The Greek word peri means around or near. Perimenopause refers to the time during which your body makes the natural transition to Menopause. Some physical changes begin years before the final menstrual period. This transition phase is called Perimenopause. It usually starts at 40 and may last 4 to 10 years.
Rajonivrithi kala :
In Ayurveda, Perimenopause is termed as Rajonivrithi kala. Raja means menstruation, nivrithi means cessation and kala means time period.
Dosha concept in Menopause :
On the basis of symptoms, differentiation can be done by applying Dosha theory to facilitate management of menopausal syndrome as Vataja Lakshanas, Pittaja Lakshanas and Kaphaja Lakshanas. As this condition is characterized by generalized Vatavriddhi, the Vataja Lakshanas are more dominantly observed than pittaja and Kaphaja Lakshana
Imbalanced Vata dosha emaciates tissues by its Ruksha,Laghu and Sheeta gunas. So symptoms like vaginal dryness, loss of skin tone, backache, constipation etc present.
In pitta dominated condition females are more prone to Urinary Tract Infections, skin rashes, hot temper, irritability, hot flushes, night sweats etc are seen
In kapha dominated menopause females may gain weight, slow digestion, fungal infections, heaviness ( guruthwa) ,depresstion etc
The factors present in the female body during this time should be considered as the base for the whole etiopathogenesis.
Importance of vata in Perienopause
In Rajonivritikala ,the more dominent dosha is Vata. Vata affects Jadaragni ( digestive process) which in turn affect dhatu agni ( metabolism). Aggravation of five subtypes of Vayu leads to an imbalance of one or more of the remaining four vayu. Prana vayu is responsible for intelligence or clarity of mind. When Prana vayu is aggravated or disturbed, it causes excess or deficient flow of Prana in the mind manifesting as anxiety and depression.
Role of Dhatwagni in Perimenopause :
In the Ayurvedic classics, the clinical symptoms manifested in Perimenopause are the manifestations of Dhatukshayaja Lakshanas along with vitiated Doshas. In Perimenopausal period there is gradual depletion in the normal levels of dhatus which result in rajakshaya. Hence it is considered as a Swabhavabala pravrutta vyadhi and symptoms of jwara or vardhakya are seen. In this period there is agni mandya, pitta kshaya, aggravation of vata along with kapha medo dushti and uttarothra dhatu kshaya occurs which ultimately results in rajakshaya. Various symptoms mentioned in Samhithas in the context of yonirogas can be seen in Perimenopausal period. Sometimes these symptoms may be troublesome and may affect the quality of life badly.
Weight changes during Perimenopause:
It is one of the biggest complaints that women face during Perimenopausal years. From an Ayurvedic view, the extra weight gain is because of vitiated Medo dhatu. Some women gain more weight around 3 to 4 kg in response to hormonal changes. In some women gained belly fat and lost muscle mass. The levels of the “hunger hormone,” Ghrelin, were found to be significantly higher among Perimenopausal women, compared to Premenopausal and Postmenopausal women.
Treatment for Perimenopause in ayurveda:
The awareness about this stage is the most important thing. Mild symptoms can manage with lifestyle changes. In case severe symptoms such as heavy bleeding with clots, severe depression, insomnia etc treatment will be required. Family also play an important role .They should take special care towards her health.
Role of Jadaragni in Treatment:
Another important part of treatment is Jadaragni ( Metabolic and digestive power). Jaadaragni undergoes abnormal changes by unwholesome food. So treatment should include medicines which maintain a powerful Jadaragni.
According to Acharya Vagbhata, women suffering from yoniroga have to use taila(oil) and arishtas (medicinal alcoholic preparations) depending upon the predominance of dosha along with ksheera (milk) or māmsarasa (meat soup).
Food like soyabeans, tomato, carrots, cucumber, beets, apple, oats, barley dates, cherries, wheat, garlic, red beans etc. are helpful in
Avoid : Foods which are aggravating Vata should avoid especially guru, ushna and ruksha foods such as spicy foods ,chilli, garam masala etc
Medicines are useful:
Therapies like oil massage ( abhyanga ) and Sirodhara are very useful in conditions like headache, disturbed sleep, stress etc..
In the Perimenopause , females will go through a number of hormonal changes. These changes may also be accompanied by symptoms such as hot flushes and mood swings. Eating well and being active can help make this transition as smooth as possible. Acharya Charaka has established the fact that diseases are innumerable, and Ayurvedic diagnostic approach mainly depends on symptomatology based on the involvement of Dosha so; peri Menopausal syndrome can be well understood on the basis of Dosha.
Treatment Case Study
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