Hi MD. Afzaal. Khush Aamdid. Khuda aapko khush rakhe! Generally forty years conjunction of age is start of perimaopausal phase (pre - phase) but there could be other symptoms like mood swings, headaches, insomnia, hot flashes/ night sweats, vaginal dryness etc. These may or may not present. Average age to start menopause is 45 yrs but 1% women may experience it at 40 or before too. But this all could be due to anaemia too. Not necessarily hormonal level decrease in the beginning. If you could get Rajah Pravartini Vati or Kasisadi vati, regular use can induce bleeding if deficiency is not much. It s pure Ayurvedic. Rodhrasav, louhasav and Ashokarishta liquids should be started in directed proportions. Generally this medicine is started about a week before expected menses date and given for a period of a week to two or till m.c. sets in. I advise you not to involve in synthetic hormonal drugs for this since side effects will be there but Ayurveda may be slower but natural with sustained effect for long periods. Sooner or later menopause has to come by nature. So do not ruin hormonal cycle by synthetics. In your wife s case, she can start above med. any time and continue for beyond two weeks. Green leafy vegetables and its soups should be regualrly taken to supplement iron. Diet should otherwise be light. Deep breathing at least 10 minutes in fresh air should be done by her and if possible, fresh air walks may be done for half an hr daily. You may get medicines easily from India or may be some Ayurveda shops are in Pakistan too. Hope it helps you. For any further query or advise, pl write through direct question. I ll be happy to help you.