Brazil: Ayurvedic MDs reveal inflammation and metabolic health tips for women

Two Ayurvedic medical doctors are sharing what they say women need to understand about inflammation and metabolic health during midlife. Avanti Kumar-Singh, M.D. and Tanmeet Sethi, M.D., founders of Arvasi, say that symptoms like hot flashes, night sweats, brain fog, and aches are signs that the body’s fire element, or pitta, is out of balance. They say the goal is not to put out the fire, but to find balance.

Pitta is the dosha, or body type, responsible for metabolism, digestion, focus, and drive. Kumar-Singh says women between the ages of 25 and 55, a period called the householder years in Ayurveda, need a lot of pitta. This time often includes excelling in careers, partnering, having children, and caring for elders. “It’s common for women to have too much fire,” says Kumar-Singh. “The accumulation of that fire, if it isn’t balanced, will show up as menopausal symptoms like hot flashes, night sweats, brain fog, inflammation, aches, and pains.”

Perimenopause makes this balancing act harder due to shifting hormones. Kumar-Singh explains that estrogen and progesterone are anti-inflammatory. As these hormones decrease in midlife, women can feel “slammed from both directions,” leading to a wide range of symptoms. This increase in fire is another way of saying there is an increase in inflammation.

This inflammation also impacts metabolic health. Sethi says she sees this in biomarkers like CRP, cortisol, and insulin. “If we’re talking about insulin, we know that as women go through menopause, they tend to become more insulin resistant, even without changes in diet or exercise,” says Sethi. She looks at insulin levels because it gives a real-time sense of the body’s inflammatory environment. The goal from a preventive medicine standpoint is to identify metabolic changes long before blood sugar levels indicate prediabetes or diabetes. “Unfortunately, as insulin levels rise, they contribute to a more inflammatory environment and are closely connected with cortisol,” she says. Cortisol rises with stress and can contribute to midsection weight gain.

Sethi calls perimenopause and menopause a “metabolic transformation in the body.” The question, she says, is how much the metabolic pattern is deranged and how much it is being supported by what a woman is doing to counteract that.

The doctors recommend several steps to calm the fire and reduce inflammation. The first step is awareness. Kumar-Singh encourages women to ask themselves why they are making certain choices and whether those choices will increase or balance the fire. For example, is choosing a HIIT class when sleep-deprived and anxious going to fuel or calm the fire? Having this awareness helps connect daily habits to symptoms.

A second focus is gut health. Sethi says the gut is where the fire is most active. Research shows gut health and the microbiome impact blood sugar control and anxiety. Improving gut health includes eating a fiber-rich diet, getting 25 to 38 grams of fiber a day, including fermented foods, and staying physically active.

Sleep is another key area. Sethi says even one night of sleep deprivation can make bloodwork look prediabetic. It raises insulin and glucose levels, disrupts appetite hormones, triggers cravings, and heightens anxiety. She looks at the full picture, including cortisol levels, stress, anxiety, and progesterone levels, which support restful sleep. She also looks at circadian rhythm and how a person prepares for sleep.

Nutrition and strength training are also important. Research shows people can lose up to 8% of muscle mass each decade after age 30, and this loss often accelerates after menopause. Eating enough protein and strength training are important for building and preserving lean mass. Sethi says good sleep is needed for these habits to be most effective. She also uses an Ayurvedic approach to nutrition, prescribing different foods and spices depending on a person’s dosha to calm the fire.

Managing health during perimenopause and menopause may also include hormone replacement therapy (HRT). HRT is personalized, including the hormones given, the dose, and the delivery method. Both doctors agree HRT can benefit women, but it is not the only thing that needs to be done. “I find that the women who do best are those who have a strong foundation in lifestyle medicine alongside their HRT or other treatments,” says Sethi.

The doctors say perimenopause can feel like a confusing time where women feel they are losing control of their body. But they say the patterns underneath the symptoms make sense, and there are ways to find balance. The goal is to support the body’s metabolic transformation through awareness, gut health, sleep, nutrition, and appropriate medical treatments.