Q&A with David Simon, MD

Q. I am on the verge of menopause and would like to explore alternatives to hormone replacement therapy. What do you suggest as a healthy and holistic approach to menopause?

A. According to Ayurveda, three biological principles or doshas govern our mind and body. Vata is the wind principle of change; Pitta is the fire principle of metabolism; and Kapha is the earth principle of protection. Excessive accumulation of any principle leads to symptoms that disturb optimal health.

During their reproductive years, women generally have fewer problems with Pitta, because they release accumulated heat with their monthly menstrual flow. With the onset of menopause, women lose the opportunity to release excess Pitta, resulting first in hot flashes and then in tissue dryness and bone loss.

Interventions that soothe, cool, and nurture are helpful in easing your transition. Favor foods that are sweet (complex carbohydrates, nuts, organic dairy), bitter (green and yellow vegetables), and astringent (beans, lentils, green tea, pomegranates). A daily massage with a cooling oil such as coconut or olive can help balance your physiology. Relaxation techniques and breathing exercises have been shown to reduce the frequency and intensity of hot flashes. Soy products and black cohosh have been shown to modestly reduce hot flashes.

Commit to using this time to center and balance your body and mind, and you will transition gracefully into the next phase of your life. Then you can channel your creative energies into personal fulfillment, vitality, and spiritual awakening.

Q. I am in my mid-30s and my girlfriend is a few years older. She wants have a child, but I’m not sure if I do. The time pressure is on, but I don’t feel ready for the stress and turmoil a baby will bring into our already stressful lives. What can I do to get more clarity around this important decision?

A. Whenever facing an important choice, take the time to quiet your mind through meditation so you can hear the voice of your soul. Envision the possible scenarios and listen to your heart for signals of comfort or discomfort. Deepak and I recently wrote a book on conscious pregnancy called Magical Beginnings, Enchanted Lives. Read through it and see if the stories inspire or alarm you.

Having a child is a wonderful, heart-expanding experience, but one that is guaranteed to change all aspects of your life. If you are certain you want a family, but now doesn’t seem the right time, consider what needs to change for you to feel ready. There is no one path that is right for everyone, but if you listen to the still voice within, you’ll find yours.

Q. I don’t experience that much physical discomfort before or during my period, but my emotions swing wildly. How can I channel that emotional energy toward creativity rather than depression and frustration?

A. Mood swings are common before menstruation, as the cyclic rising and falling of reproductive hormones can contribute to physical and emotional unevenness. In terms of Ayurveda, one of the important purposes served by a woman’s period is the elimination of toxins from the body. From this perspective, a woman’s emotional or physical concerns in the week prior to menstrual flow represent a build-up of toxins since the last period.

Taking steps to improve mind-body balance can improve your emotional and physical comfort prior to your period. Yoga, as well as cardiovascular and strength training, several times per week will help you release stress and enhance circulatory health.

Meditation and other forms of relaxation techniques can help stabilize your emotions. Learning to express your needs consciously rather than letting your frustrations build up can help prevent your inner tyrant from wreaking havoc on your relationships.