Author: Vrinda Devani, MD
In a culture that tends to glorify youth and
productivity, thinking about menopause and the changes that come with it can
bring up trepidation. Navigating this time of life can be challenging to say
the least, but it can also be a window of opportunity and a new beginning—a
chance to realign with our values and prioritize our own well-being.
We may have heard stories from friends about their own
trials through menopause—and for those of us who have yet to go through it, we
might end up feeling resigned to a similar experience.
For many of us, it conjures visions of hot flashes,
dizzying mood swings, and long nights lying awake.
Thankfully, the Ayurvedic approach can help ease many of
these challenges and support a different experience—one that is graceful,
luminous, and empowered.
Menopause in Ayurveda
The classical Ayurvedic texts do not refer to menopause
as a disorder. In fact, menopause, as a disease, has been known to be
relatively uncommon in the East until recently, particularly in non-urbanized
areas that have been less affected by westernization. For this reason, many
refer to it as a disease of the West.
From an Ayurvedic perspective, the stage of life you’re
going through at a given moment can impact your overall health—especially when
it comes to menopause and its associated experiences.
Ayurveda recognizes three major stages of life—childhood,
adulthood, and elderhood. Each stage is associated with one of the three doshas.
·
Childhood (Brahmacharya Ashram)
is generally viewed as a time full of growth, building, and learning. Ayurveda
associates this stage of life with kapha, the dosha of earth
and water.
·
Adulthood (Grihastha Ashram)
is considered the time of achievements and accomplishments, and is associated
with pitta, the dosha of fire and water.
·
Elderhood (Sannyasa Ashram),
traditionally, has been viewed as a period of letting go of the need to
achieve. It is associated with vata, the dosha of air and
ether.
When you enter menopause, you’re transitioning into the
vata-dominated period of your life, which allows for insight, clairvoyance, and
wisdom to grow from deep reflection and contemplation on the life lived thus
far. Vata also has a dispersing nature, which may inspire some to share this
wisdom with their loved ones and society at large.
Some reach this stage of life with a sigh of
relief—knowing that all of our major responsibilities have been taken care of,
and fully ready to shift awareness within. This stage of life is a terrific
opportunity to get to know ourselves and make time for self-care, reflection,
and meditation.
That said, not all of us are retired (or even close to
retirement) when we reach menopause, which can make the experience a more
daunting prospect.
An Ayurvedic Perspective on Menopause and Hormones
During menopause, levels of estrogen and progesterone,
two powerful female hormones, drop. Both of these hormones provide two subtle,
yet vital substances in our body:
1. Ojas. Ojas is
a superfine substance that is responsible for building immunity,
stability, and nourishment. As such, it can be seen as a very subtle and
refined form of kapha. The very end product of nutrition in our body, after
it passes through all of the seven layers of tissues (or dhatus), including
the final layer of our reproductive organs, is ojas.
Our immune system, which thrives when we have strong ojas, gives us the
ability to tolerate our external environment, as well as changes to our
internal ecosystem. So it happens that those with low ojas are more prone to
imbalances and illnesses.
For instance, you will see that with hot flashes, a lack of hormones causes the
temperature zone in which we feel comfortable to narrow substantially. This
makes it difficult to remain within a comfortable temperature range.
2. Tejas. Tejas is
a refined version of pitta. It acts as the positive subtle essence
of agni, our digestive fire. It governs intelligence,
discernment, enthusiasm, and all types of digestion and transformation.
Without tejas, there is no guidance as to where pitta and
heat should flow to so it can serve its purpose. Ideally, the mind and body by
this point in the life cycle have built enough intelligence to continue with
these functions without necessarily needing hormones to guide it. But if tejas
is lacking, we can experience imbalance.
Since hormones serve vital pitta and kapha functions, it
is very important that these two doshas, specifically, are balanced to a very
healthy level when entering menopause.
·
Pitta should primarily reside in its home in the
core, providing a solid source of agni. Kapha should not be depleted, as
it nourishes all tissues so that they are not whisked away with the littlest
change.
During menopause, we are low on ojas, and so we have a
lessened ability to maintain balance, even in the same environment and with the
same stressors. Couple that with the erratic nature of vata, and when
unchecked, our body shifts into a sympathetic overdrive.
Our nervous system is a delicate balance of the
sympathetic nervous system, a stress-oriented system that exists for
self-preservation, and the parasympathetic nervous system, which functions to
relax and renew. These two branches work as opposing yet complementary systems.
Because of low ojas, menopause becomes a state of high
sympathetic nervous system—cortisol levels increase, blood pressure increases,
heart rate increases. This state of stress drives high pitta throughout the
body, ready to attack any threat.
Further this with the cessation of the monthly blood
release. The menstrual cycle can be seen as a therapeutic rakta moksha. This
is a therapy used in traditional panchakarma, where blood is
let out for the purpose of releasing excess pitta.
In the ideal, healthy state of the menopausal individual,
we shift away from pitta predominance, mentally and physically, to vata
predominance. In an ideal scenario of perfect health, the body would transition
just fine. But with persistent pitta activities and constant activation of the
hot and sharp sympathetic system, pitta remains trapped in the body. In the
end, we are left with the following process:
1. Elevated,
ungrounded vata disperses throughout the body, carrying your core digestive
fire, agni, away from its home in the stomach and intestines. This leads to
difficulty with digestion and overall nutrition.
2. The
heat traveling in the circulatory system gives rise to hot flashes, troubled
sleep, and, in an extreme case, heart disease.
3. High
vata also flows downward, drying out the vagina.
4. High
vata in the colon and other deeper tissues causes dryness. In an extreme case,
it can lead to conditions such as osteoporosis.
5. Superfine
tejas, also decreased, leads to troubles with memory and concentration and a higher
predisposition to cancers.
How the Doshas Influence Menopause
As with all of Ayurveda, there are many ways that an
imbalance can manifest. The interplay of the doshas add different layers of
diversity. Use this table to understand what flavor your menopausal transition
has or will have. Knowing this will help you see what doshas may be out of
balance so that you can adjust your diet and lifestyle accordingly. Take the
dosha quiz to determine which dosha or doshas you should focus on balancing:
1.
Vata
·
Dry skin or mucous membranes (including the
vagina)
·
Scanty bleeding during perimenopause
·
Digestive discomfort and occasional constipation
·
Trouble concentrating or sleeping
·
Anxiousness, worry, and fear
·
Bone loss
2.
Pitta
·
Hot flashes
·
Irritability
·
Heavy bleeding during perimenopause
·
Skin discomfort and imbalances
·
Anger, irritation, jealousy, criticism,
competitiveness
·
Feelings of excess heat in the body
·
Heart imbalances
3.
Kapha
·
Weight gain
·
Feeling sad, unmotivated, or greedy
·
Decreased concentration due to dullness
·
Feeling “bogged down”
All of these shifts—the changes in hormones, the
reduction of ojas and tejas, and the influence of the doshas—often cause an
imbalance in the gunas, or qualities, leading to too much dry, rough, mobile,
subtle, spreading, cold, or hot qualities. We can see these reflected in the
above table—increased dryness can lead to dry skin, while increased heat can
lead to hot flashes and irritability.
The Path to a Graceful Menopause
While most studies are small or preliminary, there is a
growing body of evidence and exciting initial findings to support an
alternative approach to menopause that embodies nourishment, contentment, and
balance.
There is also growing support for herbalists and
alternative practitioners and their care for reproductive health.4 A
holistic approach not only eases many of the challenges that many who go
through menopause face, but also empowers us to live with more joy and
fulfillment.
Ultimately, attaining the luminous, graceful menopause
that the sages have lived from time immemorial can be simplified into three
main goals:
·
Increase juiciness. Some kapha during
menopause is a great thing, as long as it is in balance.
·
Be calm. Bring vata and pitta back to
balance by calming the sympathetic nervous system.
·
Strengthen your agni. When your agni
functions optimally, your whole-body functions optimally because it is well
nourished and has the intelligence it needs.
Keep these goals in mind as you make your way through the
basic pointers outlined below. Remember the aggravating qualities of
menopause—dry, rough, mobile, subtle, spreading, cold or hot—and see the
opposing qualities come to life in the recommendations.
Make Peace with the Past. Making peace with
the past and creating acceptance for the present and future is the single-most important
element of your transition. There is nothing that drives our stress like anger,
resentment, and irritations—especially from the past.
Take time and make space to make peace with yourself, all
those that you have crossed paths with, and your life at large.
Do a Monthly Cleanse. Take two tablespoons
of ghee with two tablets of Blood Cleanse twice daily for
four days each month as you go through the transition, especially if you are
experiencing lots of heat and high pitta.
Eating an easy-to-digest kitchari diet and
doing a daily abhyanga during these four days will support the
cleansing process.
Eat a Vata-Balancing Diet. A vata-balancing
diet (that does not aggravate pitta) consists of warm, well-cooked foods,
cooked with spices that aid in digestion, such as cumin, fennel, coriander,
saffron, turmeric, and hingvastak.
Support Your Agni. Have a teaspoon of grated
ginger with lime and a pinch of salt before and after meals. You can also
drink CCF Tea (cumin, coriander, and fennel seeds)
throughout the day.
Practice Pranayama and Yoga. Learn the art of
breathing slowly and deeply and use yoga to calm your nervous system, decrease
stress, and help with menopausal symptoms. If you’re new to pranayama, start
by practicing Nadi Shodhana (Alternate Nostril Breathing) daily for
up to 20 minutes.
Try Yoga Nidra. Also known as yogic sleep,
yoga nidra is a meditative process done while lying on your back or in a
similar comfortable position. Take at least 10 minutes every afternoon to
practice this restful process to ease your mind and calm your nervous system.
Bathe Yourself in Moonlight. Spend summer
nights moon bathing. The direct illumination from the moon was traditionally
used as a therapy to increase ojas and bring coolness to the body. Even just 15
minutes a few times a week can make a difference.
Take Women’s Natural Transition. Women’s
Natural Transition formula has the perfect blend of herbs that nourish and
calm vata, while at the same time cooling pitta.
Increase Moisture. Rasayana literally
means “increasing juice.” Dryness is the quality that tends to become most
excessive in the menopausal body.
Ways to Increase Moisture
·
Abhyanga. Not only does the practice
of self-massage literally oleate the body, but it also is one of the
most effective ways of calming vata and also the nervous system. Study
after study has shown massage as effective in easing anxious feelings and
stress. It can also be very effective at helping with
uncomfortable joints.
·
Shirodhara. Shirodhara, the slow
pouring of oils on the third eye, is a classic therapy for calming and
balancing the mind. Find an Ayurvedic therapist that can support
you with this therapy.
·
Hydration. Your body is 75 percent
water and requires this fluid for nutrition and elimination of wastes.
Drink plenty of water and have sufficient electrolytes and essential fatty
acids to help maintain the quality and quantity of your waters.
·
Chyavanprash. Chyavanprash is
one of the most classic rejuvenating formulas used in Ayurveda. It was created
to build nutrition and ojas. It also has natural antioxidant properties, as
amalaki is its primary ingredient
Cooling Hot Flashes
Up to 80 percent of those going through menopause suffer
from hot flashes. This is important, not only as a cause of unease, but also as
a sign of significant pitta running havoc throughout the bloodstream. Regular
hot flashes can be a sign of further imbalance in the body.
Like most other menopausal symptoms, it is a signal to
take rest and relax—your sympathetic nervous system is on high.
Practice a Cooling Pranayama. Try
practicing Nadi Shodhana for up to twenty minutes daily to decrease
your level of stress and calm your nervous system. Sheetali Pranayama (Cooling
Breath) is extremely cooling and can be used during a hot flash.
Adjust Your Diet. Reduce caffeine and alcohol
intake and eat pitta-balancing foods which are also energetically
cooling, such as coconut oil.
Drink Pomegranate Juice and Fresh Lime or Peppermint
Tea. These refreshing drinks can cool and cleanse the blood of natural
toxins and excess heat.
Maintain a Healthy Weight. Excess weight can
serve as an insulating layer, making the body hotter. But be careful—if you are
underweight, losing further weight will create stress on the body.
Meditate. The ability to maintain inner peace
despite external circumstances can serve all of us well. A daily dose of
meditation and other ways of achieving mindfulness can go a long way with hot
flashes.
Herbs for Cooling the Body
·
Healthy Pitta helps balance pitta in the
body with cooling herbs.
·
Blood Cleanse will help remove excess pitta
from the blood specifically.
Improving Sleep
To bring more restful sleep, increase
heaviness—especially before nighttime. As most cases of sleep disturbance are
caused by hot flashes, the above recommendations will also help.
Drink Milk Before Bedtime. Drink hot, boiled
milk with some nutmeg. If you are still having difficulty with sleep, drink
milk that has been boiled with two cloves of garlic. With either of these
recipes, adding a pinch of turmeric will make the milk easier to
digest.
Meditate Before Sleep. Take five minutes to
shut the mind off with your breath or a meditation technique. Those five
minutes are worth an hour of sleep.
Sleep Hygiene Tips
·
Sleep at a set time and wake at a set time.
·
Get sufficient sleep! We often underestimate the
amount of sleep we need. The average adult needs 7–8 hours of sleep.
·
Avoid naps during the day.
·
Go to sleep with the T.V. off.
Herbs for Promoting Healthy Sleep
·
Ashwagandha tablets calm the mind and shake
stress off of the body, and taking a couple tablets a day can bring a sense of
rest to the overtaxed. You can also add a half teaspoon of the powder to
your cup of milk. (Milk also acts as an anupan, a carrier
substance which helps deliver herbs deeper into the body's tissues.)
·
I Sleep Soundly, which has ashwagandha and
valerian among other soothing herbs, may do just the trick. Take two tablets
half an hour before bedtime.
Countering Vaginal Dryness
Dryness in the vagina affects sexual function for many.
This is a simple problem with potentially significant effects, affecting 10–40
percent of people at least once in their lifetime. This is clearly the result
of high vata in the pelvis, as narrowing and shortening of the vagina and a
loss of fat in the labia accompany it.
Increase Lubrication. Chemical-free, natural lubricants,
and moisturizers can provide relief to vaginal dryness. Ayurveda’s natural
lubricants, ghee or sesame oil, can potentially serve you equally well.
Stay Hydrated. Oppose the dry quality with fluids, such
as tulsi tea or even just plain water. A rule of thumb is to drink in ounces
the number that you get when you half your weight in pounds. For an example, if
you weigh 120 pounds, drink 60 ounces daily.
Caring for Your Heart
Cleanse your body of excess heat and strengthen your
digestive fire to metabolize excess kapha that may create blockages. These are
key ingredients for a healthy heart.
Mental Relaxation. Meditation and other
calming practices, such as Tai Chi, all decrease your risk of having poor heart
health by keeping stress levels at bay and decreasing your heart’s workload.26
Get Exercise. A daily yoga practice not only
keeps your body free of stagnation, but it is also successful at balancing the
mind. Also, consider taking a healthy walk daily for 30 minutes.
Herbs for Heart Health
·
Arjuna is an herb gaining press for great
effects on the heart.
·
Heart Formula was designed especially for
supporting proper function of the heart with arjuna and other Ayurvedic herbs.
Maintaining Bone Health
Your bones grow most around the age of 20. Around the age
of 35, you begin to slowly lose bone mass with the greatest bone loss occurring
in the years around your very last menstrual period.30 Thus, your bones are a
dynamic tissue and the sooner you start supporting your bones, the better.
Keeping your colon clean is an important component of
maintaining healthy bones. The wisdom of Ayurveda has long seen the dhara kala,
or membrane, of the colon as being intimately connected to the dhara kala of
the bones. So it is no surprise when we find that bowel and colon imbalances
can also impact the bones.
·
Strive for Healthy Bowel Movements. Ayurveda
encourages having bowel movements 1–2 times a day.
·
Drink Plenty of Water. This helps keep the colon
functioning at its best.
·
Get Enough Calcium. While intake of calcium is
very important, studies are finding that the amount may vary depending on your
diet. For instance, the protein-dominated diet of the West may require more
dietary calcium as protein can decrease the absorption of calcium. Sesame seeds
and dairy are excellent calcium sources.
·
Eat an Adequate Amount of Fiber. Make sure you
eat fruits and vegetables, especially high-fiber vegetables that are also a
good source of calcium—such as leafy green vegetables, in balance with
proteins.
·
Daily Dose of Vitamin D. There are many
supplements, but the best, most nourishing source is the sun when it interacts
with your skin. Ideal times are non-peak times early in the morning or late in
the evening, and during late spring through early fall, when the sun has its
greatest impact. Be careful not to burn.