Management Of Rajonivritti Lakshanas w . s . r . to Postmenopausal Syndrome in Ayurveda ”

Rajonivritti as a diseased condition is not described separately in the classical texts of Ayurveda,. According to Acharya Sushruta and various other references too, 50 years is mentioned as the age of Rajonivritti,.Rajonivrutti janya lakshana is a group of symptoms produced by degenerative changes . Menopause is defined retrospectively as the time of the final menstrual period, followed by 12 months of amenorrhea.Currently, the number of menopausal women is about 43 million and projected figures in 2026 have estimated to be 103 million. So, menopausal health demands even higher priority in Indian scenario. In modern science, hormone replacement therapy is one and only alternative for these health hazards, but it has a wider range of secondary health complications., Therefore, many menopausal women use complementary therapies to cope with their symptoms. It has become essential to understand the etiopathogenesis and to study the basic principle of the treatment of Rajonivrutti janya lakshana. AimLiterary Study of Management of Rajonivritti Lakshanas w.r.s.to Postmenopausal Syndrome In Ayurveda. Objectives – To review literature compilation related to Rajonivritti Lakshanas.,Postmenopausal Syndrome &basic Ayurvedic principles of Management of Rajonivritti Lakshanas. Material & Method – Brihatrayi and Laghutrayi of Ayurveda classics.Modern text related to Postmenopausal Syndrome & other relevant science literature along with Internet material and research papers. ConclusionOn the basis of Ayurveda as well as Modern fundamentals after analyzing the above facts, basic Ayurvedic principles of Management of Rajonivritti Lakshanas.has been played a valuable role. KeywordsRajonivritti Lakshanas, Postmenopausal Syndrome, Management, Ayurveda Introduction Menopause is defined retrospectively as the time of the final menstrual period, followed by 12 months of amenorrhea. Post-menopause describes the period following the final menses. 1 Rajonivritti as a diseased condition is not described separately in the classical texts of Ayurveda,. According to Acharya Sushruta and various other references too, 50 years is mentioned as the age of Rajonivritti,.Rajonivrutti janya lakshana is a group of symptoms produced by degenerative changes . AYURLOG National Journal of Research in Ayurved Science A peer-reviewed open access Indexed e-journal of Ayurved http://www.ayurlog.com April2020 | Volume 08th | Issue: 2nd ISSN: 2320-7329


Introduction
Menopause is defined retrospectively as the time of the final menstrual period, followed by 12 months of amenorrhea. Post-menopause describes the period following the final menses. 1 Rajonivritti as a diseased condition is not described separately in the classical texts of Ayurveda,. According to Acharya Sushruta and various other references too, 50 years is mentioned as the age of Rajonivritti,.Rajonivrutti janya lakshana is a group of symptoms produced by degenerative changes .
Currently, the number of menopausal women is about 43 million and projected figures in 2026 have estimated to be 103 million. 2 So, menopausal health demands even higher priority in Indian scenario. 3 In modern science, hormone replacement therapy is one and only alternative for these health hazards. 4,5,6  Need of the Study: An estimated 80% of females experience physical or psychosocial symptoms while approaching menopause, leading to change in their quality of life (QOL). 7 Many symptoms found related to postmenopausal syndrome are hot flushes, irritability, mood swings, insomnia, dry vagina, difficulty concentrating, mental confusion, stress incontinence, urge incontinence, osteoporotic symptoms, depression, headache, vasomotor symptoms, insomnia etc. In modern science, hormonal replacement therapy (HRT) is the only alternative for menopausal syndrome, but it has a wider range of secondary health complications like vaginal bleeding, breast cancer, endometrial cancer, gallbladder diseases, etc.Non-hormonal pharmacologic therapies have been shown to be less effective than hormonal therapy and to be associated with their own adverse events that restrict their use for many women. 8 Therefore, many menopausal women use complementary therapies to cope with their symptoms. 9

Ayurvedic Review of Menopausal Syndrome
Rajonivritti as a diseased condition is not described separately in the classical texts of Ayurveda, Rajonivritti Kala is mentioned by almost all Acharyas without any controversy. According to Acharya Sushruta and various other references too, 50 years is mentioned as the age of Rajonivritti, when the body is fully in grip of senility. 10,11,12,13 In the Classical Ayurvedic text, the Astanga Hrdayam, it is said: "Just as the lotus closes at the end of the day, so also the yoni after the rutu kala(the period suitable for conception); thereafter she will not be receptive for sukra(semen.)." 14 Rajonivrutti janya lakshana is a group of symptoms produced by degenerative changes. Pittadominant menopausal symp-toms-Angry, irritable, excess hot flushes,night sweats, extremely heavy periods with burning sensation, skin rashes, as-sociated complaints such as UTI (uri-anry track infection).

3)
Kaphadominant menopausal Symp-toms-Weight gain, lethargy, depression, lack of motivation, hormonal changes such as Thyroid malfunction,fibrocystic changes in uterus or in the breast and excessive fluid retention  Modern Review of Menopausal Syndrome Each phase of a women's life is beautiful and should be considered as gracious.right from the moment that she entered the world or when she steps in adolescence which makes her capable to be prepared to experience motherhood, or finally the transition to menopause.The word'Menopause'comes from the greek word'Menos'(month) & 'Pausis' (cessation).Menopause is a natural phenomenon occurs at the age of 45-55 years. Menopause means permanent cessation of menstruation at the end of reproductive life due to loss of ovarian follicular activity. 18 The menopause is a gradual and natural transitional phase of adjustment between the active and inactive ovarian function and occupies several years of a women's life and involves biological and psychological changes adjustments. This period is usually associated with unavoidable manifestation of aging process in women. 19 Most women experience near complete loss of production of estrogen by their mid-fifties. 20 During reproductive years,women are protected by female hormones, i.e. estrogen and progesterone. With menopause, women enter an estrogen deficient phase in their lives, which accelerates the ageing process resulting into greater vulnerability to psychosomatic problems. Hot flushes, sweating, changes in mood and libidoare some of the important outcomes affecting the quality of life (QoL) during climacterium in women. QoL covers physical,functional, emotional, social, and cognitive variables up to 85%of menopausal women. 21  Cause of Menopause- Menopause is because by the nature declining function of the ovaries.which gradually produces lower and lower levels the hormones oestrogen,progesterone,and testosterone. In Ayurvedic classics, menopause finds its mention by name only as part of normal physiology and natural aging. which can be judiciously implemented to alleviate menopausal as well as associated aging problems. Each phase of our life gives its own opportunity for growth and personal expansion so this transitional stage of a woman's life should be looked upon as her wiser days with a positive approach. Ayurvedic treatment of Menopause focuses on strengthening and rejuvenating the reproductive system.

Preventive Measures
The and Yuktivyapashray Chikitsa (rationale therapy). 28 Yukti is a method of analysis that targets multiple variables 32 . Yuktivypashray Chikitsa means complex multicomponent clinical interventions. It consists of Nidan Parivarjan (avoidance of causative factors), Samshodhan Chikitsa (cleansing of body by Panchakarma/ purifying measures)) and Samshaman Chikitsa (palliative therapies). Samshaman Chikitsa is indicated for the patient not fit for Samshodhan and is also used after Samshodhan Chikitsa. It includes Ahara (wholesome food), Vihar (wholesome activities) and Aushadha (medicament). 29 30 (Ashtang Samgraha, Sharir 1/69) GhritaisVata-pitta shamaka(pacifying), Balya (strengthening),Agnivardhaka (promoting digestion), Madhura, Saumya(agreeable),Sheeta-Virya (cooling in effect), Shulahara (pain relieving), Jwarhara (antipyretic), Vrishya(aphrodisiac) and Vayasthapaka(age stabilizer). 31 Thus, it not only pacifies Vata and Pitta but also improves the general condition of the body and acts as a rejuvenator of the body. Ghrita is Yogavahi. 32 (special affinity to carry and to potentiate the actions of the main drug to which it is mixed) and thus helps in increasing bio-availability of other drugs without losing its own property.

Management of Dhatukhsaya Through Rasayan Chikitsa(rejuvenation therapy)
It is a unique concept of Ayurveda. It provides a comprehensive physiologic and metabolic restoration for aging. Rasayana chikitsa is mainly used for maintaining the health of healthy individuals although it can be used for diseased also.The word Rasa in rasayan has multiple references; it refers to the Rasa Dhatu in the context of Rasadi Sapta Dhatu(body tissues) and to the pharmacodynamic properties of a drug in the context of Rasa Guna etc. Ayana means circulation, the measures by which one is capable of getting the nourishing Rasa. Acting through a complex and comprehensive mechanism of rasasamvahan(circulation of nutrient juices), dhatu, agni and srotas,it nourishes bodily tissues through micro-nutrition, thus helping in regeneration, revival and revitalization of Dhatu. they act by enriching the nutritional value of the circulating plasma. Acting at the level of Agni i.e. at the level of digestion and metabolism acting at the level of Srotamsi(the microcirculatory channels carrying nutrition to the tissues) These Rasayana cleans and activate the microcirculatory channels i.e. Sroto Shuddhi leading to improved tissue health and their quality . 33

Actions of Rasayana Drug
 Prevents senile degeneration  Stimulate metabolism  Promote body resistance and immunity  Improves memory and intelligence  Increase vitality  Freedom from disease  Restore health and increase long life 6.

Maintenance of Mansik(mental) health
The aggravated Vata with Rasa Dhatukshaya affects the mental health of menopausal female. Hence it is very important for a physician to appreciate and understand the psychological state of the female 7.
Role of Agni Agni is important integral part of the body. Agni is causative factor for life span, colour and complexion, strength and enthusiasm. Derangement in Agni causes disturbances in all above factors. Postmenopausal females are more prone for Agnidushti due to Dhatukshay, ageing and aggravating Vata. For good digestion Agni must be maintained. 34

8.
Role of Abhyanga Abhyanga is said to be Jarahar, Shramhar, Vatahar, Drishtiprasdakar, Pushtikar, Ayushyakar, Swapnakar, Kleshsahhtwa, Kapha Vata Nirodhan. It has considered as important part of the external Snehana. By the Abhyanga with oil, human body become strong and smooth-skinned. It becomes unsusceptible to the disease of Vata and resistant to the exhaustion and exertion. If the body of an individual is oleated properly through Abhyanga then he lives for a long time without any decay of disease. It helps to prevent and arrest the ageing process by rejuvenations. 35

9.
Role of Shirodhara In this procedure Medicated oil milk or butter milk are poured in continuous straight over head. It is mainly useful in premature greying of hairs, fatigue, sleeplessness, stress and psychological disorders. Research conducted on this has proved its utility in management of Manasika Bhavas. 36

10.
Role of Basti Vatadosha is the major factor contributing in kshaya of all dhatus. Gradual decline in all dhatus occurring in menopausal age. Vata is responsible for controlling all the central nervous functions in the body. It also controls neuro-muscular activities and the mind.Basti (medicated enema) is one among the most important Panchakarma therapies for maintence of Vata,which is also considered as "Chikitsardha" (half of entire treatments). It is possessed with multidimensional action.Matra Basti is useful in menopausal female as less quantity of Sneha is used and can be given at all time without any complications. 37 [17] When used in proper way these are beneficial in breast CA, Endometrial CA and also in the management of menopause. Shatavari, Shatapushpa, Guduchi etc are rich source of phytoestrogens.These are also useful in reducing the menopausal sign and symptoms like hot flush, vaginitis, anxiety and osteoporosis. 41

13.
Yoga and meditation Yoga is useful for controlling mental problems mainly to stress and strain. Astang Yoga includes Yama, Niyam, Asan, Pranayam, Pratyahar, Dharana, Dhyan and Samadhi. Out of these Asana, Pranayam and Dhyan can be effectively used in menopausal female. 42 Yoga is among the most commonly used complementary therapies for menopausal symptoms. 43,44 Pranayama was found to be effective in relieving postmenopausal symptoms in female patients in previous clinical trials. 45

Discussion:-
The objective of the present study entitled, "Management Of Rajonivritti Lakshanas w.s.r to Postmenopausal Syndrome in Ayurveda"were searched and analyzed. On the basis of Ayurveda as well as Modern fundamentals after analyzing the above facts, Both the term Rajonivritti and Menopause literally convey same meaning.In modern science Hormone Replacement Therapy (HRT) is one and only alternative for this health hazard by which one can get spectacular achievement in combating the disease, but it has a wider range of secondary health complications. Thus it can be concluded that Ayurvedic management of Menopausal Syndrome is very much effective with no untoward side effects, it is cost effective and increase the longevity.
Result:-Menopause is not a disease but transitory phase , It is the phase where Dhatukshaya starts and Vata Dosha turn out to be Predominant Dosha. Management of vitiated Vata and Dhatukshaya through Rasayan chikitsa,Abhangya,Basti,Shirodhara supplement of Phytoestogens, Bruhaniya, Balya and Vayasthapan drugs along with maintenance of mental health with the help of Yoga and meditation definitely helps menopausal females to change annoying menopause to healthy and happy menopause.