What is the Menopause?

Menopause is defined as the cessation of a woman’s menstrual periods [ for 12 months]. It causes various physical and psychological symptoms as a result of lack of oestrogen hormone. Western medicine provides treatment with HRT which replaces the missing hormones; however, it does not suit everyone. There are risks of developing certain cancers associated with taking HRT. Also, maybe women simply want to manage the menopause without medical treatment such as HRT.

What is the Ayurvedic view on Menopause?

As menopause is not a disease as such, Ayurveda promotes a holistic diet and lifestyle-based approach to managing the menopause. Ayurveda also advises stress reduction, weight management and proper herbal supplementation. Herbal medication can also be given if needed to manage more severe symptoms. It occurs between the ages of 45-55. In the East attitudes towards the condition are more positive than in the West where it can be viewed as a crisis, rather than a normal transition in a woman’s life. The concept of preparation for this time of life is very important. By developing healthy routines and habits earlier in a woman’s life , it can minimize the effects of menopause.

What does an Ayurvedic assessment of a patient with menopause involves?

Ayurvedic assessment of menopause looks to find which dosha or subtle energies are imbalanced in each case. Essentially confirmation of menopause is a clinical diagnosis made by taking a detailed history focussing on physical and especially psychological symptoms. Careful questioning about a woman’s menstrual history is needed to determine exactly what phase of menopause is present – either pre- [ before], peri- [ during] and post- [after] menopause.

Menopausal symptoms are broadly divided into:

1. Vasomotor symptoms such as hot flushes, skin changes, vaginal dryness and reduced libido. These indicate a Pitta type imbalance.
2. Psychological symptoms such as, increased stress and anxiety, brain fog, difficulties in concentration, depression. These are due Vata imbalance.

An Ayurvedic consultation will involve a comprehensive and detailed assessment of diet / nutrition, digestive status, elimination of waste products [ urine, stool and sweat], lifestyle, routines and daily habits. Of particular importance is a psychological assessment of the patient as well as her stress / anxiety levels and emotional state. Physical examination may be needed to check.

1. Posture, [any slumping shoulders or loss of height which may indicate osteoporosis of the spine].
2. Gait, flexibility, muscle tone and strength and general fitness level.
3. Skin – healthy / wrinkled dry?

Once this is completed, we will have a clearer indication as to the factors in her life which causing her imbalance or imbalances, which manifest as symptoms as described above.

Treatment

This is dependent on which dosha imbalance is dominant either vata, pitta or even kapha. Consider treatment under following categories for each.

1. Nutrition dietary plan.
2. Lifestyle including daily routines, exercise, yoga, meditation, stress reduction, massage/use of herbal oils , sleep hygiene, counselling talking therapy.
3. Herbs/medication

VATA

Characterised by following symptoms. Nervousness, anxiety/ palpitations, mood swings, depression, insomnia. Loss of skin tone, vaginal dryness, feeling cold, joint pains, irregular periods [ perimenopause] Constipation, bloating.

Treatment advice

1. Diet – warm food [ stews] and drinks, regular meals, encourage warming spices fennel, cumin, ginger, pepper, cinnamon.
2. Avoid stimulants – caffeine alcohol, cold drinks, sugary drinks, oats [ rice better], beans [ except tofu and mung dal which can be eaten]
3. Lifestyle – regular routine, early bed, meals on time, oil massage with Maharayana oil, almond or olive oil, light exercise [ walking] yoga, relaxing meditation. Essentially trying to get the patient to slow down!
4. Herbs/ medication – heating herbs as listed above, ginger, pepper, cumin

Remember to use specific remedies to address any imbalance in digestive fire or accumulation of toxins [Ama].

PITTA

Predominant symptoms

Psychological – anger, irritability, temper

Skin – flushing, heat, night sweats, rashes, acne.

Reproductive / urinary- heavy periods, / Urinary tract infections.

Treatment

1. Nutrition / diet – increase cooling sweet foods, fruits [ big juicy fruits], spices to pacify Pitta, such as coriander, cardamon, fennel. Cooling oils olive and coconut.
2. Avoid hot spices, drinks and alcohol, peppers, tomatoes, red meats and honey [heating]
3. Lifestyle – routine again, bed before 10pm, avoid strenuous exercise [ recommend walking in nature by water], massage with cooling oils eg coconut /sesame oils.
4. Meditation/ yoga to reduce anger and stress levels.
5. Herbs/ supplements
6. Cooling herbs coriander ,cardamom, mint, fennel [ very good after meals], saffron.

Medication

Shatavari choorna [ often used with ashwaganda] Kumari oil application for skin problems
Paaka choorna for pitta balancing digestive issue.
Remember to use specific remedies to address any imbalance in digestive fire [ agni deepana] or accumulation of Ama [ ama pachana]

KAPHA

Not a common presentation in menopause, but can occur with symptoms such as lethargy, depression, weight gain, fluid retention, slow digestion, lack motivation. Briefly favour a more light, dry and warming foods and spices [ caution with salt as fluid retention] Rejuvenation/ stimulating lifestyle interventions for this imbalance.

Conclusion

Menopause is an interesting condition to consider from an Ayurvedic perspective. It is a natural transition in a woman’s life which can last over several years with different phases. It can present with imbalances in various doshas either single or multiple, commonly in the vata /pitta doshas. Emphasis on preparation / preventative strategies in the lead up to menopause is vital. These must focus on the core principles of Ayurveda to maintain optimum health.

These are diet /nutrition, lifestyle, exercises, stress reduction using yoga and meditation, and use of herbs and spices in food preparation. This will require significant motivation on the part of the patient as it will require discipline and development of new habits and routines. It can help to think of menopause as a “wake up call” for woman’s overall health.

This will encourage them to pay more attention to their health and lifestyle at a critical juncture in their life. This will ensure the best possible outcome. In addition to the above advice, herbal remedies and supplements can be prescribed to manage the acute symptoms caused by the doshic imbalances. The information and advice included above are general recommendations and do not form a treatment plan.

Menopause can be a complicated presentation and always seek a professional consultation from a qualified Ayurvedic practitioner for the best outcome. Self-diagnosis and treatment is fraught with difficulty and may make your conditions worse!