Aging in Ayurveda is associated with the process of degeneration and decay (Kshaya). Ayurveda considers aging Nishpratikriya — natural changes that cannot be resisted.
Menopause (Rajonivritti) occurring in an aging body (Jarapakva Shareer) is associated with gradual diminution in the qualities of Dosha (Vata, Pitta and Kapha), tissue and organs (Dhatu Kshaya) and metabolic wastes (Mala), Agni and Oja.
Decay and degeneration (Dhatu Kshaya) naturally lead to Vata Vitiation. With advancing age, progressive vitiation of Vata due to its fundamental properties of unctuousness (Ruksha), unstable (Chala), light (Laghu), abundance (Bahu), quick (Shighra) and cold (Sheeta) further precipitates the involution and atrophy (Soshana and Kshaya) of different tissues, organs and organ systems (Dhatu).
This degeneration manifests as loss of the perceptive powers of sensory organs (Indriya Kshaya), loss of strength (Bala Kshaya) and loss of reproductive strength (Virya Kshaya). This may explain various symptoms of menopause related to degenerative changes in the body — such as urogenital atrophy, thinning of the membranes of the vulva, vagina, cervix and outer urinary tract, shrinking and loss of elasticity of all genital areas and skin, breast atrophy, decreased libido, problems reaching orgasm and dyspareunia.
The shift from Pitta to Vata dominance
The relative predominance of the three Doshas — Vata, Pitta and Kapha — changes with age in the mind and body. As per fundamental principles of Ayurveda, Kapha is the predominant Dosha during childhood, Pitta during adulthood and Vata during old age.
The menopausal transition represents a period of dynamic change from middle age to old age. This transition from Pitta dominance to a Vata dominant phase of life is the cause of most symptoms of menopause. Pitta is more akin to metabolic activities and Vata has an active role in degeneration. The resulting imbalance of Dosha during this transition and Kshaya of Medo Dhatu (fatty tissues) may be the cause of hot flushes and excessive sweating, while Rasa Dhatu Kshaya associated with increasing Vata in mind and body may cause sleep disturbance, irritability and dryness of the vagina — the commonest symptoms associated with menopause.
References
- Atridev Gupta (ed.), 2nd ed. Charak Samhita, Shareer Sthan, Katidha Purusheeyam Shareer Vykhya, Chapter One, Verse 115, Bhrgava Pustakalaya, Varanasi
- Atridev Gupta, 2nd ed. Charak Samhita, Viman Sthan, Chapter 8, Verse 22 (also Sushrut Samhita, Chapter 15, Verse 22)
- WHO Scientific Group. Research on the menopause in the 1990s. World Health Organ Tech Rep Ser. 1996;866:1–107.