We have stepped into New Year 2019 and welcomed it with a celebration. Similarly, we can welcome the transition “menopause in women” with a celebration.

"Don't you think so? Don't you think that this Pause is very important in a woman’s life?

Menopause is a natural and beautiful transitional marker which indicates the end of the monthly menstrual cycle.

We should celebrate this phase as it offers a woman plenty of time for herself. This transitional period gives her space (the desired time); creates awareness, helps her rejuvenate and is an opportunity to work on spiritual growth.

Ayurveda text has termed this period as Rajonivritti-kala. This period is dominated by "Vata Dosha" with vitiated state of Pitta and Kapha doshas. Therefore, Sage Sushrut prescribed Rasayana for the healthcare of women.

What is Menopause?

When a pause in the regular menstrual cycle occurs, for more than 12 months, for women between the average ages of 42 to 52 it is called Menopause.

Significance of Menopause

Menopause is not a disease or a disorder. It’s a just a cessation (discontinuation) of the monthly periods and not the end of life. Women need to be made aware of and educated about this natural phenomena.

Let us understand this in some detail. There are three stages of menopause.

1 Perimenopause - period before onset of menopause.

2 Menopause - period of actual cessation menstruation known as menopause.

3 Post menopause - one year after menopause.

When menopause happens before the age of 42 it is called premature menopause. It could be caused by irregular lifestyle, diet & some stress disorders like depression, schizophrenia etc. Other causes could be Gynecological disorders like polycystic ovarian disorders, fibroid, thyroid dysfunction and surgical removal of Uterus or ovary or fallopian tubes, chemotherapy etc.

At what age could Menopause happen?

It usually happens between 42 and 52 although actual age could vary. Age depends on genes, individual lifestyle and diet.

Ayurveda has quoted following two types of Rajonivrutti kala in which Dhatukshaya (in this context dhatukshay is related to decrease levels of Artava/Rajas-which is upadhatu of Rasa in female reproductive organ) occurs in a female body.

First is Kalaj. It means natural depletion in structure & function of reproductive organs around the average age of 50.

Second is Akalaj. If menopause occurs before the age of 50 due to irregular lifestyle etc it is termed as akalaj.

Let us know about the pathological tests to be done for confirmation of the menopause.

Pathological investigation

FSH - increased level of Follicle stimulating hormone - more than 30mIU/ml.
LH - increased level of Luteinizing hormone.
Estrogen & progesterone Level - decreased level of estradiol & progesterone hormones.
S Calcium & Vitamin D level - decreased.
Thyroid profile - imbalance.
Lipid Profile - increased level of LDL & decreased level of HDL (Prone to CVD).
Androgen/Testosterone level.
S. Prolactin - high level interrupt function of estrogen and progesterone. It indicates the pituitary tumor during menopause period.
CBC & Serum Iron.
Pap smear test - to detect viral infection or cancerous growth in cervix.
USG Pelvis - reduced size of reproductive organs.

Signs and Symptoms

Whilst every woman has a different body constitution there are some common signs and symptoms during menopause. It is important to be aware of these signs so that anxiety and stress are avoided. Symptoms can be categorized as -

Physical

Irregular menstruation which then turns into complete Cessation of the menstrual cycle - due to Hormonal imbalance.
Lack of appetite and Indigestion - due to decrease in the motility of intestine.
Obesity - weight gains more on thighs, buttocks & abdomen region.
Hot flushes - higher level of FSH and LH dilates vessels of peripheral circulation.
Dry skin and lack of tone or elasticity of skin and organs.
Dyspareunia - pain during sexual intercourse due to less secretion of fluid by vaginal glands and or vaginal atrophy.
Urinary incontinency and vaginal infection - lack of immunity.
Uterine prolapse - loss of tone in pelvic & core muscle.
Hirsutism - high level of androgen.
Insomnia and night sweats - low level of estrogen and Melatonin (sleep promoting hormone in women).
Joint and Muscular pain - deficiency of Vitamin D and calcium resulting in osteoporosis, stiffness and soreness in joints.

Physiological

Difficult in breathing.
Palpitation.

Psychological

Libido - lack of sex drive due to low androgen level.
Mood swings, anxiety, stress, depression, irritation, feeling of loneliness and lethargy, fatigue etc.
Decreased level of endorphins.
Fear of death and loneliness.

Intellectual

Forgetfulness

Spiritual

Cognitive changes. Therefore, sometimes old people behave like children.
Feeling of sadness and not at peace with oneself.

This period almost comes after one year of menopause. At this stage, women are more prone to get affected with various diseases like cardiovascular, metabolic and immunocompromised diseases like heart disease, diabetes and cancer of reproductive organs - ovarian, uterine cancer respectively.

How can Women cope with Menopuase?

A Modern science

Symptomatic treatment and Hormonal Replacement Therapy.
Estrogen supplements with or without progesterone through oral pills or local suppository,
Vitamins and minerals supplements,
Oral or injectable Vitamin D/Cholecalciferol /calcium supplements,
Oral Vitamin E & Vitamin C.

B Ayurveda and Yoga

Ayurveda & Yoga has a holistic approach towards caring for human being. These ancient sciences have a wide range of therapies for prevention and cure remedies. They can assist a woman overcome any obstacles during her menopausal period.

There are rejuvenation therapies in Ayurveda texts such as Abhyanga & Pottali (complete body massage), Nasya (nasal oil drops to stimulate nervous system), Panchakarma (elimination of toxins & rejuvenation), Kati Basti (back massage), Padabhyanga, Shirodhara and Shiroabhyanga.

In Ayurveda, Basti Chikitsa is one of the important panchkarma. This helps re-establish imbalance state of vatadosha & so automatically helps to correct other dosha functions too. Also Rasayana like Shatavari, chavanprasha are helpful.

C Diet

Flax seeds that help hormonal balance,
Vitamin B & Protein Carbohydrates & Iron supplement are found in soybeans for vegans & for non-vegan red meat, or chicken,
Low Fat but high fiber diet with Omega 3 fatty acid for eg fish, whole grains, and legumes,
Vitamin C through citrus fruits like Lemon, Oranges,
Vitamin A through raw carrots,
Water supplementary fruits through grapes and berries,
Vitamin E through almonds,
Potassium through green vegetables and banana,
Rich in protein, Vitamin D & Calcium - Eggs, Cheese, Milk, yogurts dairy & Broccoli, Figs helps to balance calcium & Vitamin D deficiency and nourish bones thus preventing osteoporosis.
Estrogen supplements - Wild yams.

D Changes in lifestyle

Avoid coffee, refined sugar and sweetners, alcohol and smoking,
Revisit personal hobbies like reading, listening music, singing, dancing traveling,
Morning Sunbath for vitamin D,
Sound Sleep and rest.

E Yoga

Women should practice yoga before the onset of menopause as it will prepare their body and mind to cope with this change. Yoga boosts positive spirit & longevity; thereby improving physical and mental health. It strengthens mind and muscle through techniques given below.

Asana - Strengthen pelvic & abdominal muscles, ligaments and bones.

Standing Postures - Tadasana, Parvatasana, Trikonasana, Paschimottanasana, Adhomikasana, Virbhadrasana.

Supine Postures - Shavasana Setubanadasana, Janushirshasana, Halasana.

Prone postures - Bhujangasana, Makarasana, Brahmudra, Jivhabandha & Simhamudra.

Kriya-Jalneti, Basti, Kapalbhati.

Pranayama - Lom vilom, Ujjayi, Bhramari helps balance emotional & psychological state.

Bandha-Jalandar bandh, Mool bandha, Uddiyaana Bandha - directing inward awareness & enhances chakras.

Mudra- Ashvini Mudra, Drusti & Trataka, Meditation- Rejuvenation and Yoga Nidra- Relaxation.

F Psychological counseling

Listen to woman with attention. Offer love and care. Council her to being aware of and accepting menopause.

Please note that the above therapies should be taken under an expert guidance.

Lastly look at menopause as a tool to explore and enjoy new things in life.

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