Perimenopause is a natural transition that every woman experiences as she approaches menopause. This phase, often accompanied by uncomfortable symptoms, can be a daunting period for many. Symptoms such as hot flashes, insomnia, anxiety, weight gain, mood swings, vaginal dryness, pain during sexual intercourse, and even osteoporosis can pose challenges for some women during this life stage.

However, according to Ayurveda, it’s not the perimenopause itself that causes discomfort, but rather underlying imbalances that may not have been addressed earlier in life. This is a pivotal time in a woman’s life, offering the opportunity to prioritize her health and well-being in all aspects—physically, mentally, emotionally, sexually, and spiritually.

The good news is that you can start making lifestyle adjustments now to better prepare for and navigate the transition to menopause.

The Western Perspective on Perimenopause and Menopause

Hormones as Key to Balance

Hormones act as chemical messengers produced by the endocrine glands, responsible for regulating various bodily functions such as metabolism, growth and development, mood, reproduction, and the immune system.

Transported throughout the body via the bloodstream, hormones interact with specific cells, tissues, and organs. They work in harmony to maintain the body’s homeostasis, or balance.

The regularity of the menstrual cycle is mainly upheld by the harmonious interplay of key hormones, including estrogen, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH).

Hormonal Changes in Perimenopause, Menopause, and Postmenopause

Perimenopause refers to the time “around menopause.” What I may not have been fully aware of before delving into this subject years ago is that there are three phases with distinct characteristics and sometimes overlapping symptoms.

Perimenopause

Perimenopause is the transitional phase preceding menopause, marked by hormonal fluctuations. During this period, hormone levels can fluctuate, resulting in a gradual decrease in progesterone and varying estrogen levels. Consequently, periods of estrogen dominance or even high estrogen levels can occur during the transition from perimenopause to menopause.

If you experience endometriosis (or have some doubts), you might notice heightened symptoms or uncertainty in distinguishing between endometriosis and perimenopause symptoms. In such cases, I encourage you to read this article on perimenopause and menopause when dealing with endometriosis.

Perimenopause may manifest with varying degrees of symptoms for each individual: irregular menstrual cycles, either shorter (less than 27 days apart) or longer (up to over 60 days apart), intermittent anovulatory cycles, heavy or light menstruation, as well as emotional changes, premenstrual syndrome (PMS), reduced libido, vaginal dryness, insomnia, fatigue, difficulty concentrating, and anxiety…

It can commence in the forties or even mid-thirties and concludes after 12 consecutive months without menstruation. This marks the beginning of menopause.

Menopause

Menopause is the point where a woman has not had a menstrual period for 12 consecutive months, indicating the end of her reproductive phase. Ovaries cease to consistently produce estrogen and progesterone, leading to the cessation of menstruation. On average, menopause occurs around the age of 51. 

Some women might experience a reduction in perimenopausal symptoms. For others, symptoms remain similar to those experienced during perimenopause (hot flashes, night sweats, skin and vaginal dryness, urinary issues, weight gain, mood swings, concentration problems, etc.).

Postmenopause

Postmenopause signifies the period following menopause, characterized by consistently low hormone levels. Symptoms related to hormonal fluctuations may diminish during this phase, but it becomes crucial to monitor bone, heart, metabolic, and overall health.

Am I in Perimenopause?

Even subtle signs you perceive can offer indications. Don’t hesitate to discuss changes you experience with your doctor or gynecologist. This allows you to assess your situation and confirm whether your discomforts are linked to perimenopause.

I had moments of uncertainty about certain feelings: is it a recurrence of endometriosis? Or symptoms of perimenopause? I chose to clarify my situation, especially since endometriosis might correlate with an early risk of menopause. The gynecologist conducted an inquiry, performed an examination, and requested blood tests to verify hormone levels (FSH, estradiol, thyroid hormones, etc.), as well as a lipid profile, blood glucose levels, hemoglobin A1c, and potential deficiencies (particularly iron).

Keep in mind that due to significant hormonal fluctuations during perimenopause, blood tests provide only a snapshot and may not be fully reliable.

Apart from analyses, you alone inhabit your body and sense whether you feel well or not. You can initiate some adjustments now. While I am attentive to my lifestyle, I have introduced specific modifications to support my body, mind, and spirit. The sooner these changes are implemented, the more you can prevent or rapidly restore bodily equilibrium.

Ayurveda encourages us to heed our body’s signals, thereby taking appropriate measures to restore balance, homeostasis, and foster contributors to our well-being. We delve into this in the following chapter.

The Ayurvedic Perspective on Menopause and Perimenopause

Ayurveda views menopause as a natural life transition accompanied by shifts in both body and mind. Rather than considering it a disorder or ailment, Ayurveda recognizes menopause as an essential and natural transformation inherent in the cycle of life.

This period is associated with wisdom, the potential to achieve higher levels of spirituality, and an opportunity to celebrate past achievements.

Moreover, it’s a time to focus on oneself, aspirations, and inner growth.

Menopause represents a transition to what’s often referred to as the “golden age” but also acts as a significant revealer. Any latent afflictions or pre-existing imbalances can manifest or exacerbate during menopause.

Take comfort in knowing that there’s still time to make adjustments that will benefit you as you navigate this transitional phase. Some adaptations may be enough to restore balance, while others might require a bit more support. Ayurveda is less concerned with the symptoms themselves and more focused on addressing the imbalances underlying these symptoms. It also advocates for prioritizing contributors to health as early as possible.

Naturally Supporting the Transition to Menopause: Where to Begin?

Introducing Regularity and Stability

Ayurveda considers menopause a natural transition between the Pitta and Vata doshas. During this Vata phase, characterized by the elements of air and ether, Vata dosha imbalances are often responsible for the discomforts experienced during menopause.

Addressing Vata imbalance is Ayurveda’s primary approach to alleviate these symptoms. A simple way to pacify aggravated Vata dosha is by introducing regularity and stability during this period of change.

As a preventive measure, whether you experience symptoms, cycle irregularities, or endometriosis, you can start by incorporating a few simple yet wonderfully effective elements into your daily routine:

• Wake up at the same time, ideally before sunrise.
• Eliminate toxins: use a tongue scraper, practice dry brushing, and perform nasal cleansing with a neti pot. It’s also advisable to avoid toxins and endocrine disruptors.
• Engage in yoga postures, breathing exercises, or meditation.
• Have meals at regular times and in a peaceful environment.
• Try to have dinner before 6:00 PM.
  Chew your food thoroughly to aid digestion.
• Eat sufficient healthy fats and proteins to support hormonal and mental health while preserving muscle mass.
• Prepare for a peaceful transition to the night by reducing activities and screen exposure before bedtime.
• Go to bed before 10:00 PM for good quantity and quality sleep.

Begin a simple daily routine with one or a few of these straightforward elements that you find most manageable to implement and integrate into your daily life. Once you’re familiar with these practices and they become ingrained in your routine, you can gradually incorporate additional practices.

Yoga Practice for Perimenopause

An adapted yoga practice can help alleviate perimenopausal symptoms, reduce stress levels, enhance vitality, and improve overall quality of life during this life stage.

To pacify aggravated Vata dosha, I recommend a yoga practice involving calm and steady postures that promote grounding and stability. This will help soothe the nervous system and tranquilize the mind. You can also incorporate postures that enhance stamina, muscle strength, and physical resilience without exhausting yourself through overly strenuous practice.

Relaxation is essential to assist the body in adjusting, recuperating, and cultivating vitality (Ojas).

Meditation and breathwork can aid in calming the mind to relax the body. Studies have demonstrated that meditation and mindfulness can alleviate numerous perimenopausal symptoms, including hot flashes, depression, and stress.

These adjustments might prove sufficient for some individuals, assisting them in mitigating perimenopausal discomforts. However, others may require additional support.

Seeking Additional Support: A Holistic, Systemic, Personalized Approach

A holistic, systemic, and personalized approach can offer effective solutions tailored to your specific needs while considering your unique constitution, imbalances, and conditions like endometriosis.

These customized practices will optimize factors contributing to your overall health, restore balance, and promote well-being during the transition to menopause. For instance:

• Supporting and optimizing contributors to overall health
• Mitigating health imbalances and disruptors
• Enhancing the response and regulation of the nervous system
• Supporting and optimizing the HPA axis (the hypothalamic-pituitary-adrenal axis), a key player in hormone regulation and numerous bodily functions
• Supporting and optimizing the digestive system (healthy gut microbiome, robust immunity, efficient nutrient digestion and assimilation, effective toxin elimination, etc.)
• …

This approach is applicable to women at any stage of perimenopause or menopause. Since manifestations and imbalances are unique to each individual, a personalized practice can be beneficial. By listening to your body and taking suitable actions that resonate with you, you have the potential to alleviate symptoms and embrace menopause with renewed vitality and enduring well-being.

Menopause, often accompanied by uncomfortable symptoms, can be a period of concern for many women. In reality, this life stage presents a wonderful opportunity for women to prioritize their health and well-being in all dimensions: physical, mental, emotional, and spiritual. You have the chance to initiate lifestyle adjustments today that will help you better prepare for and gracefully navigate the transition to menopause. These adjustments will also establish the foundation for improved health, equilibrium, and energy, allowing you to relish the golden years.

You’re not alone on this journey. For personalized support and guidance, I invite you to book a free consultation, and together we can explore how I can best assist you.