AYURVEDIC MANAGEMENT OF PREMATURE MENOPAUSE

PREMATURE MENOPAUSE

Ø Premature menopause / Premature Ovarian Failure / Premature ovarian insufficiency is the loss of function of the ovaries before age of 40.

Ø A commonly cited triad for the diagnosis is amenorrhea, hypergonadotropinism, and hypoestrogenism.

Causes:

The cause of POF is usually idiopathic

·    Genetic abnormalities: Chromosomes including sex chromosomes may be abnormal. Sex chromosomes abnormalities include Turner’s syndrome and disorders that confer a Y chromosome (which normally occurs only in males).

·     Autoimmune disorders: the body produces abnormal antibodies that attack the body’s tissues, including the ovaries. Examples are thyroiditis, vitiligo, and myasthenia gravis.

·      Metabolic disorders: Addison’s disease.

·      Viral Infections: Mumps is an example

·      Chemotherapy for cancer

·      Radiation Therapy

·     Surgical removal of the ovaries: Surgery to remove the uterus (hysterectomy) ends menstrual periods but does not cause menopause as long as the ovaries are functioning.

·      Toxins e.g., tobacco.

Classification:

There are two basic kinds of premature ovarian failure.

1.   Where there are few to no remaining follicles – causes includes genetic disorders, auto immune damage, chemotherapy, radiation to the pelvic region, surgery, endometriosis and infection.

2.   Where there is abundant number of follicles – one frequent cause is auto immune ovarian disease which damages the maturing follicles, but leaves the primordial follicles intact.

Symptoms:

·      Irregular or skipped periods (Amenorrhea), which may be present for years or may develop after a pregnancy or after stopping birth control pills.

·      Night sweats

·      Hot f lashes

·      Vaginal dryness

·      Irritability or difficulty in concentrating.

·      Decreased sexual desire

Diagnosis

Premature menopause is suspected when women younger than 40 have menopausal symptoms. A pregnancy test is done, and levels of oestrogen and follicle-stimulating hormones are measured on several occasions to confirm the diagnosis.

Treatment

Estrogen and other therapies used during natural menopause are used to treat symptoms.

 Ayurvedic perspective

·      Pitta Kshayam

·      Artava Agni Kshayam

·     Aggrevation of sheeta guna in the dhatus, so pitta cannot sustain. Ultimately this leads to dhatvagnimandhya. 

Medication

Snehapanam

Dose should be fixed after proper assessment of patient balam.

·      Dhanwantara Vasti pakam – vata pitta haram

·      Shatahwadi tailam – kaphaharam

·      Sahacharadi vasti pakam – yoni visheshatvam

Swedanam

·      Jambheera panda Swedam

·      Pizhicchil

Virechanam

Dose: 25 gm (Along with hot water at 9.30 AM)

·      Kalyanaka Gulam

·      Sukumara Eranda Tailam

Vasti

Kshara Vasti (C.D 73/29-31)

DRAVYAM	QUANTITY
Meltfiltered)	100 gm
Lavanam	15 gm
Sneham murcchita tila tailam can be added	100 ml
Shatahwa kalkam	15 gm
Gomutram	400 ml
Total QTY	600 ml

Nasya Kalpana

Dose: 2 drops in each nostril

·      Shadbindhu Tailam

·      Shirovirechana Tailam

Shamana Chikitsa

Kashaya Kalpana

Dose: 60 ml b.d half an hour before food.

·      Chitraka Grantyadi kashayam

·      Kalyanakam Kashayam

·      Saptasaram kashayam

·      Kanashatahwai kashayam

Choorna Kalpana

Dose: 5 gm b.d with kulattha Kwatha/hot water

·      Hinhguvachadi choornam

·      Vaishwanara choornam

Vati / Gulika Kalpana

Dose: 2 b.d after food.

·      Rajapravartini vati

·      Chandraprabha vati

·      Hinguvachadi vati

·      Sivagulika

Arishta/Asava Kalpana

Dose: 25 ml b.d after food.

·      Lakshmanarishtam

·      Panchakolasavam

·      Lohasavam

·      Kumaryasavam

Ksharam/Bhasma Kalpana

Dose: 3 gm with honey

·      Kalyanaka Ksharam

·      Avilthodhadi bhasmam

When pitta gets aggrevated,

·      Avipathi choornam – 5 gm bd after food.

·      Shatavari gudam – 10 gm b.d with milk after food.

·      Shatavari Ksheera kashayam – 60 ml at 6 pm in the evening.