Every woman's experience of menopause is different, based on her genetics, physical and psychological makeup and overall health. Her views of aging and menopause, and those of the people around her, will also shape the experience. Over the past 50 years, with the availability of hormone replacement therapies, women have had the option of treating the discomforts associated with menopause medically. The upshot of this practice is that menopause if viewed as a disease or hormone deficiency, and hormone supplementation is required to reestablish a healthy balance.
Beyond the physical experience of menopause, there are also social implications associated with the end of fertility. In a culture that values youth and beauty such as ours, menopause is a marked milestone in the aging process, and one that is frequently not welcome. However, in many cultures where aging citizens are valued for their wisdom, menopause is an anticipated event.
How can TCM Help?
Practitioners of Traditional Chinese Medicine offer another paradigm in which to consider the experience of menopause. The Yellow Emperor's Inner Classic, an ancient Chinese medical text, describes the seven-year cycles of women, in which menopause occurs at about age 49, or the seventh cycle (7 x 7). While this text was written two thousand years ago, the theories regarding menopause are relatively unchanged. Understanding from a Chinese standpoint how we experience menopause involves looking at the body in a different way, one that is more symbolic in nature.
Aging and the Role of Essence
Essence is one of the most important substances in the body in Chinese theory, and is responsible for birth, growth, development, sexuality, maturation, and aging. It is also the foundation or source for all other substances in the body, including Yin and Yang. There are two kinds of Essence in our bodies, Congenital Essence and Acquired Essence.
Congenital Essence is bestowed upon us from our parents and is similar to our genetic makeup. Congenital Essence declines as we age, and when it is completely used up, we die. Acquired Essence can augment Congenital Essence. It is made from what we eat and the amount we have is the result of our individual lifestyle and dietary habits. It is possible to be born with weak Congenital Essence and live a long and vigorous life through judicious eating and lifestyle habits. It is also possible to be born with strong Congenital Essence and squander it to cause premature aging and ill-health through poor diet and lifestyle habits.
The Role of the Kidney
The Kidney is the organ most closely related to Essence, aging, and menopause. In Chinese medicine, the organs are not necessarily physical entities, but rather, symbolic systems of functioning. Thousands of years ago, as Chinese medicine was evolving, the function of organs was discovered by the observation of and relationships between the body systems, rather than through dissection. So, while the Kidney is associated with water metabolism and the formation of urine, it is also the organ that houses Essence, Yin and Yang.
As we age, the gradual depletion of Kidney Essence is the mechanism responsible for the timing and signs or symptoms of menopause. It is also responsible for weakening of the bones, loss of teeth, hearing loss, confusion and memory problems-all manifestations associated with the Kidney.
Menopause and the Concept of Yin and Yang
Yin and Yang are ancient concepts developed to understand the nature of change and are relevant to the change that occurs during menopause.
The Chinese character for Yang includes radicals (character components) indicating the sunny side of the hill, which is bright, warm, and transforming. Also, Yang in nature are daytime, light, upward movement (much like heat rising), and activity. In the body, Yang is transforming and acts like a warming pilot light.
Similarly, the character for Yin represents the shady side of the hill, which is cool, moist, and nourishing. In contrast to Yang, Yin is associated with nighttime, darkness, sinking or downward movement, and contraction. The cooling and nourishing nature of Yin in the body is similar to hormones, body fluids, blood, and bone marrow. Essence is also a relatively Yin substance, due to its nourishing nature.
As a representation of change, Yin and Yang are constantly in a state of flux, and Yin and Yang counterbalance each other. This means that when Yang increases, Yin decreases and vice versa.
During menopause, the natural seventh cycle, Essence decreases, and as a result Yin substances in the body also tend to decrease. This decrease in Yin causes a relative increase in Yang, which can most readily be seen in the occurrence of hot flushes, which are warm and rising in nature.
Another menopausal change associated with this relative overabundance of Yang is insomnia. At night, which is the Yin time of the 24-hour cycle, the activity of surplus Yang can make sleep difficult to achieve, and can be aggravated by night sweats.
The active nature of Yang can also affect the heart, causing palpitations. Along with its activity, Yang is also drying in nature. Common complaints during menopause include dry skin, wrinkles, and vaginal dryness.
It's important to note that not all women experience a relative deficiency of Yin and overabundance of Yang during menopause. For some, Yang can become deficient and Yin becomes overabundant. Signs of this imbalance may include a slowing of the metabolism (Yang is active and transforming) causing weight gain and oedema (too much Yin/fluids in the tissues).
Easing the Transition
Chinese medicine offers a number of modalities to help balance the body during menopause.
Acupuncture can be effective in alleviating the signs of menopause, such as hot flashes and insomnia. Acupuncture involves the insertion of very thin needles into various points on the body to balance energy, Yin, and Yang.
Acupuncture may also be used to alleviate stress and emotional symptoms during menopause, as stress in general depletes Essence and can create additional heat in the body. Many practitioners will augment acupuncture treatments by combining other modalities, such as the use of herbs, food therapy, and lifestyle counseling for best results.
Chinese herbal medicine is a tradition which is thousands of years old, and remains in use today. In fact, researchers often explore the actions of Chinese herbs in developing new drugs. While many women turn to one single herb, such as Black Cohosh or Evening Primrose for relief, the tradition of Chinese herbology is to combine several herbs into a formula. By combining herbs, formulas can be developed and prescribed with specific actions such as nourishing Yin, clearing heat, or moistening dryness,.
In the Chinese tradition, food is considered medicine that we eat three times a day. Foods have very specific properties, such as the warming effects of ginger and scallions or the cooling sensation of mint. In addition, foods can act like herbs in that they can nourish Yin or Yang, boost energy, tonify the blood, and even help resolve phlegm. Chinese dietary therapy is considered to be the underpinnings of good health and a way to preserve Essence as we age.
"Acupuncture significantly alleviated menopause symptoms, but had no effect on hot flush. Breast cancer patients concerned about the adverse effects of hormone therapy should consider acupuncture. Further large-scale studies that also measure biomarkers or cytokines may help to elucidate the mechanism by which acupuncture alleviates menopause symptoms in patients with breast cancer."
- Effect of acupuncture on hot flush and menopause symptoms in breast cancer - A systematic review and meta-analysis, by TJ Chien. CH Hsu, CY Liu and CJ Fang. Read more here.
"We found insufficient evidence that Chinese herbal medicines were any more or less effective than placebo or HT for the relief of vasomotor symptoms. Effects on safety were inconclusive. The quality of the evidence ranged from very low to moderate; there is a need for well-designed randomised controlled studies."
- Chinese herbal medicine for menopausal symptoms, by X Zhu, Y Liew and Z Liu. Read more here.
"TCM therapeutics of acupuncture, CHM and moxibustion show promising results for the treatment of mood and pain symptoms co-occurring with hot flushes."
- Effects of traditional Chinese medicine on symptom clusters during the menopausal transition, by L Taylor-Swanson, A Thomas, R Ismail, JG Schnall, L Cray, ES Mitchell and NF Woods. Read more here.
If you're feeling the effects of menopause, Dr Li's TCM Clinic can help to ease your transition and alleviate your symptoms. We have qualified practitioners who are confident in treating women's health. Call us now to make an appointment for your first free consultation.
Dr. Li's TCM Clinic - Lane Cove, Rhodes, Macquarie Centre, North Ryde & Chatswood