Geriatric Women Healthcare wsr to Menopause in Ayurveda
Dr. Priyanka Gupta
Geriatric Women Healthcare wsr
to Menopause in Ayurveda
Introduction• The Geriatrics
is a developing
field of caring aged population• A women care is essential as
to care the major population of aged and to care the family care system
• Ayurveda have shown its integrity and responsibility of
caring women from birth to finale passing stages of
menarche and menopause
Geriatric Women Healthcare wsr to Menopause in Ayurveda
Dr. Priyanka Gupta
Global scenario • Over 65 aged world’s population by 2025 will increase by
10%• Where in the Asia will see the proportion of its elderly
population almost double, i.e. from 6% of 2000 becomes 10% in 2025
• It is found that there will be Feminization Of Aging (more women than men of older age)
• 2025 scenario exhibits, – 54% of people between the ages 60 and above, – 63 % of very old people (80 and above). – Thus the disease burden appears significantly more in
women compared to men
Geriatric Women Healthcare wsr to Menopause in Ayurveda
Dr. Priyanka Gupta
Indian Scenario• Indian Women (rural / urban) suffer
from chronic diseases– 93.5% women have insufficient
nutrition intake– 26% women have low physical
activity– 1 in 4 women suffer from high
blood pressure– 4 in 5 women have high risk obesity
(waist hip ratio) that increases cardiovascular disease risk
– physically immobile percentage of persons is also high among women
Geriatric Women Healthcare wsr to Menopause in Ayurveda
Dr. Priyanka Gupta
Specific Health Concerns of Older Women in India
• In India an average female life expectancy
in 2011 is 68 years and is
projected an increase to 73 years by 2021
• The estimated mean age of menopause is 46 years in India, and is lower than
that of the Caucasians• An early age of menopause
predisposes
a women to chronic health disorders a decade earlier than the Caucasian
women•
Geriatric Women Healthcare wsr to Menopause in Ayurveda
Dr. Priyanka Gupta
68 y
ears
2011
73 y
ears
2021
Female life expectancy
It is reported that . . .
• 10-20 years earlier osteoporotic fractures
• 4.4% of Asian women at a younger age have 1st myocardial infarction attack than in European women
• 10 years earlier Type 2 Diabetes Mellitus (DM) than the Caucasians
• Before the age of 50 years Breast cancer incidence peaks
• From 1990 to 2020 115% cardiovascular disease (CVD) increase
• From 1990 to 2020 104% cerebrovascular incidence
• The mean BMD of Indian women is two SDs lower than western
Geriatric Women Healthcare wsr to Menopause in Ayurveda
Dr. Priyanka Gupta
These facts indicate the need to have a well- planned effective Preventive and cost effective system in place to promote a healthy and an active ageing population.
Steps to improved
health of Older
Women through
Ayurveda
• One cannot ‘improve’
health of an older woman without improving her health in childhood, adolescence and in childbearing
years
• Older women’s compromised quality of life is not due to age alone even it is because of many factors
• Ayurveda got the potentiality for aged–– Prevention, – Promotion of health and
– Management of diseases
Geriatric Women Healthcare wsr to Menopause in Ayurveda
Dr. Priyanka Gupta
• Ayurveda considers the 7 dhatu potentiate through Panchakarma and Rasayana
• Panchakarma is a bio-cleansing program comprising of five main procedures to revert vitiated Three Dosha.
• Rasayana deals with the tissue degeneration and loss related to ageing and tissue regularization
• Rasayana is a method to control / slow down / minimizing the aging process
• Rasayana becomes more fruitful and effective if it is preceded with suitable Panchakarma
Geriatric Women Healthcare wsr to Menopause in Ayurveda
Dr. Priyanka Gupta
Ayurvedic
Approach to Menopause• Ayurveda
says that menopause mark a natural
transition
in one’s life where in the conventional
model represents menopause as “ovarian failure”– It’s been seen as a disease, a disorder‐an
abnormal lack of hormones that creates health
problems• Each woman's menopause experience is unique • It is nature’s protective phenomenon against
reproductive morbidity and mortality in the ageing
population• Ayurveda considers that ‐
it is a transition from a
time where life is dominated by Pitta
(Young age)
to one dominated by Vata (Old age)
Geriatric Women Healthcare wsr to Menopause in Ayurveda
Dr. Priyanka Gupta
CCRAS approved Preventive Protocol for Menopausal Syndrome
A.
Prevention through Achara
Rasayana (Dincharya,ritu
charya
& Sadvritta)
1. Consumption of godhuma
(wheat), old rice, mudga
(green gram), soya,
fresh seasonal fruits, ghee, nuts, milk etc.
2. Regular medicated oil massage and exposure to mild sun light
3. Practice personal and social good conduct
4. Maintain healthy body weight
5. Regular exercises, yoga and meditation
6. Control of blood pressure and cholesterol levels
7. Use of calcium supplements and diet rich in calcium and antioxidants
8. Use of rasayana
drugs
9. Avoid heavy and unwholesome food, excess pungent, salty and sour food
items etc.
10. Avoid excessive physical exertion
Geriatric Women Healthcare wsr to Menopause in Ayurveda
Dr. Priyanka Gupta
CCRAS approved Preventive Protocol for Menopausal Syndrome
B. Yogic Practices
‐
The following yogic practices are beneficial in
menopausal syndrome; however, these should be performed only
under the guidance of qualified Yoga therapist.
• 1. Suryanamaskara, Tadasana, Katicakrasana, Vajrasana,
Ushtrasana, Sarvangasana,
• Setubandhasana, Baddhakonasana, Pavanamuktasana,
Upavishtakonasana, Merudandasanchalanasana
• 2. Bhramari, Nadishodhana, Shitali
pranayama
• 3. Moolabandha
with Ashvini
mudra
• 4. Deep relaxation technique/ Yoga nidra/ Nadi
anusandhana.
C. Counseling Advice the patient to develop positive approach towards
menopause
Geriatric Women Healthcare wsr to Menopause in Ayurveda
Dr. Priyanka Gupta
Preventive Aspect and Treatment Protocol for Menopausal
Syndrome continued…….Medical managementLine of treatment1. Shodhana
chikitsa
(bio‐cleansing therapies) / other
therapeutic procedures followed byshaman
chikitsa
(palliative therapy) should be advocated.
i. Snehana: Gentle massage with medicated oils such as :•
Mahanarayana
taila
•
Kshirabala
taila•
Mahamasha
taila
•
Bala
tail
Geriatric Women Healthcare wsr to Menopause in Ayurveda
Dr. Priyanka Gupta
Preventive Aspect and Treatment Protocol for
Menopausal Syndrome continued…….
ii. Internal Snehana
(internal oleation) with medicated ghrita
(Sukumara
ghrita/
• Dadimadi
ghrita
etc) 50 ml with 2‐3 gm saindhava
lavana
daily for 3‐7 days before
• panchakarma
(bio‐cleansing procedure)iii. Sirodhara
with Yashtimadhu
kashaya
and
milk 45 minutes daily for 15 daysiv. Takra
dhara
45 minutes daily for 15 days
v. Matra
vasti
with Dhanvantara
taila
/ Sukumara
ghrita
50 ml daily for 15 days
Geriatric Women Healthcare wsr to Menopause in Ayurveda
Dr. Priyanka Gupta
Drug Dosage (per dose)
MOA/ Vehicle* Duration**
For debilityShatavari Churna 1 -3gm Water/ milk 15 daysAmalki Churna 1 -3gm Water 15 daysMadhuyashti Churna
1 -3gm Water 15 days
Ashwagandha Churna
3gm Milk 15 days
For fragile bonesAsthishrinkhala Churna
1 -3gm Water 15 days
Kukkutanda twaka bhasma
250mg Milk/ Water 15 days
Geriatric Women Healthcare wsr to Menopause in Ayurveda
Dr. Priyanka Gupta
Drug Dosage (per dose) MOA/ Vehicle* Duration**
For excessive bleeding
Pushyanuga
Churna 1 ‐3gm Rice water 15 days
Chandraprabha
Vati 1.5 gm Water 15 days
Lodhrasava 10‐20 ml Water 15 days
Ashokaarishta 10‐20 ml Water 15 days
Sukumara
Ghrita 10 gm Warm milk/ Warm water 15 days
Dadimadi
Ghrita 30‐50 ml Warm water 3‐7 days
For hot flushes / night sweats/ burning sensation
Prawala
Pishti 250‐500mg Water 15 days
Mukta
Pishti 250‐500mg Water/Milk 15 days
Chandanasava 10‐20 ml Water 15 days
Usheerasava 10‐20 ml Water 15 days
Kamadudha
Ras 125‐250 mg Water 15 days
Dhanwantar
Taila for matra
vasti 15 days
For debility/ anaemia
Ashwagandharishta 10‐20 ml Water 15 days
Shatavari
Guda 6 gm Milk 15 days
Lohasava 10‐20 ml Water 15 days
For insomnia/ mood swings
Manas
mitra
Vatkam 125 ml Milk 15 days
Brahmi
Vati 125‐250 mg Milk 15 days
Brahma Rasayana 10 gm thrice daily Milk 15 days
For fragile bones
Lakshadi
Taila for matra
vasti 15 days
Dhanwantar
Taila for matra
vasti 15 days
Geriatric Women Healthcare wsr to Menopause in Ayurveda
Dr. Priyanka Gupta
Geriatric Women Healthcare wsr to Menopause in Ayurveda
Dr. Priyanka Gupta
1. Kuppurajan etal, Effect of Aswagandha (Withania somnifera) on the process of ageing in Human volunteers . Journal of Research in Ayurveda and Siddha.
2. Clinical and Experimental trial of Guggulu (Medoroga). 1989, Central Council for Research in Ayurveda and Siddha, Janakpuri, New Delhi.
Health status improvement RCTs• Aswagandha (Withania somnifera) root powder 3 gm.
was showed significant increase in Haemoglobin, RBC count, hair melanin and decrease in serum cholesterol and ESR (1).
• Guggulu( Commiphora wightii ) Cardinal clinical manifestations of disease like precordial pain and dyspnoea were relieved in in most of the cases in a clinical study tried with Guggulu . The reversal of ECG changes substantiated the anti-ischaemic effect of the drug in the treatment of ischemic heart diseases (2).
Geriatric Women Healthcare wsr to Menopause in Ayurveda
Dr. Priyanka Gupta
1. Bichile, LS et al., Double blind randomized controlled trial of Sallaki Vs Diclofenac in treatment of Rheumatoid arthritis, Select Research Papers on Evidence Based drugs in Ayurveda, Dept of ISM&H, Ministry of Health, Government of India, New Delhi-2000. 3
2. NB Brindavanam, N.Bhattacharya, C.K.Katiyar and DBA Narayana – Multi-facetted protective Role of Rasayana Therapy: A review of investigations on Cyawanprasa– Ayurvedic Conference on Rasayana 2002, Rashtriya Ayurveda Vidyapeeth
3. Dahanukar et al., Immunotherapy with Tinospora cordifolia: A new lead in the management of obstructive jaundice by Tinospora cordifolia, Indian J Gastroenterol, 12 (1993) 5.
Health status improvement RCTs• Anti-inflammatory (1)
– Sallaki (Boswelia serrata)-• Immunomodulatory activity
– Cyawanprasa (2), – Guduchi (3) (Tinospora cordifolia) -
Geriatric Women Healthcare wsr to Menopause in Ayurveda
Dr. Priyanka Gupta
Conclusion
• Ayurveda is showing its face in
improving and regulating the Global
Health Scenario • The involvement in protecting the aged
especially the women population who
are under the influence of different
systemic diseases before and after
menopause –– Is achieved through different
dietetic and regimen or medicines
by Ayurveda proves its efficacy
through RCTs. – Still more women centered health
care modules are required to satisfy
the needs of 2025.
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