Menopausal transition or perimenopause is the phase of aging process during which a woman passes from reproductive to non-reproductive stage. It is the period around the late reproductive years, usually late 40 s to early 50s. It begins with menstrual cycle irregularity and extends to one year after permanent cessation of menses. Most of the women begin to experience an array of physical, psychological, vasomotor and urogenital symptoms long before they meet the definition of menopause due to gradual loss of ovarian follicular activity. For about 20% of women with perimenopausal symptoms are highly problematic. In Ayurveda the term ârajakshayaâ 1is used to denote the condition. As explained in classical references the normal menstrual flow is gradually decreases by the age of 50 yrsâjara pakwa sareeranam yathi panchasata:kshayamâ.2 Rajas is considered as the upadhatu of rasa3 or raktha4.1 In perimenopausal period there is gradual depletion in the normal levels of dhatus which result in rajakshaya. Hence it is considered as a Swabhavabala pravrutta vyadhi5 and symptoms of jara or vardhakya are seen. In this period there is agni mandya, pitta kshaya, aggravation of vata along with kapha medo dushti and uttarothra dhatu kshaya occurs which ultimately results in rajakshaya. No direct description about perimenopausal symptoms are available in Ayurvedic classics.Various symptoms mentioned in samhithas in the context of yonirogas can be seen in perimenopausal period. Sometimes these symptoms may be troublesome and may affect the quality of life badly. Ayurveda offers effective modalities and herbal formulations for the management of perimenopausal symptoms. To cope up these and to get symptomatic relief these, the line of treatment should be rasayana, balya, dhatukrith and rasa raktha prasadana. Jwarasamaka or Santhapasamaka treatment principles can be adopted. Life style modifications which include balanced diet, exercises along with specific yogasanas and pranayama can also improve the quality of life in menopausal transition.
