Menopause

This post is copied from our older, original blog. Original post date 04/04/2012. 

By Marcie Bower, Lic.Ac.

A lot of women come in for acupuncture and herbal medicine treatment to seek relief for symptoms of menopause. Menopause refers to the time in a woman’s life when her menstrual periods stop and she is no longer fertile. This is a natural process of the ovaries lessening their production of the hormones estrogen and progesterone. While the cessation of periods is a healthy and natural thing, this hormone disruption can cause many unpleasant symptoms for some women – sometimes lasting for many years. Common symptoms of this menopausal hormonal fluctuation include hotflashes, nightsweats, poor memory, anxiety and depression, low libido, irritability, vaginal dryness, insomnia, fatigue, hair loss, and osteoporosis.

For many years, the standard treatment was hormone replacement therapy (HRT), which many women still choose to opt for. HRT supplements the body with either estrogen only or estrogen and progesterone together to moderate the symptoms of menopause and prevent osteoporosis. (If there has not been a hysterectomy, then progesterone should be included in HRT because estrogen alone increases the risk of cancer. Women who have had their uterus removed usually are put on estrogen only.) However, HRT is not without risks. A landmark study published in 2002 – the Women’s Health Initiative (http://www.nhlbi.nih.gov/whi/index.html) – found that HRT increased risk of heart attack, stroke, blood clots, and breast cancer compared with placebo. (http://www.nhlbi.nih.gov/whi/whi_faq.htm) Today, many more bioidentical hormone options exist on the market, which may be safer. However, the National Cancer Institute still acknowledges that there are risks associated with HRT. (http://www.cancer.gov/cancertopics/factsheet/Risk/menopausal-hormones) The FDA recommends that women take HRT in as low of a dose for as short of a time as needed to control symptoms.

Given the very serious risks of HRT, many women opt to try to control menopausal symptoms through more natural means. And here is the good news – acupuncture and Chinese Herbal Medicine can be a wonderfully effective treatment for menopausal symptoms!

In Traditional Chinese Medicine, we talk about the concepts of Yin and Yang. Yin and Yang are two equal and opposite forces that exist in all of us, and perfect health is a balance between Yin and Yang. Yin refers to the watery, cooling, passive, receptive, heavy aspects of our body. Yang refers to the fiery, hot, active, expansive, light aspects of our body. When there is not enough Yin (water) to anchor the Yang (fire), we see an apparent excess of Yang symptoms. These include hotflashes, nightsweats, dryness, and irritability. The weakness of Yin leads to poor memory, anxiety, sleep issues, and fatigue.

In TCM, we also talk about different energy systems. These systems are named after our organs (such as Heart, Liver, and Kidney), but when we talk about these we aren’t talking about the physical organ in your body – rather a form of energy within the body that governs our health and well-being. The Kidneys, in TCM, govern our life cycles from birth to death, our hormones, and reproduction. So as you can tell, menopause is an issue related to the Kidneys. The Kidneys also control our hearing, our low back and knees, urinary function, and our hair and nails. Thus, many women tend to experience pain or weakness in the low back and knees, hair loss, incontinence, and problems hearing during the menopausal time.

In TCM theory, a healthy baby is born with equal parts of yin and yang. Over the course of the life cycle, women’s yin is slowly depleted, while men slowly deplete their yang. This is why older men tend to get cold more easily as they get older (not enough fire to moderate the cool water), while women experience hotflashes and waves of heat (not enough cool water to moderate the fire). This decline is a natural part of the aging process and the life cycle. However, if the body is in balance, symptoms of this changing balance should not be severe or disruptive. Therefore, we can use acupuncture and Chinese Herbal Medicine to bring the body into balance, nourish the yin energy, and clear the heat symptoms.

Scientific research has shown that acupuncture can significantly reduce symptoms of hotflashes when compared to usual care (http://journals.lww.com/menopausejournal/Abstract/2009/16030/The_Acupuncture_on_Hot_Flushes_Among_Menopausal.14.aspx),(http://journals.lww.com/menopausejournal/Abstract/2012/01000/A_pilot_randomized,_single_blind,.11.aspx), (http://journals.lww.com/menopausejournal/Abstract/2010/17020/Effects_of_acupuncture_on_hot_flashes_in.12.aspx). Acupuncture has also been shown to be as effective as the leading drug therapy for treating hotflashes associated with side-effects of breast cancer hormone treatments. (http://jco.ascopubs.org/content/28/4/634.short)

Small pilot studies have also shown that Chinese Herbal Medicine can be beneficial to controlling hotflashes (http://journals.lww.com/menopausejournal/Abstract/2012/02000/A_randomized_double_blind_placebo_controlled_trial.19.aspx). Because research into CHM is fairy young in this country, further scientific research is needed to make definitive conclusions. However, clinically, we see menopausal women benefit from CHM therapy all the time. There are some wonderful CHM formulas that specifically target menopausal symptoms, and we can modify them based on which symptoms are most disruptive to the woman seeking treatment (ie, target vaginal dryness, or memory issues, or weight gain.)

As with anything, the sooner you start treatment, the better! So women between 45 and 50 who start having irregular periods and/or some hotflashes, get in for treatment as soon as possible so that your body can be brought into balance before the hormonal changes throw it too far out of whack. Menopause is a natural occurrence – a time of transition, wisdom, and growth. Acupuncture and CHM can help moderate the negative aspects of this time so that you can appreciate it for what it is!