Ayurvedic Management of Perimenopause for a Smooth Transition

Abstract

Perimenopause is a dynamic transitional phase in a woman’s life, marking the shift from reproductive years to menopause. It involves fluctuating hormones, especially declining estrogen and progesterone. In Ayurveda, this stage is seen as a natural part of the Jara (aging) process, with Vata and Pitta Doshas often becoming imbalanced and tissue nourishment (Dhatus) gradually declining. Awareness, timely lifestyle adjustments, and supportive interventions, including diet, herbs, and routines, can help manage symptoms effectively. Understanding this phase empowers women to maintain hormonal balance, vitality, and overall well-being during this pivotal life stage.

Introduction

Perimenopause is the phase leading up to menopause, the point at which menstrual periods permanently stop. During this time, the ovaries gradually produce fewer hormones, leading to irregular or unpredictable menstrual cycles. Perimenopause can start anywhere from the mid-30s to the mid-50s and may last for a few months or several years, depending on the individual. Estrogen, produced by the ovaries, is crucial for reproductive health. The hormonal shifts during perimenopause are primarily caused by decreasing estrogen levels. As estrogen declines, it disrupts the balance with progesterone, another ovarian hormone. During this phase, hormone levels often fluctuate significantly, rising and falling unpredictably. It marks the approach of the end of reproductive years and is a normal, natural process, often accompanied by various physical and emotional changes. Despite irregular menstrual cycles and declining hormone levels, pregnancy is still possible during this transitional phase.

Causes of Perimenopause

It is a natural process that occurs inside a female body. It occurs when the ovaries slowly reduce their function.

Sometimes, some risk factors may induce early perimenopause in some women. They are-

1. Family History- Women are more likely to experience early menopause if their mother or close relatives had it.
2. Autoimmune Disorders- Conditions like thyroid disease or rheumatoid arthritis may cause the immune system to damage the ovaries.
3. Chemotherapy- Radiation can harm ovarian function, leading to premature menopause.
4. Surgical Causes- Removal of the uterus or ovaries often triggers early menopause.
5. Genetic Factors- Disorders such as Turner syndrome or Fragile X syndrome can cause premature ovarian failure.
6. Lifestyle & Other Risks- Smoking, being underweight, or certain infections (mumps, TB, malaria) increase the risk of early menopause.

Symptoms

1. Irregular or missed menstruation.
2. Hot flashes.
3. Night sweats.
4. Mood swings.
5. Brain fog.
6. Low energy.
7. Frequent urination and UTI’s.
8. Difficulty sleeping or insomnia.
9. Dryness in vagina.
10. Pain during coitus.
11. Reduced libido.
12. Pain in joints and muscles.
13. Weight gain, especially around the lower abdomen.
14. Thinning of hair.
15. Loss of bone mass and an increased risk of fractures.

Diagnosis

Perimenopause is a natural transitional phase that may last for several years and is usually not diagnosed unless its symptoms become troublesome. The doctor may recommend a hormonal profile, but it is usually not required.

Treatment

If this transition is making the woman uncomfortable, some medications and supplementation can make it easy. Otherwise, no medications are required.

1. Hormone Therapy (HRT)- Estrogen (and sometimes progesterone) to restore hormonal balance and reduce symptoms.
2. Vaginal Estrogen- To address vaginal dryness.
3. Gabapentin- To reduce hot flashes.
4. SSRIs (Selective Serotonin Reuptake Inhibitors)- For depression and mood disorders.

Ayurvedic Overview

In Ayurveda, Vata, Pitta, and Kapha are the three fundamental Doshas (bio-energies) that govern all physiological and psychological processes in the body. Their balanced state is crucial for maintaining health, while their imbalance can lead to disease. During our childhood, Kapha dosha is predominant, in young adults Pitta dosha is the predominant one and during old age, there is predominance of Vata dosha. Perimenopause is a state of imbalance of these doshas, with Vata being the dominant one. In Ayurveda, Rajonivrutti is menopause, so we can say that perimenopause is the period just before Rajonivrutti (Menopause), when the woman is going through a transition period in late 40’s or early 50’s. This transition from Pitta predominant young adult age to the Vata predominant old age, can be really difficult for some women. Dhatukshaya (degeneration of body tissues), especially Shukradhatu (Reproductive tissue) due to Kala (Age) also contributes in reducing Jananashakti (Fertility) and causing constant fatigue at this age.

Vata imbalance causes- Aniyamit Rajasrava (Irregular menses), Yoni shushkata (Vaginal dryness), Nidra Alpata (Disturbed sleeping) or Nidra Naash (Insomnia), thinning of hair, pain in various body parts, sandhishoola (Pain in the joints) and anxiety. Imbalanced Pitta is responsible for night sweats, hot flashes and irritability in perimenopausal women. In Ayurveda, we can help manage these symptoms by focusing on balancing Vata dosha, nourishing the body with Rasayana (Rejuvenators) and practicing Yoga and Pranayama (Breathing techniques) helps in keeping the mind calm, keeping mood swings at bay. Herbs like Shatavari (Asparagus racemosus), Ashoka (Saraca indica), Ashwagandha (Withania somnifera), Kumari (Aloe barbadensis), Lodhra (Symplocos racemosa) and Vidari (Pueraria tuberosa). They support uterine health, hormonal balance and nourishes the body. Other therapies like Shirodhara (Therapeutic pouring of medicated oil on head) with Brahmi Taila is extremely helpful in calming the mind and improving sleep quality.

Dietary Habits and Lifestyle Modifications:

1. Dietary Habits

Include Vitamin-E rich, raw and sprouted seeds and nuts, unpasteurised & high quality milk in your diet. Healthy fats like ghee, sesame oil, almonds, flaxseeds, fenugreek, leafy greens, carrots, beets, ginger, turmeric, cumin, coriander, and fennel also help. Vitamin-C and B6 rich foods like avocado, broccoli, bell peppers, spinach, bananas, and kale should also be included. Avoid white flour and all its products, white sugar, all processed, refined and denatured foods.

2. Lifestyle Modifications

Plenty of outdoor exercise, such as walking, jogging, swimming, cycling should be done. Try avoiding mental & emotional distresses and worries. Add Yogasanas like Setu Bandhasana (Bridge Pose), Balasana (Child’s Pose) and Pranayama (Breathing exercises) like Bhramari (Bee breath) and Anulom-Vilom (Alternate nasal breathing)  to your routine.

Herbal Remedies for Perimenopause by Planet Ayurveda

Planet Ayurveda is all about bringing the goodness of Ayurveda into everyday life. It offers a wide range of remedies made from authentic herbs to support health and wellness. From digestion to immunity and chronic conditions, the herbal capsules, powders, and care packs are trusted worldwide. With expert guidance and a focus on purity, Planet Ayurveda makes natural healing simple and effective.

For women dealing with the perimenopause phase, we have a 40-Fit Women Care Pack and Vitamin-D3. The pack contains-

1. Female Health Support
2. Naari Kalyan Churna
3. Brahmi Capsules
4. Coral Calcium Complex

Product Description

1. Female Health Support

These capsules are made from potent herbs like Ashok (Saraca indica), Lodhra (Symplocos racemosa) and Shatavari (Asparagus racemosus). It balances all three doshas (Vata, Pitta and Kapha) & has active compounds like flavonoids, such as quercetin, glycosides, saponins, tannins and triterpenes like betulinic acid etc. It is yonidoshahara (balances female reproductive system disorders), helps regulate fluctuating hormones, support smoother menstrual cycles, along with improving mood and easing restlessness.

Dosage- 1-2 Capsules twice daily, with plain water, after meals.

2. Naari Kalyan Churna

This herbal powder is made from key ingredients like Ashwagandha (Withania somnifera), Shatavari (Asparagus racemosus) and Brahmi (Bacopa monnieri). The active constituents like saponins, alkaloids, steroidal lactones, flavonoids and polysaccharides are present in these herbs and they help in strengthening bones, muscles and counter weakness and early osteoporosis risk. Nari Kalyan Churna also improves mental resilience and emotional stability. Moreover, as the name suggests, it helps in maintaining the well-being of women by balancing all doshas.

Dosage- 1-2 teaspoons, twice daily after meals.

3. Brahmi Capsules

These capsules are made from roots of Brahmi (Bacopa monnieri). It primarily balances Pitta and Kapha doshas. Active constituents like bacosides, brahmin, hersaponin, flavonoids and phenolic compounds present in this helps manage stress, mood swings, and sleep issues commonly seen in perimenopause and menopause. It also counters peri-menopause related brain-fog.

Dosage- 1-2 Capsules twice daily, with plain water, after meals.

4. Coral Calcium Complex

These capsules are made using key ingredients like Praval Pishti (Coral calx), Akik Pishti (Agate calx) and Mukta Pishti (Pearl calx). These are very rich sources of calcium and help maintain healthy calcium levels, supporting strong bones, muscles, and proper nerve function. This acts as a supplement in perimenopausal women, to prevent osteoporosis.

Dosage- 1 capsule twice daily, after meals with plain water.

5. Vitamin-D3

These capsules are made from key ingredients like Lichen, Mushrooms, Spirulina and Chlorella. They work as natural supplements and support bone health by aiding proper calcium absorption and regulation. In addition, it helps balance the immune system and enhances the body’s natural defense against diseases

Dosage- 1 Capsule, once daily.

Conclusion

Perimenopause is a natural and inevitable transitional phase in a woman’s life, marking the gradual decline in ovarian function and the approach of menopause. While hormonal fluctuations during this period can lead to symptoms such as irregular menstruation, hot flashes, mood swings, sleep disturbances, and fatigue, understanding the underlying physiological and Ayurvedic principles can help manage these changes effectively. According to Ayurveda, perimenopause is largely a Vata-predominant phase, accompanied by Dhatukshaya, especially of Shukradhatu, which affects fertility, vitality, and overall well-being

Managing this phase requires a holistic approach: balancing Doshas, nourishing the body with Rasayanas, following dietary and lifestyle guidelines, practicing Yoga and Pranayama, and using supportive herbs like Shatavari, Ashwagandha, Kumari, Ashoka, Lodhra, and Vidari. Therapies such as Shirodhara with Brahmi Taila further help in calming the mind and improving sleep. To improve the quality of life and maintain overall well-being, both physical and mental , see an Ayurvedic physician and heal naturally.

Frequently Asked Questions (FAQ’s)

Can perimenopause start at 35?

• Perimenopause can begin as early as 35, though it usually starts in the 40s. Symptoms like irregular periods, hot flashes, or mood changes should be checked by a doctor, as they may also indicate other conditions.

At what age do periods become irregular?

• If you’re 45–50, irregular periods may indicate perimenopause. The average age is around 47, and your mother’s experience can often be a helpful guide.

What are the symptoms of low estrogen?

• Low estrogen may cause hot flashes, vaginal dryness, weak bones, irregular periods, mood swings, poor sleep, and fatigue.

What is the difference between perimenopause and premenopause?

• Perimenopause is the medical term for the transition into menopause, marked by hormonal changes, irregular periods, and symptoms like hot flashes and mood swings. Premenopause refers to the years before this phase, when periods are regular and symptoms are absent.

What is the maximum delay in periods if not pregnant?

• A delay of around 7 days can be considered normal. But if the periods are delayed by 30 days or more, or the women have missed periods for 2-3 months consecutively, consultation with a qualified doctor should be done.

Do periods change after 25?

• No, periods are usually regular in the 20's and 30’s before perimenopause sets in.

What does a stress period look like?

• A "stress period" usually brings delay or irregularity to the normal menstrual cycle. Excessive PMS symptoms can be experienced as well.