Easy Menopause with Ayurveda

Vaidya Ruchi Gulati, B.A.M.S. , M.D.

Sukh Ayurveda, D17, Noida Sec 20.
E: ayurevdaspecialist@gmail.com
MENOPAUSE, “The Change”

• In menopause the estrogen levels don’t fall to zero, but it’s the decreased level of
it and the relative increase of androgen which cause the symptoms. Strictly
speaking, a woman has reached menopause when one year has passed since her last
period. Before menopause, there is a transitional stage, known as the
perimenopause, where woman have declining fertility and fluctuating hormone
levels.
• A woman with vasomotor symptoms who has completely missed a menses is likely
to experience her final menstrual period within the next 1 to 2 years. Menopause
usually occurs several years after the onset of menstrual changes; however, about
10% of women experience abrupt onset of amenorrhea.
• To determine whether the absence of menstrual periods is caused by menopause or
another illness, mostly a physical examination and medical history of the patient is
diagnostic
 Psychological Changes

Decreased libido

Mood swings

Anxiety & nervousness

Irritability
CLINICAL Insomnia (waking in the middle of night)
FEATURES Fatigue & dizziness

Loss of concentration & short term memory

Depression

Headaches

Tinnitus
 Hot Flushes (Vasomotor Symptoms)
80% of white woman experience VM
symptoms
It’s a warm, hot feeling with perspiration
& prickling sensation starting in the chest
& shoulders moving up to face and neck

CLINICAL 3-5 mins, spontaneous, uncomfortable

and unpredictable

FEATURES Any time of day or night (night time hot

flushes with night sweats)
Sometimes heavy sweating followed by
chills
Red blotches may appear on neck, chest
& arms
 Hair Changes

Hair loss of scalp

Became drier & thinner

Hair on chin, chest, abdomen & Upper lip become coarser & darker
CLINICAL
FEATURES Skin Changes

Drier, Less elastic, thinner, more wrinkled, fat under skin thins out,

more vulnerable to injury

Because of the relative excess of Androgens in the body

 Heart changes

Peri-menopausal and early menopausal palpitations often

during or just before hot flushes

CLINICAL
FEATURES Cholesterol ↑ed due to deficient oestrogen-CV disease
incidence ↑ed

Healthy diet, regular exercise, stop smoking, keep BP

down
 Breast changes

Breast tenderness

Loss of fullness, firmness& become pendulous

CLINICAL Some glandular tissue replaced by fibrous tissue

FEATURES Body shape

Changes slightly, body fat instead of hips and thighs concentrates around waist and upper
trunk– this changes assoc with ↑ed risk of diabetes & heart disease

Avoided by activity, healthy diet, because wt gain is easier after menopause

 Reproductive changes

Ovaries &uterus become smaller, stoppage of ovulation and

menstruation

CLINICAL Mostly irregular(metrorrhagia) before complete cessation of

menses
FEATURES
Periods may become heavier(menorrhagia) or lighter than
usual during peri menopause

Pregnanacy is still possible until no periods for a year but

less likely when ovulation begins to fluctuate
 Bladder and urethra(atropic urethritis)

Urethra becomes shorter, lining becomes thinner

Bladder control is difficult, burning ,itching during urination(dysuria)

↑ed incidence of UTIs

CLINICAL
FEATURES Bladder support reduced- weakened, less elastic pelvic floor muscles

Sphincter losses strength- frequency, incontinence

Possible explanation- estrogen receptors in trigone&proximal urethra

Avoidance by pelvic floor muscle exercises

 Vaginal Changes(Atropic VulvoVaginitis)

10-40% women

Vagina becomes shorter and narrower

Less elastic, ↓ed vag secretions, so dryness &dyspareunia

Vulvovaginal pruritis
CLINICAL
FEATURES
↑ed vag infection(↓ed estrogen ↑ed pH)

Post coital spotting

Avoid dryness, vaginal lubricants

Although libido ↓ses but enjoy sex life afterwards who had active sex life before menopause

Maintain active sexual life- maintains elasticity of vaginal wall- decreased vaginal discomfort
 Bone changes

Bone density decreases

Osteoporosis &prone to fractures

Mostly spine, wrists, hip and end of thighs affected

CLINICAL Take plenty of calcium in diet, weight bearing exercises

FEATURES Muscles

Muscular aches and pains

Muscle strength and coordination decreases

GIT

Indigestion, bloating, flatulence and constipation

Investigations

• 12 months without menses

• FSH>25IU/L on two separate occasions
• Estradiol <50pg/mlor 100pmol/l
• Oral contraceptive use FSH done on free week
Rajonivritti kala

• Rajonivritti as a diseased condition is not described separately in the classical

Ayurveda texts, Rajonivritti Kala is mentioned by almost all Acharyas without any
controversy.
• 50 years is mentioned as the age of Rajonivritti, when the body is fully in grip of
senility
• When Pitta becomes depleted and vata becomes predominant
• Pitta represents hot flushes, night sweats
• Vata causes insomnia, irritability, difficulty with concentation, dryness of skin,
constipation and brittleness of bones
Rajonivritti kala

• Bone is the ashraya or host in which vata is situated

• Bone is primarily made of earth element and when vata predominates, it becomes
more space and air
• Osteoporosis is asthi kshaya
• Another feature of vata is pain therefore bone and joint pain
Rajonivritti kala
 Endometrial cancer

Breast cancer

Venous thrombolic diseses

Risks of
HRT Coronary heart disease

Lipid metabolism

Dementia
 Sources of lignans

• Linseed meal, Linseed flour, Linseed

oil, Oat bran, Oat meal, Lentil,
Asparagus

Sources of Sources of isoflavones

phytoestrogens • Textured soyabean, Soya flakes,
Soya flour, Soya sauce, Pulses.
• Beans.
• Phytoestrogens are also found in
cabbage, grains and hops
Phytoestrogens in Ayurveda

Asaparagus Ipomea Trigonella Dioscorea

racemosus, digitata, foenum, villosa,

Sida Glycyrrhiza Puereria Foeniculum

cordifolia, glabra, tuberose, vulgare,
 Out of these Shatavari- Asparagus racemosus contains active compounds Steroidal
saponins, Shatavarin I – IV, Isoflavones including 8-methoxy-5,6,4'- trihydroxyisoflavone
7-O-beta-D-glucopyranoside which shows estrogenic activity.

Clinical Studies on Shatavari prove the efficacy of this drug in relieving menopausal
symptoms. The specific effect of Shatavari on women in balancing homeostasis can be
attributed to presence of phytoestrogens.

Shatavari-
the super Pharmacological action of Shatavari shows Antioxidant, Immunomodulatory,
Antimicrobial, Cardiotonic, Digestive, Antiallergic, Anti-oxytocic and Estrogenic
properties.

Effect of Shatavari in minimizing bone loss in menopausal and postmenopausal women

was studied in which Shatavari has shown encouraging results in increasing serum
calcium (Bone formation markers)levels and decreasing urine calcium (Bone resorption
markers) and also relieved Ashti kshaya lakshana at significant level.
Menstrual Irregularity
Hot flushes/Irritability

• 1 st treat pitta
• Abhyangam with ksheerbala thailam or coconut oil
• Use same oils or cow’s ghee for nasyam
• Shatavari ghritam /shatavari lehyam 1tsf bd
• Virechan with Avipatti choornam or trivritta lehyam
• Mahatiktam kashyam
• Kamdudha rasam
Night sweats

• Shatavari ghritam
• Ashwagandha
• Manasmitra
• ksheeradhara
• These help by calming and promoting sleep
 Brahmi

Manas mitra

Mood changes
Brahma rasyanam

Ashwagandha
 Praval pishti 500mg bd

Lightly roasted seaseme seeds 1tsf

Calcium Paan with chuna

Excellent sources of calcium

 Vasantha kusumakar ras

Lack of libido Kalyanka ghritam

 Vaidya Ruchi Gulati, B.A.M.S. , M.D.
Sukh Ayurveda, D17, Noida Sec 20.
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