts help to reduce stress and strain on the body, thereby delaying ageing process and menopause and minimising the symptoms caused during menopause. Proper and timely meals, regular exercise and timely sleep is important.

 

Ahara Rasayana – Some specific diet has Rasayana benefits. In menopause, there is depletion of tissues and reduced immunity. Hence diet consisting of milk, ghee, black lentils, chickpea and vegetarian diet is considered beneficial. This diet will help in preventive management of menopause as they are good source of phytoestrogens and help in mineralization of bone as well.

 

Dravya Rasayana – Certain herbs have Rasayana effect on the body and hence administration of such herbs will help in positive effect on the body during menopause. Some of the Rasayana herbs during menopause and their effect on the body are explained below.

 

  • Shatavari (Asparagus racemosus) is commonly known as the female uterine tonic and is packed with phytoestrogens. It helps to relieve menopausal symptoms like hot flashes, night sweats, mood swings, anxiety and loss of libido.

 

  • Ashwagandha (Withania somniferra) improves sleep quality and helps in insomnia during menopause. As Ashwagandha is anabolic it improves tissue nourishment.

 

  • Ashoka (Saraca indica) helps to improve ovarian function.

 

  • Amalaki (Phyllanthus emblica) is rich in Vitamin C and has antioxidant properties. It supports healthy functioning of all organs and has anti-aging benefits.

 

  • Bala (Sida cordifolia), as the name suggests (In Sanskrit Bala means strength) it is a strength promoter and excellent pacifier of Vata Dosha hence helps to improve immunity and body strength in Menopause.

 

  • Kumari (Aloe vera), as the name suggests (In Sanskrit Kumari means Young girl) it has a regenerating effect on the female and it restores youthfulness.

 

  • Yashtimadhu (Glycyrrhiza glabra) is a coolant that helps relieve hot flushes, night sweats and excess sweating. It is also one of the Medhya Rasayana herbs that strengthen memory and intellect.

 

  • Asthisringala (Cissus quadrangularis), Godanti (Gypsum), Praval Pishti (Coral calcium), Mukta Pishti (Purified pearl) are suggested for fragile bones as they are rich in calcium and strengthens bones and helps in conditions like osteopenia, osteoporosis.

 

The above herbs, as well as spices mainly cumin, fenugreek and fennel reduce the severity of menopausal syndrome as they have phytoestrogen effects, thereby improves quality of life. Phytoestrogens are considered as the dietary oestrogens which are non-steroidal plant derivates, hence might be more safer option than synthetic oestrogens. They are structurally and functionally similar to the naturally occurring oestrogen compounds in the body hence mimic the effect of oestrogens reducing menopausal symptoms.

 

Thus, Rasayana management of menopause helps to improve immunity, gives calmness of the mind, enhances vitality, stimulates metabolism, slows down degeneration.

 

Panchakarma can help in Menopause

 

Ayurveda detoxification procedures are useful in menopause. As the cellular nutrition is compromised because of low digestive and metabolic fire, Panchakarma procedures according to one’s constitution and menopausal symptoms are suggested for betterment.

 

  • Vamana or Therapeutic emesis is suggested when there is Kapha imbalance like weight gain or metabolic problems like Hypothyroid or High cholesterol are experienced by the menopausal woman.
  • Virechana or Therapeutic Purgation is effective in Pitta imbalances like hot flushes, night sweats, burning sensation as well as in metabolic disorders as Virechana helps to correct metabolism. Ghritapana (Internal oleation) prior to Vamana and Virechana are done using medicated ghee such as Sukumara ghrita or Triphala ghrita.
  • Basti or Therapeutic enema is the best among all other Panchakarma in menopause because primarily menopause is caused due to vitiation of Vata Dosha and Basti directly acts on the seat of Apana Vata which is responsible for menopause, hence it is more effective. Also, since Basti Panchakarma has anti-aging, immune promoting and Rasayana benefits it is beneficial in menopause. Anuvasana or Matra Basti (Oil enema) using Sukumara ghrita or Dhanvantaran oil is suggested. For Niruha Basti (Concoction or cleansing enema), a mixture of Dashmool decoction, Sukumara ghrita, paste of Shatapushpa or Brahmi, milk honey and rock salt is suggested. 
  • Nasya or Nasal medication with Brahmi ghee helps to reduce emotional problems associated with menopause. Nasya helps to reduce mood swings, irritation, anxiety, insomnia, night sweats and improves focus and memory. 
  • Shirodhara with medicated milk and decoction of Yashtimadhu helps to calm down the nervous system and reduces anxiety and stress.
  • Abhyanga or Ayurvedic massage with lukewarm sesame oil or medicated oils like Kshirabala oil or Dashmool bala oil help to improve circulation, reduce weakness, stiffness and body aches. 

 

Management of Menopausal Symptoms Naturally

 

Menopause influences the physical, psychological and emotional aspects of a woman. The tremendous changes that occur in the body during menopause due to hormonal changes may cause loss of equilibrium of the Doshas leading to different symptoms like hot flushes, black pain, vaginal dryness, mood swings, etc. The depletion of body tissues also leads to various symptoms.

 

  • Decrease of Rasa Dhatu (Plasma / Lymph) causes palpitations, dizziness, dryness, excess thirst, pain in the body and intolerance to noise.

 

  • Decrease of Rakta Dhatu (Blood tissue) causes dryness in the body.

 

  • Dryness, pain in joints, pricking pain occur due to decrease of Mamsa Dhatu (Muscle tissue).

 

  • Pain in the bones, dryness of the hairs, hair fall and looseness of joints occur due to decrease of Asthi Dhatu (Bone tissue).

 

  • Weakness, tiredness, bone pain occurs due to decrease of Majja Dhatu (Bone marrow).

 

  • Pain in the vagina, tiredness, weakness and anaemia occur due to decrease of Shukra Dhatu (Reproductive tissue).

 

The menopausal symptoms, doshas involved and suitable Ayurveda suggestions are listed in the table.

 

 

Menopausal Symptom

 

 

Doshas Involved

 

Ayurvedic Suggestion

 

Shirashula: Headache

Vata Pitta

  • Muktasukti and Godanti are suggestions.
  • Apply one drop of ghee inside each nostril at bedtime
  • Nasya Panchakarma is suggested
  • Reduce excess intake of cold food and drinks.
  • Avoid fasting or long gap between meals

Hridspandana: Palpitations

Vata Pitta

  • Brahmi is suggested.
  • Shirodhara treatment helps.
  • Do everything at slow pace
  • Avoid over strain
  • Avoid coffee, tea, spicy food

Balakshaya: Weakness

Vata

  • Intake of Ashwagandha and Guduchi are suggested
  • Eat timely food
  • Include ghee and milk in daily diet.
  • Abhyanga and Basti Panchakarma are useful.

Vibandha: Constipation

Vata

  • Take one tsp Isabgol (Psyllium husk) at bedtime with a cup of warm milk. Alternatively, Avipathikar churna 1 tsp at bedtime with a cup of warm water will help.
  • Include sesame seeds and flax seeds in diet
  • Stay hydrated, drink 6 to 8 glasses of water daily
  • Include sufficient ghee or oil in diet
  • Include more cooked or steamed vegetables but reduce raw salads.

Ati Sthoulya: Weight gain

Kapha

  • Regular exercise for 45 minutes to one hour atleast 5 times a week
  • Be physically active during the day.
  • Drink lukewarm water
  • Reduce excess intake of cold food and drinks, refined sugar, saturated fats, meat in diet.
  • Udwartana (Herbal powder scrub), Vashpa Swedana (Steam bath), Virechana and Basti Panchakarma are suggested.

Vali: Appearance of wrinkles

Vata

  • Apply coconut oil or Ghee cream on face and gently massage the face. Also, application of aloe vera gel on the face is beneficial.
  • Use of Amalaki internally is suggested.

Anidra: Insomnia

Vata

  • Take a cup of warm milk added with 2 pinches of nutmeg and 1 crushed cardamom at bedtime.
  • Shirodhara and Tarpana treatments are beneficial.
  • Massage feet with lukewarm sesame oil at bedtime.

Asthi Kshaya: Osteoporosis

Vata

  • Kshirabasti (Enema with milk medicated with bitter herbs like Guduchi, Nimba, etc) is beneficial.
  • Take Praval Pishti, Godanti, Asthisringala herbs.
  • Include milk, yoghurt and sesame seeds in diet.

Osha: Hot flushes

Pitta

  • Use cotton or linen dresses
  • Drink fennel infusion, coconut water
  • Include milk, ghee and juicy vegetables like squash in diet.

Swedadhikya: Excess Sweating

Pitta

Same suggestions as for hot flushes

Ratri Sweda: Night sweats

Pitta Vata

Same suggestions as for hot flushes

Katishula: Low back pain

Vata

  • Massage with warm sesame oil on low back region
  • Do back strengthening exercise daily like Sarvangasana, Bhujangasana, stretching exercise.
  • Avoid long stationary standing.
  • Matra Basti (Oil enema) with lukewarm ghee or sesame oil is suggested.

Sandhi Shula: Joint pains

Vata

  • Same suggestion as for low back pain, however here specific exercise for improved mobility and stiffness of the joints like ankle / wrist rotation, knee stretching, etc. are suggested.

Krichchra Vyavayata: Loss of libido

Vata

  • Oral use of Shatavari is suggested.

Yoni Shushkata: Dryness in vagina

Vata

  • Yonipichu treatment is suggested. In Yonipichu, after voiding urine, vaginal tampon dipped in lukewarm Yonipichu oil is inserted into the vagina for 2 hours or till the next urge for urination occurs.

Yoni Srava: Vaginal discharge

Kapha Vata

  • Yoni Prakshalana (Vaginal wash) with lukewarm Triphala or fenugreek decoction

Prabhuta Mutrata: Increased frequency of Urination / Urinary Incontinence

Vata

  • Chandraprabha vati and Gokshuradi vati are suggested
  • Sitz bath in warm water added with Triphala decoction or few pinches of Tankan powder is suggested.

Vaichitya: Loss of focus

Vata

  • Apply one drop of ghee in nostril at bedtime
  • Practice Trataka and meditation
  • Shirodhara and Nasya are beneficial.
  • Herbs like Brahmi, Ashwagandha, Shankhapushpi, Saraswatarishtam are useful.

Anavasthita Chitatvam: Mood Swings

Vata

  • Kshiradhara (Shirodhara with medicated milk) is beneficial.
  • Brahmi or Saraswat ghee is useful.

Chinta: Anxiety

Vata Pitta

Suggestions for Loss of focus and mood swings will be beneficial

Amarsha: Irritability

Pitta

Suggestions for Loss of focus and mood swings will be beneficial

Vishaada: Depression

Kapha Vata

  • Nasya Panchakarma is beneficial.
  • Herbs like Jyotishmati, Vacha and Saraswat churna are suggested.

 

 

Herbal Formulations useful in Menopause

 

Taila / Medicated oils: Lakshadi taila, Dhanvatara taila

Lehya / Herbal jam: Brahma Rasayana, Shatavari Gulam

Vati / Tablet: Brahmi vati, Chandraprabha vati

Kashayam / Decoction: Saptasaram Kashayam

Arishta - Asava / Fermented Liquids: Lohasava, Lodhrasava, Usheerasava, Chandanasava, Ashwagandharishta, Ashokarishta

Ghrita / Medicated ghee: Dadmiadi ghrita, Sukumara ghrita

Churna / Herbal powder: Pushyanuga churna, Yashtimadhu churna, Ashwagandha churna, Amalaki churna, Shatavari churna

 

 

Proper diet, sleep and exercise are considered as the foundation for good health. Specific diet, sleep and exercise during menopause are explained below.

 

  • DIET

 

  • Eat timely meals, preferably freshly prepared and warm. Eat slowly and mindfully. Avoid fasting or long gap between meals. Favor natural sweet taste in diet.
  • Reduce pungent, bitter and astringent tastes.
  • Include dairy products like milk, ghee, yoghurt, buttermilk in diet. Also, all unrefined oils like olive, sesame, coconut oil are good. Include seeds such as sesame, sunflower, pumpkin seeds in diet. Wheat, rice, green gram, soya and nuts are suggested. Fruits like grapes, berries, pomegranate, oranges, lemon are good. Fresh and seasonal vegetables, especially juicy ones like squash which are well cooked is good. Coconut water, fennel infusion, fruit juices, lemon juice is good. Natural sweets like honey, raisins, figs are suggested. Alcohol, sodas, caffeinated beverages, tea, cold drinks should be avoided.
  • Excess hot and excess cold food and drinks should be avoided. Food and drinks which are lukewarm or at room temperature is best.
  • Food cravings are common because of imbalance of Doshas during menopause. However, one should opt for healthy alternatives and avoid favoring single taste in diet. Diet should comprise of all six tastes with predominance of sweet and sour tastes, moderate salty taste but less of bitter, pungent and astringent tastes.
  • Spices like fennel, coriander, mint, turmeric, cumin, dry ginger, fenugreek are good. Avoid hot spices like garlic, fresh ginger, mustard, carom seeds, chilies.
  • Prefer to take vegetarian food. Ayurveda says there are three qualities of the mind – Sattva, Rajas and Tamas states. Sattva or the balanced state is best for good physical and mental health. It has Rasayana benefits too. Sattva state of mind can be achieved by following positive habits like eating vegetarian diet, including milk, ghee, honey in daily diet; not being harsh with people, being polite, humble and having increased stress tolerance; practicing Yoga and meditation daily. Rajas

 

  • SLEEP

 

Regular and timely sleep is a must. Avoid staying awake late at night as it increases Vata Dosha hence aggravates menopausal symptoms. Also sleeping during daytime is not good as it vitiates Kapha Dosha, hence leads to aggravation of metabolic problems and weight gain.

 

  • EXERCISE

 

Avoid sedentary lifestyle. Regular exercise is suggested to maintain healthy body weight and improve physiological functions in the body. Simple exercise like Yoga, walking, cycling, swimming, jogging is good. Avoid strenuous sports or strenuous exercise like Ashtanga Yoga, Vikrama Yoga (Hot yoga) during menopause as over strain leads to further aggravation of Vata and depletion of tissues increasing menopausal symptoms. Yoga and meditation help in calmness of the mind thereby reducing problems like mood swings, sleeplessness, irritation, lack of concentration. Yoga especially Suryanamaskar (Sun salute), Tadasana (Mountain pose), Ushtrasana (Camel pose), Vajrasana (Thunderbolt / Diamond pose), Sarvangasana (Shoulder stand), Pavanamuktasana (Wind relieving pose), Setubandhasana (Shoulder supported bridge pose), Baddhakonsana (Bound angle pose), Yoga Nidra (Yogic sleep pose), Nadi Shodhana (Alternate nostril breathing), Bhramari Pranayama (Humming bee breath), Sheetali Pranayama (Cooling breath) and Mulabandha with Ashwini Mudra (Root lock with horse gesture) have a positive effect on uterus thereby on menopause.

 

 

If you wish to consult Ayurveda, you may choose to contact one of our Ayurveda Practitioners Gurnam Saini or Pooja Saini in Melbourne. Both of our practitioners are Qualfied Ayurveda Doctors from India. You may contact us at "Pure Herbal Ayurved Clinic".  People who can't reach us personally, may choose for online Ayurveda consultation. 

 

 

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Author Bio:

Gurnam Saini has over 15 years’ experience in Ayurvedic naturopathy treatments in Melbourne, Australia. He has completed his bachelor degree in Ayurvedic Medicine and Surgery from Baba Farid University of Health Sciences, India. He has done MD in Alternative Medicine and certificate courses in Panchakarma Detox, Pulse diagnosis and skin care. He is also a member of the Australasian Association of Ayurveda (AAA). He has won awards for ground-breaking work in Ayurveda globally. Read More