Menopause is not a disease; it is a natural transition, just not managed well most of the time

The Ayurvedic View of Menopause

Ayurveda sees menopause not as an illness, but as a natural stage of life, a transition just as important as puberty. It marks the shift from a more “fire-driven” stage of life (pitta) into a more “air-and-space” stage (vāta).

When this change happens, many women experience symptoms such as hot flushes, insomnia, dryness, anxiety, or weight gain. In Ayurveda, these are understood not as “hormone deficiency,” but as the result of imbalances in the body’s natural energies (called doshas vāta, pitta, kapha) and weakened tissues (dhātus, the body’s building blocks like blood, muscle, and bone).

The Ayurvedic approach is different from simply replacing hormones. Instead, the focus is on:

Strengthening agni – the body’s digestive fire, which governs how well we transform food, hormones, and emotions.
Clearing ama – toxins or “sludge” that build up when digestion and metabolism are weak.
Nourishing tissues (dhātus) – rebuilding strength in the body’s systems so they can support this new stage of life.

Beyond the physical, Ayurveda also teaches that menopause is a time of wisdom and reflection. It is a chance to reset priorities, release what no longer serves you, and create a foundation of health, balance, and vitality for the years ahead.

What HRT Can Offer

Today, bioidentical hormone replacement therapy (HRT) is very different from the synthetic hormones used in the past. For the right woman, started at the right time, HRT can:

Reduce hot flushes, night sweats, and sleep problems
Support bone density and heart health
Improve clarity, mood, and quality of life

But here’s what most women are never told: hormones don’t simply circulate and vanish on their own. Every dose of oestrogen or progesterone has to be processed and cleared by the liver, and this is where problems often begin.

That’s why, before we consider HRT for a client, we always check whether their body can actually digest and detoxify those hormones safely. We use testing first to see how their pathways are functioning. In some cases, HRT may be useful as a short-term support but only while we work on rebalancing the body, strengthening digestion, and clearing the channels so it can manage hormones naturally again.

For example, one of our clients came in struggling with severe hot flushes and restless sleep. She was considering HRT, but when we ran her tests, we found her liver pathways were congested and not clearing oestrogen properly. If we had added hormones straight away, her symptoms would likely have worsened. Instead, we focused on clearing toxins, rebuilding her digestion, and supporting liver function. Within a few months, her hot flushes had disappeared, her sleep improved, and we did not need to use HRT as she was feeling great.

This is why we say: it’s not just about adding hormones — it’s about making sure your body can use and clear them the right way.

The Missing Piece: Liver Detox Pathways

When your body makes hormones or you take them through HRT, they don’t just disappear on their own. They must be processed and cleared by the liver. This happens in two important steps:

Phase 1: Breaking Down

The liver uses enzymes (the cytochrome P450 system) to convert oestrogen into smaller metabolites:

2-OH (2-hydroxyestrone) – generally considered the protective pathway.
4-OH (4-hydroxyestrone) – a potentially harmful metabolite that can damage DNA if not cleared.
16-OH (16-hydroxyestrone) – a growth-stimulating metabolite linked to fibroids, weight gain, and higher cancer risk if dominant.

These are like “half-burned sparks from a fire”; if they’re not quickly neutralised, they can damage tissues.

Ayurvedic view: Phase 1 reflects the quality of Agni (digestive fire). If agni is too sharp (tikshna), it produces excess reactive by-products (toxic sparks). If agni is weak (manda), detox is sluggish and incomplete.

Phase 2: Clearing Out

Next, the liver must package up those metabolites so they can be safely excreted through urine or stool. This involves three key processes:

Methylation – attaches a methyl group to deactivate toxic estrogens (especially 4-OH).
Sulfation – uses sulphur compounds to make hormones water-soluble.
Glucuronidation – binds hormones to glucuronic acid so they can leave via bile and stool.

If Phase 2 is sluggish, these metabolites recirculate back into the bloodstream (enterohepatic recirculation). This can worsen symptoms like breast tenderness, bloating, mood swings, and weight gain and increases long-term risks for fibroids, clotting, and hormone-driven cancers.

Ayurvedic view: Phase 2 depends on strong tissues (dhātus), clear channels (srotas), and low levels of Ama (toxic residue). If tissues are depleted or channels blocked, hormones recycle back into the system instead of being released.

This is why, if these pathways are blocked, adding more hormones with HRT is like pouring water into a clogged drain; instead of helping, it creates overflow and damage

Why This Step Often Fails

Phase 2 detox depends on nutrients and tissue health. Deficiencies in B vitamins (B6, B12, folate), magnesium, zinc, and selenium can slow methylation. A congested liver, sluggish gut, or poor bile flow also means hormones are not excreted but reabsorbed, adding to the burden.

This is why some women feel worse on HRT, not because of the hormones themselves, but because their “exit routes” are blocked.

Why Doctors Rarely Talk About This

Most women are prescribed HRT based on symptoms alone. The liver’s role in hormone clearance is rarely assessed.

Standard practice doesn’t test whether your liver is handling hormones well.
Doctors rarely measure oestrogen metabolites or methylation efficiency, even though these determine whether HRT is safe or risky.
Instead, women are left with “try it and see,” which can backfire if detox pathways are congested.

This is why some women actually feel worse on HRT, developing breast tenderness, bloating, or mood swings, because the underlying problem isn’t being addressed.

Even more concerning, some women feel better at first, but if hormones aren’t being cleared properly, the hidden build-up continues silently. Over time, this can lead to bigger health issues like fibroids, clotting problems, or hormone-driven cancers.

The key isn’t just “adding hormones,” it’s making sure your body can process and clear them safely.

How Ayurveda Supports the Liver

The Ayurvedic Perspective

Ayurveda has long recognised that when the body’s “channels” (srotas) are blocked and digestion (agni) is weak, waste and toxins build up, and this sets the stage for disease.

What modern science calls Phase 1 and Phase 2 liver detox, Ayurveda explains in these terms:

Agni (digestive fire): If too weak, detox is sluggish. If too strong, it creates too many harmful by-products.
Ama (toxins): The build-up of waste that happens when clearance fails, which then circulates back into tissues.
Srotas (channels): The body’s pathways that must stay clear so hormones and nutrients can flow freely.

Ayurvedic Solutions for Hormone Balance

Diet: Choose warm, grounding foods that are easy to digest. Avoid highly processed, inflammatory, or very spicy foods that stress the system.
Herbs:

Shatavari – deeply nourishes tissues and helps balance hormones.
Guduchi and Amalaki – support the liver, immunity, and natural detox.
Triphala – gently supports elimination and reduces hormone reabsorption.

Daily practices: Self-oil massage (abhyanga), yoga, breathing practices (prāṇāyāma), and seasonal cleansing (Panchakarma) to keep channels clear.

Rasāyana (rejuvenation): Therapies and herbs that rebuild vitality (ojas), calm the nervous system, and strengthen resilience.

In simple terms: Ayurveda teaches that if your digestion is strong, toxins are cleared, and channels are open, your body can process hormones safely, whether they come from within or through HRT.

The Integrative Path Forward

Test first: Use advanced testing (like the DUTCH test) to see how your body is metabolising oestrogen. Send us a message to find out more.
Prepare the body: Use Ayurvedic detox and nourishment to strengthen agni, clear ama, and open channels.
Support pathways: Add the right nutrients, foods, and herbs for both Phase 1 and Phase 2 clearance
Personalise HRT: If hormones are used, they can be introduced safely, working with the body, not against it.

The takeaway: Menopause isn’t a disease. It’s a transition. But if liver congestion is ignored, HRT can worsen symptoms and create long-term risks. Ayurveda offers the missing link — preparing and supporting the body so that modern therapies (if chosen) can work safely and effectively.

Bringing It All Together

Menopause is not a disease; it is a natural transition. But whether you choose to use HRT or not, the key is making sure your body can process and clear hormones safely. This is the missing step that is so often overlooked in conventional care.

Modern science shows us the importance of the liver’s detox pathways. Ayurveda has been teaching the same truth for thousands of years: if digestion is strong, toxins are cleared, and channels are open, the body finds balance naturally.

When we combine the best of both worlds: modern testing like the DUTCH test with Ayurvedic wisdom in food, herbs, and daily practices, we get the full picture. We can see not just if hormones are needed, but also whether the body is ready to handle them.

The message is simple: Don’t just add hormones. Support your body so it can use them wisely and clear them safely. This is how you step into menopause, not just surviving, but thriving with strength, clarity, and vitality for the years ahead.

Your Next Step

If you are considering HRT or you simply want to understand how your body is handling hormones, book a consultation with us. We’ll run the right tests (like the DUTCH test), review your results, and design a personalised plan that combines the best of modern medicine and Ayurveda to support you through this transition.

Ayurvedic Words Made Simple

Doshas (Vata, Pitta, Kapha): The three energies or forces in the body.

Vata = air + space (movement, nervous system, circulation).
Pitta = fire + water (digestion, metabolism, transformation).
Kapha = earth + water (structure, stability, lubrication).
When they’re in balance, you feel healthy. When they’re out of balance, symptoms appear.

Agni: Literally “fire.” Your digestive and metabolic power determines how well you break down food, absorb nutrients, and process hormones. Strong agni = good health.
Ama: Toxins or waste that build up when digestion is weak. Think of it as “sludge” that clogs your system and blocks energy and hormones from flowing smoothly.
Dhātus: The body’s seven tissues: blood, muscle, fat, bone, nerves, reproductive tissue, and plasma/fluids. If they’re nourished, you feel strong and resilient.
Srotas: The body’s channels or pathways, like rivers. They carry nutrients, hormones, and waste. If blocked, imbalance and disease occur.
We work deeply on all of the above in our detox.