Chinese Medicine and Menopause
by Dr. Philippa Nunes, BASc., DTCM, R.Ac.
If you have reached your menopause years, you are experiencing many changes in your physical body and other areas of your life that may be making you feel uncertain of what is happening and what is coming next. Perhaps this transition has been smooth sailing and you feel energized by the new opportunities it is opening up for you. Or, like many women, you may be experiencing some typical and unsettling symptoms of menopause such as hot flashes, night sweats or mood changes. These may range in severity from mild to quite severe.
Menopause is a normal and natural part of a woman’s life. The term menopause refers to the final menstrual cycle, which marks the end of a woman’s ability to conceive. Most reach menopause between the ages of 48 to 55, although some as early as 40 or as late as 60. The average age is 51. Perimenopause on the other hand, is the transition period from the first menstrual irregularities that mark the beginning of this change, to menopause, the complete cessation of menses. It usually lasts anywhere from 2 to 5 years, and sometimes longer. During this time the ovaries gradually stop producing eggs and the hormones necessary for reproduction, estrogen and progesterone.
As a result, you will have noticed that your periods have become irregular, either coming closer together or farther apart, lasting longer or shorter than usual, and that the flow is significantly heavier or lighter than is was. You may have already skipped one or more periods altogether.
Since estrogen affects many other areas of the body, such as the brain, heart, blood vessels, bones and genitourinary tissues, decreasing estrogen levels during perimenopause often trigger a number of symptoms. You may be experiencing hot flashes followed by sweating and then chills. These may also occur at night and wake you up frequently. Your sleep may be poor, leading to fatigue during the day. You may have noticed mood changes such as depression, anxiety or irritability. Perhaps vaginal dryness, pain during intercourse, decreased libido, urgent or painful urination, recurrent urinary tract infections, or stress incontinence are affecting your peace of mind.
These issues can make it challenging to get through the day, especially if you are chronically tired and can’t seem to get a decent night’s sleep. They can impact your relationships, social interactions, family life, productivity at work, and physical activity.
Chinese Medicine can work independently or in synergy with Western therapies you are undergoing to help ease the transition through menopause. You may have tried or considered hormone replacement therapy or medications such as antidepressants to manage hot flashes and mood changes.
Acupuncture, herbal medicine and lifestyle/diet changes are the main tools in the TCM toolbox that can help bring your body back into balance and alleviate the symptoms any imbalance is generating. Although menopause is a natural process, distressing symptoms are a sign of imbalance in the body, often brought about or exacerbated by other factors such as our hectic lifestyles.
The Kidney in Chinese Medicine is the key organ involved in menopause. It governs growth, development, reproduction and aging. The Kidney stores a precious substance called Essence, which is an inherited energy we receive from our parents at the moment of our conception. It is replenished and fortified, or depleted, through how we live. Proper nutrition, clean air and water, sufficient sleep, appropriate exercise and a balanced lifestyle protect our Essence. Prolonged stress, poor diet, and stimulants or drugs such as alcohol, cigarettes and caffeine deplete it. Essence gives us fertility, libido, the ability to regenerate, suppleness to our skin and strength to our bones. It is the material foundation of a sharp mind, clear thinking, strong will power, and a good memory. It maintains our youth, is finite in quantity, and declines throughout our life as we age. There is a natural decline in Essence during menopause, and an imbalanced deficiency of the Kidney Essence, either in its Yin or Yang aspect, is the cause of most menopausal problems. Therefore the condition of our Kidney Essence upon entering perimenopause will directly affect the kind of transition we have. There may be other associated conditions and involvement of other organs occurring against this backdrop of Kidney deficiency, which may need to be addressed also. Thus the appropriate TCM treatment and modalities utilized will depend on your unique pattern and will be tailored to you.
Acupuncture works by regulating the Qi, or energy, in the body. It moves energy when it is has ceased to flow properly, dissipates it when it is excessive, and adds energy where it is needed. For example, stagnant energy can cause abdominal pain, menses with dark clotted blood that stop for a long time and start again, and depression. Excessive energy can cause hot flashes, excessive sweating, insomnia, anxiety and agitation. Deficient energy can cause cold hands and feet, low back ache, swollen ankles, frequent urination, and a lack of motivation.
Chinese herbs are natural substances, mostly from plants but also minerals and animals, each of which has specific and well documented properties. Consider herbs to be concentrated forms of food. Each food we ingest has specific effects on our bodies. The Chinese have studied the effects of thousands of foods and herbs over 3000 years to learn how to they can be used to treat illness and improve health. Diet is the first line of treatment in TCM. When dietary changes and acupuncture alone aren’t able to correct imbalances and resolve symptoms fast enough, an herbal formula may be prescribed according to your particular pattern to support the healing process. Herbs are effective to nourish the Yin, Blood and Essence, and to tonify deficiencies when used in conjunction with a correct diet and acupuncture.
Receiving treatment is only half of the equation however. Acupuncture and herbs put energy into your system to help it heal, regain balance, and restore depleted reserves like Kidney Essence. If that energy isn’t depleted by how you live, then the energy is retained by your body and builds treatment by treatment. As previously mentioned, if a woman protects her Essence through a healthy lifestyle in the years prior to starting perimenopause, she will likely have a much easier transition through it. Indeed, some women experience little or no symptoms at all. Therefore certain diet and lifestyle guidelines are important to follow as best as possible for all women going through perimenopause, and for those who are years away from it but want to improve their health so as to avoid potential discomforts later on.
In broad terms, a life of moderation protects one’s Essence. This means avoiding excesses and overdoing things. Some examples are many years of overworking either long hours or in high stress environments, excessive emotional stress, fanatical or extreme exercise regimes or no exercise at all, excessively restricted diets that fail to meet the nutritional needs of the body, and diets excessive in harmful foods or other substances. Eat a diet with a high content of vegetables, especially leafy green vegetables and some fruit. Smoking, alcohol, caffeine (coffee, tea, chocolate, colas), spicy foods, sugar, and large amounts of dairy or red meat should be avoided. They generate heat, burn the yin and body fluids, and trigger hot flashes. Likewise processed foods, additives, flour, and greasy or fried foods should have a limited place in your diet. A diet of nutritious whole foods, both plant and animal, local and in season, and as close to their natural state as possible is truly the best for your body. Take any steps you can to reduce unnecessary stress in your life and let go of what you can’t change. Get plenty of sleep, balance work with play and take time out for yourself to renew your body and spirit. Mindfulness practices like meditation, tai qi, qi gong and yoga are very beneficial to restore your Essence and peace of mind.
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