July 2007

Menopause

By Elliot Wagner, O.M.D., L.Ac., Doctor of Oriental Medicine

Menopause is defined as the complete cessation of the menstrual cycle, determined once a woman has not had a period for one year. It is a normal part of the maturation process, but so many women suffer embarrassing, weakening, and debilitating symptoms during menopause that it tends to be regarded as a medical problem. The number of women who consult their doctors for menopausal problems is so high that Premarin, a brand of synthetic estrogen, was the single most widely prescribed medication for any reason throughout the nineties (in spite of the fact that it was, and is, prescribed only for menopausal women).

In 1991 the National Institutes of Health created the Women's Health Initiative to study the effects of hormone therapy, diet, and certain dietary supplements on the health of menopausal women. This multi-million dollar, 15-year project involved more than 150,000 women aged 50-79. The findings of this huge undertaking by the federal government rocked the medical world when, in 2002 and again in 2004, the NIH announced the termination of the hormone portions of the study "in the interest of safety" after they determined that, among the women taking hormones, there were significantly more overall health risks than benefits. These increased risks included blood clots and strokes, higher incidence of dementia (doubled in women 65 or older), urinary incontinence, venous thrombosis, and breast cancer.

After the results of the NIH studies were announced the popularity of synthetic hormones began to decline and, while they are still considered the standard treatment for menopause and related conditions, and are widely used by menopausal women, this study initiated in the minds of many women a desire to look for alternatives to these medications.

One of the logical places to look for alternatives was the traditional medicines of the world. In traditional cultures menopause is accepted as a part of life much more than it is in developed Western countries. Chinese medical theory views menopause as the body's very wise attempt to help slow down the aging process, a process to work with, rather than as a set of symptoms to be suppressed.

According to Chinese medicine, the fundamental changes that occur during menopause are primarily attributable to kidney yin deficiency. Kidney yin deficiency can be understood as a pattern that is operative when the production of the reproductive hormones, including progesterone and estrogen, begins to decline. As we know from physiology, it is the drop in these hormones that both signals the end of the reproductive years, and creates the unpleasant symptoms that we sometimes associate with menopause and perimenopause.

The yin aspect of the body is that which is associated with substances and secretions; it is closely associated with the blood — as opposed to the yang aspect which is associated with energy and vitality. When the yin aspect is deficient (reduced), the yang aspect becomes relatively stronger. Such a pattern produces symptoms reflecting dryness, heat, and an ungrounded yang: symptoms such as delayed menstruation, hair loss, vaginal dryness, dizziness, hot flashes, five centers heat (hot and irritable sensations in the chest, palms and soles), insomnia, and dry, itchy skin. A body operating with deficient yin is akin to running a car without oil. Like the engine in your car, your body can overheat when there is a lack of cooling fluids.

Traditional Chinese medicine is an effective way to treat the symptoms of menopause. Acupuncture and Chinese herbs have demonstrated powerful effects on the endocrine system; alleviating the imbalance that causes hot flashes, vasomotor instability, loss of bone mass, and other menopausal conditions. Most importantly, they have virtually no side effects, and are gentle and safe, healing and honoring the body as it moves into its next phase.