Menopause, also known as the climacteric, is the time in most women’s lives when menstrual periods stop permanently, and they are no longer able to have children. Menopause typically occurs between 45 and 55 years of age.One more definition of menopause is that “when a woman has not had any vaginal bleeding for a year”.It may also be defined by a decrease in hormone production by the ovaries. In those who have had surgery to remove their uterus but they still have ovaries, menopause may be viewed to have occurred at the time of the surgery or when their hormone levels fell. Following the removal of the uterus, symptoms typically occur earlier, at an average of 45 years of age.
Before menopause, a woman’s periods typically become irregular, which means that periods may be longer or shorter in duration, or be lighter or heavier in terms of the amount of flow.
During this time, women often experience hot flashes; these typically last from 30 seconds to ten minutes, and may be associated with shivering, sweating and reddening of the skin. Hot flashes often stop occurring after a year or two. Other symptoms may include vaginal dryness, trouble sleeping, and mood changes. The severity of symptoms varies between women. While menopause is often thought to be linked to an increase in heart disease, this primarily occurs due to increasing age and does not have a direct relationship with menopause. In some women, problems that were previously present like endometriosis or painful periods will improve after menopause.
Menopause is usually a natural change. It can occur earlier in those who smoke tobacco. Other causes include surgery that removes both ovaries, or some types of chemotherapy. At the physiological level, menopause happens because of a decrease in the ovaries’ production of the hormones estrogen and progesterone. While typically not needed, a diagnosis of menopause can be confirmed by measuring hormone levels in either the blood or urine. Menopause is the opposite of menarche, the time at which a girl’s periods start.
Specific treatment is not usually needed. Some symptoms, however, may be improved with treatment. With respect to hot flashes, avoiding smoking, caffeine, and alcohol is often recommended. Sleeping in a cool room and using a fan may also help.
- Signs and symptoms
- Symptoms of menopause
Symptoms during menopause
At this time a woman could experience the other symptoms of menopause such as hot flashes and mood swings. These symptoms would then not be associated with the cessation of menstruation. Another possibility is that premature ovarian failure will occur earlier than the expected time of menopause, as early as 1 to 2 years following the hysterectomy. If this happens, a woman may or may not experience symptoms of menopause.
Irregular vaginal bleeding
Irregular vaginal bleeding may occur as a woman reaches menopause. Some women have minimal problems with abnormal bleeding during the prior time to menopause whereas others have unpredictable, excessive bleeding. Menstrual periods (menses) may occur more frequently (meaning the cycle shortens in duration), or they may get farther and farther apart (meaning the cycle lengthens in duration) before stopping. There is no “normal” pattern of bleeding during the perimenopause, and patterns vary from woman to woman. It is common for women in perimenopause to have a period after going for several months without one. There is also no set length of time it takes for a woman to complete the menopausal transition.
The menstrual abnormalities that begin in the perimenopause are also associated with a decrease in fertility, since ovulation has become irregular. However, women who are perimenopausal may still become pregnant until they have reached true menopause (the absence of periods for one year) and should still use contraception if they do not wish to become pregnant.
Hot flashes and night sweats
Hot flashes are common among women undergoing menopause. A hot flash is a feeling of warmth that spreads over the body and is often most pronounced in the head and chest. A hot flash is sometimes associated with flushing and is sometimes followed by perspiration. Hot flashes usually last from 30 seconds to several minutes. Although the exact cause of hot flashes is not fully understood, hot flashes are likely due to a combination of hormonal and biochemical fluctuations brought on by declining estrogen levels.
There is currently no method to predict when hot flashes will begin and how long they will last. Hot flashes occur in up to 40% of regularly menstruating women in their forties, so they may begin before the menstrual irregularities characteristic of menopause even begin. About 80% of women will be finished having hot flashes after five years. Sometimes (in about 10% of women), hot flashes can last as long as 10 years. There is no way to predict when hot flashes will cease, though they tend to decrease in frequency over time. They may also wax and wane in their severity. The average woman who has hot flashes will have them for about five years.
Sometimes hot flashes are accompanied by night sweats (episodes of drenching sweats at nighttime). This may lead to awakening and difficulty falling asleep again, resulting in unrefreshing sleep and daytime tiredness.
Vaginal symptoms occur as a result of the lining tissues of the vagina becoming thinner, drier, and less elastic as estrogen levels fall. Symptoms may include vaginal dryness, itching, or irritation and/or pain with sexual intercourse (dyspareunia). The vaginal changes also lead to an increased risk of vaginal infections.
The lining of the urethra (the transport tube leading from the bladder to discharge urine outside the body) also undergoes changes similar to the tissues of the vagina, and becomes drier, thinner, and less elastic with declining estrogen levels. This can lead to an increased risk of urinary tract infection, feeling the need to urinate more frequently, or leakage of urine (urinary incontinence). The incontinence can result from a strong, sudden urge to urinate or may occur during straining when coughing, laughing, or lifting heavy objects.
Emotional and cognitive symptoms
Women in perimenopause often report a variety of thinking (cognitive) and/or emotional symptoms, including fatigue, memory problems, irritability, and rapid changes in mood. It is difficult to precisely determine exactly which behavioral symptoms are due directly to the hormonal changes of menopause. Research in this area has been difficult for many reasons.
Emotional and cognitive symptoms are so common that it is sometimes difficult in a given woman to know if they are due to menopause. The night sweats that may occur during perimenopause can also contribute to feelings of tiredness and fatigue, which can have an effect on mood and cognitive performance. Finally, many women may be experiencing other life changes during the time of perimenopause or after menopause, such as stressful life events, that may also cause emotional symptoms.
Other physical changes
Many women report some degree of weight gain along with menopause. The distribution of body fat may change, with body fat being deposited more in the waist and abdominal area than in the hips and thighs. Changes in skin texture, including wrinkles, may develop along with worsening of adult acne in those affected by this condition. Since the body continues to produce small levels of the male hormone testosterone, some women may experience some hair growth on the chin, upper lip, chest, or abdomen.
34 Menopause Symptoms
Many women experience some physical and emotional symptoms during menopause, caused by hormonal imbalance. Typically, a woman will begin to experience menopause symptoms around her mid-40’s as her body’s reproductive capability comes to the end.
List of the 34 Menopause Symptoms
- Hot Flashes
- Night Sweats
- Irregular Periods
- Loss of Libido
- Vaginal Dryness
- Mood Swings
- Hair Loss
- Sleep Disorders
- Difficult Concentrating
- Memory Lapses
- Weight Gain
- Brittle Nails
- Changes in Odor
- Irregular Heartbeat
- Panic Disorder Pains
- Breast Pain
- Joint Pain
- Burning Tongue
- Electric Shocks
- Digestive Problems
- Gum Problems
- Muscle Tension
- Itchy Skin
- Tingling Extremities
Other physical symptoms
Other physical symptoms of menopause include: lack of energy, joint soreness, stiffness, back pain, breast enlargement,breast pain, heart palpitations, headache, dizziness, dry, itchy skin, thinning, tingling skin, weight gain, urinary incontinence, urinary urgency,interrupted sleeping patterns, heavy night sweats, hot flashes.
Psychological symptoms include: anxiety, poor memory, inability to concentrate, depressive mood, irritability, mood swings, less interest in sexual activity.
Long term effects
- A possible but contentious increased risk of atherosclerosis The risk of acute myocardial infarction and other cardiovascular diseases rises sharply after menopause, but the risk can be reduced by managing risk factors, such as tobacco smoking, hypertension, increased blood lipids and body weight.
- Increased risk of osteopenia and osteoporosis
The typical age of menopause (last period from natural causes) is between 40 and 61.
In rare cases, a woman’s ovaries stop working at a very early age, ranging anywhere from the age of puberty to age 40, and this is known as premature ovarian failure (POF).
Undiagnosed and untreated coeliac disease is a risk factor for early menopause. Coeliac disease can present with several non-gastrointestinal symptoms, in the absence of gastrointestinal symptoms, and most cases escape timely recognition and go undiagnosed, leading to a risk of long-term complications.
Women who have undergone hysterectomy go through menopause on average 3.7 years earlier than the expected age.
Other factors which can promote an earlier onset of menopause (usually 1 to 3 years early) are: smoking cigarettes, or being extremely thin.
Menopause can be surgically induced by bilateral oophorectomy (removal of ovaries), which is often, but not always, done in conjunction with removal of the Fallopian tubes (salpingo-oophorectomy) and uterus (hysterectomy). Cessation of menses as a result of removal of the ovaries is called “surgical menopause”.
Removal of the uterus without removal of the ovaries does not directly cause menopause, although pelvic surgery of this type can often precipitate a somewhat earlier menopause, perhaps because of a compromised blood supply to the ovaries.
The stages of the menopause transition have been classified according to a woman’s reported bleeding pattern, supported by changes in the pituitary follicle-stimulating hormone (FSH) levels.
Hot flushes and other vasomotor symptoms accompany the menopausal transition. Some time it is claimed that hot flashes occurring during the menopausal transition are caused by low estrogen levels
Premenopause is a term used to mean the years leading up to the last period, when the levels of reproductive hormones are already becoming more variable and lower, and the effects of hormone withdrawal are present. Premenopause often starts some time before the monthly cycles become noticeably irregular in timing.
The term “perimenopause”, which literally means “around the menopause”, refers to the menopause transition years, a span of time both before and after the date of the final episode of flow. During perimenopause, lot of changes may occur, Some of these changes are hot flashes, night sweats, difficulty sleeping, vaginal dryness or atrophy, incontinence, osteoporosis, and heart disease. During this period, fertility diminishes, but is not considered to reach zero until the official date of menopause. The official date is determined retroactively, once 12 months have passed after the last appearance of menstrual blood.
The term “postmenopausal” describes women who have not experienced any menstrual flow for a minimum of 12 months, assuming that they do still have a uterus, and are not pregnant or lactating. In women without a uterus, menopause or postmenopause can be identified by a blood test showing a very high FSH level. Thus postmenopause is all of the time in a woman’s life that take place after her last period, or more accurately, all of the time that follows the point when her ovaries become inactive.
A woman’s reproductive hormone levels continue to drop and fluctuate for some time into post-menopause, so hormone withdrawal effects such as hot flashes may take several years to disappear.
Any period-like flow during postmenopause, even spotting, must be reported. The cause may be minor, but the possibility of endometrial cancer must be checked for.
Perimenopause is a natural stage of life. It is not a disease or a disorder, and therefore it does not automatically require any kind of medical treatment. However, in those cases where the physical, mental, and emotional effects of perimenopause are strong enough that they significantly disrupt the everyday life of the woman experiencing them, palliative medical therapy of course herbal or panchakarma line of management may sometimes be appropriate.
- At what age does a woman typically reach menopause?
The average age of menopause is 51 years old. But there is no way to predict when an individual woman will have menopause or begin having symptoms suggestive of menopause. The age at which a woman starts having menstrual periods is also not related to the age of menopause onset. Most women reach menopause between the ages of 45 and 55, but menopause may occur as earlier as ages 30s or 40s, or may not occur until a woman reaches her 60s. As a rough “rule of thumb,” women tend to undergo menopause at an age similar to that of their mothers.
- Perimenopause, often accompanied by irregularities in the menstrual cycle along with the typical symptoms of early menopause, can begin up to 10 years prior to the last menstrual period.
Ayurvedic Symptoms of Menopause:
Ayurveda links menopause with aging. Aging is a ‘Vata’ predominant stage of life. Thus, the symptoms of menopause experienced by some women are similar to the symptoms seen when the Vata dosha rises and upsets the normal balance of the body. Vata-type menopausal symptoms tend to include depression, anxiety, and insomnia. Menopause may also manifest itself as a rise in the other two humors also. Women with Pitta-type symptoms are often angry and suffer hot flashes. Kapha type symptoms include listlessness, weight gain, and feelings of mental and physical heaviness.
Ayurvedic Treatment of Menopause
The type of treatment depends upon the dosha in which the woman’s menopausal symptoms are manifesting.
Health problems at menopause represent imbalances in the body that were already growing in the body and are unmasked by the stress of shifting hormones. Menopause symptoms are Nature’s wake-up call to let you know you need to start paying more attention to your health. Taking proper steps in the direction of balancing the imbalance doshas, paying attention to your diet and making lifestyle changes now is critical to ensuring that you age gracefully without the burden of chronic health problems.
VataType- Nervousness, anxiety, panic, mood swings, vaginal dryness, loss of skin tone, feeling cold, irregular periods, insomnia, mild or variable hot flashes, constipation, palpitations, bloating and joints aches and pains.
Diet – Increase warm food and drinks, regular meals, and use spices such as fennel and cumin. Decrease caffeine and other stimulants, refined sugar, cold drinks, salads.
Lifestyle – Early bedtime, oil massage using almond and olive oil, meditation, yoga, Regular exercise like walking
Anti-Vata herbs include ashwagandha, arjuna, cardamom, garlic, ginseng, guggul, sandalwood.
PittaType- Symptoms – Prone to Hot Temper, anger, irritability, feeling hot, hot flashes, night sweats, heavy periods, excessive bleeding, urinary tract infections, skin rashes and acne.
Diet – Increase cooling foods, water intake, sweet juicy fruits (grapes, pears, plums, mango, melons, apples,) yellow squash, cucumber, organic foods. Use spices such as cinnamon, cardamom and fennel. Avoid hot spicy foods, hot drinks and alcohol. no eating late at night.
Lifestyle – Go to bed before 10 PM , oil massage using coconut and sesame oil. Use Meditation and other techniques to reduce anger, hatred and resentment. Exercise and exposure to the sun are limited.
Kapha-Type- Prone to Weight Gain: sluggishness, lethargy, weight gain for no reason, fluid retention, yeast infections, lazy, depressed, lacking motivation, slow digestion.
Ayurvedic Tips: Increase exercise, fruits, whole grains, legumes, vegetables, spices such as black pepper, turmeric and ginger. Get up early (by 6AM). Decrease meat, cheese, sugar, cold foods and drinks.
Key factors in achieving graceful menopause
A smooth menopause transition and great health in the years to come can be achieved with the help of –
- Balancing Doshas – Ascertain the imbalance dosha according to your symptoms and follow the advice given above to balance that dosha.
- Balancing Diet – Diet plays a key role in balancing hormones during and after menopause.
Eat a varied diet high in fruits, vegetables, whole grains and dried beans . Variety and moderation are important because just as too much estrogen is unhealthy after menopause.
Apana Vata, which governs the genito-urinary tract, elimination, and menstruation, is a key area to attend to when preparing for menopause. Drink plenty of warm water throughout the day. Eat plenty of cooked, leafy greens, as this helps elimination and is also a good source of calcium. For both Pitta and Vata imbalances, a breakfast of cooked apples and figs is a good way to start the day, as it balances the doshas and cleanses the digestive track.
- Panchakarma – More serious symptoms, such as frequent hot flashes, continual sleep disturbance, and moderate to severe mood swings, are signs of deeper imbalances.
Ayurveda describes that these stubborn symptoms are usually due to the buildup of wastes and toxins, referred to as “Ama,” in the body’s tissues.
In this case, a traditional Ayurvedic detoxification program “panchakarma,” may be needed to clear the body’s channels and gain relief. This internal cleansing approach is also the treatment of choice for more serious problems such as osteoporosis and high cholesterol.
Ayurveda describes that your hormonal changes at menopause will be smooth and easy if three factors are in place.
- Your mind/body system (consisting of three doshas) is in “balance.”
- Your diet is wholesome and rich in phytoestrogens
- Your body is “clean” and uncluttered inside so your hormones and body can “talk” effectively.
What are some natural ways to alleviate menopause symptoms?
- Herbs such as shatavari (asparagus racemosa), black cohosh (Cimicifuga racemosa), wild yam (Dioscorea villosa), Motherwort (Leonurus cardiaca) and chaste tree (Vitex agnus-castus) are known to help alleviate menopausal symptoms by virtue of the phytoesptrogens they supply
- Take foods high in plant estrogens such as soy beans,lima beans, nuts, seeds, fennel, celery, parsley and flaxseed oil
- Increase calcium intake and take 400 to 800 IU of vitamin E daily to treat hot flashes and reduce the risk of cardiovascular disease
- Lot of ayurvedic formulation with herbs such as Shatavari, Ashoka tree, Chebulic myrobalan, country mallow, licorice and Indian pennywort. This has been formulated specifically to alleviate menopausal symptoms as well as provide overall hormonal balance. Its herbs provide phytoestrogens in the required quantities and are an excellent alternative to allopathic managments without any side effects.
Ayurvedic Treatment, Lifestyle Tips
5 Natural Ways to Balance Your Hormones
- Eat your broccoli. Cruciferous vegetables such as broccoli, cauliflower, bok choy, Brussels sprouts, cabbage, and kohlrabi which is metabolized in the body and have been shown to have some anti-cancer effects, particularly for breast cancer.
- Maintain a healthy weight. Excessive adipose (fat) tissue can act as an endocrine organ, producing more estrogen in the body. By maintaining a healthy weight, your body is not stimulated to overproduce certain hormones.
- Include phytoestrogens in your diet. Found in foodslike flax seeds, sunflower seeds, bean sprouts, and legumes such as beans and peas, are plant-based substances that can help balance your hormones naturally.
- Consider the use of herbal remedies. Ayurvedic herb shatavari has been useful for both menopausal hot flashes and PMS associated with irritability and mood swings. Other herbal remedies have also proven helpful for both physical and psychological symptoms.
- Breathe deeply. Doing yoga or pranayam for about fifteen minutes of deep belly breathing twice daily has been shown in several clinical trials to decrease hot flashes and night sweats as well as improve a woman’s sense of well-being.
Root Causes of Menopausal Symptoms
There are several types of major imbalances:
- The buildup of toxins and impurities in tissues.
- Blockage of the channels of circulation responsible for nourishing and cleansing the tissues.
- Imbalance of digestive and metabolic processes.
- Imbalance and deterioration of nervous system strength and stability.
- Accumulation of physical and mental stress.
- Lowering of natural resistance and immunity.
- Disruption of natural biological rhythms through improper patterns of eating, sleeping and exercise.
Cleansing the Body of Toxins and Impurities
According to Ayurveda, the menstrual cycle not only helps maintain the reproductive system but also acts as an important internal cleansing process for the entire female physiology. When menstruation stops, the body loses a valuable natural cleansing mechanism. If there has been a build-up of toxins in the physiology when menstruation ends, impurities quickly accumulate in greater quantity and start to create many of the negative symptoms of menopause.
Accumulation of toxins and impurities creates unwanted symptoms by
- Localizing in tissues and disrupting their delicate biochemistry, and
- Localizing in channels of circulation blocking the natural nourishment and elimination processes throughout the body.
The Ayurveda cleansing regimens available in the classics in the form of panchakarma therapies
- Prevent the build-up of impurities that can manifest years later as symptoms of menopause.
- Provide cleansing periods for the body after menopause when the important cleansing periods of menstruation have been lost.
The treatments systematically:
- Loosen impurities that have become embedded in tissues and help liquefy them through massage and the penetration of herbalized oils.
- Soften and open the channels of circulation and elimination so proper nourishment can reach the tissues and impurities can be more easily eliminated.
- Activate the elimination process for the most thorough cleansing of the entire physiology.
Nutrition, Digestion and Metabolism
Proper nutrition maintains balance in the body while improper nutrition can disturb digestion and lead to the creation of toxins. Most of the impurities that do localize in tissues originally come from poorly digested and improperly eliminated foods. Ayurveda nutrition and digestion recommendations are another main line of defense against impurity build-up.
The physiological principle at the basis of digestive and metabolic processes is called Pitta. Many conditions, including some symptoms of menopause, are caused by imbalanced Pitta. These include:
- most skin disorders, rashes, inflammation, etc.
- heartburn and ulcers
- excessive anger and irritability
- excessive hot flashes during menopause
- hormonal imbalances
A wide variety of time-tested Ayurveda recommendations help balance Pitta and remove the symptoms caused by its aggravation.
Foods that can easily be digested, creating micronutrients that are then assimilated into the tissues to rebuild their strength, will be recommended.
Stress Management: Increasing Nervous System Balance and Immune Function
Excessive mental, emotional and physical stress can worsen many of the symptoms of menopause. Stress also deteriorates the body’s general ability to heal itself. This is due to the hormonal changes and other biochemical responses to stress that aggravate the metabolism, create pain and depress the immune response.
The sleep disturbance often created by symptoms of menopause increases fatigue, which in turn increases one’s susceptibility to stress, which in turn aggravates symptoms of menopause.
Lifestyle and Daily Routine
One of the most important factors for maintaining high resistance to stress and stability in the nervous system is to have a lifestyle that does not disturb natural bodily rhythms. When we eat, sleep and exercise in constantly fluctuating and disturbing patterns, the body loses its natural balancing cycles and cannot cleanse or heal itself as effectively. Therefore, regularity in our daily routine is important before, during and after the menopausal period of life.
Ayurveda Herbs and Reduction in Free Radicals
Traditional Ayurveda theory says that herbs are most effective after a person completes an internal cleansing program. The cleansing and rejuvenation treatments that you will receive daily are the main focus of the treatment.