What is Menopause?

Menopause is the name for a natural process that all women experience, as the monthly cycle gradually comes to an end, most commonly sometime between the ages of 45 - 55. Perhaps due to popular stereotypes, we also tend to think of it as a pathological state that causes much physical and emotional suffering. In reality, many women may only experience relatively mild discomfort. But according to some estimates, roughly 15% of women will struggle with this transition, and their challenges are real and profound.

There is a wide range of symptoms that can accompany menopause, and each woman’s experience is unique. All women will notice gradual changes in menstruation (often called peri-menopause) in the lead up to a full cessation (menopause is defined as a year without a period). Cycles may become either longer or shorter. The length of the period can also change, sometimes dramatically. Likewise, blood flow may suddenly become heavy or quite light with lots of spotting. These menstrual changes can be accompanied by mood fluctuations, sleep disturbance, hot flashes, night sweats, skin changes, urinary complaints, sexual dysfunction, and more. But regardless of the specifics and severity of your symptoms, Chinese medicine offers a holistic framework for promoting balance during life transitions.

What is Menopause from the Lens of Chinese Medicine?

It is important for women to recognize that it is often quite possible to manage the process of menopause. In order to understand how this may be possible, it is helpful to turn to the Chinese medicine understanding of the process and think in terms of “root” and “branch.”

According to Chinese medicine, the root of menopause is a gradual decline in one’s Kidney Qi. According to Chinese medicine theory, the Kidneys are understood as the source of reproductive fertility, for both men and women, and this decline is an inevitable part of the aging process. But if this process is affected by any number of factors, such as chronic illness, surgeries (especially gynecological ones), diet and lifestyle, emotional stresses, environmental factors, as well as specific constitutions, this can lead to serious imbalances in the “branch” organs, which in this case are the Liver and Heart. 

Many of the classic symptoms of menopause are directly related to dysfunctions in the Liver and Heart. The Liver and Kidneys are said to share the “same source of Essence and Blood,”  so a decline in the Kidneys will lead to a disturbance in the properties of the Liver.

For example, according to classic Chinese medicine theory, the Liver can become “overactive” and unrestrained, leading to headaches, dizziness, irritability, and angry outbursts. Or the Liver’s property to distribute Qi can be constrained, leading to emotional volatility and various discomforts, particularly in the flanks and abdomen. The Heart is also grounded in the Kidneys because the two are said to exchange Fire (from the Heart) and Water (from the Kidney).

If this communication is disrupted, the Heart becomes deficient and is no longer able to properly store the Spirit. An unsettled Spirit will cause disrupted sleep, excessive dreaming, heart palpitations, anxiety, and lack of mental acuity. Broadly speaking, throughout this process, there is a tendency to create internal fire, rooted in the deficiency Kidneys, but presenting as excess, usually in the Heart and Liver. This is the basic explanation for the classic symptom of menopause: the hot flash.

How Chinese Medicine Approaches Menopause Support

Since the root of menopause is in the Kidneys, it would seem that the solution would simply be to supplement the Kidneys. But this approach rarely leads to satisfactory results and mistakes the physiological for the pathological. In traditional Chinese medicine, menopause symptoms are often addressed by considering imbalances in the Kidneys, Heart, Liver, and also the Spleen and Stomach, which are considered central to digestion and overall balance in the body. The reason why these two organs are so important is that they receive food and water and distribute their refined essence to all the organs. They are key to maintaining the abundance of Qi and Blood, which is the only way to slow the inevitable decline of all the organs, including the Kidneys. Spleen and Stomach can be important to menopause treatments for additional reasons. Liver Qi constraint can directly impair the function of these two organs. The Spleen is also essential for facilitating the communication between the Kidneys and the Heart.

Menopause is a complicated physiological process, so it is not surprising that the Chinese medicine explanations for it are also complex. “Individuals experiencing pronounced changes may benefit from working with an acupuncturist to explore personalized support rooted in Chinese medicine. The DAO Labs Menopause Bundle, designed to support balance in key organ systems identified in Chinese medicine. 

The first formula in this bundle is Cool Slumber (Tian Wang Bu Xin Dan). It is a classic formula for facilitating the communication of the Heart and Kidneys. As I explain in my overview of this formula, we have used a version of the classic formula that includes some additional herbs to address the Spleen, making it well-suited to support women during menopause-related transitions.

But in order to address the complications of the Liver, we have also included Emotional Balance (Xiao Yao San) in this bundle. This formula is formulated to support emotional well-being during times of hormonal transition. It also has the added benefit of being an excellent formula for fortifying the Spleen, making it particularly suited to menopause sufferers. 

In Chinese herbal medicine practice, both of these formulas are commonly used to support women during menopause, and sometimes only one of them is needed. Together, they offer a comprehensive approach to supporting balance during this transitional phase. I recommend taking one sachet of Emotional Balance each morning to help get through the emotional challenges of the day and one scoop of Cool Slumber at night to aid with sleep, irritability, and anxiousness. 

There is one other important consideration for practitioners whose menopause patients are experiencing irregular bleeding. Whether bleeding is heavier or more prolonged than normal, this situation is often related to a Spleen Qi deficiency and the inability of the Spleen to retain Blood. In this situation, Mental Tranquility (Gui Pi Tang) is a go-to formula in traditional Chinese medicine for supporting emotional balance and restful sleep—both of which can be affected during menopause. It’s also traditionally used to help maintain menstrual harmony.

Practitioners may explore different herbal combinations based on each individual’s experience by moving between Mental Tranquility and the Menopause Bundle, depending on what set of symptoms is predominant at any given moment.

Care Consideration: Just a reminder that the above information is not a substitute for medical care and is not a substitute for medical advice or recommendations from a healthcare provider.  This information is not intended to treat, mitigate, or cure any disease.  That said, we encourage you to connect with an Acupuncturist in your community to learn more about this and other Traditional Chinese Medicine options.  If you’ve got questions about Chinese herbal medicine or getting started with an Acupuncturist, feel free to connect with us at hello@mydaolabs.com.

Dr. Eric Karchmer is a practicing Chinese medical doctor, medical anthropologist, and co-founder and Chief Doctor of Chinese Medicine for DAO Labs. From 1995-2000, Eric studied at the Beijing University of Chinese Medicine and today is both a licensed acupuncturist and professor at Appalachian State University. Eric can be reached at drkarchmer@mydaolabs.com.