Perimenopause Symptoms, Ayurvedic Treatment, Lifestyle Tips

Menopause means the cessation of menstrual periods. It is a natural phenomenon in all women. Perimenopause period is in around menopause. It usually starts at 40 and may last for 4 – 10 years.

Introduction

Perimenopausal period may vary depending on hereditary factors, nature, body constitution, mental status, stress levels, working condition, country of residence etc. But due to present lifestyle, medicinal therapies undergone etc., in few of the races and communities, menopause can occur at 35-36, which is becoming more common these days. Menopause at an age of 50-52 years is also reported in some countries. Irrespective of the age, if menstrual cycle ceases without any signs and symptoms and physiological or bodily dysfunctions, it need not be considered a health problem. Whereas if the individual suffers from any health complaints for prolonged period (4 months to few years), then medical supervision is required. 
In Ayurveda perimenopause period is termed as Rajonivritti kala. Raja means Menstruation, nivritti means retirement or cessation and kala means time period.

Common features

Common features of menopausal syndrome:
The ovaries gradually reduce estrogen hormone production, which is the main reason behind following symptoms.
Irregular menstruation
Prolonged bleeding or scanty menstruation
Back ache – non specific kind
Headache – partial head ache or head ache of interfering agent
Body ache
Neuritis or numbness in body parts
Fatigue, excessive tiredness
Nausea
Anorexia (tastelessness)
Excess sweating
Inferiority or constant grief
Mood elevation
Nervousness
Intestinal problems
Acid peptic disorders
Excess or decreased appetite
Abdominal discomfort
Stress and strain
Loss of sleep, disturbed sleep
Hot flushes
Breast tenderness
Worse premenstrual syndrome
Lower sex drive
Vaginal dryness; discomfort during sex due to friction
Urine leakage when coughing or sneezing
Urinary urgency (an urgent need to urinate more frequently)

A woman suffers from one or many of the above symptoms during menopause. The severity of symptoms may vary from person to person. Seldom, all the above symptoms are found in an individual.

Is treatment required?

When treatment is required for perimenopause and when not?
First of all, knowledge about presence of such a stage and awareness of symptoms is very essential.
If the symptoms are mild and managed with lifestyle changes – such as regular oil massage for stress and body ache, treatment is not required.
But in severe symptoms such as heavy bleeding with clots, severe stress, depression, excessive sweating, etc, treatment will be required.

Family support

Much care should be taken towards the woman. Especially, family members like husband, children and in laws should take special care towards her health and mind set up. The family members should know that, the hormonal imbalance causes changes in the body and mind of the woman, during that particular age. During conversations and discussions, enough care should be taken not to hurt her.

Active lifestyle, exercise, hobbies

The woman should wisely engage herself in one or the other activity to keep herself busy. By this, her body and mind will be engaged, which is very important for physical and mental health.
Reading books, social service, interaction with family and friends, listening to music, mind games with family members or members of ladies club etc. are few of the ways to keep the mind occupied.
Visit to religious centers (according to ones liking), early morning walk for 15 – 20 minutes, outdoor games, charitable works, good habits like knitting, doll making, weaving, designing etc. gives enough exercise to the body too.

Pranayama, oil massage

Pranayama – It helps to keep mental balance. Women will be better equipped to handle mood swings and stress.
Learn about a simple Pranayama technique

Oil massage:
Osteo arthritis, depleted calcium and bone strength are common symptoms after menopause. Hence, regular oil massage with Maha Narayana taila  or Ksheerabala taila is really useful in
headache, body ache,
sleeping problems
arthritis
joint pains.
Oil massage everyday is the best option. If not, at least once or twice a week. It can be done by yourself or at a center.
If you do not get any time to do massage, here is a quick massage technique which you can finish within 3 – 5 minutes.

Recommended diet

A diet rich in calcium –  green leafy vegetables, cabbage, soya food, lady finger, beans, almonds, sesame seeds, flax seed. garlic, basil
A diet rich in iron- cooked beans, cereals, pumpkin seed, carrot, dates, sesame seed, chickpeas, peanuts, pecans, walnuts, pistachios, roasted almonds, roasted cashews, or sunflower seeds, raisins, peaches, or prunes, spinach, bread,
A variety of fruits and vegetables.
Include a teaspoon of ghee in diet. It promotes memory and concentration.

Foods to avoid

Avoid high amounts of fried foods, oils.
Avoid excess salt intake.
Avoid sugar, if you can.
If you are suffering from hot flashes, avoid excess spicy foods and coffee.

Ayurvedic treatment

Ayurvedic treatment for menopausal symptoms: 
Symptomatic treatment followed with measures to pacify Dosha imbalance should be adopted. Between 40-50 years, both pitta and vata are aggravated. So measures should be taken to pacify both Vata and Pitta dosha.

Ayurvedic medicines

Few of the important Ayurvedic medicines for perimenopause:
Medicines suggested are general guidelines to medical practitioners. Do not use these medicines for self-medication / self treatment. Consult your doctor for the right advice
Medicines to stop heavy periods:
Pushyanuga choorna – used in the Ayurvedic treatment of Menorrhagia, Metrorrhagia, Leucorrhoea, Menstrual disorder, Excessive menstrual bleeding of various etiology.
Ashokarishta – used in Ayurveda treatments for many diseases like Pain menstruation, heavy periods, fever, bleeding disorders etc.
Patrangasava – used in heavy periods, leucorrhea, fever etc

Medicines used in treating stress, anxiety, mood swings and sleep disturbances:
Ashwagandharishta – used in the treatment of fatigue, stress, mood disorders etc.
Medicines to improve strength and immunity: 
Jeerakarishta – useful in digestive disorders, IBS, low strength
Balarishta –  used mainly in neurological conditions, Vata disorders, muscular and joint pain and weakness. 

Medicines to treat vaginal dryness, frequent urination and urinary tract infections:
Chandraprabha vati – used in Ayurvedic treatment of urinary tract infection, difficulty in urination, urinary calculi. It helps to relieve constipation, bloating, abdominal colic pain, low back pain.
Gokshuradi guggulu –  Widely used in the Ayurvedic treatment for diabetes, difficulty in passing urine (dysurea).
It is also used in female health care. Female gynecological problems like menorrhagia.
Trin Panchmool Kwath –used in the treatment of urinary tract disorders associated with burning sensation.

For hot flashes:
Pitta dosha balancing diet
Medicines such as
Kamdudha Ras, Praval Pishti – are very useful in balancing Pitta and also act as a source for calcium.

In cases of low hemoglobin, Ayurvedic treatment for anemia will be required.

Rejuvenation – anti aging therapy:
Women can adopt any one specific, safe,effective and rejuvenating Ayurvedic formulation, on due consultation of the physician. It helps to overcome the fatigue, anxiety, anemia, trace elemental deficiency etc. Few of the important rejuvenating formulations are given below.
Shatavari Rasayana – widely used in the treatment of gynecological conditions, diseases of urinary tract and liver complications.
Sukumara ghrita – used in  lower abdominal pain in women, abscess, hemorrhoids, menstrual pain, inflammation, constipation.
Lohasava
Amalaki Rasayana
Dhatri loha
Saptamruta loha
Sarivadyavaleha
Thengupookkuladi Rasayana etc.

Effective home remedies

Simple and effective home remedies for perimenopause symptoms:
Equal quantity of cumin seeds and fenugreek powder  – 50 grams each – are fried in 50 grams of ghee. It is powdered well. To it 50 grams of organic jaggery is added, powdered well. This is made into laddu (round bolus) of 10gram each. Daily 1-2 laddus should be taken along with lukewarm milk. This helps to prevent the trace elemental deficiency caused during menopause.

5 grams of ground nut, cashew nut, sesame seeds, jaggery or honey and ginger powder each are taken and pounded well. This semisolid mass is taken along with warm water, early in the morning. This restores the vitality and energy and prevents fatigue and other symptoms commonly found during menopause.

So, menopause is a natural biological cycle that every woman has to go through. It marks the permanent end to monthly period and it is confirmed when a woman has no periods for 12 months in a row. Have prior knowledge about the symptoms of menopause and be mentally prepared.

Learn how to getover physical symptoms and how to manage physical and mental stresses caused due to the transition. Make conscious efforts to eat healthy and nutritious food during menopause, learn new skills or pick up your old hobbies, practice yoga and meditation and other relaxation methods. Let your efforts bring new hope to your life just like rain brings the rainbow on a sunny day. Remember, menopause is not just the end of one stage of your life, but also marks the beginning of a new stage with new opportunities in your life!

Menopause Tridosha, Important Herbs

How Doshas affect menopause? What are important herbs? Dr JV Hebbar: 
Menopause happens between 45 to 50 years of age in women. In layman’s terms, this is considered middle age. 
If we divide the lifespan into three parts, the middle part is dominated by Pitta Dosha and the last part i.e., old age is dominated by Vata Dosha. 
Menopause happens in Pitta dominant part of woman’s life and also has some Vata Dosha effects as well. So, most of the symptoms of menopause such as hot flashes, vaginal dryness, fatigue, weaker bones, stress, anxiety, sleep issues, irritability etc. can be attributed to the effects of dominant Pitta and Vata Doshas. 

Herbs that primarily control Pitta dosha but also have Vata balancing effects are usually preferred. 
Shatavari – In a menopausal woman, it helps to support the estrogen hormone and being coolant, is useful in treating hot flashes. It also has aphrodisiac, rejuvenating and anti aging effects, hence useful in rejuvenating the body. Shatavari is also explained as Medhya – improves intelligence, relieves stress, anxiety and improves sleep. 

Read: Shatavari Asparagus racemosus Uses, Research, Side Effects
Other herbs that are useful are – 

Ashwagandha, Shilajit, 
Dashamoola – group of 10 anti inflammatory roots, 
Bala – Sida cordifolia etc. 
Article by Dr MS Krishnamurthy and Dr Hebbar