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Introduction

The postmenopausal phase marks a significant transition in a woman’s life, characterized by the permanent cessation of menstruation due to ovarian senescence and it occurs at the age of 45-55 year This physiological change is often accompanied by various systemic alterations, including hormonal imbalance, decreased bone density, urogenital atrophy, and psychological disturbances. 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 Rajonivritti4.Rajonivrutti janya lakshana is a group of symptoms are similar to the postmenopausal syndrome. India has a large population, which has already crossed the 1 billion marks with 71 million people over 60 years of age and the number of menopausal women about 43 million. Projected figures in 2026 have estimated the population in India will be 1.4 billion, people over 60 years 173 million, and the menopausal population 103 million. Average age of menopause is 47.5 years in Indian women with an average life expectancy of 71 years2 From an Ayurvedic perspective, menopause signifies a natural shift towards vata predominance, leading to symptoms such as dryness, anxiety, insomnia, and joint disorders, which correlate with classical vata vikara.In  this context, Snehpan (internal oleation) and Basti Chikitsa (therapeutic enema) hold significant therapeutic value. These modalities, rooted in the principles of Ayurvedic anatomy and physiology, aim to pacify aggravated vata, nourish the dhatus (tissues), and restore systemic balance. Snehapana supports lubrication of internal channels and replenishment of ojas, while Basti—regarded as the prime treatment for vata works at the level of the colon, influencing the entire body through its regulatory effect on vata dosha. Understanding their relevance in postmenopausal health through the lens of Ayurvedic and modern anatomicophysiological principles offers a promising integrative approach for managing this transitional phase effectively.

AIM:

To Study the Role of Snehapan and Bastichikitsakitsa in Post menopause (Rajonivrutti) In View of Anatomico-Physiological Aspect

OBJECTIVES-

      1) To Study the Rajonivrutti (Postmenopausal syndrome According to Ayurved and Modern science

      2) To Study the Snehpan and Basti chikitsa in view of Anatomico-physiological aspect

      3) To Evaluate the role of Snehpan and Basti chikitsa according to Ayurved and modern in view of Anatomy and physiology

MATERIAL AND METHOD:

Data collected from Classical literature – Ayurvedic Samhita and their commentaries

Modern textbooks – Google schlor, pubmed and another database

Ayurvedic aspect of Rajonivritti

Rajonivritti is not described separately as a pathological condition or severe health problem in Ayurvedic classics. The ancient acharyas termed it as a normal physiology.Human life span is grossly divided into 3 stages in literature, namely Balyavastha, Madhyamavastha and Vrudhvastha which are dominated by Kapha, Pitta, Vata respectively. Achaya Sushruta also classified Madhymavastha in 4 groups - Vrudhi, Yuwa, Dhatu Sampurnata, Kshaya. In all contexts of Ayurvedic literature the age for Rajonivrutti is stated around 50 years. Rajonivrutti is phase where women pass from   Madhyamavastha to Vrudhavastha. Sushruta Acharya has explained that there is Shareera-Shaithilya (weaking of tissues) in Vrudha-Avastha. This stage of life is dominated by Vatadosha, this affects the female body. The dominant Vata Dosha specially with Laghu and Ruksha Guna results in reduction in Dravata of Rasa Dhatu. This further leads to Dhatukshya starting from Rasa Dhatu, further respective Updhatu Kshaya takes place. Thus, leading to Artava Nasha (amenorrhea). The vitiated Vata Dosha also disturbs the other Sharira as well as Manas Dosha (Raja and Tama Dosha) leading to various psychological disturbances. Thus, according to Ayurveda, we can make a correlation between the different menopausal symptoms seen in the body.

Rajonivritti kala (Age of Menopause)

According to Sushruta and various other references too, 50 years is mentioned as the age of Rajonivritti, when the body is fully in grip of senility.Acharya Arundatta opines that the age mentioned above is a probable age and not a fixed one. There may be some variations in this regard.

Signs and Symtoms of Menopause

• Physical Changes

Although in 50% of women, the effect of Menopause is temporarily delayed by a trickle of estrogen from the adrenal gland, the female body including genitalia reacts to waning ovarian function by atrophy, inactivity and retrogression.

In Ovary: The ovaries shrink in size.

In Fallopian tubes: The fallopian tubes show feature of atrophy.

In Uterus: The uterus gradually gets smaller in size.

In Cervix: The cervix becomes smaller in size.

In Vagina: The vagina becomes narrower and smaller

due to gradual loss of elasticity 5

• Vasomotor Symtoms-Hot flashes, Palpitation, Night

Sexual Urogenital Symtoms- Vaginal dryness burning itching, loss of libidos sweat etc

• Chronic Disease- Osteoporosis,cardiovascular diseases

• Psychological sign and Symptoms in Menopause

1. Anxiety
2. Depression
3.  Tension
4. Headache
5. Irritability
6. Nervousness
7. Feeling unhappy
8. Fatigue
9. Excitability
10. Crying
11. Palpitations
12. Loss of interest in most things
13.  Difficulty in concentrating
14. Insomina 6   

MANAGEMENT

After analysing the Samprapti and Lakshanas, we may conclude that Vata-Pittahara Chikitsa, along with Snehpan and Basti chikitsa, can effectively manage menopausal symptoms. Early intervention helps balance aggravating factors, reducing the severity or even preventing symptoms.

Ayurvedic review of Snehpan

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In Ashtang Hridya, Snehpan is indicated in Those who are habituated in taking more wine, excessive sexual contacts with women and doing heavy exercises.Persons thinking too much.Aged persons, children, debilitated persons,Emaciated and dry,Who are having depleted of blood and reproductive tissues,Persons suffering from neurological disorders and eye diseases

The person who resorts to oleation therapy frequently, will have the increased power of digestion, the clean gastro- intestinal tract, well established body tissues, strength, color and complexion, well functioned sense organs, delayed aging and thus lives one hundred years healthy and happily.

Modern Aspect

• Lipids and Blood brain barrier

1.Absorption & Distribution

Water?soluble drugs mainly remain in extracellular fluids and do not cross into cerebrospinal fluid (CSF) or cell interiors.

Lipid?soluble drugs penetrate both extracellular and intracellular spaces—including cells, mitochondria, microsomes, and nuclei—because cell membranes are lipid?rich.

2. Blood?Brain Barrier (BBB)

The BBB’s lipophilic (fat?loving) nature allows lipid?soluble drugs to cross more easily. Sneha’s lipid-rich formulation therefore can potentially bypass the BBB.

3.Action on enteric nervous system

90% of Serotonin, 50% dopamine and 30 other    neurotransmitters are produced and co regulated by Intestines in the enteric nervous system Cholesterol and lipid components are critical for neurotransmitter synthesis. Sneha contains essential lipids and cholesterol, supporting serotonin regulation and overall neurotransmission.

4.Central Nervous System (CNS) Effects

Unsaturated fatty acids in Sneha potentially act within brain tissue and neural pathways.

Sneha may also exhibit CNS antidepressant action by modulating afferent synaptic transmission, and increasing serotonin levels in brain regions like the hypothalamus and hippocampus.

For the bodily doshas, the supreme (parama) medicines in proper sequence are Basti, Virechana, Vamana — and then taila, gh?ita, madhu.These correspond to therapies for the three doshas: Basti (Enema) for Vata,Virechana (purgation) for pitta.Vamana (therapeutic emesis) for kapha and taila (oil), ghr?ita (ghee), Madhu (honey) are prescribed respectively to pacify the psychological or mental doshas (rajas and tamas), through wisdom, steadiness, and inner knowledge.Dhi, Dhairya, Atmadi?Vijnana are the supreme mental?dosha remedies. Basti is the supreme treatment, to treat vitiated Vata Dosha and thus considered as Ardhachikitsa. Sneha Basti or Matra Basti is also an excellent alternative for the treatment of menopausal symptoms because it can be used at any time without causing any complications. It also aids in the regulation of the vitiated Vata Dosha that is prevalent during menopause

Gut- Brain axis:

The gut-brain axis, refers to the bidirectional communication pathway between the gastrointestinal tract and the central nervous system (brain).8This complex interplay involves the nervous system, endocrine system, and immune system, and it is significantly influenced by Estrogen levels and the gut microbiome.

Hormonal Changes:

During menopause, Estrogen levels decline, which can disrupt the gut microbiome's balance (dysbiosis) and affect mood, sleep, and cognitive function through the gut-brain axis.

Gut Microbiome Shifts Estrogen helps maintain a healthy microbiome. Its decline can lead to changes in gut bacteria that affect inflammation, metabolism, and neurotransmitter production (e.g., serotonin)

Estrobolome Role:

The Estrobolome (gut bacteria that metabolize Estrogen) becomes less active with hormonal decline, influencing estrogen recycling and contributing to symptoms.

Discussion

Menopause marks the transition to Vata dominance in life and Depletion of Shukra dhatu and Ojas.

Role of Snehapana (Oleation Therapy):

Physiological Aspect:

Snehapana involves internal administration of medicated ghee/oils, improving unctuousness in the body Counters dryness (Roukshya) caused by increased Vata.Enhances Agni (digestive/metabolic fire) and nourishes Dhatus, especially Asthi (bone) and Majja (marrow). Sneha acts through Mrudu Vyayi, Snigddha, Sara Gunas.

Anatomical Relevance:

Supports mucosal membranes (vaginal and gastrointestinal) Helps preserve joint cartilage and synovial fluid. It crosses the blood brain barrier and promotes neurological stability, benefiting the brain and nerves affected by Estrogen withdrawal.

Role of Basti Chikitsa (Medicated Enema):

Physiological Aspects:

Basti is the prime treatment for Vata disorders.It Helps to regulate the Apana Vayu, which governs pelvic and reproductive functions.Basti rejuvenates colon health, improves absorption, and enhances nervous system balance. Changes in Estrogen during menopause affect the gut microbiome, which in turn influences brain function and mental health through the gut-brain axis, highlighting the importance of gut health in managing menopausal symptoms

Anatomical Relevance:

Basti drvya acts on the colon (a Vata seat), from which Vata spreads to the rest of the body and it has Indirectly impact on pelvic organs including uterus, bladder, and Vaginal canal.Basti chikitsa Strengthens lower back and hips, commonly affected during menopause.

Conclusion

Hormonal Replacement therapy is used for the treatment of postmenopausal Symtoms has positive association with higher risk of Breast cancer, Osteoporosis, Cardiovascular diseases, Psycological diseases. Snehpan and Basti are two cornerstone therapies in ayurveda - significant in managing Postmenopausal health specifically psychological symtoms.From an anatomical and physiological standpoint Snehapana and Basti Chikitsa together address the systemic dryness, neurological instability, joint degeneration, and hormonal imbalance seen in postmenopausal women. These therapies help to restore lubrication in tissues.

Balance Vata dosha, the dominant force behind postmenopausal symptoms.Promote rejuvenation (Rasayana effect) of tissues like bone, nerve, and reproductive systems. Offer a holistic and preventive approach without hormonal side effects.Hence, integrating Ayurvedic therapies like Snehapana and Basti with lifestyle management can be a safe and effective strategy for postmenopausal health, especially in women seeking natural and individualized care.