Menopause is a transition that all women eventually pass through on their way from reproductive age to the non-reproductive stage in their life. Technically speaking, ‘menopause’ is the complete cessation of menstruation.1 Menopause usually starts somewhere around the age of 48 and proceeds through age 55, with an average age of 51. According to Chinese medicine in the Simple Questions—a foundational text for Chinese medicine—the average age at which a woman starts her menopause transition is 49.1
In the clinical setting, most women will experience some combination of basic symptoms that include:
- Hot flushing and night sweating
- Mood swings: anxiety, depression, insomnia
- Drying hair, skin, nails, vaginal tissue
- Back pain and osteoporosis
- Fatigue and headaches
- Poor memory and concentration
From a biomedical perspective, the main cause of menopause symptoms is ovarian changes that lead to a decrease in estrogen (in the form of estradiol) production. Nearly 85% of women suffer from hot flushes and nearly 45% continue to experience them for up to 10 years after menopause.
Normal biomedical treatment for menopausal symptoms is usually based on hormone replacement therapy (HRT or ERT): native estrogens, conjugated equine estrogens or synthetic estrogens in a dose that is approximately 1/7th of the dose used for the contraceptive pill.1
Different from biomedical approach, the Chinese medicine perspective on menopause focuses on the declining state of the Kidney Essence (the foundational energies that provide substance and function to the body). Menopausal symptoms are, on a basic level, due to the naturally decline of Kidney Essence, which can be broken down into two aspects: declining Kidney Yin (substance) and declining Kidney Yang (function). Depending on the symptoms a patient presents with in the clinic, Chinese medicine will determine which deficiency (Yin or Yang) is most affected and treat according to the pattern. Often, both Kidney Yin and Yang are affected and need to be addressed.
Treatment according to Chinese medicine patterns for menopause is essential. While acupuncture is an excellent choice for initial symptom management, it is important to incorporate herbal remedies into the treatment strategy for a more complete therapy. Because both Kidney Yin and Yang are often deficient, common formulas such as Zuo Gui Wan (Restore the Left [Kidney]) and You Gui Wan (Restore the Right [Kidney]) are incorporated into the herbal strategy. While the Kidneys are the principle Chinese medicine organs associated with decline in menopause cases, other factors can often complicate the patient’s case such as the presence of Phlegm and Dampness (pathogenic disease causing factors) and Qi Stagnation and Blood Stasis (lack of proper energy and blood movement).1 Often, if secondary factors such as Phlegm and Blood Stasis are not addressed, simply treating the Kidney deficiency will not resolve the condition.
The expected prognosis for menopause symptom management is good, and most patients begin to see results within 2-3 months of regular acupuncture and herbal treatments.
Recently, I had a 53-year-old female patient visit my clinic in Eugene requesting treatment for hot flashes (flushes) and insomnia. After a detailed patient history and intake, I decided that her Kidneys were deficient and need to be strengthened, but she also had a Phlegm/Damp condition that would likely make the treatment challenging. I chose to place her on twin formulas from the Classical Pearl line: Guanyin Pearls and Earth Pearls at dose of 3 capsules each in the morning and 3 capsules in the evening. Additionally, I recommended a tonic formula of Eucommia Bark, which is known in Chinese Herbal medicine to strongly tonify Kidney Essence. After 2 months of weekly acupuncture treatments and compliancy with her herbal medicine, my patient happily shared that she had noticed a significant change in her ability to fall asleep at night and also a decrease in her hot flashes. As of this blog write-up, she continues to use herbs and acupuncture to manage her symptoms, and feels much better now than when she first arrived in my clinic—and does not need to use HRT at this moment.
The take away from this discussion on menopause is: acupuncture and Chinese herbal medicine are an excellent choices for patients who are suffering from menopause symptoms and are interested in other treatment options beyond biomedical HRT treatment.