An Ayurvedic Guide to Menopause

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 prioritise 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.

In this article:

1. Menopause in Ayurveda
2. An Ayurvedic Perspective on Menopause and Hormones
3. How the Doshas Influence Menopause
4. The Path to a Graceful Menopause
5. Tips for 5 Main Concerns of Menopause
6. Embracing Menopause Early

1.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, for this reason, many refer to it as a disease of the West.

So let’s dispel the discouraging negative connotations of menopause in our society and support a more empowering story…..

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 recognises 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.

So how do we balance menopause with our daily lives? Can Ayurveda’s ancient wisdom still apply to modern-day living? The answer is yes! Read on to learn how…..   

2. 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 (blood cleansing). 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 travelling 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.

3. 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 flavour 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. 

Here are some clues as to which energy (dosha) is out of balance :

Vata	Dry skin or mucous membranes (including the vagina)Scanty bleeding during perimenopauseDigestive discomfort and occasional constipationTrouble concentrating or sleepingAnxiousness, worry, and fearBone density loss
Pitta	Hot flashesIrritabilityHeavy bleeding during perimenopauseSkin discomfort and imbalancesAnger, irritation, jealousy, criticism, competitivenessFeelings of excess heat in the bodyHeart imbalances
Kapha	Weight gainFeeling sad, unmotivated, or greedyDecreased concentration due to dullnessFeeling “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.

4. 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.  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 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 (digestive fire). When your Agni functions optimally, your whole body functions optimally because it is well-nourished and has the intelligence it needs.

Here are some of my recommendations to see you through your transition.  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/Detox. especially if you are experiencing lots of heat and high pitta. Speak with me for details of a specific plan.

Eating an easy-to-digest kitchari diet and doing a daily abhyanga (body oiling) with the correct oil for your type- Pitta requires a cooling coconut, almond or avacado oil ) 

Eat a Vata-Balancing Diet. A vata-balancing diet (that does not aggravate pitta) consisting of warm, well-cooked foods, cooked with spices that aid in digestion, such as cumin, fennel, coriander, saffron, turmeric, and triphala.

Support Your Digestion (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. Pomegranate, Lime and mint tea are also cooling.

Practice Pranayama (breathing exercises and calming 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. Contact me for more details.

Try Yoga Nidra. Also known as yogic sleep is a guided meditation 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. Contact me for more details.

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.

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. Calming oils for Vata are sesame, almond and apricot kernel. You can add  2 drops of either Jasmine, Rose Geranium, Bergamot, Ylang-Ylang, Sandalwood, Lavender, Patchouli, Tulsi, Basil, Ginger or a mix of 3. 
• Shirodhara. Shirodhara, the slow pouring of oils on the third eye area (on the forehead, parallel between the eyebrows)  is a classic therapy for calming and balancing the mind. Rubbing oils here can also be soothing.
• Hydration. Your body is 75 percent water and requires this fluid for nutrition and elimination of wastes. Drink plenty of water 2-4 Litres a day of room temperature/luke warm water  and have sufficient electrolytes and essential fatty acids to help maintain the quality and quantity of your waters.

5. Tips for Five Main Concerns of Menopause

While all of the recommendations discussed are amazingly beneficial for overall menopausal wellness, there are particular areas where you might want more specific guidance. In the following section, I review the top five most common concerns associated with menopause.

a) 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 (breathing exercise). 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. Contact me for more details.

Adjust Your Diet. Reduce caffeine and alcohol intake and eat pitta-balancing foods which are also energetically cooling. Contact me for more details.

Drink cooling fluids such as Pomegranate Juice and Fresh Lime or Peppermint Tea. These refreshing drinks can cool and cleanse the blood of natural toxins and excess heat.CCF Tea is a good option too.

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

Brahmi powder –  (Centella asiatica) is a renowned mental rejuvenative traditionally used to promote the intellect, 

• It enhances mental performance, and supports proper function of the nervous system.

Brahmi also calms Vata in the mind and reduces excess Kapha in the body. A truly amazing herb that lives up to its name, which means “the energy of universal consciousness.”

Gotu Kola supplements- are cooling and relaxing, making them an excellent tonic for Pitta. For anger and irritability, brahmi/gotu kola tea can be taken three times daily. 

Guduchi stem, (Tinospora cordifolia)- Has the unusual characteristic of being heating while simultaneously removing excess Pitta from the body. 

• This heat burns accumulated natural toxins purifying the liver, kidneys, joints, and blood.
•  It also helps soothe the skin and promotes a clear, healthy complexion. 
• As a rejuvenative, guduchi strengthens the tissues, bolsters immunity, and promotes vitality while calming the mind and supporting proper function of the nervous system. 
• It is also traditionally used to promote longevity and to support healthy reproduction.

Shatavari root (Asparagus racemosus) Rejuvenation for Vata and Pitta that Promotes Vitality and Strength. 

• It maintains a healthy female reproductive system. 
• Supports healthy lactation. 
• Supports fertility and a healthy libido. 
• A nourishing tonic for women and men.

Shatavari is a rejuvenating herb that cools the body and strengthens and nourishes the tissues. Traditionally used to maintain the healthy production of female hormones, Shatavari may be translated as “100 spouses,” implying its role in promoting fertility and vitality. As a nutritive tonic it encourages the healthy production of milk in lactating mothers and the healthy production of semen in would-be fathers. It is also useful for supporting the menopausal transition. Shatavari supports a healthy immune system and assists in both physical and mental digestion. Its unctuous quality soothes and nurtures membranes of the lungs, stomach, kidneys, and reproductive organs, and gives it a building nature that makes it a great support for anyone looking for a nourishing grounding effect. Its bitter and sweet taste also has a cooling effect on the system. These combined qualities make it a rasayana (rejuvenative) for the reproductive system, the digestive system (particularly when pitta is involved), and the blood. Sattvic (pure, harmonious) in nature, Shatavari calms the mind and promotes love and devotion.

 Manjistha root (Rubia cordifolia) Nature’s Blood Cleanser

• Removes natural toxins and excess heat from the blood
• Supports healthy skin and a clear complexion
• Supports proper function of the liver and kidneys
• Excellent for reducing Pitta and Kapha
• Maintains clear channels in the body, supporting the healthy flow of blood and urine.

Manjistha (Rubia cordifolia) is the quintessential blood purifier in the Ayurvedic pharmacopoeia. It removes excess heat and natural toxins from the blood helping to support healthy skin and a clear complexion. It is one of the best Pitta-pacifying herbs and is used to support the proper function of the liver and kidneys. Manjistha is also excellent for reducing excess Kapha. It helps to maintain clear channels in the body supporting the healthy flow of blood and urine.

Bhumyamalaki herb (Phyllanthus amarus) Detoxifies and Strengthens the Liver

• Supports proper function of the liver
• Cleanses the gall bladder
• Promotes healthy skin
• Cools and soothes the digestive tract

Bhumyamalaki (Phyllanthus spp.) is the classic Ayurvedic herb for the liver. It is very bitter in taste and has an action that is cooling, soothing, and cleansing. With its special affinity for the liver, bhumyamalaki acts to cleanse, detoxify, and strengthen this essential organ. It also supports proper function of the gall bladder and promotes healthy skin. An excellent herb for both Pitta and Kapha, bhumyamalaki is useful for those with constitutions that would benefit from its dry and light qualities.

Fennel seed (Foeniculum vulgare) Aromatic Spice that Supports Healthy Digestion

• Rekindles the digestive fire without aggravating pitta
• Supports a comfortable post-meal experience
• Supports healthy urination and soothes the urinary tract
• Calms and soothes the nerves and muscles
• Supports a healthy, comfortable menstrual cycle
• Supports the healthy flow of milk in lactating mothers

Fennel (Foeniculum vulgare) is an excellent herb for supporting a healthy, comfortable digestive experience. It is especially useful for strengthening the digestive fire without aggravating pitta. The roasted seeds are commonly served post-meal in Indian restaurants to support digestion and to freshen the breath. Fennel seeds combine well with cumin and coriander and makes a great digestive tea. It also soothes the urinary tract and promotes healthy urination. Fennel supports healthy lactation in nursing mothers and is also used to promote menstrual comfort. A tonic for the nervous system, fennel calms the mind and increases clarity of consciousness.

b) 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. It can also be tremendously helpful for a woman in Pitta-imbalanced menopause to have her own room to sleep in, especially if her moods are putting a stress on her relationship!

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.
• Invest in a good cooling pillow and cotton sheets

b) 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.)

c) 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 moisturisers can provide relief to vaginal dryness. Ayurveda’s natural lubricants, ghee or sesame oil, can potentially serve you equally well. These can be applied with a finger or on a tampon and inserted.

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.

d) Caring for Your Heart

Cleanse your body of excess heat and strengthen your digestive fire to metabolise 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.

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 a herb gaining press for great effects on the heart. A traditional Rejuvenative and Tonic for the Heart. It…

• Supports proper function of the heart
• Strengthens and tones the circulatory system
• Supports healthy blood pressure already within the normal range
• Maintains healthy cholesterol levels already within the normal range

In Ayurvedic medicine Arjuna (Terminalia arjuna) is the foremost rejuvenative for the heart. It strengthens and tones the circulatory system and promotes proper function of the heart muscles. Arjuna’s strengthening and toning actions help maintain healthy blood pressure already within the normal range. It is also used to help maintain healthy cholesterol levels and to support healthy coagulation. Arjuna is traditionally used to promote emotional balance for those experiencing grief and sadness. It is said to mend a “broken heart” and to impart courage and strengthen the will. 

e) 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. 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 Fibre. Make sure you eat fruits and vegetables, especially high-fibre 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 Autumn, when the sun has its greatest impact. Be careful not to burn.

Yoga for Healthy Bones 

A gentle, yet effective yoga practice that is appropriate for any age can be a great way to prevent bone loss. Daily practice will not only help decrease bone loss, but will also help with balance and stamina, both very important factors in preventing bone fractures.

Yoga postures that focus on opening the hips and strengthening the pelvis and core will root Vata and activate the root of the boney tissue—the pelvis and sacrum. Consider practicing the following:

• Warrior I (Virabhadrasana I)
• Warrior II (Virabhadrasana II)
• Extended Side Angle Pose (Utthita Parsvakonasana)
• Bound Angle Pose (Baddha Konasana)
• Wide-Legged Forward Bend (Prasarita Padottanasana)

Herbs for Bone Health

Ashwagandha-Rejuvenation for Vata & Kapha that promotes vitality & strength and  is particularly good for supporting healthy joints.

•  Increases energy and vitality
• General adaptogen for combating stress
• Assists in calming the mind and promotes restful sleep
• Supports proper function of the adrenals

Ashwagandha is one of the most highly regarded and commonly used herbal adaptogens in the Ayurvedic pharmacopoeia. Maximising the body’s ability to resist stress, it enables the body to reserve and sustain vital energy throughout the day while calming the nervous system and promoting sound, restful sleep at night. It is said to bestow upon its user the vitality and strength of a horse and is considered one of the best herbs for revitalizing the male reproductive system and supporting a healthy libido for all. It maintains proper nourishment of the tissues, particularly muscle and bone, promoting muscle strength and supporting comfortable joint movement. Ashwagandha also supports the proper function of the adrenals, and as a rejuvenative, it is especially useful to seniors and anyone who would benefit from a nourishing, natural source of energy.

Triphala is cleansing to the colon and promotes healthy rejuvenation. Assists natural cleansing

• Gently maintains regularity
• Nourishes and rejuvenates the tissues
• Supports healthy digestion and absorption
• Supports the proper functions of the digestive, circulatory, and respiratory systems
• Natural antioxidant

Triphala is recommended and used more than any other Ayurvedic herbal formulation. Popular for its unique ability to gently cleanse and detoxify the system while simultaneously replenishing and nourishing it, this traditional formula supports the proper functions of the digestive, circulatory, and respiratory systems. Translated as “three fruits,” it is composed of the dried fruits of amalaki, bibhitaki, and haritaki. Containing five of the six tastes (all but salty), Triphala readily removes excess Vata, Pitta, and Kapha from the body, bringing balance and proper functioning to the system. It is commonly taken as a daily supplement to help maintain balance of the doshas.

6. Embracing Menopause Early

If menopause is something you know you will experience one day, then the most successful approach to achieving a graceful menopause is to start now—no matter what age you are. Like puberty, menopause is just another of life’s many journeys, and like any other period of change, disarray and discomfort can arise simply because of imbalance.

Ayurveda encourages you to enjoy the journey—and to trust the inner intelligence and clarity that is available throughout menopause. 

The greatest thing you can offer to yourself, your family, and your community is the knowledge that shines through as a result of caring deeply for your body, mind, and heart. I hope that this article will support you in doing just that.