For perimenopause : Start with Cap. Evanova 1-0-1 after food with water. Shatavari tablet 1-0-1 after food with water For breast cyst: Kanchanar guggul 1-0-1 after food with water Vriddhivadhika vati 1-0-1 after food with water. Massage warm castor oil on cyst area on breast. Twice daily, Do pranayam lom -vilom bhastrika bhamri 5-10mins twice daily Do Brisk walking atleast 30 minutes daily in open air area. Include fresh green vegetables semi cooked/ sauted in your diet daily Include fresh seasonal fruits and seasonal vegetables in your diet. If you take above recommended meditation,as these medicines are recommended as per your problems mentioned then no need to take ashwagandha or black cohost.
HELLO,
You are 45 years old and in perimenopause, which is the transition phase before menopause. During this time -ovaries do not release hormones regularly -Estrogen and progesterone fluctuate up and down -This causes hot flashes, breast pain, mood changes, sleep disturbance
You also have:- -A cyst in the right breast -Mild thyroid imbalance (TSH 3.3)
WHY BREAST PAIN AND CYST HAPPEN NOW Breast tissue is very sensitive to hormonal changes. During perimenopause -Estrogen may spike suddenly -Progesterone ma be low -This causes fluid retention, tenderness, cyst formation
WHY ONLY RIGHT BREAST? In Ayurveda, right side is pitta-dominant -Hormonal heat + congestion-> Pain and cyst formation
AYURVEDIC VIEW
DOSHA IMBALANCE You have a combined imbalance of -Vata-> hot flashes, anxiety, dryness, irregularity -Pitta-> breast pain, burning, heat, inflammation -Kapha-> cyst, heaviness, stagnation
This imbalance leads to hormonal congestion, not cancer
TREATMENT GOALS -balance fluctuating hormones naturally -reduce breast pain and prevent cyst enlargement -normalize thyroid function gently -reduce hot flashes without overstimulating estrogen -detoxify lymphatic and Breast tissue -calm nervous system -prevent future cysts and complication
INTERNAL MEDICATIONS
1) SHATAVARI KALPA= 1 tsp with warm milk once daily after mea for 3 months = nourishes female hormones, stabiles estrogen flutuations, reduces hot flashes
2) KANCHANAR GUGGULU= 1 tab twice daily after meals for 8 weeks =breaks cystic growth, improves lymphatic drainage, helps thyroid nodules and mild hypothyroidism
3) GUDUCHI GHAN VATI= 2 tabs twice daily after meals for 3 months =reduces inflammation supports liver hormone metabolism, prevents cyst recurrence
4) ASHWAGANDHA (low dose)= 300 mg once daily at night for 6 weeks = calms vata, reduces stress related hot flashes, supports thyroid gentle
WHY BLACK COHOSH IS AVOIDED -acts like estrogen -may worsen breast cyst and tenderness -not ideal with thyroid imbalance
EXTERNAL THERAPIES
1) BREAST OIL APPLICATION (3-4 times/week) OIL= castor oil (best),
HOW TO USE = gentle massage around breast, avoid pressing on cyst, clockwise circular motion, warm compress after = improves lymph flow, reduces pain, prevents stagnation
DIET -warm cooked meals -steamed vegetables -whole grains (millets, rice) -flaxseed powder- 1 tsp daily -turmeric, cumin, coriander -coconut watr 2-3 times/week
AVOID -caffeine (tea, coffee) -dairy excess (cheese, panner) -soy products -sugar and bakery foods -cold foods and drinks -fried foods
WHY DIET MATTERS -food directly affects Hormones and breast tissue
LIFESTYLE MODIFICATIONS -regular sleep 10-6 ideal -Avoid late nights -daily oil massage before bath -avoid tight bras -avoid excessive chest workouts -stress management is essnetial
YOGA ASANAS -Baddha konasana= hormonal balance -Supta baddha konasana= breast pain relief -viparita karani= hot flashes -bhujangasana= lymph drainage
PRANAYAM -Sheetali/sheetakri= reduces hot flashes -Anulom Vilom= hormonal regulation -Bhramari= anxiety and sleep 15-20 min daily is eough
SIMPLE HOME REMEDIES -coriander + fennel tea daily -turmeric + warm milk at night -castor oil pack over breast once weekly -flaxseed daily -warm showers (avoid very hot water)
-Your condition is very common and manageable -breast cysts during perimenopause are usually bening -Ayurveda works best with Patience and consistency -Avoid panic and unnecessary hormonal medications unless required
With correct diet, herbs, lifestyle and calm mind -breast pain reduces -hot flashes settle -thyroid stabilizes -menopause transition becomes smoother
DO FOLLOW
HOPE THIS MIGHT BE HELPFUL
THANK YOU
DR. MAITRI ACHARYA
Hlo,
You’re in perimenopause, with hot flashes + one-sided breast soreness, a known breast cyst, and a borderline-controlled thyroid (TSH ~3.3 without meds) — so we need a gentle, hormone-balancing Ayurvedic approach, not strong estrogen-stimulating herbs.
⚠️ Important note (safety first) Black Cohosh → ❌ NOT advised if you have: Breast cysts / fibrocystic breast Thyroid imbalance It can act on estrogen receptors and may worsen breast pain or cyst activity.
Ashwagandha → ⚠️ Use cautiously Can stimulate thyroid hormone Acceptable only in low dose, short term, and not if breast pain increases
✅ Short & Safe Ayurvedic Prescription 🌿 1. For hot flashes + hormonal balance (preferred over Black Cohosh)
- Shatavari churna Dose: ½ tsp twice daily With: Warm milk or water Time: Morning & night Action: Cooling, hormone-balancing, breast-safe
🌿 2. For breast soreness & cyst support
- Kanchanar Guggulu Dose: 1 tablet twice daily After meals Action: Helps cysts, lymphatic congestion, thyroid-related swelling
🌿 3. For anxiety, sleep, perimenopausal stress (instead of Ashwagandha)
- Brahmi vati (plain) Dose: 1 tablet at night Action: Calms mind, supports sleep, no thyroid overstimulation
🌿 4. External application (VERY effective) Castor oil pack on right breast 3–4 times per week, night Avoid during periods Helps cyst pain & congestion
❌ Avoid for now Black Cohosh High-dose Ashwagandha Soy isoflavones Hormone “boosters” Excess caffeine & chocolate (increase breast pain)
🥗 Diet tips (very important) Increase: Bottle gourd, pumpkin, cucumber, flaxseed (1 tsp/day) Reduce: Tea/coffee, sugar, spicy food Add: Warm, freshly cooked meals
🧪 When to consult immediately Pain persists >2–3 weeks Nipple discharge Lump increases or becomes hard TSH rises again or palpitations start
✅ Bottom line ✔ Yes to Shatavari + Kanchanar Guggulu ⚠️ Ashwagandha only if needed & low dose ❌ No Black Cohosh with breast cysts
Tq
Usually we do not recommend black cohost when there is active breast cyst But once if you tell what’s the size of cyst and did you had mammography recently accordingly I can advise you more precisely
RIGHT SIDED BREAST SORENESS WITH A KNOWN CYST MEANS THE BREAST TISSUE IS ALREADY HORMONALLY REACTIVE SO ANY HERB THAT HAS STRONG HORMONE MODULATING OR ESTROGEN LIKE ACTION MUST BE USED WITH CAUTION
ASHWAGANDHA CAN STIMULATE THYROID FUNCTION AND MAY INCREASE T4 AND T3 LEVELS SINCE YOU HAVE RECENTLY BROUGHT TSH DOWN WITHOUT MEDICATION THIS SHOWS YOUR THYROID IS RESPONSIVE USING ASHWAGANDHA WITHOUT MONITORING MAY PUSH THE THYROID INTO OVERACTIVITY AND CAN ALSO INCREASE BREAST TENDERNESS SO I DO NOT ADVISE ASHWAGANDHA AT THIS STAGE
BLACK COHOSH HAS ESTROGEN MODULATING EFFECTS IN WOMEN WITH BREAST CYSTS BREAST PAIN OR FIBROCYSTIC CHANGES IT CAN SOMETIMES WORSEN TENDERNESS IT IS NOT ADVISABLE WITHOUT CLEAR IMAGING FOLLOW UP AND SHOULD NOT BE SELF STARTED
AVOID BOTH ASHWAGANDHA AND BLACK COHOSH
YOUR PRIORITY SHOULD BE STABILISING HORMONAL FLUCTUATION REDUCING BREAST INFLAMMATION SUPPORTING PERIMENOPAUSE WITHOUT DIRECT HORMONE STIMULATION
AVOID COFFEE CHOCOLATE AND EXCESS DAIRY USE WARM COOKED FOODS REDUCE SPICY FRIED AND VERY SOUR FOODS ENSURE REGULAR SLEEP AND STRESS CONTROL
HOT FLASHES AND BREAST PAIN IN PERIMENOPAUSE ARE OFTEN STRESS AND LIVER METABOLISM RELATED RATHER THAN DEFICIENCY
IF BREAST PAIN PERSISTS OR INCREASES REPEAT ULTRASOUND OR MAMMOGRAPHY
PLEASE DO NOT SELF MEDICATE WITH HORMONE ACTIVE HERBS IN YOUR CURRENT CONDITION
1.Shatavari kalpa 1 tsp with warm milk twice daily after meals 2.Ashokarishta 20 ml with 20 ml water twice daily after meals 3.Guduchi ghan vati 2 tab twice daily with water after meals 4.Triphala churna 1 tsp at bedtime with warm water
🧘 Lifestyle & Diet Tips Cooling diet: Favor cucumbers, melons, coconut water, leafy greens; avoid spicy, oily, and fried foods.
Stress reduction: Yoga, pranayama (especially sheetali/sitkari cooling breaths), and meditation help balance hormones.
Sleep hygiene: Regular sleep schedule is crucial for hormone regulation.
Avoid heat exposure: Hot flashes worsen with caffeine, alcohol, and excess sun/heat.
Hello
As you mentioned you are in the menopausal age where body has a hormonal roller coaster going on. Also you mentioned about the fluctuations of TSH.
Please consult a gynac and get a mammography done for the lump.
You can continue with ashwagandha and black cohost .
🧘♀️ Start with UJJAYI, ANULOM VILOM, BHRAMARI exercise as they all will help you get calm with the issues created by the hormonal disturbance.
Supportively Start
💊 Syp. Evecare Forte 3 tsp twice a day before food.
After mammography if the lump is a benign one, take 💊Tab. Kanchanar Guggul 2 tabs twice a day before food Also apply a lep of this same tablet on the lump
REMMEMBER
Not getting diagnosed about what the lump is may cause something serious if it is hazardous. Do get the MAMMOGRAPHY done.



