Menopausal Syndrome

(The Change, Natural Transition, Climacteric ,रजोनिवृत्ति )

“Age gracefully with menopause”

FACTS & FEARS

Menopause is cessation of menstruation. Menopause usually occurs between the age of 45-55 years marking the end of the child bearing age. One of the most difficult ages in a woman’s life is during menopause. Menopause is not a disease, a natural process. An inevitable phase in a woman’s life. It’s a natural transition. It does not occur in a day but is a slow process. It is only that a woman enters a new phase in life after menopause. With increasing life expectancy, a woman spends one third of her lifetime under postmenopausal period. It is the time to rediscover herself. It is the time for her old hobbies

Japanese woman experiences negligible or nil postmenopausal symptoms due to intake of soybean, tofu, miso. American and African women experience more hot flushes and night sweats. The population of postmenopausal woman is expected to reach 1200 million by the year 2030 and India will be second highest after china. A woman who attains premature menopause are at a higher risk of being affected with osteoporosis, heart diseases, diabetes, hypertension and breast cancer.

"Menopause Mantra : Learn to enjoy new beginning."

Osteoporosis is more severe in whites then the Asians and it is least severe in women with dark complexion. Ancient women who lead a less stressful life, experienced nil or negligible menopausal symptoms. Close knit family might have supported her at home in case of distress. Today’s nuclear family may be a contributory factor in aggravating symptoms. As present-day woman faces the stress of job as well. Family members need a lot of patience and understanding during this time considering all the unpleasant symptoms a woman can experience during menopause. Family and friends support is vital to help her through this difficult phase effectively.

With increasing life expectancy a women spends one third of her lifetime under post menopausal period. The population of post menopausal women is expected to reach 1200 million by the year 2030 and India will be second highest after China thus increasing the osteoporosis burden (W.H.O). Women living in villages are more prone to "premature Menopause". A women who attain premature menopause are at a higher risk of being affected with osteoporosis, heart diseases, diabetes, hypertension and breast cancer.

"Forgetfulness is a natural part of menopause and ageing."

"Menopause is a normal physiological process."

Introduction

Menopause is a natural phase for women, the, period when fertility slowly declines over a few years till it finally ceases. Menopause means permanent cessation of menstruation at the end of the reproductive life due to ovarian follicular activity. During the period before menopause, a woman undergoes physical and mental disturbances.

Ovaries which produces female sex hormones like estrogen and progesterone start shrinking. It becomes small. As a result oestrogen level fall over a time.

As a result there is a cessation of periods. This is a natural phenomenon. As a result you cannot have biological children. It does not cause any obstruction in your life. One can have a normal sex life. After one year it is presumed that the menopause is complete.

At the time of Menarche (starting of periods) a girl goes through physical changes, like development of breast, waists etc. As a result of increased oestrogen level in the body. As a result fat cells increases in the body.)

Similarly two years before Menopause (cessation of periods) some changes starts in the body. Like changes in the fat distribution which causes weight gain.

Menopause is natural hormonal milestone which comes in the life of each women.

Suppose the level of estrogen falls abruptly or in case of surgical menopause (when ovaries are removed surgically), women will face symptoms of menopause such as mood swings, cravings sudden hair loss, pigmentation or eruption on face, night sweats or hot flushes.

At night women feels warm or hot flushes having night sweats, which is not continuous but off and on. Sometimes in a day also she may switch to air conditioner off and on, sometimes using fan or covering oneself with bed sheets or removing bedsheet from the body keeps on going. These are called hot flushes. There is weight gain tendency due to change in body fat distribution. all these will occur. Weight gain starts 2 years before the menopause. At this moment body produces estrogen from ovaries and fat cells. So that it is able to support you through the phase of menopause. Means instead of estrogen and progesterone thrashing this body fat cpoe up with the crises of menopause. As estrogen should not fall abruptly our fat cells are slightly increased, when there is drop of female hormone.

Women should not go for crash diet. Not too much increase only a mild increase in fat cells. so that your body should be able to support you.

To avoid menopausal crises, body hormones like estrogen should drop gradually.

To cope up with all menopausal changes, you have to make peace with your body, or be in equilibrium with it. After one year menopause is complete. Accept the fact that you have changes in the body.

What you should do

Random diet
Exercise

This change gives you to reach the menopause smoothly. Later on your body changes to normal shape as before.

Time of Menopause is genetically regulated. Mostly the time of menopause of mother or bua will decide the time of your menopause. Mother is the closest link so find out. Suppose your mother had menopause around 50 years or so, your menopause will also be around that zone.

What is healthy menopause ?

In an ideally menopause process a women of age of 45 or over will begin skipping menstrual periods. She may notice some hot flushes and night sweats, particularly if she is a "Pitta Prakruti" women. Gradually the flow will become lighter, number of days of menstrual bleeding will diminish, menstrual period will space out and eventually will cease. Once a women has not experienced menstrual bleeding for a whole year, she is said to have attained menopause.

This may take place in three ways : a . The menses may cease gradually, appearing at gradually lengthening intervals until finally it stops altogether .b . They may cease quite suddenly. c . There may be a series of hemorrhages.

During Perimenopausal time, ovaries begin to become less sensitive to master hormones and menopause indicates complete insensitivity. As a result ovaries fail to produce ovum and hence no fertilization takes place either. Sometimes owing to anovulation (lack of ovum), heavy bleeding occurs during this time. It is also the hormonal imbalance that causes heavy bleeding.

In Menopausal phase: Inside the pelvis uterus becomes smaller. Ovaries also regress in size. Muscles of the pelvis becomes lax and lack tone. Hence most woman complain of prolapse of either uterus or walls of vagina. Factors that hasten the physiological (normal) menopause are, smoking, hysterectomy (surgical removal of uterus) and life in high altitude.

It is important to know since how many years you have started gaining weight as hormone variation during menopause will attribute for water retention and thereby, you may be putting on weight. Due to hormonal variations, you will have the tendency to eat more. So it is advised not to skip meals, and try to spend energy by keeping yourself engaged in physical activities. Also add steamed vegetables (salads) to your diet which will give you a fullness of stomach feel.

Most women have a false sense of security about being infertile as they near menopause, hence fail to use contraception. This is not true. Though fertility declines, pregnancy can still occur. Number of unintended pregnancies during this period is statistically significant. Types of menopause:

Premature menopause

Early menopause -

Late menopause

Medical menopause -

Surgical menopause.

Premature Ovarian Failure

Women with premature ovarian failure should take HRT not only to control menopausal symptoms, but also to prevent complications of estrogen deficiency. Estrogen treatment is continued till the age of 50 years. The increased risk of breast cancer and possibly heart disease and dementia does not apply to woman starting HRT for premature ovarian failure. Studies have shown that HRT does not usually cause

“Menopause is Midlife emotional crisis with many health problems”.

Causes

Estrogen Hormone Level Menopause

● Natural aging process

● Estrogen deficiency.

● According to Ayurveda it is “imbalance of doshas (HUMOURS)” in the females due to deposit of “ama” (waste and toxins) in the body. In this phase Air element (Vata Dosha) takes predominance and (water element) Kapha Dosha depletes while (Fire element) pitta is either in increased or in decreased stage. In this case detoxification is required which can be carried out through Panchkarma.

● According to Ayurveda ,it is a "Vata" process. Menopause process announces the transition between the pitta and vata. time of life.

● It is due to compensatory gonadotrophic over-activity of the hypothalamus and pituitary.

“Proper diet, nutritional supplements, exercise and simple lifestyle changes is the remedy”.

Signs & Symptoms.

ITCHY – your estrogen and/or testosterone levels are likely to be less than optimal
BITCHY – your cortisol and testosterone levels are out of control
SWEATY – your estrogen is probably running low and your progesterone even lower causing hot flashes or night sweats or both!
SLEEPY – your master sleep hormone melatonin may be low and those night sweats can seriously interfere with a good night’s sleep
BLOATED – sounds like your estrogen is dominating, while out of balance cortisol stress hormones have you hardwired to overeat
FORGETFUL – (no way no how can you keep a number or name in your head for more than 2 seconds) your estrogen, testosterone and stress hormones may have gone away along with your memory
ALL DRIED UP – your supplies of estrogen and testosterone may be running thin, along with thinning drying skin inside and out

●· Bloating : Bloating is a condition where your belly feels full and tight, often due to gas.

● Water retention :

● Irregularity / Menstrual periods the occur less often and eventually stop : In the pattern of the periods, in frequent periods. Heavy periods : Heavy bleeding during the cycle or continuous bleeding which persist for 10-12 days. Cessation of menses : No menses for one year.

● Breast changes. : As your milk system starts to shut down, glandular tissue in your breasts shrinks. That causes them to become less dense and more fatty, which can lead to sagging. You may also notice that your breasts aren't as full as they used to be, and their size may change.

Sagging breast

● Anxiety : Poor memory and concentration, faulty memory.

● Mood swings

● Depression :

● Brain Fog :

A good night's rest helps with concentration, cognition and other brain functions, Helps with weight loss and depression and basically is the only way your body can recharge and heal itself.

● Decrease confidence

● Lack of Motivation

● Loss of libido

● Difficulty in focusing

● Dry brittle Hairs : Hair thinning : Discoloration of hairs.

● Hair Loss :

● Discoloration of hair :

● Hirsutism. : Appearance of facial hair. Causes of Unwanted Facial Hair After Menopause
During menopause, a woman's body stops circulating estrogen but continues to circulate the same amounts of testosterone. The imbalance of hormones causes the appearance of some male secondary sex characteristics, like coarse facial hair

● Frontal Alopecia : Receding hair line :

● Tingling extremities : It is common as a result of nerve compression or damage.

● Itchy skin and blemish begins to appear.

● Crawly skin (Formication)

● Night Sweats : Night sweats begins with the estrogen's level decline

● Skin Dryness :

● Burning tongue :

● Receding gums :

● Dry mouth : This is when the salivary glands may decrease in their production, and a woman's mouth could have a dry, cotton-filled sensation to it.

● Menopausal Acne

Menopausal Acne

● Wrinkles

Wrinkles.

● Dry Eyes

Dry eyes after Menopause

● Electric shocks :

● Changed in odor : The first thing that can happen is that you can become more aware of smells around you. Your sense of smell can become a lot more acute. Now this can mean that you start to smell things that you never noticed before. You might be walking down the street or in your back garden and suddenly, you can smell the flowers or smell other things in the air.

● Increased in yeast infection : Vaginal yeast infection.

● Thinning & fragile skin.

● Brittle Nails :

● Allergies worsen :

● Ringing ears / Tinnitus :

● Irregular Heart Beat: Heart Palpitations, Coronary artery disease.

● Breast Pain : Sore breast, hormone fluctuations may reach a higher intensity level during menopause thus resulting in painful breast tissue.

● Digestive Problems:

● Burning mouth syndrome:

● Muscle tension : It is often painful sensation in muscle being tight and strained in various parts of body. Typically women between the age old 45-55 years going through the menopausal transition. Muscle pain in back, neck and shoulder is common is common during menopause.

● Fatigue / Constant Tiredness Dizziness : Avoid snacking on sugary foods often a sharp rise in blood glucose may be followed by a sharp dip and leave you feeling tired and drained, so instead consume fresh fruits.

● Irregular heart beat :

Ageing & Menopause

● Menopausal quick weight gain :

● Osteoporosis / Thinning bones : (porous bone) Due to decreasing bone mineral density. There is also an increased risk of bone weakness and bone fractures and aching joints. Usually there should be a balance between bone formation and resorption. But this rate gets shifted towards more resorption in menopause.

Avoid fizzy drinks as they prevent the body from absorbing magnesium and calcium that are important for bone strength.

● Muscle ache

● Joint Pain backpain, & Muscle pain : Tense muscles. Vague aches and pains; Joint stiffness.

● Atrophic vaginitis : Vaginal dryness with itchy feeling and pain during intercourse. Vaginal dryness and itchiness in the genital area.

Melasma: “During menopause, some women experience more pigmentation on their face, called melasma, which is modeled pigmentation on the cheeks, upper lip and forehead,”

● Atrophic cystitis Or Recurrent Urinary Tract Infections : Women also complain of increased frequency, urgency and other symptoms that resembles urinary infections. This is due to Atrophic cystitis (inflammation of bladder because of its wall atrophy)

● Stress Incontinence of urine: Loss in bladder control causing leaks in urine, especially when sneezing and coughing. Frequent urination at night

● Urogenital Atrophy : In Post Menopausal women is worsen by smoking and is more apparent in women who have not had a vaginal birth.

● Urinary Pain and frequent urinary track infection :

● Increased Irritability :

● High cholesterol levels.

● Constipation

● Headaches

● Insomnia : Difficulty Sleeping

● Hypothyroidism commonly precipitated in menopause.
● Dizziness, Vertigo :

● Clammy skin : Night sweats are caused by changes in estrogen levels that trick your body into thinking you have an elevated body temperature. You awaken with a racing heart, cold and clammy skin and a bed soaked with sweat. wet skin

wet skin

● Bleeding gums, Chronic bad breath:

· Loosening of teeth :

After menopause bad cholesterol levels become high. and good cholesterol levels low.

BALANCING DOSHAS
VATA (Air element)

Anxiety
Insomnia
Poor Skin Tone : The skin loses its elasticity, hence wrinkles appear. Poor skin tone, Skin rashes, dry skin, spot and blemishes begin to appear. Allergies.
Vaginal dryness
Depression
Nervousness
Constipation
Joint ache

Recommendations : Cumin , fennel, cardamom, should be included in cooking.

Avoid : Caffeine, cold drinks, dry food. Include frequent small meals.

Lifestyle : Going to bed early can help balance vata dosha.

Useful Herbs : Aloe vera, Ashwagandha, Guggulu, Vidari, Shatavari, Arjuna should be used to control vata.

PITTA (Fire element)

● Hot flushes

In 75% of women. (sudden hot sensation in the body especially over face and neck without having any relation to the external weather), accompanied by sweating. Heat begins from the umbilical area and moves upwards towards head, followed by sweating of the head and upper body. Hot flushes which last from few seconds to minutes upset most women. Night Sweats.

Japanese woman rarely experience hot flushes etc probably because their diet contains large amount of soy proteins, a food rich in certain plant estrogen. It is also found in grains, cereals, dried beans, flax seed, lentils, peanuts. Vegetables such as sweet potatoes, carrot garlic and fruit such as strawberries, pears and plum.

Hot Flushes

Avoid stimulant such as tea, coffee, alcohol, chocolate etc especially at night as they provoke hot flushes.
Irritability : To help you feel less irritable, eat breakfast,eat little and often your blood sugar.
Urinary Tract Infections
Skin Rashes
Angry Out Burst
Heavy Periods (Unovulatory cycle)

Recommendations : Massage with coconut, sandalwood or sesame oil.

Avoid : Alcohol, pungent, sour, salty, hot spicy food .

Consume plenty of water and fruit juices (grapes, melons and plums etc.)

Practice meditation and stress reducing techniques.

Moderate yoga should be performed.

Avoid excessive exposure to sun.

Useful Herbs : Shatavari, Chandana, Aloe vera, Vidari.

KAPHA (Water element)

Weight Gain : Many people associate the menopause with weight gain but as we get older we need few calories. Eating a bit less will help. Obesity due to deposition of fat around the hips.
Sleepiness
Slow Digestion
Lethargy

Recommendations : Consume light, dry warm food.

Avoid : Avoid sweet, sour, cold, oily food.

Include spices like black pepper, turmeric and ginger in day to day life.

Lifestyle : : Should have small meals and finish all meals by 6 P.M.

Exercise regularly.

Useful Herbs : Ginger, Black pepper, Cinnamon, Cardemom, Guggulu, Ashwagandha, and mustard.

“Prevention is almost always better (and less stressful, and cheaper) than cure.”

Diagnosis

● Age around 45 - 55 years.

● The clinical diagnosis is confirmed following stoppage of menstruation for one year.

● Laboratory testing of Follicular stimulating hormone (F.S.H) < 35 miu /ml.

● Bone Mineral densitometry (B.M.D) for osteoporosis

● Breast self examination : Screening of cancer begins at home. It should be done every month. First look at the mirror- Are both breast of same size? Nipples at the same level ? Is the nipple pulled in? Is the skin over the breast normal? Second feel both the breasts with the pad of fingers, carefully and also the armpits. Check for discharge from the nipples. Go to doctor once a year, when in doubt.
● Mammogram : It is an X-Ray of breast. It should be done every year.
● Pap Smear : To pick up early signs of tumors in the female reproductive system.It is a test where a surface of the mouth of uterus or cervix is scraped (painless) and tested for precancerous condition. It should be done every three years.
● Transvaginal Ultrasound : It should be done every year to look for the size of ovaries and the uterus, especially the lining of uterus. It is useful as it may detect cancers before the symptoms appear, though precancerous lesions cannot be picked up.

● Blood test for vitamin D

● Blood sugar test: Fasting and post postprandial.

● Urine examination for routine examination (RE) and culture and sensitivity test (CS) and sugar test.

● Lipid profile

● Hemoglobin and general blood counts: To help detect anemia

● Thyroid test (T3,T4 & TSH)

● Kidney function test (KFT)

● Liver function test (LFT)

● Menopausal rating scale: 44. It is a questionnaire that evaluates women for

● a. psychological parameters such as depression and anxiety.

● b. physical parameters such as cardiac problems, pains and

● c. Urogenital problems such as vaginal dryness and urinary complaints.

“Menopause is not a negative phase in a woman's life cycle!”

Lifestyle

● Early to bed and early to rise. Going to bed early can help balance excess Vata.
● Regular sleep, simple exercises to tone and strengthen bones and muscles.

● Include frequent small meals

● Consume plenty of water and fruit juices (grapes, melon, plum etc.)

● Regular exercise, walking.
● Weight control.

● Sleep and eat on time.

● Vitamin D : Sun bath: Exposure to sun as vitamin D helps the body for calcium absorption. Sunlight for at least 30 minutes every day.

● It is advisable to keep the cholesterol levels and weight under close monitor. As coronary artery disease (cause of heart attack) are more common after menopause.

● Reduce the intake of salt in food.

● After dinner walk a must.

● Almond 6-7 every morning soaked overnight.

● Regular intake of balanced meals.

● Drink warm liquids.

● Music can ease mood swing.

● Go on vacation to refresh your self.

Don't
● No smoking no alcohol

“Women who exercise regularly and maintain balance diet tend to suffer less”.

Exercise

At least half an hour per day throughout your life. So that you are not dependant on others.

Do exercise which increases your strength, which increases your flexibility and which increases your stability.

YOGA,Strength training, cardio , combination of all is good.

Do Yoga daily.

Strength training twice a week.

● For a stronger core try modified Flutter kick

Scissor Kick

How

Lie on your back and place both arms on your sides, palms down, and extend your legs straight up to the sky, heels reaching up. Slowly lower one heel towards the floor, keeping that leg extended. Go as low as possible keeping your back pressed to the floor (if your back arches as you lower your leg, you've gone too low). With control bring your leg back up to the starting position. Switch legs. To make the movement easier, bend your knees. Try 5 movements per sides, for 10 in total.

Why

Strengthening core muscles will improve posture, balance and stability and relieve strain on your back helping to prevent or ease back pain. Strong core muscles also make it easier to do many physical activities, such as swinging a golf club or tennis racquet, doing house work that involves bending, lifting and twisting, reaching for an item from top shelf or sitting on a desk or work station for several hours.

● Weight bearing exercises :

● Simple exercises to tone and strengthen bones and muscles and regulates the circulation of blood. It also increases the level of serotonin, endorphin and dopamine in blood. Serotonin brings a calming effect and a sense of tranquility. Endorphin is a pain reliever which also reduces stress. Dopamine increases mental alertness.

● Exercise improves psychological health and relaxes body and mind.

● Regular exercise is recommended: It decreases blood cholesterol, decreases bone loss, improves ability to deal with stress, depression, anxiety and weight gain. Improves circulation and heart functions.

● Exercise also helps to prevent osteoporosis, especially weight bearing exercises like walking, jogging, squatting, or sitting on a chair without chair. Also lifting weights. climbing staircase, dancing. Use of dumbbells.

● Squat, forward bends, twists reduces Vata hence good for menopause.

● Kegel exercises: To strengthen the pelvic floor muscle. You can do these by tightening your pelvic muscles, as if trying to stop the flow of urine.

“Post menopause : Ovaries stop producing hormones : estrogen & progesterone”.

Yoga

Practice Yoga daily.

● Utkatasana

Weight bearing exercise : Utkatasana, Chair Pose, or fierce pose, is a standing asana in modern yoga as exercise. It was a low squatting asana in medieval hatha yoga. It is a weight bearing exercise, good for menopause.

● Mountain Pose / Tadasana: (ताड़ासन )

Awareness on synchronization of breath with body movement, maintaining balance and stretch of the whole body.
Benefit :

It strengthens knee ,thigh and ankle.
Strengthens the body
Relaxes the muscles
Improves the posture
Enhances body flexibility
Increases height in formative years.
Boost mental awareness
Promotes weight loss.
Boosts Energy Levels.
Improves Your Mood.
Provides Relief From Sciatica.

● Tree Pose Vrikshasana ( वृक्षासन )

Technique : Duration 20-30 seconds. Need to stand firmly and in a symmetrical fashion. Look straight ahead. Now make the thoracic spine straight pull the shoulder blades back and raise the arms. Press the palms together while stretching the arms and elbows as far as possible. Make sure not to slump in front due to the weight of the arms.

Benefit :

Improves balance and stability in the legs.
On a metaphysical level, helps one to achieve balance in other aspects of life.
Strengthens the ligaments and tendon of the feet.
Strengthens and tones the entire standing leg, up to the buttocks.
Assists the body in establishing pelvic stability.

● Eagle Pose Garudasana ( गरुड़ासन )

Technique : In Sanskrit Garuda means kidneys. First stand straight and then bring left leg forward over the right leg and now coil left leg over right leg. Then in similar manner coil both the hands together and both palms should touch each other in a position of Namaskar. Hold it for some times and then repeat its steps with another side of the body.

Benefit :

Stronger arms legs, knees and ankles.
Open shoulder joints, creating space between the shoulder blades'
Open hips and IT band
Increased circulation to all joints.
Improved digestion and elimination.
Improved balance
Improved focus.

● Shavasana : (शव आसन ) For relaxation lie down on your back and stretch out your body in a relaxed posture. Your legs should be apart and your arms by your side with palms facing the ceiling. Close your eyes and focus on deep abdominal breathing. Expand the lungs and the stomach while inhaling and relax the whole body while exhaling. Regular practice will give relief from hypertension and irritability.

● Vajra Asana

(वज्र आसन)

● Butterfly asana

● Uttana Padasana

“Menopause is a normal part of ageing.”

● Hero Pose Virasana (वीरासन )

Increases the blood circulation around the legs and helps in regulating blood pressure.

Benefit : Stretches the hip, thighs, knees ankles and feet. Improves circulation and and relieves tired legs, Strengthens foot arches relieving flat foot. Improves digestion and relieves gas. Help relieves symptoms of menopause. Improves posture.

● Squatting

● Reclined Hero Pose Supta Vajrasana ( सुप्त वज्रासन )

Supta means to sleep, pr supine reclined position.

Supta means lying down. When the powerful Vajrasana is performed in a lying down stance

Benefits :

It massages the abdominal region, therefore it improves the digestive system and and removes constipation.
The pelvic joint becomes elastic.
This pose expands the upper chest region, that envisages the increased oxygen flow into the respiratory system so it is good for asthma and respiratory disorders.
It stretches the lower spine and tones the spinal nerve and muscles in the region.
Thigh muscles are stretched and toned . This improves the flexibility of upper leg.
Supta Vajrasana activates the Vajra nadi .
It is good for thyroid.

Contraindicated :

Persons with lower back pain, sacral issues, knee injuries, and degenerated disc should avoid this pose.
Pregnancy ,should not be done.
People who are suffering from cervical spondylosis and osteoarthritis should avoid this pose.

Others

Pawanmuktaasana, Padmasana, Supt pawanmuktaasana , Bhujangasana, Dhanurasana, Shashankasana, Vipareeta karani Asana, Sarvangaasana, halasana, Matsyasana, Vajrasana, (after each meal)

Head To Knee Forward Bend Pose Janu Sirsasana (जानुशीर्षासन )

Benefits :

Helps relieve symptoms of Menopause.

Pranayama

● Bhastrika

● Kapalbhati

● Anulom Vilom
अनुलोम विलोम

● Udhageet Pranayama

● Bhramari pranayama

(भ्रामरी प्राणायाम)

“Healthy lifestyle is also the best way to ease symptoms of the menopause”..

Massage

● Regular body massage with oil (to prevent Vata) when nearing menopause. Oil Massage by sesame, almond, coconut, linseed oil or olive oil, which are natural products for relieving aches and pains.

Mudra

● Yoni Mudra

This mudra is specially designed for women. The posture of this mudra is held at the level of abdomen.

Formation :

Join the thumbs and the index fingers , interlock the other fingers. The thumb will be facing upwards and the index fingers will be facing downwards.

This can be performed the other way.

Effect:

the thumb and the index fingers touch each other they reflect volume of heat and air waves.. Other fingers remain interlocked would solve the problems of the womb.

Benefits :.

Practicing this mudra every day for 10 minutes followed by Prana mudra will solve the menopause related problem

● Prana Mudra :

● Shankha Mudra:

शंखा मुद्रा

● Place the thumb of the left hand at the base of the right thumb. This is a point of Thyroid gland in the palm. Fold the fingers of the right hand covering the left thumb. Join the index finger of the left hand with the thumb tip of right hand. The other three fingers of the left hand are to be placed on the back of right palm. This Mudra can be performed with reversing hands too. The thumb which represents the element fire is covered by the fingers hence fire is subdued. The union of left index finger and the thumb creates balance of wind. This Mudra rejuvenate the whole body.

● Surabhi Mudra

Mudra For Acidity, Awakens Kundalini Shakti. Tridoshaka. Menopausal problem.

Kamadhenu is the divine cow who dwells in heaven and grants all our wishes. Surabhi is the daughter of the divine cow Kamadhenu. Like the mother she also grants our prayers and she secretes nectar from her udders. This mudra represents the four udders of Surabhi.

Formation :

Form Namaste and keep the thumbs apart. Join the tips of index fingers and middle fingers which are opposite to each other then join little finger with the ring finger tips which are opposite to each other. The mudra formed looks like the udders of the cow. This is Surabhi mudra.

Effect :

Thumbs kept apart help reduce the fire. The joining of tips of middle and index fingers and joining of the tips of ring fingers and little fingers remove the problems of bile and gout. and rheumatism. As the eight fingers come together they activate a number of nerve centers and glands especially Adrenaline, Pituitary and Pineal.

Benefits :

All glands Adrenaline, Pituitary,, Pineal and thyroid functions better.
The three doshas, Vata, Pitta and Kapha get balanced.
Acidity is cured immediately.
There is a lot of development in creativity. Novelty increases in every endeavor we take up.
Desires and dreams are realized.
To realize our dreams one has to perform this mudra for 10 minutes everyday for at least 15 days.
Surabhi mudra has its influence on our mind. It increases our power to think and help blossoming of our creative faculty. This mudra helps us to realize all our dreams.
With Gayitri Japa, this mudra improves the 'Aura' of the body.

There are various types of Surabhi mudras performed by placing the thumb at the base of the elements.

● Gyan Mudra

Hridhay Mudra

Pran Mudra

Meditation

Practice meditation and stress reducing techniques. Meditation can go long way in aiding psychological slides, sleeplessness.

Yoga Nidra

"Lead your life in a regulated manner."

Rest and Recovery

Life is an interaction of me and we time.

ME TIME : Make sure that you are napping in the afternoon for 20 minutes. Preponing your bed time between 9.30 PM and 11PM in the night. If you sleep longer in the afternoon , you won't be able to sleep in night. As insomnia is also one of the symptoms of menopause. Or if you are on diet you won't be able to sleep. Even over exercising may cause less sleep. If you don't get proper good night sleep your menopausal symptoms will trouble you. To avoid this take a nap in the afternoon

WE TIME :

Yoga

Maha - Banda

Separate all three together.

Antar Mauna

Japa Aum / Gayatri / of own choice.

Developing hobbies, creativity, social activities, , beginning of spiritual life, positive attitude, and balanced diet.

Sadvritta

One should observe Sadvritta (अच्छा बर्ताव) i.e. practicing personal and social good conduct.

Diet

MENOPAUSE : NO DIETING , NO FASTING.

As we have rich tradition of eating and feeding people, so the diversity of diet is maintained. And we have a good sense of where to stop eating.

When we go on diet, calorie deficit, keto or fasting our diversity shrinks, micronutrients reduced and all menopausal symptoms arise and weight gain increases. It is dangerous. So do not start any diet which is not sustainable. Do a diet which your children can also eat , you are able to celebrate also which make you confident about food , not confuse you, and which you feel you can eat whole life. If diet is sustainable, than all your symptoms of menopause will go away, There will be variety in diet. Your skin will blow, your waist will be small. Diseases like constipation, bloating, acidity all will go away automatically

Take care of diet as the body is changing and shifting. You should be able to get all nutrient in your diet and also micronutrients , which includes Polyphenol and phytoestrogen. For example ऋषीची भाजी - Rushichi Bhaji | Ganesh Chaturthi Special , modak : Rice floor with coconut. In shrad or pitra moksha amavasya (Karel, pumpkin, torai are cooked with puree and rice kheer. In Navratri festival sweet potato, kuttu puree ,rajgira, sabudana is eaten. In south india pongal is eaten in new year. It makes diversity in diet. Which helps us to cope up change in our life in menopause period. Following this it add diversity in the diet. it gives polyphenol, phyto oestrogen and other nutrients in the diet.

Your diet should be LST

LOCAL

SEASONAL and

TRADITIONAL

Local means fruits and vegetables which grows around you. Green vegetables like sarson ka saag is a vegetable of Punjab. Ambaadi chi bhaji from Maharashtra, Hare chane ki bhaji from Jabalpur, Kashmiri Haaq from Kashmir, Uttranchal Saag which has two type of vegetables "Kashmiri haaq"and "poi". Pulicha keerai Masiyal from Tamilnadu etc.Eating arbi, Gimikand. In Dusshera puree, Shreekhand is eaten. In Diwali dry snacks prepared like chawada, chakali, laddoo,anarsa,. Puranpoli, kadhi all should be consumed.

Seasonal Fruits and vegetables which comes in season should be eaten in season. like jamun comes in rainy season, mangoes, water melon, muskmelon which comes in summer,

Traditional It gives you all nutrients. As your grandmother, mother or aunts have taught you to prepare. Traditional cooking methods we get from the ladies of the family. We get it from oral wisdom or guru shishya parampara.. This is how food wisdom reaches.

Food rich in Plant estrogen :

● Japanese women rarely experience hot flushes etc. probably because their diet contains large amount of soy proteins, a food rich in plant estrogen.

● Whole food including grains, cereals, dried beans, flax seeds, lentils, peanuts. Vegetables such ad sweet potato, carrots, garlic. Fruits such as strawberries, pears and plums.

● Nutritious diet and proteins.

● Calcium : 1 gram per day.

Calcium rich foods: milk, Take a glass of milk per day. Ghee, curs, cheese, & Butter
Vegetables includes such as leafy and fresh green vegetables, Asparagus, sweet potatoes, carrots, garlic and broccoli,. Okra, greens such as drumstick leaves, spinach, (पालक ) , fenugreek (मेथी ) , asparagus, (चौलाई ), tomato, broccoli, kale, Ragi, sesame seed, flax seeds, banana stem, sesame seeds
Fruits such as strawberries, pears and plum, almond, apricot. Juicy fruits like apple, mango grapes, oranges should be consumed.
Dry fruits like almond, apricot, figs
Eat a healthy diet balanced in protein, low fat and carbohydrate
Dietary supplement: , zinc and vitamin D
Seeds : Flax seed (अलसी का बीज ).Sesame seeds Tila roasted is a high source of calcium ; sunflower seeds,
Amla powder.
Wholesome diet rich in phytoestrogens and isoflavones. They are present in soybeans, flaxseed oil and green tea. Soybean: It has phytoestrogens Using soybean in varieties of Indian food Form like chapatis mix, soy balls on sambhar or plain roasted soy or soy milk , tofu , help to ease menopausal symptoms effectively.
Another source of phytoestrogens are “lignin's” compound found in whole food including grains, cereals, dried beans,, lentils, peanuts,
Beetroot juice is found to be highly beneficial for menopausal problems.
Spices such as black pepper, turmeric and ginger are highly beneficial.
Increase the use of fennel and cumin in food.
Ragi: A little bit of Ragi added to the wheat floor of chapattis daily can do wonders for the bones
High fiber diet to avoid constipation
Fennel, Cardamom should be included in cooking.
Sprouts

● Recipe to help relieve menopausal symptoms Heat 2 tsp vegetable oil in pan. Add onion and sauté until onion is translucent. Add garlic, ginger paste masala powder cook for 2 minutes. Pour coconut milk. Sprinkle salt and powder, cloves, cinnamon stick and cardamoms. Lower heat and simmer for few minutes. Add the cubed pieces of paneer and peas. Cook for few minutes. Serve with rice and chapatis.

Avoid

●   Excessive spicy, fermented. pungent food and high protein diet
●  Avoid worry
●   Avoid excessive exposure to sun.

● Avoid refined sugar, aerated cold drinks, dry food.

● Avoid stale and junk food

● No smoking no alcohol.

● Excess tea & Coffee

● Avoid fats this will help to avert coronary artery disease.

● Avoid pungent, sour, salty, hot, spicy fermented food.

● Keeping awake at night, erratic hours.

● Heavy foods like cheese, butter, meat should be avoided.

● Suppression of natural urges.

● Avoid hot bath.
● Avoid fermented foods.
● Avoid fizzy drinks as they prevent the body from absorbing magnesium and calcium that are important for bone strength

“Sleep and eat on time”.

Herbs

Herbs Used : Vtapittashamak (वातपित्तशामक) Herbs used for menopause have properties that help in strengthening and rejuvenating the female reproductive system, apart from this they regulate the hormones too.
● Amla : (Embilica officinalis)

● Shankhapushpi (शंकपुष्पी)

●   Soybeans : It has phytoestrogen that almost replicates the property of estrogen, thus it naturally helps the need of estrogen in the body.
●  Ashoka : Ashoka is considered as the best drug for all gynecological disorders. It calms down the symptoms owing to menopausal and post menopausal stress.IT also keeps a tab on the hormone keeping their level in normalcy.
● Asparagus Root : Shatavari (शतावरी) It gives strength to the uterus and female reproductive organ.
●  Ashwagandha : It is also known as the Indian Ginseng. It helps to relieve stress and restore calm to those experiencing erratic or unstable hormonal imbalance
●   Guggulu (Commiphora wightii) good for obesity and pain. (गुग्गुलु)
●    Cissus quadrangularis Hadjod Asthisamharaka : A Panacea for bone health.

● Guduchi (Tinospora cordifolia) गिलोय

● Aloe Vera Kumari

● Mandukaparni (Centella asiatica)

● Common herbs and spices such as thyme, oregano, nutmeg and turmeric also have estrogenic properties..

● Saffron

● Terminalia arjuna

● Cardamom and fennel to relieve pitta symptoms like hot flushes.

● Licorice

● Sandalwood.

● Yashti (Glycyrrhiza glabra) (यष्टि मधु) liquorice

● Vidari

● Celery seed or Ajwain

● Ginseng to boost vitality.

● Coriander is cooling and acts as a diuretic.

Home Remedies

For Hot Flushes'

Narial Barfi

Banana Chips

Ridge Guard / Turai Peel + Sesame Chutney / दोडक्याच्या सालीची चटणी

Ingredients

6 Ridge Gourd Skin (Turai/ Peerkangai)
1 tablespoon Sesame seeds (Til seeds) , roasted
Green chilly
Kadhi Patta
1tsf mustard seeds
Hingh
1 teaspoon Red Chilli powder
1 teaspoon Sugar/ grated gur
1/2 teaspoon Cumin seeds (Jeera)
2 tsf oil
Salt to taste
The nutritive peels of the humble Ridge gourd (Dodka) can be used to make a quick, lip smacking chutney. Sesame can be added along with the ridge gourd for an extra crunch, and to increase the health quotient of the chutney. Flax seeds can be another addition to increase the nutritive value of the chutney.

How to make Ridge Gourd Peel Chutney Recipe

To begin making the Ridge Gourd Peel chutney, roughly chop the peels of the ridge gourd.
In an iron Kadhai, on an medium flame heat oil. Add mustard seeds, cumin seeds, hingh,white sesame seeds, chopped chillies, curry leaves and turmeric, Fry for 30 sec, Add salt and sugar or grated jaggery.
Now add ridge Guard peel and roast them till they change color to brown and become crunchy in texture.
Alternatively, you can also microwave the peels with oil for about 1-1/2 minutes.
Let the roasted ridge gourd peels cool down and then coarsely grind them in a mixer grinder.

Other Remedies

● Fenugreek Laddu : Powder of roasted fenugreek seed is mixed with jaggery syrup made into laddus.

● Black Till Laddu : Coarsely powdered roasted black sesame seeds and mixed jaggery are recommended as they are rich in vitamin E , which will ton the uterus.

● Green leafy Vegetables : Variety of green vegetables preparations along with rice, roti or lentils.

● Ragi Laddu : Roasted ragi flour and roasted coarsely pound peanuts mixed with jaggery syrup made into laddus.

● Urad Dal Laddus: It is made from finely powder of roasted urad dal, jaggery, cardemom and desiccated coconut,

● Rice flour laddu : Laddu made from roasted rice flour mixed with jaggery, dry coconut, ginger powder, cardamom. pepper jeera mixed with ghee.

● Soak 2 teaspoonful of Fenugreek (Methi) at night. Munch it with little buttermilk, early in the morning.

● Mix 2 teaspoon of roasted Soy powder in milk & drink it once or twice a day. Soy can also be used in other form in the food i.e. as chapatis by mixing in wheat flour.

● Shankhapushpi . helps to improve memory, sleeplessness.

● Ashokarishta daily good for overall health. It calms down the symptoms owing to menopausal and post menopausal stress.

● Chandanadi Taila : Massage with this oil helps to alley insomnia and mood swings, which can occur due to vata vitiation.

Special menopausal women clinic

* Ram Manohar .Lohia Hospital Delhi : Every Tuesday between 2 PM and 4 PM. Screening of women for cervical cancer and breast cancer is also done

Prevention
● It is advisable to keep the cholesterol levels and weight under control

● Reduce body weight

● Vitamin B 12 It is found in non- vegetarian foods and so vegetarian may need a supplement.

● Protein balance should be maintained.

Menopause Myths

● You cannot get pregnant after the menopause? False It can and does happen, so carry on using contraception for two years after your last period. If you are under 50 and for one year if you are over 50.

● You are going to put on weight False Middle age spread is often linked to the hormonal changes, at this time of life but as yet there is no proof of this. Those extra inches could just be part of growing older and being less active.

● You menopause will be difficult because your mum's was. False There is no evidence that this is the case, although the age at which your mother went through the menopause could give you a clue as to when to expect symptoms. This is because the age of menopause , tends to be similar in mothers and daughters.

"Menopause (natural or surgical) will abate the process of endometriosis."

Treatment

ALLOPATHIC:

● Nutritious diet with proteins.

● Weight bearing exercises.

● Vitamin D 400-800 mg/day: Many women suffer from Vitamin D Deficiency. The cause of joint pain, fatigue and hair fall. Vitamin D pouches or Tab can be taken. Note : Do not overdose on Vitamin D, Follow your doctors advise strictly.

● Calcium 1 g/day : The body losses vital calcium for several reasons including the over consumption of sugar., which leads to an acid imbalance and subsequent release of calcium by the kidneys to compensate. If you are calcium deficient chances of joint pain get higher.

● Tab Premarin 0.625-1.25 mg per day for 25 days every month

● Tab Progynova 2mg /day for 25 days every month.

● Tab Lynoral0.02-0.05mg / day for 25 days every month followed by

● Tab Duphaston (natural Progesteron) 10 mg for 10-12 days each month to prevent endometrial hyperplasia or endometrial carcinoma.

● Marina : An intra uterine device : Mirena is often prescribed for women with heavy menstrual bleeding

● Skin : The skin bears the major brunt of the damage due to ageing. Amla in its various forms to combat the effects of on maturity. As Amla is rich in vitamin C and also contains several other vitamins. and minerals that helps slow down the ageing process.

● Vitamin B 12 : If you feel emotionally down with chronic feeling of tiredness, you could be suffering from deficiency of vitamin B 12. It is found in non vegetarian foods and so , vegetarians need a supplements.

● Protein Imbalance : There is a high prevalence of protein deficiency among women, due to which they suffer from hair loss, skin changes, flabby muscles, stubborn weight. Protein deficiency is especially evident during and after menopause.

● Vitamin E Tab Evian once a day

● Iron and vitamin C

● Tab Cartilamine forte for pain.

● Hormone replacement therapy (HRT) : H.R.T involves combination of estrogen and progesterone hormone supplementation. It would be wise to reserve HRT for extremely obstinate cases that fail to respond to any other measure. H.R.T can also be administered in the form of trans-dermal therapy through dermal patches. It can also be given as intrauterine device in form of Mirena.

● Surgical: Hysterectomy.

● Osteoporosis: Calcium 1500 gram per day. Vitamin D 400-800 mg/day

● Stroke: Consume less oil and fatty items. Regular exercise and pranayama will help to bring down lipid levels

● Hot flushes: Avoid stimulants such as coffee, alcohol, chocolate etc. especially at night as they provoke hot flushes. Evening primrose oil cap or applied to skin.

● Urinary Tract Infection: Good amount of fluid intake. Regular and complete emptying of bladder with maintaining proper hygiene of genital area should be done. Syrup Alkacitron 2 tbsp. three times a day. Antibiotic after culture and sensitivity test. Tab Ofloxacin 400 mg twice a day for 5 - 10 days. Prefer cotton undergarments. Weak bladder ; Avoid caffeine and artificial sweeteners, and do simple exercise to strengthen the pelvic muscle.

● Tiredness & Mood swings : Avoid snacking on sugary foods often a sharp rise in blood glucose may be followed by a sharp dip and leave you feeling tired and drained, so instead consume fresh fruits. Eating six times a day keep your sugar levels stable.

● Weight gain: Eating a bit less will help. Don’t forget to exercise. restrict fat and carbohydrates.

● No Smoking No alcohol.

● Hormone Replacement Therapy (HRT) for Premature menopause : Forms the mainstay of managing menopause and its various manifestations.

● HRT can also be administered in the form of transdermal therapy through dermal patches, which releases 50-100 mg of beta-estradiole daily.

Air Conditioners help : For Hot flushes.

AYURVEDA:

●   Good counselling.
●   Balance Dosha : Mind, body system is in balance.
●   Balanced diet : Diet is wholesome and rich in phytoestrogen.
●   Panchakarma: Cleansing therapy. This help to clear the body's channels by the various internal cleansing processes.
Detoxification of body is done through Panchakarma.
A.      Gentle body massage :   Regular body massage with oil (to prevent Vata) when nearing menopause.    Oil Massage by sesame, almond, coconut, linseed oil or olive oil, which are natural products for relieving aches and pains.. Or  body massage using Dhanwantharam tailam, twice a week.

B.      Shirodhara It is done by continuous flow of medicated oil, decoction and butter milk on the head, which soothes and calms the brain.

Body is cleaned and uncluttered inside.

●   Rejuvenation Tonic (रसायन) like :

a . Amla -  Amla: Amla powder daily. Take Amla in its various forms as it is Vitamin C which helps to slow down the ageing process. Take amla in chutney, Chyawanprash, candy, powder or fresh form
b . Chyawanprash,
c . Ashwagandha (Withania somnifera) known as Indian ginseng, it helps to relieve stress and restore calm.  Boil 10 gram of Ashwagandha, Shatavari and liquorice in 200 ml of milk and drink   it  twice daily. It will help in reducing hot flushes, mood swings and depression
d . Shatavari (Asparagus racemose) It’s root gives strength to the uterus and female reproductive organ
  e . Brahma Rasayana

f . Shatavari : This herb is renowned for reducing the effects of the ageing process.. It can be taken with milk or water.

● Natural calcium supplement: Consume 200 mg of Pravala bhasma (प्रवाल भस्म ) or Kukkutandatwak bhasma (कुक्कुट अंड भस्म) with milk. This will help to keep your bones fit and rejoicing.

● Linseed oil or flax seed oil

● Balaksheer paka: It is the milk decoction of bala moola (roots if Sida cordifolia). Its strength promoting and rejuvenating. 100 ml twice a day.

● 10 drops of Ksheera bala oil (daily with milk will help to keep your nerves fit and fine. It will also improve brain functions

● Burning micturition 250 grams of cumin seeds roasted on a pan until golden brown and then powdered coarsely. A teaspoon of this powdered is boiled in about 250 ml of water, filtered and used as douche after urination, This brings in relief from burning sensation . No intake of spices

● Take a cup of hot water. Add1 tsf of coriander powder. Close the lid and keep it for 5-10 minutes to cool. Drink this infusion twice a day. Avoid aromatic soaps to wash urinary area, instead Triphala Kashaya .

● Constipation : exercise and supplementation of probiotics (beneficial bacteria in our digestive system) will help to relieve constipation. Hence consuming yogurt, oats, whole grain, fruits, vegetables and increasing fluids will be beneficial. Take 1 tsf of ghee per day with food. Taking 1 tsp Triphala churna at bed time with warm water will reduce constipation. 2-3 teaspoonful of Gull - Khand गुलकcद with one tsp of butter in the morning before breakfast, helps to overcome constipation. Exercise regularly.

● Gandhatailam (गंधा तेल) for week bones.

● Chandraprabha vati: It helps in Vata vitiation which is one of the foremost causes of menopausal problems.
● Chandanadi taila: (चंदन के तेल ) Massage with this oil helps to allay insomnia and mood swings which can occur due to Vata vitiation.

“Remember Menopause is not a time to pause, but to stride along! There is still a long way to go”

WHETHER YOU ARE IN MENOPAUSE OR NOT ?

CORRECT DIET

CORRECT EXERCISE

PROPER REST AND RECOVERY

YOU NEED NOT WAIT FOR ANY OCCASION TO START.

YOU CAN START IT FROM TODAY ITSELF.

Link: https://madhuchhandacdmo.blogspot.com/2018/12/menopausal-syndrome.html

* Medicine as suggested above should only be taken under the consultation and supervision of registered medical practitioner.

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