Menopause is the point when periods stop for good because the ovaries no longer release eggs or make much
oestrogen. It is a natural stage of life, not a disease — but its symptoms can be disruptive, and the years after
it bring new risks to bones and heart. Effective treatments exist. Ayurveda sees this as a Vata-dominant
stage of life and focuses on nourishment, routine and calm.
What is menopause?
Menopause is confirmed when a woman has had no period for 12 months in a row without another
cause. Worldwide the average age is about 51; Indian studies report an earlier average, around 46–47. Menopause
before 40 is called premature ovarian insufficiency, and between 40 and 45 early menopause —
both need medical assessment because the longer time without oestrogen affects bones and heart. Surgery to remove
both ovaries, and some cancer treatments, cause an immediate menopause.
Slow, unforced breathing and gentle yoga help manage stress. Avoid breath-holding and forceful techniques if you have heart disease, high blood pressure or are pregnant.
The stages
The menopause transition. Symptoms usually start in perimenopause, while periods are still happening.
Because pregnancy is still possible during perimenopause, contraception is advised until 12 months after the
last period if you are over 50, or 2 years if you are under 50.
Symptoms
Hot flushes and night sweats — affect most women; a wave of heat over the face and chest, often with sweating and palpitations
Sleep problems, tiredness and difficulty concentrating (“brain fog”)
Mood changes — irritability, anxiety, low mood
Vaginal dryness, discomfort during sex, urinary urgency and repeated urine infections
Joint and muscle aches, headaches, reduced sex drive
Changes in weight distribution towards the waist; drier skin and hair
When to see a doctor
Any vaginal bleeding after menopause — even spotting, 12 months or more after your last period —
must be checked promptly, as it can be a sign of womb (endometrial) cancer.
Very heavy, prolonged or frequent bleeding during perimenopause, or bleeding after sex
Periods stopping before the age of 45
Symptoms that are affecting your work, relationships or sleep
Low mood that persists, or any thoughts of self-harm (Tele-MANAS: 14416)
A new breast lump, or chest pain or breathlessness on exertion
Treatment options
Hormone replacement therapy (HRT) is the most effective treatment for hot flushes and night sweats. For most healthy women under 60, benefits outweigh risks. Women who still have a womb need a progestogen with oestrogen to protect the womb lining. Your doctor will review your personal risks, such as breast cancer, blood clots and liver disease.
Vaginal oestrogen (cream, tablet or ring) treats dryness and urinary symptoms with very little absorbed into the body; it can be used long-term.
Non-hormonal medicines — some antidepressants, gabapentin, and newer targeted treatments — help flushes when HRT is unsuitable.
Cognitive behavioural therapy (CBT) reduces the impact of flushes, sleep problems and low mood.
Vaginal moisturisers and lubricants are helpful and available without prescription.
Bones & heart
Oestrogen protects bone. In the first years after menopause, bone density falls quickly, raising the risk of
osteoporosis and fractures of the hip, spine and wrist. Heart-disease risk also rises to match men's. Ask your
doctor about blood pressure, blood sugar and cholesterol checks, and whether you need a bone-density (DEXA) scan
— especially if you had an early menopause, a previous fracture, low body weight, smoke, or have taken steroid tablets.
Ayurvedic view
Pacify Vata → cool excess Pitta (flushes, irritability) → keep digestion strong → nourish the tissues and Ojas with Rasayana.
Ayurveda divides life into three stages, with the later years governed by Vata — the quality of
dryness, lightness and movement. The ending of menstruation (Rajonivritti) is seen as a natural part of
this transition. Symptoms appear when the change is not smooth: Vata-type (anxiety, insomnia, dryness,
joint pains), Pitta-type (hot flushes, sweating, irritability) or Kapha-type (weight gain,
lethargy, low mood). Care focuses on a regular routine, warm and nourishing food, oil massage, stress reduction
and Rasayana (rejuvenative) herbs.
Ayurvedic herbs & safety
Shatavari (Asparagus racemosus) — the classical women's Rasayana, used for dryness and flushes
Ashwagandha — for stress, sleep and energy; rare liver injury has been reported, and it can affect thyroid function
Brahmi and Jatamansi — for anxiety, sleep and concentration
Amalaki and Guduchi — cooling, for Pitta-type symptoms
Evidence for these herbs in menopause is limited. Some plant products have oestrogen-like effects, so check with
your doctor if you have had breast or womb cancer, or take HRT, blood thinners or thyroid medicine. Use only
licensed products from a qualified practitioner, and report side effects through the Ministry of Ayush
pharmacovigilance programme.
Diet & lifestyle
Calcium-rich foods daily: milk, curd, paneer, ragi (finger millet), sesame (til), green leafy vegetables, and small fish with bones if you eat them.
Vitamin D: safe daylight exposure; your doctor may advise a supplement.
Protein at each meal: dal, pulses, soy, eggs, fish or paneer, to protect muscle.
Weight-bearing and strength exercise: brisk walking, stair climbing, and resistance training twice a week protect bones and balance.
Cool the flushes: layered cotton clothing, a fan, cool water; notice personal triggers such as spicy food, hot drinks, alcohol and stress.
Calm and sleep: regular bedtimes, slow breathing (Sheetali and Nadi Shodhana), gentle yoga, and a warm sesame-oil foot massage at night.
Stop smoking; keep alcohol low.
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