Abstract

With the improvement of health facilities, the elderly population is increasing. Consequently, the number of women experiencing menopausal syndrome is also increasing. Early menopause significantly contributes to this group. Symptoms of menopause may vary from somatovegetative, psychological to uro-genital. But we do not have a specific protocol to efficiently manage all these symptoms. Hormone replacement therapy (HRT) is an option, but the outcomes are not satisfactory. According to a community-based cross-sectional study in 400 middle-aged women (40–60 years) in Haryana, India, in the year 2020, the prevalence of menopausal symptoms was found to be 87.7%. The majority of the study subjects experienced anxiety (80%), followed by physical and mental exhaustion (71.5%), sleep problems (61.2%), irritability (60.7%), joint and muscular discomfort (56%), and heart problems (54%). The most classical symptom of menopause, i.e., hot flushes, was reported in 36.7% of the participants. The quality of life was impaired in 70.2% of the study subjects. The psychological symptoms are attributed to 70.8% of the poor quality of life. As per the need of the hour, this study was carried out to assess the effectiveness of the Indian system of medicine in managing menopausal syndrome. In this study, the Menopausal Rating Scale (MRS) was used as an assessment tool. The study was conducted on 100 patients aged 40 to 65 attending the Ayurveda Institute OPD. The clinical comparative study was carried out with Lakshadi Guggulu, Shatavari Churna, and Lakshadi Tail for 2 months. After the study, it can be concluded that in women with mild to moderate symptoms of menopausal syndrome, a combined treatment (Lakshadi Guggulu + Shatavari Churna + Lakshadi Tail) yields better results in both somatic and psychological complaints compared to individual interventions.

• 1.   Sussman M, Trocio J, Best C, et al. Prevalence of menopausal symptoms among mid-life women: findings from electronic medical records. BMC Women’s Health. 2015;15:58.
• 2.   Treloar AE. Menstrual cyclicity and the premenopause. Maturitas 1981;3:249–264.
• 3.   United Nations, Department of Economic and Social Affairs. (2021) World Prospects 2021. https://population.un.org/wpp/Download/ Standard/Population/.
• 4.   United Nations, Department of Economic and Social Affairs, Population Division (2019). World Population Ageing 2019: Highlights (ST/ ESA/SER.A/430). https://www.un.org/en/ development/desa/population/publications/ pdf/ageing/WorldPopulationAgeing2019- Highlights.pdf.
• 5.   Kalhan M, Singhania K, Choudhary P, Verma S, Kaushal P, Singh T. Prevalence of Menopausal Symptoms and its Effect on Quality of Life among Rural Middle Aged Women (40-60 Years) of Haryana, India. Int J Appl Basic Med Res. 2020 Jul-Sep;10(3):183-188. doi: 10.4103/ ijabmr.IJABMR_428_19. Epub 2020 Jul 11. PMID: 33088741; PMCID: PMC7534715.
• 6.   Hill K. The demography of menopause. Maturitas. 1996;23:113–127.
• 7.   Woods NF, Mitchell ES. Symptoms during the perimenopause: prevalence, severity, trajectory, and significance in women’s lives. Am J Med. 2005;118 (suppl 12B):14–24.
• 8.   Posadzki P, Lee MS, Moon TW, Choi TY, Park TY, Ernst E. Prevalence of complementary and alternative medicine (CAM) use by menopausal women: a systematic review of surveys. Maturitas. 2013;75:34–43.
• 9.   Ma J, Drieling R, Stafford RS. US women desire greater professional guidance on hormone and alternative therapies for menopause symptom management. Menopause. 2006;13:506–516.
• 10.   Ernst E, Posadzki P. Alternative therapies for the management of menopausal symptoms In: Panay N, Briggs P, Kovacs G, eds. Managing the Menopause: 21st Century Solutions. Cambridge, England: Cambridge University Press; 2015:157–162.
• 11.   Laksha Guggulu (Chakrapanidutta, Chakardutta, Tripathy Indradeva., Dr. In: Chakradutta Bhagna Chikitsa. 15. Dwivedy Ramanath., Prof, editor. Vol. 14. Varanasi: published by Chaukhambha Sanskrit Sansthan; p. 276.).
• 12.   Sharma P. Dravya Guna Vijnana. 6th ed. Varanasi: Chaukhamba Bharati Academy; 1982. p. 562.
• 13.   Lakshadi tail (Vagbhata. Ashtanga Hridaya. Sarvangasundari vyakhyana by Arunadutta. Ayurveda Rasayana vyakhyana by Hemadri. Varanasi: Chowkambha Surbharati prakashan; 2010.Uttarasthana. Chapter -2. Verse – 54-56. PP- 956. Pg-784).
• 14.   Modi MB, Donga SB, Dei L. Clinical evaluation of Ashokarishta, Ashwagandha Churna and Praval Pishti in the management of menopausal syndrome. Ayu. 2012 Oct;33(4):511-6. doi: 10.4103/0974-8520.110529. PMID: 23723668; PMCID: PMC3665193.
• 15.   Santwani K, Shukla VD, Santwani MA, Thaker G. An assessment of Manasika Bhavas in menopausal syndrome and its management. Ayu. 2010 Jul;31(3):311-8. doi: 10.4103/0974- 8520.77156. PMID: 22131732; PMCID: PMC3221064.
• 16.   Gargi, S. (2021). Case study on management of Menopausal Syndrome with Ayurvedic formulations and Pranayama. Ayurlog: National Journal of Research in Ayurved Science, 9(01).
• 17.   Akhila M and Dr. Laxmipriya Dei,Ayurvedic management of menopausal syndrome with Vayasthapana gana: A case report,International Journal of Herbal Medicine 2019; 7(6): 43-46.
• 18.   Dr Gouri G. Ganpatye1, Dr. Shivani Sanjeev Gavande2, Peri-Menopausal SyndromeAyurvedic Management - A Case Report, International Journal of Science and Research (IJSR) ISSN: 2319-7064 SJIF (2019): 7.583,Page: 1455, 1456.
• 19.   Dr. Nileema Nandanwankar and Dr. Mayuri N. Manwatkar, Ayurveda Management of Menopause: A Case Study, World Journal of Pharmaceutical and Medical Research, wjpmr, 2022,8(6), 211-212.
• 20.   (Schneider HPG, Heinemann LAJ, Rosemeier HP, Potthoff P, Behre HM. The Menopause Rating Scale (MRS): Reliability of scores of menopausal complaints. Climacteric. 2000;3:59– 64.).
• 21.   Ahsan M, Mallick AK, Singh R, Prasad RR. Assessment of menopausal symptoms during perimenopause and postmenopause in tertiary care hospital, Bareilly (India). J Basic Clin Reprod Sci. 2015;4:2-7.
• 22.   Gold EB, Colvin A, Avis N, Bromberger J, Greendale GA, Powell L, Sternfeld B, Matthews K. Longitudinal analysis of the association between vasomotor symptoms and race/ ethnicity across the menopausal transition: study of women’s health across the nation. Am J Public Health. 2006 Jul;96(7):1226-35.
• 23.   Gold EB, Sternfeld B, Kelsey JL, Brown C, Mouton C, Reame N, Salamone L, Stellato R. Relation of demographic and lifestyle factors to symptoms in a multi-racial/ethnic population of women 40-55 years of age. Am J Epidemiol. 2000 Sep 1;152(5):463-73.
• 24.   Sternfeld B, Quesenberry C, Husson G. Habitual physical activity and menopausal symptoms: a case control study. Journal of women’s health. 1999;8(1):115-123.
• 25.   Lee Y, Kim H. Relationship between menopausal symptoms, depression, and exercise in middle aged women. Int J Nurs Studies. 2008;45:1816- 22.
• 26.   Yanikkerem E, Koltan SO, Tamay AG, Dikayak S. Relationship between women’s attitude towards menopause and quality of life. Climacteric. 2012;15:552-62.
• 27.   Rosemeier H, Schultz B. Psychological aspects of menopause. In Fischl, F. (ed.), Menopause and ropause: Hormone replacement therapy through the ages new cognition and therapy concept. Gablitz: Krause and Pachemegg publishers;2001:21-28.
• 28.   Adler SR, Fosket JR, Kagawa-Singer M, McGraw SA, Wong-Kim E, Gold E et al. Conceptualizing menopause and midlife: Chinese American and Chinese women in the US. Maturitas. 2000;35(1):11- 23.
• 29.   Upadhyaya Govindprasad., Dr. Ayurvediya Manas Roga Chikitsa – Chaukhambha Surbharti Prakashan, 2nd Khanda. 1998:128.
• 30.   Amrita Mishra, Rajashree V. Shelare. An Ayurvedic and Contemporary Overview of Menopause: A Conceptual Approach. International Journal of Ayurveda and Pharma Research. 2018;6(2):34-38).
• 31.   Sharma JN, Comparison of the AntiInflammatory activity of Commiphora mukul (An indigenous drug) with those of Phenylbutazone and Ibuprofen in experimental arthritis induced by Mycobacterial Adjuvant. Arzneimittelforschung, 1977; 27; p.1455–1457.
• 32.   Arora RB et al. Anti-inflammatory studies on a crystalline steroid isolated from Commiphora mukul. Indian Journal of Medical Research. 1972; 60; p.929–931.
• 33.   Duwiejua M et al. Anti-Inflammatory Activity of Resins from Some Species of the Plant Family Burseraceae. Planta Medica. 1993; 59; p.12–16.
• 34.   Atta AH, Alkofahi A. Anti-Nociceptive and Anti-Inflammatory Effects of Some Jordanian Medicinal Plant Extracts. Journal of Ethnopharmacology. 1998; 60; p.117–124.
• 35.   Deshpande P. J. Effect of Shell-lac in healing of fracture. Mechanics. March April,1999; 28(3-4);.
• 36.   Veena Sharma, Sadhana Sharma, Pracheta, Ritu Paliwal, Withania Somnifera: A Rejuvenating Ayurvedic Medicinal Herb for the Treatment of Various Human Ailments. International Journal of Pharmtech Research. Jan-Mar, 2011; 3 (1); p.187-192.
• 37.   Sudip Kumar Rath, Ashashri Shinde, Pankaj Gahunge, Naresh Kumar Khemani, Review of Antioxidant Activity of Rasayana Herbs Described in Ayurveda International Journal of Ayurvedic and Herbal Medicine. 2012; 2 (1); p. 202:217.
• 38.   Kakubha- Data base on medicinal plant used in Ayurveda, CCRAS, Vol-3, p. 57-62.
• 39.   Garima Mishra, Saurabh Srivastava, B.P.Nagori, Pharmacological and Therapeutic Activity of Cissus quadrangularis: An Overview. International Journal of Pharmtech Research. April-June, 2010; 2 (2); p. 1298-1310.
• 40.   Singh SP, Mishra N, Dixit KS, Singh N, Kohli RP: An experimentally study of analgesic activity of Cissus quadrangularis. Indian J of Pharmacol. 1984; 79; p. 162- 163.
• 41.   Priyanka Vijay et al, Analgesic, AntiInflammatory and Antipyretic Activity of Cissus quadrangularis. Journal of Pharmaceutical Science and Technology. 2010; 2 (1); p. 111-118.
• 42.   Alcoholic extract of the stem showed activity against Escherichia coli. With India- Raw Materials, II, 184; Fl Br Ind, I, p. 645.
• 43.   Justin Raj S., Baby Joseph, Pharmacognostic and traditional properties of Cissus quadrancularis Linn -An overview. International Journal of Pharma and Bio Sciences. Jan-Mar, 2011; 2 (1); p.131-139.
• 44.   Udupa K. N. and Guru Charan Prasad, Further Studies on the Effect of Cissus quadrangularis in Accelerating Fracture Healing. Ind. Jour. Med. Res. Jan, 1964; 52(1); p.26-35.
• 45.   Deka D.K., Lahon L.C., Saikia J., Mukit A. Effect of Cissus quadrangular/s in accelerating healing Process of experimentally fractured radius-ulna of dog: A preliminary study. Indian Journal of Pharmacology. 1994; 26; p. 44-45.
• 46.   Kshipra Rajora, Sarvesh Kumar Singh, R.S. Sharma, S.N Sharma, Clinical Study on Laksha Guggulu, Snehana, Swedana and Traction in osteoarthritis. AYU. 2010; 31 (1) p.80.87.
• 47.   Shashi Alok, Sanjay Kumar Jain, Amita Verma, Mayank Kumar, Alok Mahor and Monika Sabharwal: Plant Profile, phytochemistry and pharmacology of Asparagus racemosus (Shatavari): A review. Asian Pacific Journal of Tropical Diseases. 2013;3(3):242-251.
• 48.   Ajitha Sharma, Devasya Narayana Sharma, A Comprehensive Review of the Pharmacological Actions of Asparagus racemosus, American Journal of Pharmtech Research 2017;7.
• 49.   Ramit Singla and Vikas Jaitak. Shatavari (Asparagus racemosus wild): A Review on its cultivation, Morphology, Phytochemistry and Pharmacological Importance. International Journal of Pharmaceutical Sciences and Research. 2014;Vol.5(3):742-757.
• 50.   Prashant Sakharam Bhokardankar, Sandeep Gorakh Mane, Bhupendra Prakash Khairanar. An Overview of Shatavari (Asparagus racemosus) an Ayurvedic Drug. International Journal of Ayurveda and Pharma Research. 2019;7(7):60-65.
• 51.   Kalajvani Selvaraj, Girija Sivakumar, Vishnu Priya Veeraraghavan, Vijaya S Dandannavar, Geetha Royapuram Veeraraghavan, Gayathri Rengasamy. Asparagus racemosus- A Review. A multifaceted Review Journal in the Field of Pharmacy. 2019;10(1):87-89.
• 52.   Shifali Thakur, Hemlata Kaurav, Gitika Chaudhary. Shatavari (Asparagus racemosus) – The Best Female Reproductive Tonic. International Journal of Research and Review. 2021;8(5):73-84.
• 53.   Gogte VM. Ayurvedic pharmacology and therapeutic uses of medicinal plants. Mumbai: SPARC; 2000.

Data Sharing Statement

Funding