An Ayurvedic Approach for Managing Menopause

Last year my body became my enemy. When I looked in the mirror (something I’d begun to avoid), a stranger stared back at me—and she looked not only older but also frightened. Many women of my generation (the ubiquitous “boomers”) are now hitting menopause. While some sail right through, I capsized. Experts point out how natural menopause is and predict that on the other side of the hormonal shift lies wisdom, an appreciation of freedom, and maybe even a kind of post-menopausal zest. But that seemed unlikely for the woman in my mirror.

Last year my body became my enemy. When I looked in the mirror (something I’d begun to avoid), a stranger stared back at me—and she looked not only older but also frightened.

Nothing had prepared me for what followed my final period at age 52. I lost the ability to sleep properly, think clearly, relax, or be nice. I was subject not only to hot flashes and mood swings (more like mood zigzags), but also to anxiety attacks that left me breathless and trembling. Most disheartening of all was the aching in my muscles and joints that kept getting worse as the months lumbered along. A physician at my HMO shrugged off my symptoms and ruled out HRT (hormone replacement therapy) because I’m at high risk for breast cancer. But something had to be done.

Help!

I began reading about various kinds of holistic and alternative medicine and eventually settled on ayurveda, one of the oldest systems of natural medicine in the world. While modern Western medicine focuses on disease, ayurveda focuses on wellness and prevention. In the latter approach, attitude, emotions, and behaviors (including diet) have profound effects on our health, either nourishing or weakening our minds and bodies. 

Maintaining the connection between our bodies’ inner intelligence and our physiology is the basis of good health. I decided to start listening to and learning about this ramshackle structure—mind, body, whatever—that seemed to be letting me down and growing old before my eyes. But I soon found that even if we agree with the notion that we have a great capacity to heal ourselves, most of us need some help, especially those of us with years of bad habits under our ever-expanding belts. My research led me to The Raj, a wellness center in Fairfield, Iowa, that looks and acts more like a luxury spa. There, I consulted with Dr. Nancy Lonsdorf, a Johns Hopkins’ trained physician who is an ayurvedic expert on women’s health and the author of A Woman’s Best Medicine for Menopause.

In the ayurvedic view, the primary obstacle to wellness is an aggravation or excess in the doshas—three powerful underlying forces of nature that govern mind and body known as vata, pitta, and kapha. Doshas can be thought of as modes of intelligence within nature that determine our constitution, personality, appearance, and health. Each dosha regulates several functions: vata represents the elements of air and ether and controls all forms of movement in our bodies, including blood circulation, digestion, breathing, and the nervous system; pitta represents fire and water and governs metabolism; kapha represents earth and water, governing such structures as tissues and bones.

Doshas can be thought of as modes of intelligence within nature that determine our constitution, personality, appearance, and health.

The three doshas function in all of us to varying degrees, but one or two are usually dominant and are the most likely to become excessive or aggravated. This state of imbalance can result in many physical and mental symptoms, for it reduces the effectiveness of the digestion process and results in poor absorption of nutrients as well as inefficient elimination of metabolic wastes. The result is the creation and buildup of toxins, or ama, a sticky, noxious residue that gradually clogs the cells and various channels within the body. These channels, ranging from microscopic to the size of our digestive tract, are meant for cleansing and internal communication. Ama accumulates in these channels for many reasons, but most commonly from poor diet, stress, and the bombardment of environmental pollutants. By the time we turn 50, the accumulation of toxins can begin to create havoc with our health. I was diagnosed as vata-pitta (these two doshas equally dominant), and both were aggravated.

Panchakarma for Menopause

Ayurveda treatments are individualized, but they usually consist of specific dietary guidelines, herbal supplements, meditation, hatha yoga, and detoxification (also referred to as rejuvenation). The Raj is one of the few places in the U.S. to offer the rejuvenation program called panchakarma, the most effective way to cleanse the body of toxins and reestablish balance.

My first step, before going to The Raj, was to describe my concerns and habits in a phone interview, and then to follow certain dietary recommendations for nearly a month. Beyond the predictable increase in vegetables, fruit, whole grains, and pure water, the diet included specific foods and spices that have “pacifying” effects on the different doshas. I was not happy (or surprised) at the instructions to give up (at least temporarily) all forms of caffeine, alcohol, and red meat, as well as processed and junk food, but I was determined to give it a shot. My craving for lattes, wine, burgers, pizza, and Cheetos never quite left me, but I started feeling better and even lost several pounds. I still, however, was not sleeping properly, and I was a mess by the time I uncurled my aching body from my car in Fairfield, Iowa.

The Raj is an elegant and immaculate facility on 100 acres of meadows and woods. What struck me immediately was the silence in the lobby, the library, the gardens—everywhere. The main building has 18 suites in it, but the actual number of residents changes often because the treatment lasts anywhere from three days to a couple of weeks. Both genders are usually represented, and many people come as couples or even families. The typical staff-patient ratio is an astounding 2:1.

My first morning I met Dr. Lonsdorf, who observed me closely as she talked with me at length. Then she took my pulse. This is the primary diagnostic tool in ayurveda, a complex and intricate kind of pulse-taking that determines the levels of all three doshas and much more. The doctor immediately commented on what an extremely strong constitution I was blessed with, but explained that excess vata in my system was to blame for my insomnia and anxiety, while excess pitta was causing my hot flashes, heartburn, and irritability. We needed to focus on these problems as well as the ama that had accumulated in my body.

Daily massage treatments, designed to loosen and mobilize the toxins, open up all the channels, and flush out the system, were prescribed. Meanwhile, I was told to drink endless cups of warm (never cold) water and follow a strict diet and stress-reduction regime—both aimed at eliminating ama.

My first morning of treatment I found myself, literally, in the hands of two strong and gentle female massage therapists. After explaining the procedures to me, they worked in silence and in perfect synch, each one the mirror image of the other, with me in the middle. These intricate two-sided massages were like a dance for three, with my body the focus and, in a sense, both music and instrument. Each treatment lasted 2–21⁄2 hours, but time no longer seemed to matter. With my eyes closed, I floated, let go.

For my first treatment, udvartana, a paste made primarily of chickpeas and heated sesame oil was massaged all over my body. The paste was very warm, smelled nutty, and felt grainy but pleasant. Next came a treatment called shirodhara, in which warm oil was poured in a thin, steady stream back and forth over my forehead for about 20 minutes. This was especially potent when it hit the center of my forehead (where the “third eye,” the seat of inner wisdom, is said to reside). The oil trickling down my scalp felt like incredibly soft fingers. Starting out very warm, the oil applications end up exquisitely cool. Although difficult to describe why this feels so good, here’s one image that came to me: all my mental junk—worries, negativity, etc.—had somehow been strung along a cord coiled inside my head and now was being gently tugged out, one inch at a time.

Another of my favorite treatments was pinda, a massage using hot milk mixed with rice and herbs. This time, rather than using their hands directly, each of the massage techs used a bolus (basically an udder-like object filled with fluid) to apply the liquid and rub it in. Again, up and down my whole body, over and over. The softness of the bolus on each side of me, along with the smell of warm sweetened milk, made me feel incredibly nurtured (again, uniquely “mothered”).

I felt more and more tension melt away. But, as I had been forewarned, the experience was not 24 hours of ecstasy—there are ups and downs. Some toxins seem to kick and scream all the while you’re trying to get rid of them. Euphoria is common, but so are headaches, lethargy, and melancholy. True to my nature, I vacillated wildly throughout my stay, but mostly I felt better as the hours and days slowly passed. My skin became baby soft, my body light, and my mind more and more serene. I was still not sleeping well, but the staff assured me that it’s common for some symptoms to intensify before disappearing.

I also realized that, beyond simply disliking the flab and wrinkles and avoiding the mirror, I had lost trust in, and respect for, my body.

In between treatments I attended yoga classes, took leisurely walks through the grounds filled with yellow and blue wildflowers, ate tasty vegetarian meals, attended lectures with the other residents, and meditated. I got out of bed each morning looking like hell, with oily hair and no makeup, and climbed into old comfy sweats, not caring how I looked to the outside world. I became totally immersed in my own body, my health, my hopes for change. And at some point I realized how bitterly pessimistic I had become about my future. Before beginning treatment, I’d been wondering how I was going to survive the aging process if I felt so awful at 52. I had been feeling as though I was on the final lap, coming to the end of a journey instead of reaching the middle. I also realized that, beyond simply disliking the flab and wrinkles and avoiding the mirror, I had lost trust in, and respect for, my body. The massages made me keenly aware of each sensation, muscle, tendon, organ, and bone, and my body came alive in ways that prompted me to look at and appreciate myself, my whole self.

Home Again

I left The Raj armed with instructions and a diet more attuned to the real world—more flexible and allowing for some indulgences. But I was warned to be careful, especially during the first month after panchakarma—the process would continue, and my body would let me know what it could tolerate and what it needed. I was advised against trying to change everything all at once, but rather simply to “listen to my changing desires.” A latte one morning left me light-headed, a rich steak dinner made me nauseous, too much wine made me ache. My mind/body was speaking loud and clear.

I also came home with many ayurvedic supplements—combinations of such herbal remedies as Winter Cherry (Ashwagandha), Indian Gooseberry, Nutgrass, and Valerian Root. For continued purification, Dr. Lonsdorf also prescribed an herbal water/tea made by soaking fennel, cumin, and coriander seeds, ginger, and licorice root.

Now, when I look in the mirror, I recognize the person smiling back at me. She and I share a body that is more worthy of respect and care than ever.

Within a week of returning home, I started sleeping 7–9 hours a night. My hot flashes and anxiety attacks disappeared, and my moods stabilized. As an unexpected bonus, even my respiratory allergies went into hiding. My aches and pains diminished somewhat, although that is a problem I’m still working on. Hatha yoga is especially helpful, but some things take more time. Now, when I look in the mirror, I recognize the person smiling back at me. She and I share a body that is more worthy of respect and care than ever.