Are your periods irregular lately? If you are also experiencing hot flashes, night sweats, difficulty sleeping at night, mood swings and you are in your forties, you may be approaching menopause. Don’t let menopause affect your quality of life. Read on to find out how TCM can help you to have a healthy and pleasant menopause.
When Does Menopause Begin?
Menopause is the time when a woman’s menstrual cycle comes to an end. It is a natural aging process that occurs when a woman stops having periods permanently, and can no longer become pregnant naturally.
Menopause usually occurs between 45 to 55 years old, even though it may be earlier or later for some women. Early and late menopause sometimes runs in the families. For women who smoke, menopause tends to take place at a younger age. In Singapore, the average age of menopause is 49 years.
The diagnosis of menopause is made when a woman has not had a period for a year with no other underlying cause. Blood tests to check the levels of the hormones produced by the ovaries may be ordered to confirm the diagnosis, even though it is often not necessary.
Hormonal Changes Occur During Menopause
Menopause occurs when the ovarian reserve has depleted and the ovaries’ production of the hormones estrogen and progesterone decreases significantly. Estrogen continues to be produced by other body tissues, resulting in higher and erratic changes in the estradiol level during the menstrual cycle. At the same time, the follicle-stimulating hormones produced by the pituitary gland (a pea-sized gland at the base of the brain) increases, possibly to try to stimulate the ovaries. Most of the menopausal symptoms experienced by women going through menopause are thought to be related to the changes in the secretion patterns of these hormones.
A woman may experience menopausal symptoms as early as 8 to 10 years before her last menstrual period. The duration and severity of the symptoms are different for every woman. For many women, menopausal symptoms can have a negative impact on the quality of life.
Signs And Symptoms
Irregular periods are often the first sign of a woman approaching her menopause. The menstrual cycle can range from every 2 to 3 weeks to a few months. The flow may also be lighter or heavier than usual.
Hot flash is one of the most common menopausal symptoms that many women find it unpleasant and uncomfortable, with some finding it unbearable, especially when it is accompanied by heavy sweating and rapid heartbeats. Hot flash is a feeling of intense heat that is often felt in the head, chest and arms, and can spread to the whole body. The skin can become red and sweaty. It typically lasts from 30 seconds to a few minutes, but can continue for as long as an hour. Some women experience hot flash once a day, while others can have them for all day and night. Hot flashes that occurred at night may be accompanied by night sweats, which are episodes of profuse sweating that can drench the sleepwear and bedsheet. This can affect the sleep at night, leading to daytime tiredness.
Hormonal changes and the physical discomfort during menopause often have an impact on the woman’s emotions, leading to feelings of irritability, anxiety, panic, weepiness, and even depression. Many women also find that they have difficulty concentrating and are becoming more forgetful.
Other common menopausal symptoms include vagina dryness, decreased sex drive, increased susceptibility to urinary tract infection.
The long-term effect of a decrease in estrogen level associated with menopause can increase the risk of developing certain conditions, such as heart diseases and osteoporosis (a condition in which the bones become thin and weak, and may break easily).
Managing Menopause With Traditional Chinese Medicine (TCM)
In Traditional Chinese Medicine, menopause is recognized as an aging process that is due mainly to the depletion of the Kidney energy.
According to Nei Jing (an ancient Chinese Medical text that lays out the fundamental principles of Traditional Chinese Medicine), when a woman ages, the Kidney energy starts to deplete, and as the Kidney energy becomes exhausted, her period will stop.
Kidney Yin Deficiency: The Essential Reason For Menopause Symptoms
Kidney Yin deficiency (肾阴虚) is the essential reason for symptoms associated with menopause. In TCM, Kidney Yin is the foundation of “fluids”, including essence, blood and body fluids, that moisten and nourish the whole body. Women with yin-inclined body constitution, those who have heavy and prolonged periods, and those who have given birth to many children are more likely to develop menopausal symptoms associated with Kidney Yin deficiency. Symptoms include irregular periods, a shorter than normal cycle, increase or decrease in menstrual blood flow, vaginal dryness, dry skin, thirsty, afternoon heat, hot flashes, heat sensation in the hands and foot, dizziness, ringing in the ears, soreness in the lower back and knee, constipation. Herbs commonly used to nourish Kidney Yin include shu di huang (熟地黄), shan yao (山药), shan zhu yu (山茱萸), fu ling (茯苓), mu dan pi (牡丹皮), gou qi zi (枸杞子).
A deficient in the Kidney Yang (肾阳虚) can also result in menopausal symptoms. In TCM, Kidney Yang is the foundation of the body’s vital energy (Yang Qi) that warms and promotes the function of organs and tissues. Women with yang-inclined body constitution, those who are suffering from long-term illnesses, those who indulge in excessive sexual activities, and those who consume excessive cold food and drinks are more prone to Kidney Yang deficiency. Symptoms include irregular periods with heavy menstrual flow or spotting throughout the cycle, cold limbs and cold lower back, decreased sex drive, frequent urine, especially at night. Herbs commonly used to nourish Kidney Yang include rou gui (肉桂), yin yang huo (淫羊藿), ba ji tian (巴戟天), tu si zi (菟丝子), rou cong rong (肉苁蓉).
A Combination Of Kidney Yin & Yang Deficiency Is Commonly Seen In Clinical Practice
However, clinically most menopausal women develop Kidney Yang deficiency as a result of prolonged Kidney Yin deficiency, and they present symptoms of a deficient in both Kidney Yin and Kidney Yang (肾阴阳俱虚). Symptoms include irregular periods with either shorter or longer cycle, episodes of hot flashes, and yet having cold limbs and lower back, dizziness and ringing of the ears. The herbal formula er xian tang (二仙汤) is often used with some modification to take into consideration each individual’s specific conditions.
Another very common disharmony pattern that extend from Kidney Yin deficiency is Excessive Heart Fire due to an imbalance in the Heart and Kidneys. In TCM, Heart belongs to the Fire element, and Kidney belongs to the Water element. There is a dynamic flow of energy between the two organs to nourish and control each other to maintain a balance state. When Kidney Yin becomes deficient, its function to control Heart Fire is reduced, and this result in an overactive Heart Fire.
Women with this disharmony pattern besides having Kidney Yin deficiency symptoms, also experience symptoms of Excessive Heart Fire symptoms, such as palpitation, irritability, insomnia with excessive dreams. The tip of the tongue is red, and the pulse is rapid and thready. In addition to herbs to nourish Kidney Yin, herbs that helps to clear Heart Fire, such as mai dong (麦冬), bai he (百合), huang lian (黄连) are also added.
The Use Of Acupuncture
Studies shows that acupuncture significantly reduces menopausal symptoms such as hot flashes, night sweats, emotional symptoms, as well as skin and hair problems. Acupuncture involves the insertion of thin needles at specific points (acupoints) on the body to optimise energy flow and restore the balance of the body.
The use of acupuncture is based on TCM Meridian and Internal Organ Theory. Depending on the individual’s disharmony patterns, acupoints are often chosen to nourish the Kidney and clear Excessive Heart Fire.
Commonly used acupuncture points for treating menopause include
Ren & Du Channel: GV20 bai hui 百会、RN4 guan yuan 关元、RN6 qi hai 气海;
Spleen & Stomach Meridian: ST29 gui lai 归来、ST36 zu san li 足三里、SP6 san yin jiao 三阴交;
Kidney Meridian: KI3 tai xi 太溪;
Heart Meridian: HT6 yin xi 阴郄、HT7 shen men 神门;
Urinary Bladder Meridian: UB15 xin shu 心俞、UB23 shen shu 肾俞