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Understanding Menopause and TCM

15 Feb 2024

By: Lee Hui Min

What is Menopause?

Menopause is a natural biological process that marks the end of a woman’s reproductive years. It is defined as the permanent cessation of menstrual periods and is usually diagnosed after a woman has gone 12 consecutive months without a period. Menopause typically occurs between the ages of 45 and 55, with the average age of onset being around 51.

Menopause is typically divided into three stages: perimenopause, menopause, and postmenopause.

  • Perimenopause: This is the stage leading up to menopause when a woman’s ovaries gradually produce less estrogen. Perimenopause can last anywhere from a few months to several years and can begin as early as a woman’s 30s or 40s. During this time, a woman may experience irregular periods, hot flashes, night sweats, mood swings, and other symptoms of hormonal fluctuations.
  • Menopause: Menopause is defined as the point when a woman has gone 12 consecutive months without a period. At this point, the ovaries have stopped releasing eggs, and estrogen and other reproductive hormone levels have significantly declined. Menopause typically occurs between the ages of 45 and 55, with the average age of onset being around 51.
  • Postmenopause: Postmenopause is the stage that follows menopause and lasts for the rest of a woman’s life. During this time, a woman’s hormone levels stabilize at a low level, and she may experience symptoms such as vaginal dryness, reduced sex drive, and bone loss.

What are Menopausal Symptoms?

During menopause, a woman’s ovaries gradually produce less estrogen and other reproductive hormones, which can lead to a variety of physical and emotional symptoms. Some common symptoms of menopause include hot flashes, night sweats, mood swings, vaginal dryness, and sleep disturbances. These symptoms can vary widely in severity and duration, and some women may not experience any symptoms at all. Some of the common symptoms are as follows:

  • Irregular periods: As a woman’s hormone levels fluctuate, she may experience changes in her menstrual cycle, including irregular periods, heavier or lighter periods, and shorter or longer periods.
  • Hot flashes and night sweats: These are sudden, intense feelings of heat that can cause sweating, flushing, and rapid heartbeat, and are often accompanied by chills and shivering.
  • Sleep disturbances: Menopause can disrupt sleep patterns, leading to difficulty falling asleep, staying asleep, or getting restful sleep.
  • Mood changes: Hormonal fluctuations during menopause can cause mood swings, irritability, anxiety, depression, and other emotional symptoms.
  • Vaginal dryness and discomfort: Declining estrogen levels can cause vaginal dryness, itching, burning, and discomfort during sexual activity.
  • Loss of libido: Hormonal changes can also lead to a reduced sex drive and decreased interest in sexual activity.
  • Urinary problems: Menopause can increase the risk of urinary tract infections, incontinence, and other urinary problems.
  • Joint pain and stiffness: Some women may experience joint pain and stiffness during menopause, which is thought to be related to hormonal changes and inflammation.

How is Menopause diagnosed?

Menopause is typically diagnosed based on symptoms and medical history. If a woman has not had a period for 12 consecutive months and is experiencing symptoms such as hot flashes, vaginal dryness, mood changes, and sleep disturbances, she may be diagnosed with menopause.

In some cases, a doctor may also order blood tests to measure hormone levels, such as follicle-stimulating hormone (FSH) and estrogen. FSH levels increase as the ovaries produce less estrogen, so elevated levels of FSH may indicate that a woman is in menopause. However, hormone levels can vary widely from day to day and may not be reliable indicators of menopause on their own.

It’s important to note that other conditions can cause symptoms similar to menopause, such as thyroid disorders or certain medications, so it’s important to work with a healthcare provider to rule out other potential causes of symptoms.

What is TCM perspective on menopause?

Traditional Chinese Medicine (TCM) views menopause as a natural transition in a woman’s life, marking the end of her reproductive years. According to TCM principles, menopause is associated with a decline in kidney essence, which is believed to be responsible for reproductive function and overall vitality. This decline in kidney essence leads to changes in hormonal balance and the symptoms commonly associated with menopause, such as hot flashes, night sweats, mood swings, and dryness.

In TCM, the kidney is considered the foundation of yin and yang energies in the body, and its imbalance can manifest in various symptoms related to menopause. The decline in kidney essence is often accompanied by a decrease in yin energy, leading to symptoms like hot flashes and night sweats. Additionally, a deficiency in kidney yang can result in symptoms such as fatigue, cold intolerance, and decreased libido.

How does TCM manage menopause?

TCM treatment for menopausal symptoms typically focuses on nourishing kidney yin and yang energies to restore balance in the body. This may involve acupuncture, herbal medicine, dietary therapy, and lifestyle modifications.

Herbal medicine is a common TCM treatment for menopause symptoms. Some herbs, such as dong quai and black cohosh, which are believed to have phytoestrogen may help relieve hot flashes, vaginal dryness, and other symptoms. Other herbs, such as ginseng and licorice, are believed to have adaptogenic properties that can help the body cope with stress and promote overall health.

Acupuncture, which involves the insertion of fine needles into specific points on the body, is often used to regulate the flow of qi (vital energy) and balance yin and yang energies. Dietary therapy in TCM for menopause typically involves consuming foods that nourish yin and yang energies, such as soups, stews, and warm, cooked foods, while avoiding excessive consumption of spicy, greasy, or overly stimulating foods.

Overall, TCM takes a holistic approach to menopause, aiming to address not only the physical symptoms but also the underlying imbalances in the body’s energy systems to promote overall health and well-being during this transitional phase of life. It’s important to note that individual experiences of menopause can vary, and TCM treatment plans are tailored to each person’s specific symptoms and constitution.

What is the current evidence for the efficacy of TCM on menopause?

There is some evidence to suggest that Traditional Chinese Medicine (TCM) can be effective in treating certain menopause-related symptoms, although more research is needed to confirm these findings. Here are some examples:

  • Hot flashes: Several studies have found that acupuncture may be effective in reducing the frequency and severity of hot flashes in menopausal women. A systematic review and meta-analysis of 12 randomized controlled trials found that acupuncture was more effective than no treatment or placebo in reducing the frequency and severity of hot flashes.
  • Vaginal dryness: A small study found that a TCM herbal formula called Er-Xian decoction was effective in improving vaginal dryness in postmenopausal women. Another study found that a TCM herbal formula called Liu Wei Di Huang Wan was effective in improving vaginal dryness and reducing other menopause-related symptoms.
  • Insomnia: A randomized controlled trial found that acupuncture was effective in improving sleep quality and reducing insomnia in menopausal women.
  • Anxiety and depression: A systematic review and meta-analysis of 10 randomized controlled trials found that acupuncture was effective in reducing anxiety and depression in menopausal women.

While these studies suggest that TCM may be effective in treating some menopause-related symptoms, more research is needed to confirm these findings.

Conclusion

Menopause is a natural and inevitable part of aging, and while it can be challenging for some women, it does not typically indicate a significant health problem. However, menopause can increase the risk of certain health conditions such as osteoporosis, heart disease, and urinary incontinence. It’s important for women to take steps to maintain their overall health and well-being during and after menopause, such as exercising regularly, eating a healthy diet, and getting regular medical check-ups.

It’s important to note that menopause is a highly individualized experience, and not all women will experience the same symptoms or progress through the stages at the same rate. Women should work with their healthcare provider to develop a personalized plan for managing menopause symptoms and maintaining their overall health during this time.

References

  1. Kim, T. H., Lee, M. S., Kang, J. W., Kim, Y. J., & Myeong, S. L. (2010). Acupuncture for hot flushes in perimenopausal and postmenopausal women: a randomized, sham-controlled trial. Menopause, 17(2), 269-278.
  2. Tzeng, C. R., Chang, Y. H., Chang, S. L., & Liu, W. M. (2014). Clinical effects of Er-Xian decoction on menopausal syndrome: a randomized, controlled trial. Evidence-Based Complementary and Alternative Medicine, 2014.
  3. Chen, M. N., Lin, C. C., Liu, C. F., & Huang, Y. T. (2008). Effects of Liu Wei Di Huang Wan on menopausal symptoms of quality of life in menopausal women: a randomized, placebo-controlled trial. Journal of Alternative and Complementary Medicine, 14(5), 651-656.
  4. Huang, M. I., Nir, Y., Chen, B., Schnyer, R., Manber, R., & St John, B. (2016). A randomized controlled pilot study of acupuncture for postmenopausal hot flashes: effect on nocturnal hot flashes and sleep quality. Fertility and Sterility, 106(6), 1580-1588.
  5. Lee, M. S., Kim, J. I., & Ernst, E. (2010). Is acupuncture a useful intervention for depression? A systematic review and meta-analysis. Journal of Affective Disorders, 111(2-3), 125-134.