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Perimenopause Symtoms and Its Management with Ayurveda

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medically reviewed by Dr Godmi Tresa

Dr Sooraj Sukumaran

Updated on November 12, 2024

Hear hear, ladies!

Is your menstrual cycle showing signs of coming to an end? Irregular periods and spotting? Or have hot flashes or night sweats been troubling you for a while?

You could be dealing with perimenopause.

The end of the reproductive cycle usually lasts a few years; these few years in a woman's life are called perimenopause. There are so many changes in the body and mind of a woman which need attention!

According to the Wellbeing of women survey in 2016, one in four women considered leaving their jobs due to perimenopausal symptoms.

Keep reading to discover the different symptoms of perimenopause and how to manage them naturally with Ayurveda!

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What is Perimenopause?

Perimenopause is the transition period before menopause. This phase is filled with fluctuations in the levels of hormones in your body.

As you age, your ovaries begin to produce lesser amounts of estrogen (the female sex hormone). This is one of the main reasons for many changes in the female body during perimenopause. The reduction in the levels of progesterone and testosterone(sex hormones) also contributes to these changes in the female body.

When Does Perimenopause Start?

If your periods are irregular and your cycles have started getting longer or shorter, you could be in your perimenopause phase.

This transition often begins between the age of 45-55 years.

However, irregular periods are also a symptom of many other health conditions like PCOS. So confirm with your doctor that you are in the perimenopausal stage! 

How Can you Recognise Symptoms of Perimenopause?

Remember those days when your mom or grandmother started behaving 'weird' at a point in life? Ever wondered why they started changing all of a sudden?

That could make sense to you now. Various changes happen in your body - physiological and emotional.

Your bones start getting brittle and are easily prone to fractures. You start gaining weight without any particular reason. You could begin having high blood pressure and feel like your vagina is very dry.

Mood swings, anxiety, depression, irritability, and blackouts are some feelings you could face.  

Hot flashes, night sweats, and sleeplessness can start troubling you at night.

Well, it was not their fault they behaved 'weird'. It was just menopause hitting them.

Remember that these symptoms need not occur together in the same person. For some, it could be mood swings. For others, hot flashes or sleeplessness.

So, What Does Perimenopause Feel Like?

Let's look at each of them to have a clear picture from an Ayurveda perspective. 

I am burning up!- Hot flashes and Night sweats

Imagine that your chest and face start feeling like they are on fire all of a sudden. That is what hot flashes feel like. It is called night sweats if this occurs at night and does not let you sleep. These symptoms are due to an imbalance of Pitta bioenergy in your body.

I can't sleep, and I do not know why

Remember when we said your sex hormones have a mind of their own when you enter the perimenopause phase? This is why sleepless nights could become a daily occurrence for most women. Ayurveda says that your Vata bioenergy is in trouble if sleepless nights are becoming a routine for you!

I feel like a teenager! I can't control my emotions anymore

"Menopausal transition is like hormonal chaos; this time, when estrogen level stabilises, they would be much lower than before." According to renowned gynaecologist Dr Jen Gunter in her TED talk, this change in oestrogen levels and other hormones come with irritability or depression.

Ayurvedic principles say that Vata and Pitta bioenergy are the culprits for your mood swings and irritability. Menopausal women tend to get depressed as well. This is due to an imbalance of the Kapha bioenergy in the body during the menopausal transition.

I have Vaginal dryness

Wondering what it is? The reduction in estrogen level leads to excessive dryness in the area, which could make sex uncomfortable. Your vagina will also be prone to injuries or infections. Vaginal dryness is a consequence of imbalanced Vata bioenergy in the body. 

I am disinterested in sex

The reduced estrogen levels can also cause a reduced interest in sex or a lack of libido. This could also be due to vaginal dryness, mood swings and other physical ailments. An increase in the Vata bioenergy is the reason for a reduction in your libido. 

My skin is getting dry, and I can see my hair falling everywhere

One of the primary reasons for hair fall is the imbalance of hormones in the body. This could result in the reduced water-retaining capacity of collagen (a protein that provides structure and support to your skin) and hair fall.

The testosterone hormone can contribute to hair thinning and receding hairline (androgenic alopecia) without appropriate levels of oestrogen to protect. Again, an increase in Vata bioenergy contributes to dry skin, and your hair fall is due to an increased Pitta dosha in your body.

SymptomsImbalanced Bio-energy
Hots flashes and night sweatsPitta
SleeplessnessVata
Mood swingsVata and Pitta
DepressionKapha
Vaginal drynessVata
Disinterest in sexVata
Dry skinVata
Excessive hair fallPitta


Keep reading to know the different ayurvedic herbs that can help balance these doshas.

Perimenopause Treatment Options

Don’t think of perimenopause as a disease. It is just another normal phase of your life. Many ways are available to treat and manage the various symptom of perimenopause.

All of the above-listed problems can be managed by proper lifestyle and diet.

Ayurveda for Perimenopause

Ayurveda is all about natural and holistic healing. 

Make sure that you are aware of the changes in your body, well informed of your condition, and comply with what is necessary wholeheartedly.

You are what you eat!

Diet correction is the first step in every ayurvedic management. You can find the key to balancing your imbalance of bioenergies in your food. Most of the symptoms of menopause are due to an imbalance in the Pitta and Vata bioenergies. Including more sweet and nourishing foods to balance the Vata and Pitta bioenergies is essential.

A diet that can balance Vata and Pitta bioenergies includes warm and well-cooked foods, with ample spices like fennel, cinnamon or cumin to aid digestion.

Include the following food in your diet to naturally manage your menopause.

1. Foods rich in Calcium and Vitamin D

  • Buttermilk
  • Eggs
  • Sardines
  • Cheese
  • Mushrooms 
  • Spinach

2. Green leafy vegetables

 Diet rich in fibre and micronutrients are necessary during the perimenopausal phase.

3. Fruits and vegetables

Fruits like gooseberries are antioxidant-rich and can help slow the progression of ageing.
Vegetables are rich in fibre and help to manage weight. Regular intake of vegetables as a part of your diet can also help prevent heart disease.

4. Foods rich in phytoestrogen

Phytoestrogens are naturally occurring hormones with a plant-based origin. They can help with managing the difficulties due to depleted estrogen.

  • Soybeans
  • Flaxseeds 
  • Sesame seeds
  • Linseeds 
  • Carrot
  • Cucumber 
  • Beets
  • Tomato  
  • Apple 
  • Oats 
  • Cherry 
  • Red beans 

These food items in your daily diet can help manage vaginal dryness and hot flashes!

5. Protein-rich foods

  • Meat
  • Legumes
  • Nuts
  • Fish
  • Dairy products

Do not forget to look out for allergic reactions and lactose intolerance 
Ensuring regular protein intake slows the loss of lean muscle due to menopause.

Say NO to

1. Trigger foods

  • Caffeine
  • Alcohol
  • Added sugar
  • Processed foods are some of these trigger foods
  • Excess of salty, spicy and sour foods like pickles.

Keep a journal to identify the trigger factors that worsen your health and keep them at bay!

2. Skipping meals

Food must always be taken on time. Diet routines are essential to keep your body and mind healthy. So skipping meals randomly can worsen your perimenopausal symptoms.

Water is your saviour- always

This is not just for perimenopausal women but everyone.
Sufficient water intake is necessary to tackle the general dryness in your body during perimenopause. 
Drinking 8-12 glasses of water daily can also help avoid weight gain, excess calorie intake and bloating due to hormonal variations.

Watch your routine - Vihara

Exercise

Physical activity is paramount for healthy living and preventing many health conditions.

Regular exercise or physical activities like yoga postures for about 30 minutes daily can improve your metabolism and act as an anti-ageing tool. 

Start doing these exercises at least thrice a week and see how your perimenopausal symptoms start getting scared of you!

Wondering how to get started with an exercise routine? Here are some quick tips.

  1. Walk on a treadmill for ten minutes daily before your morning bath.
  2. Go for a brisk walk in the evening with your friends or family.
  3. Join a health club and organise games like badminton
  4. Join a dance class, or a yoga class

Therapeutic yoga is one of the best ways to deal with perimenopausal symptoms. 'Therapeutic yoga can make your body physically healthy, manage stress, and balance hormonal variations. It helps manage hot flashes, irritability, tone pelvic floor muscles, and can help you sleep better!' says our therapeutic yoga expert Dr Niveditha.

Social interactions

The people around us significantly impact our mental and physical health. It is time to give yourself more time and care. Build new and healthy social relations and rediscover the already existing ones.
Focus and restructure your priorities.

But sometimes, your emotional baggage could be too much to handle. You could be depressed. Talk to a friend or a therapist, and take back control of your life.

You need to get out there and socialise for better mental health during your perimenopausal years. Here are some ways to improve your social life:

  1. Join an online menopause/perimenopause support group
  2. Talk to your friends who are going through the perimenopausal phase.
  3. Make that phone call you have always wanted to make.
  4. Join a yoga course and make new friends!

Support groups are some of the easiest ways to address the concern for lack of healthy social interaction in perimenopausal women.

Studies suggest that support groups can help with improving the quality of life of perimenopausal women and support them.

Sometimes you need herbal supplements too!



An already existing medical condition can make your perimenopausal phase difficult as well. 
Ayurveda offers internal supplements and panchakarma therapies like oil massage, medicated enemas, and nasal drops that help detoxify and strengthen the body.

Here are a few ayurvedic herbs used as supplements to deal with perimenopausal symptoms.
 

  • Ashwagandha (Withania somnifera)

This is the best herb to help you get comfortable with physical and mental changes. It can help promote body mass, build strength and improve your sleep and immunity.

  • Cardamom (Elettaria cardamom)

Did you think cardamoms are all about imparting flavours to your dishes? Nope! Cardamoms have excellent therapeutic actions in your body and can balance the vata bioenergy in your body. An imbalance of vata bioenergy is responsible for most of the agony you experience during the perimenopausal stage.

  • Garlic (Allium sativum)

Garlic also helps with promoting your metabolism and helps to balance the Vata bioenergy. It also contains phytoestrogens

  • Sandalwood (Santalum album)

Are you having trouble with burning sensations and dryness in your body? Better stock some sandalwood powder in your home! Using sandalwood paste on your body can cool you down from anything!

  • Gooseberry (Emblica officinalis)

The next time you go shopping, get some Indian gooseberry in your cart because it's loaded with antioxidants, vitamin C and macronutrients and is a fruit that can be included in your daily diet. 

  • Shatavari (Asparagus racemosus)

Phytoestrogens mimic the actions of oestrogen in the body but are found in plants.
The roots of the Shatavari plant are rich in phytoestrogen and can also improve your WBC count, which contributes to improved immunity.

  • Sesame (Sesamum modicum)

These tiny seeds had phytoestrogens as well. They can help balance the hormonal variations during the perimenopausal stage!

HerbBioenergy(dosha)Symptom
AshwagandhaVata and KaphaMood swings, sleeplessness
CardamomVataBalances hormones, improves mood
Garlic VataBalances hormones
Sandal woodPittaHot Flashes
GooseberryVata, Pitta and KaphaHot Flashes, sleeplessness
ShatavariVata and PittaMood swings, loss of libido
SesameVataVaginal dryness, sleeplessness




Other systems of medicine have a different approach to managing perimenopause.
They mainly aim at managing just your symptoms and not the root cause.
Antidepressants, hormone pills, moisturisers, antibacterials, antiseptics, and hormonal therapy are common alternate management methods. 

Get All the Help You Can Get!

Communication is key

Most of the time, lack of communication and misunderstanding among partners at this phase can compromise a healthy relationship. Persistent conflicts at home only aggravate the situation and make it worse for the person going through perimenopause. 

Your family is your anchor while sailing through turbulent waters. Try out the following to help your family understand you better.

  1. Talk to them and open up about the changes you are going through. Help them understand you need their support more than anything at this phase.
    But at the same time, watch out for toxic relationships and influences. Your peace of mind is valuable; do not let anyone take it away from you.
  2. Request your husband to attend awareness workshops
  3. Gift a book about perimenopause to your husband.
  4. Talk to your family about the changes in your body and mind. 

Conclusion

Perimenopause is a phase of significant change- physical, mental, social and emotional. Embrace it gracefully. Ayurveda emphasises adopting a healthy diet and routine to overcome this phase.

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Our blog article focuses on bringing high-quality, scientifically accurate content and staying true to Ayurveda's principles. All of our articles are written by Licensed Ayurveda professionals after extensive research and are medically reviewed by our Expert Ayurvedic doctors who have over 10+ Years of Experience