Menopause is not a disease, but a normal part of life. During menopause, reduced normal oestrogen and progesterone levels create health problems. The hormone replacement therapy (HRT) is the way of shedding away menopause. Among all the women who start HRT, only half of those stick with it, because of the severe risk of breast cancer and other undesirable side effects. According to Ayurveda, healthy life style is the best way for the prevention of major health problems after menopause. If you have healthy lifestyle and are managing your stress effectively, you are likely to breeze through menopause without any major problems. Menopause may occur from 35 years to 60 years. But most women stop menstruating in their mid-forties to early fifties and spend almost 1/3 of their lives in menopause.

 What happens during menopause?
Ovaries - the body’s main producers of female sex hormones, (oestrogen and progesterone) gradually stop working, and the hormone levels drop significantly. This process begins 3 to 5 years before the final menstrual period. The hormone production in the ovaries begins to decline from the mid-thirties. In the late forties, the process accelerates and hormones fluctuate more, causing irregular menstrual cycles and unpredictable episodes of heavy bleeding. By the early to mid-fifties, periods finally end altogether.

How will I know I have menopause?
Sexual dysfunction is the most well known disability of woman after menopause. Periods become irregular, or longer or shorter. Menstrual flow lessens, but often a light period is followed by a heavy one, or 'flooding'. Sometimes, there is a gap of months between periods. You may think it is stopped – then be surprised by another. The reduction in the amount of female hormones in the body can have wide ranging effects – from short-term symptoms such as hot flushes, night sweats, and vaginal dryness, mood swings, depression to an increased risk of osteoporosis (brittle bones) and heart diseases.

How to cope with menopausal problems?
Balance life style: While eating a healthy diet and getting enough exercise provides the foundation of good health for everyone, each woman's menopause experience is unique. Symptoms vary from woman to woman. Ayurveda describes that the type of symptoms you have depends upon, which bodily principle or dosha is 'out of balance' in your mind/body system. There are three bodily principles: movement and flow (vata or airy); heat and metabolism (pitta or firey) and bodily substance (kapha or earthy.)

There are three basic types of imbalances relating to each of the three doshas.
V-Type: Anxiety, mood swings, vaginal dryness, loss of skin tone, feeling cold, irregular periods, insomnia, mild or variable hot flashes, and joints aches and pains. Increase warm food and drinks, early bedtime, oil massage, meditation, yoga, walking and spices such as fennel and cumin.

Decrease caffeine and other stimulants, refined sugar, cold drinks, salads.

P-Type: Hot temper, anger, irritability, hot flashes, night sweats, urinary tract infections, skin rashes and acne.

Increase cooling foods, water intake, sweet juicy fruits (grapes, pears, plums, mango, melons, apples), cucumber, organic foods. Go to bed before 10 PM and decrease excessive sun hot spicy foods, hot drinks and alcohol.

K-Type: Weight gain, fluid retention, depressed, lacking motivation, slow digestion, lethargy. Increase exercise, take fruits, whole grains, legumes, vegetables, spices such as black pepper, turmeric and ginger and get up early (by 6 AM) and decrease meat, cheese, sugar, cold foods and drinks.

Vitamin A: Strengthen mucous membranes, helpful for unpleasant menopause. Contains in liver (beef, pork, chicken, fish), carrot broccoli, egg, sweet potato, papaya, butter, spinach, apricot, leafy vegetables, pumpkin.

Vitamin B5 & B6: Maintain healthy skin, eyes, hair, support adrenal gland function, provide help for the common menopausal symptoms. Use meats, whole grains, brewer's yeast, eggs, soy, tofu, cauliflower, cabbage.

Vitamin C: It is needed for the manufacture of collagen, which acts like a flexible or elastic protein glue in connective tissue and bone. Contains in citrus fruits, tomatoes, capsicum, berries.

Vitamin D: It is required for the absorption and utilization of calcium and helps calcium to be deposited in bones. Helps fish liver oils, fatty fish, liver, egg yolks, butter and cow's milk.

Vitamin E: It has a protective or sparing effect on oestrogen. Use broccoli, nuts and tomatoes.

Boron: It appears to work by increasing the levels of certain forms of oestrogen. Contains in pears, raisins, peaches, almonds, honey, peas, beans and lentils and sesame seeds. Three or four apples a day or three to four ounces of peanuts may supply boron-deficient women with all they need.

Calcium: It is needed for bones – contains in milk and cheese..

Home remedies
Consuming beet juice about 90 ml twice daily can help to avoid menopausal symptoms. Consuming carrot seeds after boiling for 10 minutes in cow’s milk is very helpful. Consuming Indian spikenard (Nardostachys Jatamansi) in a dosage of 2 grams will be helpful.

Multivitamins that helps in regulating normal bodily functioning may provide relief.

Regular exercise is very helpful in reducing the menopausal symptoms. Soya beans, sprouts, cabbage, olive oil etc helps in relieving menopausal problems. Consuming Licorice (mulethi) 5 mg twice daily with water. This will help in maintaining the hormonal disturbances that occur during the menopause. 

Conclusion
The nature has solutions for all the sufferings of its creature in its own basket. The bitter phase of women’s life is menopause and compliance to hormone replacement therapy is very poor due to various side effects. Hence, upon looking at nature’s basket for remedies, it’s clear that there are number of natural products available for effortless avoidance of menopausal symptoms and for gaining healthy lifestyle.

(The authors are with Amity Institute of Pharmacy, Amity University, Lucknow, and Central Drug Research Institute, CSIR, Lucknow, respectively)