Depressive phases can happen in any stage of a woman’s life,but, it is usually uncontrollable during the peri-menopause stage due to hormonal changes. Manas roga expert Dr. Jithesh explains how this phase can be handled by just managing diet, lifestyle and adopting certain Ayurvedic practices.
Womanhood is a precious blessing of God since it is they who are endowed with the special duty to mould a human being from its stage of conception in the womb. In a woman’s life, the two milestones, menarche and menopause heralds her reproductive phase. Menarche is the first milestone where she attains the capability for reproduction. This usually happens in women between the ages of 12 and 15. Menopause is the second milestone which may be considered as the mere end of the reproductive phase in women. This usually occurs between the ages of 45-55 years.
Menopause is the permanent cessation of menses secondary to the decreased ovarian performance. In the case of natural menopause, the diagnosis is retrospective, requiring 12 months of amenorrhea. The term Perimenopauseis derived from the Greek word peri (around), men (month) and pausis (a brake, stop or rest) indicating the condition. It refers to the stage of transmission from the reproductive to the non-reproductive segment in a woman’s life. It is usually a brief 3-4 year time frame, encompassing the last menstrual period.
The peri-menopausal experience involves a multi-faceted interaction between psychological, socio-cultural and environmental factors as well as biological changes relating to the altered ovarian hormone status or deficiency. Ina number of women, menopause is barely a noticeable milestone. Their menstrual cycle ceases uneventfully and the transition results in little or no impact. For others, it is a phase of life, significant for the physical, psychological and the emotional effects. The reason for these differences among the individuals is yet to be fully understood and explored.
Upto 30% of the women attending the gynaecology clinics during their menopause is diagnosed to have a depressive disorder that ranges in severity from minor depressive symptoms to more severe forms of major depressive disorder. The depressed mood, loss of interest, anxiety, insomnia, suicidal ideations, guilt, somatic symptoms, psychomotor retardation, agitation, diurnal variation of the symptoms and panic attacks are some of the major psychological symptoms. Even though this is not sound enough to be diagnosed as a major episode, these symptoms contribute to substantial distress and social as well as occupational dysfunction.The probable reasons include the family history of mood disorders, increased psychological stressors and also the fluctuating levels of hormones as well as the general health of the individual.
A detailed management including sodhana, samana, rasayana, dietary regulations and psychological integrations such as yoga, counseling, music therapy etc. is opted to relieve the condition. The management protocol starts with the preparation for snehapana, which includes drugs with pachana property. After the correction of agni, snehapana is performed. Kalyanakaghrita, Dadimadighrita, Thiktakaghrita etc. are used to address the condition. Suitable swedas are performed followed by virechana with drugs like Avipathy choorna with drakshaswarasa. Several suitable combinations are available which includes kwatha including Drakshadi, Kalyanakam, Sukumaram, etc., and Gulika including Manasamitravatakam, Dhanwantharam gulika, suvarnamukthadi, etc. After the sodhana, drugs such as Aswagandha, Satavari, Yashti, Amalaki, Abhaya etc. is to be administered as rasayana.
Among the procedures, nasya with ksheerabala taila is ideal as the drug is Vatha-pittahara as well as indriyaprasada. Seka of siras with Useerakwatha seems really effective as well as economical. If the Vatha seems to be dominating, siropichu with dhanwantaram taila is to be done. If pitta seems dominating, sirolepa with panchagandha churna and triphala churna shows results. If the Kaphaja symptoms dominate, pradhamana will be performed with vilwadi gulika and also takradhara on head.
Use of gritha (ghee) in the diet is most beneficial. Fruits such as banana, dates, gooseberry, citrus fruits and vegetables like koosmanda, leafy vegetables, amorphophalus, fish, soya bean, green gram, etc., are recommended.Fast food, junk food, meat, spices, egg, fried items, alcohol, tobacco, etc., are contraindicated.Plenty of water intake and proper exercise is advised.
Selected yogasanas also have a role in managing the adverse symptoms that occur during this stage. Sooryanamaskaara, Setubandhanasana, Vajrasana, Bhujangasana etc. are advised. Relaxation techniques, breathing exercises and meditation can also be practiced. Exercises such as pelvic floor exercise, walking, swimming, skipping, body stretching, etc.,also needs to be practiced.Psychotherapy techniques or more scientifically the Satwavachaya chikitsa propagated by Charaka, is also effective. In this condition, it is good for the individual to opt for counseling, family counseling, group therapy, inter-personal psychotherapy, etc.,in keeping with the condition.
Lifestyle changes to maintain a cool environment and for heart dissipation may help to redress the psychological disturbances, including depression during perimenopause. The women of this group should take care of their lifestyle and adopt the following habits. Eat quality foods, exercise regularly, sleep regularly, go for periodical health checkups, and be more socially active.
Rajonivrutti occurs in the due course in the life of a woman. The intervention is a must if there are associated symptoms which cause distress to the life of the individual. From the point of view of Ayurveda, these treatments are aimed at not only remedying the perimenopausal disturbances, but also to check the problems of old age. Sodhana followed by the samana drugs, along with the psychological interventions, are intended for this and have been found to be fruitful.
Menopause should and can mark the beginning of a new and promising period of life for women, relatively free from previous obligations, and getting them ready for new career choices, more education and new ventures. Through proper care and management, it is our responsibility to use the eternal Ayurvedic principles to convert the perimenopausal period into a comfortable and productive time of life.
Professor and Head
PG Department of Manasroga
VPSV Ayurveda College