Perimenopause is defined as the period that encompasses the latter years of a woman’s reproductive life, according to current literature. It begins with the initial signs of irregular menstrual cycles and lasts for about a year, followed by amenorrhea, or the lack of periods, which can last anywhere from a few months to a few years before the final menopause.

There are two stages of the perimenopausal or menopausal phase:

• Early changes occur when the cycles are regarded to be fairly regular, while later changes occur when the cycles are thought to be less regular.
• Late alterations occur when amenorrhea is prolonged and lasts for about 60 days until the final menstrual period.
  Pitta Dosha gradually becomes less prevalent as Vata Dosha increases, according to Ayurveda.

The perimenopausal syndrome has several causes

Perimenopausal syndrome refers to the period between menopause and the onset of menopause, which can last anywhere from two to ten years. During this time, progesterone and oestrogen production diminishes, and ovulation becomes irregular.

The major change is the reduction in the functioning of the ovaries, which causes ovulation to become inconsistent or completely ceased. In other words, this means that the woman cannot conceive. Before it finally ceases, the flow and length of the menstrual cycle reduce.

Typical signs and symptoms of perimenopausal syndrome:

The symptoms of the perimenopausal syndrome are caused by a change in oestrogen and progesterone levels. The following are some of the known symptom areas:

• Mood swings or changes
• Low libido
• Lack of concentration
• Headaches
• Profuse sweating especially at night
• Hot flushes
• Vaginal dryness
• Disturbed sleep
• Joint and muscle aches
• Frequent urge to urinate.

Understanding the symptoms and seeking medical help:

Irregular periods are common during the perimenopausal stage. In the event of these symptoms, medical consultation should be sought.

• Heavy menstrual flow with blood clots.
• Cycles lasting for more than 7 days
• An interval of fewer than 20 days between cycles
• Spotting between periods
• Bleeding after intercourse

Ayurveda interventions for Perimenopausal syndrome:

Diet:

• A nutritious diet that is rich in calcium is essential to combat the beginning of the degenerative phase of bones. Women are more likely to develop osteoporosis and arthritis as they age.
• Calcium and Vitamin D through food and supplements are responsible for the good health of bones. There are numerous foods that are rich in calcium like dairy products yoghurt, milk, and cheese and tofu.
• Many green leafy vegetables like kale, drumsticks, collard greens, spinach and beans are rich sources of plant-based calcium.
• Protein-rich foods such as pulses, fish, sprouts are useful to give adequate strength and maintain stamina.
• Staying hydrated is essential to maintain the electrolyte imbalance. Drinking approximately two litres of water per day is recommended.

Lifestyle changes:

• Sunlight is undeniably the best source of Vitamin D since it is readily absorbed by the exposed skin. It is beneficial to soak in the sun first thing in the morning.
• Maintaining a healthy weight is critical for reducing discomfort throughout this period of transition.
• Staying active through regular exercise is highly effective to improve symptoms such as lethargy, fatigue, and stress.
• Yoga, Tai chi, and other slow-moving exercises that stretch the entire body can be helpful.
• Forward bending asanas or yoga poses are useful to maintain the flexibility of uterine muscles.
• Improving sleep quality or getting at least 7-8 hours of sound sleep at night is beneficial. Sleeping improves the immune system and resets the body clock.

Ayurvedic Herbs for restoring the uterine balance:

Shatavari:

Shatavari is the greatest Rasayana for uterine tonic, according to Ayurveda. It grows wild in tropical locations such as India, Australia, Brazil, Panama, and middle Africa, as well as Indonesia. It is a wonder plant that is used to treat menstruation abnormalities both alone and in conjunction with other medicines.

• Herbal remedies for hormonal imbalances have been proven to be effective.
• It aids digestion and balances the doshas
• It helps to reduce pain during menstruation.
• Improves reproductive health.
• Improves fertility.

Other herbs for the perimenopausal syndrome:

• Ginseng- Panax ginseng
• Black cohosh- Actaea racemosa
• Soy- Glycine max
• Wild Yam- Dioscorea villosa