Traditional Chinese Medicine (TCM) for Menopause

A woman going through menopause can experience a variety of symptoms, such as hot flashes and headaches, which are difficult to deal without support. Traditional Chinese medicine (TCM) can alleviate the symptoms of menopause by nourishing the essence within the body, balancing the hormonal system. TCM practitioners use herbs, acupuncture and diet therapy to treat menopause symptoms in a safe and gentle manner for women. Even if a woman chooses to use hormone replacement therapy (HRT), a conventional approach to menopause, she still can complement those treatments with herbal therapies and acupuncture because each works in different ways. TCM nourishes the body's “kidney essence” while HRT convinces the body that it is still ovulating.

How does Traditional Chinese Medicine (TCM) View Menopause?

Traditional Chinese Medicine (TCM) views menopausal symptoms as the outcome of a lifetime of choices and dietary habits. Most symptoms result from a decline of the body’s kidney energy, which includes essence, yin, and yang. Lifestyle choices are also contributors to a difficult menopause that weaken the flow of energy to the kidneys, including emotional stress, such as anxiety; overwork; inadequate rest; and an irregular diet.

According to TCM, young and healthy people produce an abundance of blood and qi (energy), which are stored by the liver and the kidneys. Menstruation is caused by an overabundance of blood and qi. Because blood is the physical manifestation of a woman, when blood is lost, some of her essence also is lost. The production of both of these vital substances decreases when menopause approaches, so the woman will hold on to her remaining blood, thereby retaining her essence. Menopause is, therefore, thought of as a deficiency of blood and qi flowing to the liver and kidney. Menopause slows down the aging process by retaining these vital substances and helping the woman maintain her essence.

Treatment of Menopause with Traditional Chinese Medicine (TCM)

In Asian countries, the incidence of menopausal symptoms among women is dramatically less than Western countries. This disparity is primarily due to differences in diet and the use of traditional medicines. Often, women in Asian countries begin to use acupuncture and herbal medicine prior to approaching menopause decreasing their likelihood of experiencing the negative aspects of these life changes.

Using Chinese Herbal Medicines for Menopausal Symptoms

For a woman experiencing menopausal symptoms, such as excessive hot flashes, a Traditional Chinese Medicine (TCM) practitioner would recommend an herbal formula to balance her body. The most typical pattern seen in menopausal women is Kidney Yin Deficiency, presenting the symptoms of hot flashes, insomnia, vaginal dryness, tinnitus, night sweats, and weakness of the lower back and knees. This condition is most commonly treated with the formula Zhi Bai Di Huang Wan, which is composed of eight herbs, including Chinese Foxglove and Cornelian Cherry. In a Dutch study, researchers found this combination to be effective in reducing the amount of hot flashes a menopausal woman experienced. The formula has been in use for hundreds of years, and is often taken long-term in middle age and older women during and after menopause.

Kidney essence deficiency often manifests as osteoporosis in menopausal women. Formulas that contain Kidney essence tonics and herbs with high calcium content are often prescribed in these cases. Additional formulas are also used for menopause based upon other symptoms the woman may be experiencing. Visiting a trained Chinese herbalist will allow a specific formula to be made specifically for your symptoms.

Using Acupuncture for Menopausal Symptoms

A Traditional Chinese Medicine (TCM) practitioner might also suggest a woman receive acupuncture treatments to alleviate menopausal symptoms, especially hot flashes. Acupuncture involves the insertion of extremely thin, sterilized needles into specific points in the body. These points contain concentrations of qi and blood. In TCM, qi is considered the life energy that flows throughout the body. By adjusting the flow of qi in the body, various physiological systems of the body can be regulated, including the endocrine system, which controls the production of hormones.

An acupuncturist will design a treatment based upon your specific menopausal symptoms. Typical acupuncture treatments for menopause including strengthening the kidney with the points Kidney 3, Kidney 7, and Urinary Bladder 23. Additional points can be added for specific symptoms, such as Stomach 36 for fatigue, Kidney 2 for hot flashes, Spleen 6 for insomnia and night sweats, and Heart 7 for emotional difficulties.

Research has demonstrated that acupuncture can significantly decrease the frequency of hot flashes. Women often respond well to acupuncture treatments twice a week for the first few weeks, followed by treatment every week for several more weeks. Continued monthly acupuncture sessions can prevent a reoccurrence.

Acupuncture needles generally do not hurt, though some clients will feel sensations of achiness, soreness, heaviness, or electrical tingling where some needles are inserted. Acupuncture generally is safe with few side effects. Sometimes a patient reports drowsiness for a few hours after the treatment or mild numbness or aching at the point where the needle was inserted.

Traditional Chinese Medicine (TCM) Dietary Changes for Menopause

The most significant difference in the diet between woman in Asia and women in Western countries is the consumption of soy products. Many women in Asian countries consume ten times the amount of soy products as their Western counterparts, eating them at every meal. Soy has a high concentration of phytoestrogens, plant compounds similar in chemical structure to estradiol, helping to alleviate menopause symptoms and protect against osteoporosis.

What is Traditional Chinese Medicine (TCM)?

According to Traditional Chinese Medicine (TCM), all phenomena in the world are related by the opposing concepts of yin and yang. Yin refers to femaleness, bones, solid organs, coldness, darkness, heaviness, downward/inward movement, and calmness. Yang refers to the opposite—maleness, the bowels, heat, light, upward/outward movement, surface, and agitation. The relationship between the two is in a constant state of flux, yet both are necessary for life. To achieve optimal health, yin and yang must be in a harmonious, dynamic balance. While menopause can move a woman’s body out of balance, TCM can help her restore harmony.

The vital substances of Chinese medical physiology that affect the yin and yang include:

• Essence: This is the vital physical presence or spirit of the body and all physical elements that are responsible for determining physical growth and development.
• Qi: This refers to energy that propels all bodily functions and is responsible for the movement, transformation, warmth, and restraint of the blood.
• Blood: Blood underlies the nourishment of the functions of qi and is the physical manifestation of the woman.
• Bodily fluids: This includes all fluids in the body. They moisten the skin, hair, tissues, joints, and organs, and allow for smooth movement of joints and other body parts. Yin fluids are thick, lining the internal organs and cushioning the brain and spinal cord. Yang fluids are thinner, such as sweat, saliva and urine.

What is Menopause?

Menopause is the normal, gradual physiological transition in a women's life from a reproductive to a non-reproductive state. It is the time when the ovaries cease to function. When a woman has had no menstrual periods for 12 months, and has no other medical reason for her periods to stop, she is in menopause. Many women sail through menopause without any unusual discomforts, while others experience various uncomfortable symptoms during this phase of life.

Menopausal symptoms often include:

• hot flushes
• night sweats
• headaches
• fatigue
• lethargy
• irritability
• vaginal dryness
• anxiety
• nervousness
• depression
• insomnia
• inability to concentrate

What Risks are Associated with Traditional Chinese Medicine (TCM)?

Patients should be aware that Chinese herbs are not without possible side effects. Exercise caution in their use, especially outside of monitored settings. While there have recently been efforts to regulate dosages and use of Chinese herbs by some governments, the active ingredients of these medicines often have not been measured precisely. This can lead to variations among formulations and batches. It is advisable to only consume Chinese herbal products that have been prescribed to you by a trained practitioner.

After an acupuncture treatment, avoid strenuous physical activity, heavy meals, alcohol intake, or sexual activity for up to eight hours.

What to Look for in a Practitioner

To find a licensed acupuncturist, always look for the "LAc" credential, which stands for Licensed Acupuncturist. Each state provides its own licensing for acupuncturists, so additional titles can include Acupuncture Physician (AP), Doctor of Oriental Medicine (DOM), Oriental Medicine Doctor (OMD), and Doctor of Acupuncture and Oriental Medicine (DAOM). The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) certifies acupuncturists (Dipl Ac) and practitioners of Chinese herbal medicine (Dipl CH) upon passing a qualifying exam; practitioners who are certified in both acupuncture and Chinese herbal medicine are designated as Diplomats in Oriental Medicine (Dipl OM).

Additional Resources

Honora Lee Wolfe, Managing Menopause Naturally with Chinese Medicine (1998), Blue Poppy Press, Inc. pgs 17-26, 126-130.

Avis NE, “A randomized, controlled pilot study of acupuncture treatment for menopausal hot flashes”, 2008 June 2.

Scheid, V. “Traditional Chinese medicine--what are we investigating? The case of menopause”, 2007 March.

Kwee, SH. “The effect of Chinese herbal medicines (CHM) on menopausal symptoms compared to hormone replacement therapy (HRT) and placebo”, 2007 Aug 8.