Some women look forward to it, other women dread it: menopause, the cessation of menstrual cycles. Just as women begin to menstruate naturally in their early teens (menarche), unless a health issue interferes, women will eventually cease to menstruate (menopause). It is a natural process, not a disease.

Some women have no problems with this transition and navigate it on their own; many women, however, experience one or several uncomfortable symptoms as menopause approaches and beyond. This time period is called perimenopause and can begin as early as your mid-thirties and continue into your late fifties and early sixties. Western and Eastern medicine have different explanations for the changes women experience during this phase, but they can complement one another as we try to understand what’s happening.

Looking at it through a biomedical lens

The number of eggs stored in a woman’s ovaries since birth are greatly reduced by the time she reaches her forties, and the ovaries no longer respond eagerly to follicle stimulating hormone (FSH) released by the pituitary, also called the master gland, which is located inside your skull just below the brain. During your reproductive years, the growing follicles in the ovaries produce estrogens that have a beneficial effect on many body tissues (unless too much estrogen is circulating at certain times). During perimenopause, estrogen production declines and your body has to adjust to the new levels. Production of other hormones, such as progesterone and testosterone, is also gradually diminished.

Considering an East Asian perspective

Eastern medicine has been observing and documenting these natural changes for over 2000 years but additionally pays close attention to a woman’s constitution and what else has been going on in her life. We focus on functional relationships, transformations and balance. The root of our reproductive system are the Kidneys, which, according to Chinese medicine, comprise many functions of hormone regulation, including adrenal, thyroid and ovarian hormones. The health and strength of our Kidneys decline as a result of hard living and aging. To preserve Kidney health, we need to live moderately and provide nourishment in the form of healthy foods, physical activity, balanced emotions, and certain tonic herbs.

Two areas are of particular concern for women in our modern-day practice: a decline in Kidney health can lead to yin deficiency, manifesting as hot flashes, and yang deficiency, causing sluggishness and weight gain; and a stagnation of Liver energy may lead to mood swings, anger and frustration, and pain or achiness in the body. Additionally, when the flow of your energy stagnates, the different physiologic functions in your body are obstructed, and unhealthy accumulations of dampness and heat result.

Natural approaches to menopause

Once we determine what the root causes of menopausal symptoms are, we can consider several treatment strategies to alleviate discomforts and support your body during the transition. Well-chosen homeopathic medicines can provide safe and immediate symptom relief, acupuncture can alleviate pain, anxiety, hot flashes and indigestion over time, and a selection of classic prescriptions of Chinese medicinal herbs are the basis of gynecologic treatments in modern clinical practice. They are very adjustable to your individual needs and do not present the same level of risk as common pharmaceutical drugs. In addition, we use several botanicals from the Western naturopathic and Ayurvedic traditions, which have been shown to help women cope with discomforts during menopause and maintain strength and mental clarity. Some of the most well-known herbal medicinals in this group are black cohosh, dong quai, chaste berry, winter cherry, and other so-called adaptogens.

I also discuss appropriate dietary improvements, nutritional supplements, and exercise with my menopausal patients. In fact, meditation has been shown to be very effective in dealing with hot flashes. One more reason to start practicing!

© 2022 Christiane Siebert