Menopause – A Transition and a New Beginning
Menopause is not a disease – it is the normal biological transition in a woman’s life from a reproductive to a non-reproductive age. In the Chinese culture, this time in a woman’s life is referred to as her “Second Spring”. It is a time worth celebrating, as the life blood returns from the source of life creation (the Uterus) back to the source of spiritual creation (the Heart). In Traditional Chinese Medicine theory, the Heart is where the Spirit resides. Menopause is, therefore, a time for spiritual growth and personal development in TCM theory.
Timelines and Definitions of Menopause
The term “menopause” refers to the discontinuation of menstruation for a period of one year or more. It usually happens between the ages of 48 and 55, with the average age in industrialized countries being age 51. The age at which menstruation stops seems to be linked to certain factors such as smoking, blindness & early puberty (all causing it to happen earlier), and obesity & higher socioeconomic class (which cause it to happen later). If menstruation and ovulation stop before the age of 35 or 40, it is called premature ovarian failure. Artificial menopause can be induced by surgically removing or damaging the ovaries, or by cancer, chemotherapy or radiation.
Perimenopause refers to the time, usually lasting 2-5 years or so, preceding the end of menstruation. During this time ovulation may still happen every month, but ovarian hormone production begins to decrease and there may be changes to menstruation such as irregularity, heaviness, or scantiness. Some symptoms associated with the physiological transition may begin to appear during this time – the term “climacteric” refers to the normal changes which occur during this time.
Postmenopause is the term used to describe the time 12 months after the last menses. Eggs are no longer being released from the ovaries, and the levels of ovarian hormones estrogen and progesterone drop significantly.
Menopausal syndrome refers to the recurring or persistent symptoms which some women experience during their climacteric period. Hot flashes, headaches, change in mood, insomnia, vaginal dryness, osteoporosis and sweating are some of the more common complaints.
Causes of Menopausal Syndrome
The hormonal basis for the progressive decline of a woman’s reproductive ability is related to her ovaries. Beginning at the time when a woman is still a fetus in her own mother’s womb, the number of her ovarian follicles (which contain the eggs) steadily declines – there are approximately 6,000,000 follicles present in a fetal ovary; about 600,000 follicles are still present at birth; 300,000 follicles remain at first menstruation; and only about 10,000 are remaining at the time of menopause. The process is a gradual one that happens over the course of a woman’s lifetime, and her lifestyle and dietary habits beginning in childhood can influence what kind of menopause she is going to have. Some gynecologists believe that, technically, only the hot flashes and vaginal dryness are related to the decreased estrogen that comes with decreased follicular activity. The rest of the symptoms, in their opinion, are due to increased stress at this time of life.
Treatment for Menopausal Syndrome
For gynecologists and endocrinologists, the treatment of choice for menopausal syndrome is hormone replacement therapy (HRT). Estrogen or an estrogen / progesterone combination is most commonly used to relieve the discomforts associated with a change in hormone levels. While the relief of symptoms can be achieved with this method, unfortunately HRT has been associated with an increased risk of heart disease, stroke, breast cancer, and endometrial hyperplasia (excessive cell growth in the uterine lining).
The Traditional Chinese Medicine treatment for menopausal syndrome is a different philosophy than hormone replacement, since Chinese medicine sees this time of life as a natural progression, and not a hormone deficiency which needs to be supplemented. In fact, if you are currently taking HRT then it is not a contraindication to also take Chinese medicinal herbs at the same time, because the two work in very different ways. It usually takes about two months for the Chinese herbs to take effect – if you are considering stopping HRT this can be done without a dangerous reaction, but it is important to realize that menopausal symptoms may return before the Chinese herbs have a chance to take effect. Chinese herbal formulas are unique to each person – hot and dry symptoms are treated with cooling, nourishing herbs. Other discomforts a woman may be experiencing are treated based upon what patterns of disharmony she is displaying according to her Chinese medicine diagnosis. Is her Liver Qi circulating? Is her Liver Yang rising? Is her Kidney Yang deficient? Are her Spleen and Liver harmonized? Is there any stagnant Blood or Phlegm? These patterns are primarily treated with herbal medicine, but acupuncture can also be used.
Self-Care for Menopausal Syndrome
Eating a healthy diet is key to minimizing discomfort – fruits, vegetables and whole grains are encouraged, while saturated fats, oils, sugar, caffeine and alcohol are discouraged. Ensuring that you are getting enough Calcium (1,500 mg/day) and Vitamin D (at least 800 IU per day) through diet or supplements is also recommended. Regular physical activity can help protect against cardiovascular disease, and moderate weight bearing exercise is advised to help prevent osteoporosis and reduce the risk of bone fractures. Living a healthy lifestyle is the best way to treat or prevent any discomforts during menopause; Traditional Chinese Medicine is a natural way to treat any discomforts that do arise during this transition.