Menopause is a natural biological process, a point in time 12 months after a woman's last period. It begins between the ages of 51 and 52 typically. In the United States, approximately 1.3 million women become menopausal each year. After menopause, it is called post-menopause.
The years leading up to menopause most often start between the ages of 45 and 55. This period is called the menopausal transition or perimenopause. It usually lasts about seven years, but can be as long as 14 years. The duration can depend on lifestyle factors such as smoking, age it commences, race and ethnicity.
During menopause or post-menopause, physical symptoms such as hot flashes and emotional symptoms may have impact on a woman’s quality of life (QOL). Furthermore, many women may be affected by them even during perimenopause, along with the change of their monthly cycles. Each woman is affected uniquely and in various ways.
From Chinese Medical perspective, when Tian Gui is exhausted, and Qi in Ren Vessel declines, and Blood in Chong Vessel becomes scanty, and the Kidney is not strong any more, the menopause follows. However, this is a gradual change and it can take a few years to reach that point. In the transition process, menopause and post-menopause, symptoms may appear mainly because of the imbalanced Yin and Yang in the Kidney. Additionally, the Heart, Liver and Spleen are often involved as the body is a whole organic system.
Firstly, the theory of Yin-Yang is going to be introduced. It is a conceptual framework which was used for observing and analyzing the material world in ancient China. They may represent two separate phenomena with opposing natures, as well as different and opposite aspects within the same phenomenon.
Water and fire are symbols of Yin and Yang. Water is cool, moist, still, and down. Fire is hot, dry, active and up. So Yin makes a body cool and Yang makes it warm or hot. Yin moistens every part of the body and Yang dries it. Yin calms a person and Yang activates him or her. During a day, Yang is dominant and we are awake and active. During a night, Yin is dominant and we are asleep and still.
Generally speaking, the quantity and influence of Yin increase slowly towards the evening and reach their peaks at midnight, and decrease slowly towards the morning and hit their nadirs at noon. Meanwhile, Yang does the opposite. Amid our life span, the quantities and influences of Yin and Yang grow gradually, and reach their peaks in our twenties and early thirties, and then decline gradually. At any moment they can be neither too much nor too little, and neither too powerful nor frail, and should match the physiological needs or changes.
No matter how they change, Yin and Yang should be together all the time and there must be a balance between them. As their equilibrium is dynamic, it must fluctuate in a normal range according to the physiological needs or changes. Thus we can function well physically and psychologically. Otherwise, we are ill. When Yin and Yang are separate, there is no life any more.
Take the sense of temperature for an example. The body temperature remains in a specific range and we feel comfortable if Yin and Yang are in good quantity and their powers are balanced. When this balance or equilibrium is broken, we feel warm or hot if Yang is relatively more and feel chill or cold if Yin is relatively more.
Secondly, symptoms relating to menopause, its transition or post-menopause fall into two types most of the time: Kidney Yin deficiency and Kidney Yang deficiency. Some of symptoms are about to be discussed to illustrate how the imbalance impacts on the body.
1) Hot flashes: whenever Yin is not enough to match Yang, and Yang becomes relatively more, and their balance is off, hot flashes occur. Whenever the balance returns, hot flashes disappear. As this balance is broken from time to time, hot flashes come in waves. They appear more during the night when Yin should be dominant but not actually in this case. Along with hot flashes, a patient may not sleep well, either having trouble in falling asleep or being easily woken up during a sleep.
2) Sweating: sweating is the result of Yang acting on Yin and takes place whenever there is more Yang. Through the sweating, the body regulates its temperature and keeps it normal. It happens physiologically and pathologically. Because Yang is abnormally active or more in this case, a woman experiences sweating following hot flashes. Many women have insomnia since they are woken up by hot flashes and night sweating a few times during a night.
3) Dryness in areas such as skin and vagina: this is the result of not enough moisture provided by Yin.
Those are a type of Yin deficiency. What is a type of Yang deficiency like?
1) Chills or feeling cold: due to the lack of Yang, the body cannot be warmed. Besides, there is more Yin relatively and its nature is cool.
2) Abdominal bloating and less appetite: Spleen and Stomach are the main organs responsible for digestion and it is Yang that guarantees their function. If Yang is weak, they cannot function well, which results in those symptoms.
3) Frequent nocturia or incontinence: it is the Bladder located in the lower abdomen that stores the urine temporarily. When a sufficient quantity has been accumulated, it is discharged from the body. This function is performed with the assistance of the Kidney. The weak Yang in the Kidney brings about frequent nocturia or incontinence or both.
Those symptoms plus the information gotten from pulse and tongue examination can help to differentiate those two types of deficiency. Of course, some women can have both types.
Thirdly, a case will be given. Sophia was 51 years old, a successful sales woman with more than 20 years of experience. She had hysterectomy at the age of 47. Sporadic hot flashes had been bothering her for a few months. Her sleeping had not been good, either caused by her hot flashes or the stress from the work. Her appetite, bowel movements and urination had been fine. After the inspection, listening, inquiring and palpation, I diagnosed her with menopause, type of Yin deficiency. The purpose of the treatment was to strengthen her Kidney Yin and restore the balance between Yin and Yang. Acupuncture was the main therapy and its frequency was twice a week.
She responded to the treatments very well. Hot flashes were better after the first session though they came back a few days later. After the second session, she reported that her sleeping and hot flashes had become better in general. After the fifth session, she had no hot flashes anymore and her sleeping was much improved. To stabilize the results, three more sessions were administered. In total, eight sessions were given.
Lastly, making changes to the diet and lifestyle can help a woman going through this period gracefully, along with the treatment. 1) Limiting the daily caffeine consume, cutting back on spicy foods, and adding foods such as soybeans, chickpeas, lentils, flaxseed, grains, beans, fruits and vegetables. 2) Avoiding triggers to hot flashes such as keeping the bedroom cool at night, wearing layers of clothing, or quitting smoking. Weight loss can also help. And 3) Exercising. It helps relieve several other symptoms of menopause including insomnia. It should be calm, tranquil types of exercise like yoga and Tai Chi.
Wish every woman has a graceful menopause, its transition and post-menopause!