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Menopause

The menopause is the normal milestone in a woman's life, marking the end of the reproductive period. It generally has its onset between the age of 40-55 years and is marked by the gradual decrease in the menstrual flow till it completely stops.

The menopausal period brings a lot of changes in a woman's life. This mainly happens due to the gradual reduction in the secretion of estrogen (female reproductive hormone), which causes many physiological, psychological and some times even pathological changes. The main physiological changes are as follows:

• The ovaries shrink in size and the production of egg (ovum) stops.
• The uterus shrinks in size and becomes hard, with thinning of the internal layer.
• The mucus layer of vagina becomes thin and the external vaginal opening becomes narrow.
• The breasts lose the fats and become saggy due to the deposition of fats around them.
• The axillary and vulval hair becomes sparse.
• There is weight gain, which increases as fats accumulation near thighs, buttocks and breasts.
• Some times there is loss of appetite, and constipation, along with psychological problems like mood fluctuation, depression, anxiety, etc.
• After menopause, serum calcium and HDL (high density lipids) levels decrease, giving rise to the weakness of bones (osteoporosis), and increased risk of heart disease (due to increase in the low density lipids or LDL).
• The sexual desire increases during menopause, with consequent fall due to ageing process.

Menopausal Syndrome
This is the syndrome that occurs during the menopausal period, predominantly due to the symptoms of estrogen withdrawal in some women. It is characterized by following signs and symptoms:

• The patient experiences hot flushes on face and neck spreading through out the body, especially at nights, followed by moderate to severe sweating. Some times, these flushes are as frequent as once every hour.
• The psychological symptoms such as increased irritability, insomnia, giddiness, tiredness, numbness in the arms and feet, etc., are more prominent.
• There is lack of libido due to painful sexual act, which is due to drying of the vagina, and lack of lubrication of vaginal wall. The symptoms begin approximately one year before menopause and last up to 2-3 years after menopause.

Treatment
The treatment of all the symptoms of menopausal syndrome is hormone replacement therapy in varying doses and combinations depending upon severity of the symptoms.

Ayurvedic Treatment
The Ayurvedic treatment is divided into cleansing therpy and drug therapy. The cleansing therapy or the Panchakarma treatment consists of internal oleation, followed by induced purgation and induced emesis to remove all the corrupted Doshas from the body systems, followed by enemata with medicated oils to subdue the vitiated Vata Dosha. Ayurveda prescribes various formulations in the form of cold infusions, decoctions and powders for the drug therapy of menopausal syndrome.

• Cold infusion of Plaksha, Ashwattha, Vata (Ficus bengalensis), and Peepal tree bark is advised in the dose of 30-50 ml. thrice daily.
• Infusion of Ashoka (Saraca indica) along with calx of purified iron should be taken in the dose of 50 ml. thrice daily.
• In the cases of excessive bleeding, powder of Nagakeshar (Messua ferra) and Lodhra (Symplocos recemosa) should be taken in the dose of 3-5 GMs. Twice daily.
• Rejuvenators like Shatavari (Asparagus recemosus), Ashwagandha (Withania somnifera) and Bala (Sida cordifolia), Amalaki (Emblica officinalis) should be taken in the powdered form in the dose of 2-3 GMs. Daily.

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