At 44, these symptoms and findings suggest a few potential imbalances and health concerns that are common in perimenopause, but they need careful handling. The pauses and changes in menstruation can reflect changing hormone levels, and Ayurveda looks at this through the balance of doshas and dhatus. The thickened endometrium and cysts suggest an underlying kapha imbalance and possible vata disturbance affecting apana vayu, the force that governs menstrual flow.
First, addressing the heavy and prolonged bleeding is important. In Siddha-Ayurvedic practice, herbs like Ashoka (Saraca indica) and Lodhra (Symplocos racemosa) are traditionally utilized to support menstrual health. Consuming Ashoka bark powder with water twice daily can aid in managing excessive bleeding. Ensure a consistent routine, and try this for at least a month to observe any improvements.
Understanding the increased TSH, indicating thyroid dysfunction, which often links with vata and kapha imbalances, is crucial too. Balancing your diet to boost agni (digestive fire and metabolism) is essential. Favor warm, cooked foods that are lightly spiced and herbal teas like ginger-tulsi can enhance digestion. Reduce cold, heavy foods that can increase kapha.
Given the findings of a bulky uterus and ovarian cyst, follow-ups with your healthcare provider are necessary to rule out conditions that may need more immediate interventions. Heavy bleeding can risk anemia and fatigue, so checking and maintaining iron levels are advised. Integrate Ayurvedic practices with regular medical assessments to ensure safety and comprehensive care. Always consult with your deeply trusted practitioner about any significant changes in symptoms or for any new treatments.



