Menopause—while technically refers to the final menstrual period of women—is not an abrupt event, but a gradual process. It is not easy to predict when menopause begins, but it can be assumed that it is complete when a woman has not had a period for a year. The average age of menopause is 51.
According to Ayurveda, menstruation (raja-pravrutti) is the natural flow of excess pitta in the form of menses (raja). Raja-nivrutti is the state of gradually diminished raja-pravrutti which ends as menopause. Ayurveda looks upon menopause as an imbalance of pitta and vaata doshas. These two doshas accumulate, spread and localize in the vital metabolic tissues manifesting as symptoms and consequences of menopause.
Menopausal age coincides with the woman’s transition from the pitta time period of her life into the vaata time period. Many of the symptoms that are experienced with menopause are a combination of the three doshas—vaata, pitta and kapha. A woman’s hormones are governed by pitta and kapha. This is one reason why many women will experience hot flushes (pitta) and weight gain (kapha) when they are menopausal. Nervousness and affected sleep will be part of vaata imbalance.
Sometime in the 40s, a woman begins the natural transition through menopause. Over the next three to five years, her ovarian production of estrogen, progesterone, and androgen slows dramatically. As levels of these hormones fluctuate, she may experience the irregular periods and mood swings. She may also notice other signs of decreased hormone production, such as hot flashes, sleep problems, vaginal dryness, recurrent vaginal or urinary tract infections, and some loss of bladder control.
While some women sail through menopause comfortably, others struggle to deal with its annoying or even debilitating symptoms. This is due to differences in lifestyle, attitude, genetics, weight, and customs. Fortunately, most of these symptoms will taper off eventually in majority of the cases as the body adjusts to new hormone levels. In the meantime, herbs, foods, supplements, or lifestyle changes can help ease the menopausal transition.
SELF-HELP GUIDELINES & AYURVEDIC REMEDIES
Many of the menopausal symptoms will benefit from a change in dietary habits. Incorporating more of the Bitter and Astringent tastes is recommended to assist the body in cooling some of the increased heat. Bitter taste is mostly in the dark green leafy vegetables.
Astringent taste will include beans, soya beans, poultry, potatoes, cabbage etc. You need to avoid the heating tastes of Pungent, Sour and Salt. Pungent includes hot spicy food, onions, garlic, mustard and chillies. Tomatoes, tamarind, citrus, vinegar, sour curds are among the sour tastes. Pickles, sauces, papads—all these items contain salts in concentrated form.
You should meditate and do yoga regularly. This will benefit all the three doshas— particularly soothing to vaata and your nervous system. Calming your nervous system is an important aspect of creating a state of well being during menopause. Estrogen is not only produced in the ovaries, it is also in the adrenal glands and adipose tissues.
If a woman is overcome by stress in her life, then she may have burned out her adrenal glands, therefore affecting her ability to supply a natural source of estrogen. The transition through menopause will be smoother if a woman is less affected by the stress in her life.
• Hot flashes (hot flushes): Some still unknown signal to the temperature-regulating portion of the brain sends blood rushing to the surface of the skin. This flush of blood raises skin temperature as much as seven degrees, bringing a feeling of heat (especially to the upper body), sweating, increased heart rate, and sometimes chills. Hot flashes that occur at night may cause intense “night sweats” that disrupt sleep. Dress in layers to take clothes on and off as needed.
Wear clothes made of cotton and other breathable fibers. Identify and avoid personal hot-flash triggers, such as stress, caffeine, alcohol-rich drinks, and spicy foods. A hot environment can cause more frequent and intense hot flashes. Keep your cool. Practice deep, slow, and belly breathing.
Consume foods rich in phyto-estrogens (naturally available selective steroid enzyme modulators that function as pro-estrogens when estrogen deficiency is present and as anti-estrogens when excess estrogen is present). Soya bean, tomato, watermelon, berries, legumes, liquorice, and pomegranates are some of the rich sources of antioxidants and phyto-estrogens. Take Ashokarishtha along with Useeraasav, the Ayurvedic herbal fermentations to get relief from hot flashes and other vasomotor symptoms.
• Changes in vaginal tissues and urinary tract: As estrogen levels decrease, vagina-tissues become thinner, drier, and more fragile. This can cause itching and burning, as well as painful sex. In addition, the vagina becomes more alkaline and less acidic, making it more susceptible to overgrowth of bacteria or yeast. Estrogen loss also causes a thinning of the tissues at the base of the bladder and lining the urethra, as well as a loss of tone in the muscles that control the bladder.
The result can be urine leakage and recurrent urinary tract infections. Drink eight glasses of water a day and other healthy liquids such as barley water, or coriander tea to keep vaginal tissues moist and to keep the system flushed. Be sure to empty the bladder completely when you urinate, so bacteria cannot multiply in any urine retained in the bladder.
Avoid dehydrating antmistamines, cola drinks, coffee, and alcohol rich drinks. Try to stay sexually active, as the saying goes, “Use it or lose it”. Pelvic floor exercises improve urinary control and sexual function by strengthening the pelvic muscles around the urethra. Here is how you perform these exercises: First identify the muscles that stop the flow when you’re urinating.
Tighten these muscles without tightening the abdominal or buttock muscles. Three times a day, tighten these muscles for four seconds and release for four seconds, 10 to 15 times. Try to work up to longer periods of contraction and relaxation, and more frequent sets. Douche with Triphala decoction two or three times a week to maintain the pH of the vagina at healthier levels and discourage bacterial or yeast infections. For recurrent urinary tract infections, take Gokshuraadi guggulu, 2 pills, twice a day.
• Insomnia and mood swings: Many women lose sleep due to night time hot flashes or the need to urinate, both of which can interfere with sleep. Insomnia can also be caused by stresses or physical and psychological changes due to aging. Practice good sleep routine.
Keep the bedroom cool, take a hot bath an hour before bedtime; use a bedside notepad to write down any thoughts that are keeping you awake, and get up and do something if you can’t fall asleep within 20 to 30 minutes. Avoid coffee, cola drinks, and other stimulants all day, not just at night. Have a relaxing cup of buffalo milk at bedtime.
Get regular daily exercise, which improves sleep quality. But exercising near bedtime can have the opposite effect. Ask a family member for an evening back massage, or massage your own feet before bed. Try massaging with almond or olive oil mixed with a few drops of Chandanaadi tailam (sandalwood oil). Generally, Jataamaansi and Aswagandha, in the powder forms, are prescribed to treat insomnia. The usual dosage is quarter and one tsp respectively.
• Osteoporosis: To prevent the brittleness and porosity in bones, consume foods high in magnesium (whole grain cereals, nuts, dairy products, bananas, and chlorophyll-rich vegetables), calcium (milk and milk products, beans, pulses, potatoes, cauliflowers, and dried figs), vitamin D (egg yolk, milk and animal liver), vitamin K (green vegetables, cereals and animal foods), and manganese (cereal, bran, nuts, and tea). Weight-bearing exercises in the morning can also prevent osteoporosis. Prawaala bhasma is an Ayurvedic preparation that contains natural calcium and is usually prescribed to treat the bone loss.