Natural Woman, Natural Menopause

How Oriental Medicine
Can Help You Cope With The Change
by Lucy Postolov, L.Ac.

“Going to Hollywood to talk about menopause was a little bit like going to Las Vegas to sell savings accounts”
-Gail Sheehy (author of ‘The Silent Passage’)

Of all the wondrous miracles of our world, none is more miraculous than the female body. It is to be appreciated, it is to be worshipped, and it is to be amazed with its timely changes that occur throughout a woman’s life. One change that is destined and brings a range of emotions from ‘anxiety’ to ‘elation’ is menopause. The French say ‘Life begins at forty’. Something else is on its way as well.

‘River of Night Sweats!’ ‘The Fire of Hot Flashes!’ ‘Terror in the Ovaries!’ No, these are not summer blockbusters coming to a theatre near you. In reality, these are a few symptoms a woman can experience when the ‘change’ is at hand. Whoever said being a goddess was going to be easy.

Defining the ‘Change’
The Merck Manual of Medical Information defines menopause as the time in a woman’s life when the cyclic function of the ovaries and menstrual periods cease. Also known as “climacteric”, it is important to note that menopause is not a disease but a normal physiological transition that indicates a phase in a woman’s life where she makes the passage from a reproductive to a non- reproductive state.

The basis for the decline of a woman’s reproductive power lies in the ovary itself. The ovarian follicles are formed before birth in the fetus. At that time they number approximately 6,000,000, decrease to 600,000 at birth, and actually number about 10,000 at the time of the menopause. Keeping this in mind, it would be correct to say that menopause is not so much an ‘event’ that takes place suddenly in a woman’s life, but a natural, gradual physiological process throughout her lifetime.

As ovaries age, response to pituitary-produced gonadotropins (follicle- stimulating and luteinizing hormones) decreases, initially with shorter follicular phases (hence, shorter cycles), fewer ovulations, decreased progesterone production, and more cycle irregularity. Eventually, the follicle fails to respond and, without feedback of estrogen, the circulating gonadotropins rise substantially. Circulating levels of estrogen and progesterone are greatly reduced.

Symptoms and Age of Occurrence
Essentially the symptoms of menopause usually occur between the ages of 48 and 55 with the median age being about 51. Remarkably, this has remained a constant throughout the world and through the centuries. Chinese medicine refers to cycles occurring in women at 7-year intervals and changes in men at 8-year intervals. Using these markers, the woman would begin her menstrual cycle at 14 (2 x 7) and shows signs of menopause at age 49 (7 x 7). The same formula can be used with the assumption that men mature at age 16 (2 x 8), affirming the belief that men mature at a later time in life. The symptoms of menopause will vary in a woman depending on her lifestyle and dietary habits to that point. As if you needed another reason to not smoke, smoking will contribute to an early menopause.

Problems that a woman is likely to experience are: fatigue, headaches, irritability, nervousness, vaginal dryness, night sweating, and the most common of symptoms which is found in 75% of women, hot flushes or flashes. A woman also may experience loss of bladder control, inflammation of the bladder or vagina, and pain during intercourse.

Osteoporosis (severe deterioration of the bones) is a major health hazard of menopause. Slender Caucasian women are at highest risk. Women who smoke cigarettes, drink excessive amounts of alcohol, take corticosteroids, have a low intake of calcium, or have a passive lifestyle are also at risk. Cardiovascular disease progresses more rapidly after menopause, when estrogen levels decrease.

Traditional Chinese Medicine View
To understand the Chinese philosophy and classifications of menopause, we need to define the foundation that Chinese medicine is based upon, and that is the concept of ‘yin’ and ‘yang’.

The terms yin and yang are used by a traditional Chinese medicine practitioner to describe the various opposing physical conditions of the body. These terms stem from a basic Chinese concept describing the inter- dependence and relationship of opposites. Much as hot cannot be understood or defined without first having experienced cold, yin cannot exist without its opposite yang, and yang cannot exist without yin. Together, the two complementary poles form a whole.

–Alternative Medicine, The Burton Goldberg Group

Here are a few examples of Chinese diagnosis, patterns and clinical manifestations of menopause:

1. Kidney-Yin deficiency. Dizziness, hot flush or flashes, night-sweating, sore back, dry mouth, dry hair, itching, constipation.
2. Kidney-Yang deficiency. Hot flushes but cold hands and feet, night- sweating, pale face, depression, chilliness, backache, swelling of the ankles.
3. Kidneys and Heart not harmonized. Hot flushes, palpitations, insomnia, night-sweating, blurred vision, dizziness, anxiety, backache, poor memory.

Chinese medicine does not refer to ‘Kidney’ and ‘Heart’ as a reference to an organ, but to a channel of energy that flows through that organ. The Kidney channel is responsible for reproductive and sexual activity, whereas the Heart channel is responsible for the emotional and mental aspect of the body. Herbal formulas will nourish the kidney essence; the acupuncture will regulate the flow of Qi (vital energy). Research reveals that acupuncture stimulates points that trigger the release of endorphins, natural analgesics found in the spinal cord, brain, and pituitary gland.

Western Treatment
The Western treatment of menopausal problems is founded on the administration of hormone replacement therapy, commonly known as HRT, in different forms. These could be native estrogens (oestradiol, oestrone, oestriol), conjugated equine estrogens, and synthetic estrogens.

The estrogen present in HRT is often supplemented by the administration of progestins. Two classes of progestins are used: native progestins and synthetic progestins. The HRT therapy can be administered orally (tablets), percutaneously (gel), transdermal (patches), vaginally (cream) and subcutaneously (implants). Increasingly, the menopause has been medicalized and defined as a ‘deficiency disease’ that needs treatment by hormone replacement therapy.

It is important to note that the menopause is not a disease and it needs medical attention only if its symptoms are severe. In the United States, 10 to 25% of women experience severe menopause.

The ‘preventive’ effect of HRT against osteoporosis and heart disease is still not clinically proven. There are many studies showing that there is a link between HRT and the increased risk of breast cancer. Finally, ‘protecting’ a woman from osteoporosis and heart disease must surely depend on many factors such as diet and lifestyle before the commencement of menopausal symptoms.

Chinese Approach to Treatment and Prevention of Menopausal Symptoms
Chinese medicine can help a woman in this period of transition from reproductive to a non-reproductive age in a gradual and healthy way. Herbal treatment, acupuncture, meditation and a correct diet will help a woman with menopausal problems. The treatment of a woman with oriental medicine will not yield ‘quick’ results, but will give a natural and balanced protection. Chinese medicine with its gentle and safe manner will tonify Kidney essence without side effects. Chinese medicine can be combined with HRT. There is no contraindication of combining the two treatments because both work in separate ways of treating menopausal problems and symptoms.

There are many different Chinese herbal formulas and acupuncture treatments that will help the menopausal woman based on the diagnosis of the individual. Each woman’s diagnosis is different and there is a combination of acupuncture and herbal treatments suited just for her.

There are dietary recommendations that will ease and/or prevent the menopausal symptoms and strengthen the Kidney essence, such as black beans, sesame seeds, soybeans, walnuts, mulberries, yams, licorice, Chinese black dates, lotus seeds and chyrsanthemum flowers. Certain dairy foods contain the best sources of calcium, notably milk, cheese, and yogurt. Certain seafood (shrimps, oysters, canned sardines, and salmon with bones) and vegetables (broccoli and parsley for example) also contain high quantities of this mineral. Kelp is one of the most calcium-rich plants available.

Daily meditation and proper rest are integral to the prevention of menopausal symptoms. Lifestyle habits that will produce a severe transition include stress, tension, overworking, smoking, excessive or lack of sexual activity, stimulants and drugs.

Menopause is inevitable; there is no denying that fact. How a woman copes with this period of her life is entirely in her hands and her trusted practitioner. Embrace the wondrous changes that occur in all phases of your life. -L.P.