Menopause

Words: Dr Ambika P NAYAK

Aging is a natural phenomenon. Add to this the decline in the production of oestrogen and progesterone — hormones  vital for sexual and reproductive development — in women, in their late-40s, or early-50s, and you’d know why they attain menopause, or the cessation of menses — monthly periods, in common parlance. Thanks to our frenzied living, compromised, or flawed, diet and lifestyle, there is today a paradigm shift too. We are witness to seeing women attaining menopause earlier than expected — sometimes, as early as in their late-30s, or early-40s.

Menopause is defined as not having a menstrual cycle for a period of approximately 12 months. Also, the changes, or the pre-menopausal phase, could start much earlier than the actual menopause. There are no precise means of predicting when menopause would occur in a woman, although evaluating follicle-stimulating hormone [FSH] — a hormone your pituitary gland makes and releases to playing a role in sexual development and reproduction — levels may be useful.

The presentation, or symptoms, during pre- or menopausal phase can vary from person to person.

Menopause is a part of the physiological [functional] process. It is not an illness, or disease. Some women are able to cope with the emotional issues of this change of life easily, while some don’t.

Symptoms

  • Irregular cycles — less to heavy, or no bleeding
  • Hot flashes [night sweats]
  • Aches and pains
  • Dizziness
  • Mood swings
  • Anxiety and depression
  • Loss of appetite, lethargy, chilliness and palpitations
  • Gastritis — flatulence, bloating, irregular bowel movements, weight gain
  • Insomnia [sleeplessness], or other sleep issues
  • Vaginal dryness, and so on.

Emotional symptoms include weepy spells and bad temper.

Menopausal symptoms may be heightened by stress.

The conventional practice is to compensate the reduction in hormonal production through hormone replacement therapy [HRT].

Now, the big question — how to tackle the dilemmas of pre-post-menopausal syndrome — that is, menopause, per se?

The basic thing to do is to fulfil certain deficiencies found in the body, alongside a change in diet and lifestyle — one that helps to maintain a hormonal equilibrium. You should also eat better and healthy to improve the general blood counts. Make sure to eat foods that contain natural phytoestrogens, like sesame seeds, flaxseeds, garden cress seeds and shoots, dill seeds and shoots, peaches, apricots, berries, almost all the nuts and soybean and its derivatives, like chunks, milk, or tofu, including asparagus shoots. Other natural food sources, rich in iron, calcium and vitamins that you should include in your daily diet plan are drumstick and its leaves, corn, dates, figs, mustard, black caraway seeds, gourds, milk and its products, finger millet, and horse gram. It is imperative to include regular physical exercises and yoga sessions — to keeping fit and be active through the day.

Healing With Ayurveda

Health problems during menopause represent imbalances in the body that were already keyed-up in the psyche, what with diet playing a key role in balancing hormones during pre-menopause and menopause. More intense symptoms, such as frequent hot flashes, continual sleep disturbances, and moderate to severe mood swings, are signs of deeper imbalances. Ayurveda suggests that such stubborn symptoms are usually due to the build-up of wastes and toxins, referred to as ama in the body’s tissues.

Traditional   Ayurveda   detoxification   programmes, such as panchakarma may be needed to clear the body’s channels to obtain relief. This internal cleansing approach is also the treatment of choice for more serious problems, such as osteoporosis and high cholesterol. Panchakarma-abhyanga [massage], mriduswedana [sudation], shirodhara, mridu virechan [purgation], basti [enema] are just as useful.

Lifestyle also plays a significant role at the time of menopause. Rasayana therapy [rejuvenation] not only prevents aging; it also brings youthfulness to the person. It increases lifespan, memory, intelligence, health, colour and complexion, strength and performance of the organs of cognition and conation. The addition of rasayana therapy is, thus, needed for the optimal management of the disorder.

  • Meher K, Pariksha A, Priyadarshini N, Meher S, “Ayurvedic Approach to Menopause: A Review,” International Research Journal of Ayurveda & Yoga, 2022;5[8]; 167-171.

There are various Ayurvedic formulations available just as well. They are best prescribed by a professional Ayurveda physician depending on one’s body type and suitability — viz., kumaryasava, ashokarista, shatavaryadi ghrita, saptasara kashaya, lodhrasava, dhanvantara gulika, pushyanuga churna, kalyanaka kashaya etc.

Shatavari is one commonly used herb that comes as a blessing to women undergoing a bad phase of pre-post-menopause. It is available in extract form — as tablets, or capsules, powder and decoction. 500mg to 1gm per day of the extract, or 6-12gm of the root powder, is the recommended dose.

Clinical Study

A study examined the safety and efficacy of a formulated Ayurveda botanical combination in reducing vasomotor and other menopause-associated symptoms in otherwise healthy women.

Methods

This was a double-blind, randomised, placebo-controlled trial conducted with 117 healthy women, aged 40–65 years using a formulated Ayurveda medicine composed of 75mg Tinospora cardifolia [Guduchi] 100mg Asparagus racemosus, 100mg Withania somnifera [Ashwagandha] and 225mg Commiphora mukul per capsule, administered as one capsule twice per day over a period of 12 weeks. The primary outcome measure was menopausal symptoms assessed by the validated Menopause-Specific Quality of Life [MENQOL] questionnaire. The secondary outcome measures included a patient-reported diary of vasomotor symptoms, serum hormone levels and health indices (body weight, blood pressure, haematological and biochemistry markers).

Results

A significant difference was demonstrated for the total MENQOL score and the vasomotor [p < 0.001], psychosocial [p < 0.001], physical [p = 0.02] and sexual domains [p < 0.001] between the active treatment and placebo groups after 12 weeks. There was a significant reduction in total hot flushes, daytime hot flushes and night sweats in the active treatment group compared to the placebo group (p ≤ 0.001). There were no significant changes observed in serum hormone levels, or health indices between the active and the placebo group.

Conclusion

This study demonstrated a combination of Tinospora cardifoliaAsparagus racemosusWithania somnifera and Commiphora mukul to be a safe and effective treatment for reducing menopausal symptoms in healthy menopausal women over a duration of 12 weeks.

  • E Steels, M Steele, M Harold, L Adams, S Coulson, “A Double-Blind, Randomised, Placebo-Controlled Trial Evaluating Safety and Efficacy of an Ayurveda Botanical Formulation in Reducing Menopausal Symptoms in Otherwise Healthy Women.” Journal of Herbal Medicine, Vol 11, Mar 2018 [30-35].
Dr AMBIKA P NAYAK, MD [Ayurveda], is Founder & Managing Director of Ayurvedeeyam, a speciality Ayurveda Clinic, based out of Bengaluru, with a branch in Udupi, Karnataka, India. Her passion for Ayurveda, the ancient, yet ‘completest’ natural medical system, and professional clinical skills are keyed to raising awareness for Ayurveda as a first choice of treatment for illness and healthy living. Dr Nayak also has credentials of being a family physician and she is loved by her patients of all age groups. She frequently shares talks regarding health with corporates and is a strong advocate of panchakarma, thanks to its fully holistic and proven therapeutic efficacy in the treatment and prevention of illness, or disease. She is also Assistant Editor [Ayurveda] @ ThinkWellness360.

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