Mind, Body and Spirit point of view.
Yesterday was the World Menopause Day. A day which was established by the International Menopause Society and has been observed since 2009. While in the past a talk about this stage in woman’s life was a sort of taboo, it is great that at this time we can speak about it openly and even have a day in the year to bring awareness and consider support options for improving women’s health and wellbeing at this important transition period.
In this blog I would like to offer a TCM view on menopause and consider how traditional Chinese medicine could help to ease this transition into, what some have called, the ‘third age’ in woman’s life.
In contrast to Western view of linearity of life, TCM sees life in a more circular way or as a path of growth with periods of certain transitions. The first chapter of the ‘Simple Questions’ describes the various stages of life in cycles of 7 years for women and 8 years for men’[i]. These cycles are linked with a flow of, what we call, the essence or Jing, that determines growth, reproduction, development, sexual maturation, conception, pregnancy, menopause and ageing.
The periods around the change of cycle are seen as important transitions or as ‘gates’ that represent transition from one place to another, one state to another. At these transitions, personality and health have opportunity to undergo great change, for better or worth. Thus it is important to bring awareness to these transitions and take special care with your life and health at these times as they can offer a chance to address long-standing illnesses as well as enhance your wellbeing and improve outlook on yourself on multiple levels.
Most women will go through the menopause between the ages of 45 and 55, but there is wide variation. While technically, the menopause is the last menstrual period (no menstrual bleeding for a year), the process is gradual, prolonged and can last for years before and after the last period. Period before the final period is known as perimenopause, which literally means “around the menopause”, refers to the transition years during which periods can became irregular and many other symptoms appear. Postmenopause, on other hand, is the period after the last menstruation and also can last for few years as woman’s reproductive hormone levels continue to drop and fluctuate for some time. Overall, this transition into the ‘third age’ can take somewhere between 7-14 years.
As you might already know, TCM is a holistic practice that dose not separate between mind, body and spirit and addresses the person as a whole. The other key concept in TCM is the Qi or the energy. Energy is everywhere and everything has energy. In TCM we mostly talk about Qi of organs, Qi of spirits, Qi flows in channels, Qi blockages and deficiencies among others. All these energies are interlinked, and we could also talk about Dao or energy of earth and heaven but I leave that for another post.
Let’s first look at the energy of spirit and how it is affected during the menopause. If we look at woman’s life cycles, the period before the menopause is what we could describe as our childbearing years. They are defined by monthly periods that make us fertile but also gives us cyclical contact with spiritual energy that renews us every month. At menopause this connection gradually weakens. If before we could spend our creative energy on caring for children, family, parent, jobs or, in other words, others without feeling depleted, after the menopause we can no longer donate this energy so freely to others without becoming depleted. Thus this is a time to acknowledge your own needs and put yourself first. This on itself is a hard transition as such attitude change can create resistance from those around us. But transit we must or at least be aware that if we do resist this change we should seek help to support our body who has lost the option of monthly spirit energy renewal.
Second, lets bring our awareness to our mind and social impact on it. In the West, the perpetuate youthfulness seems to be most valued. This is reinforced by advertising, media and social media filters. No wonder that many women feel anxious about approaching the menopause. In societies where women increase status with age by becoming the heads of the families and tribes, menopause problems are much less common[ii]. Nevertheless, this social pressure puts our minds in unease and creates, what I would like to suggest, unnecessary stress. Yet, its not the end but the new beginning. So, think about the changes of menopause in a positive light and how you can capitalise on them. This stage will bring increasing freedom and for some even financial security. Children have left the nest or at least become less demanding. For the first time you should have time and energy to do what you want, start a new project, build new relationships and discover your true self. In case if you are still mothering at this stage do enlist help as it will increase demands on your mind and body.
Now, lets look at the body. From Western point of view menopause is defined as permanent cessation of menstruation resulting from the loss of ovarian follicular activity. As ovaries secrete two main sex hormones—estrogen and progesterone menopause is often associated with hormonal imbalances and, in particular, with the rapid loss of estrogen. It is, however, important to remark that ovaries are not the only place where estrogen is produced thus we can not run out of it as such. Nevertheless, some imbalance might be triggered as ovaries would still produce progesterone even after the menopause. Yet, as some have suggested, it is ‘not that we are not producing enough sex hormones, but that they are ether insufficient to balance the effects of stress hormones (cortisol) on the body or are even being sacrificed in our body’s attempt to fuel our high levels of stress.” [iii]
In TCM view, all things in life hang in a balance between Yin and Yang. Sex hormones are seen as Yin in contrast to stress hormone cortisol that is Yang within Yang. Yin is a substance, wet, cool, nourishing, and provides lubrication for all things in the body. Yang is a warmth, energy, movement, not material. While estrogen can be seen as Yin with Yin, progesterone is more like Yang with in Yin as it is more Yang as eastrogen. This can be simply illustrated by woman’s basal temperature raise in during the progesterone phase. If we add the excessive amounts of stress or too much Yang energy at this stage the imbalances might appear. Thus, the ability to manage stress, might be the key reason why some women sail through the menopause without any symptoms. Bring your awareness to your levels of anxiety and stress and how your body experiences them. Is there a way you can minimalize stress in your life?
From elemental energy perspective, the menopause brings a natural decline in your water energy. Water is most yin of all elements. It is stillness, quietness and closely linked with the essence or Jing itself. Water is often stored in reservoirs. Similarly, water energy is closely linked to our overall energy reserves. Overwork, late nights, excessive sex, bad diet all can deplete this vital water energy. We need water energy to balance fire energy and accumulation of heat in the body. Heat that can be observed in most common symptom of menopause – hot flashes, can be generated by many factors. Bad, irregular diet, stress and ‘hot’ emotions such as feelings of anger, resentment and frustration. Thus at this stage of life it is important to re-evaluate what really matters to you. What brings more stillness and peace in your soul and body, rather that do things that goes against your will, stresses you and thus bring imbalance in your body, mind and spirit.
At the core of TCM practice is to balance the body’s energetic system and bring back the homeostasis in the body. Acupuncture, Tuina massage, herbs and dietary adjustments are all natural ways that can help in this rebalancing process. Like irregular periods, or PMS, suffering during the years of menopause in not something you should take for granted. Reach out, seek help and consider TCM to start your healing journey. Smooth your journey through this great transition and enter the third age with an ease.
In the next post I will address the efficacy of TCM in easing specific symptoms of menopause.
 there are other hormones that can be affected in menopausal period.
[i] Maciocia, G. (2005). Foundations of Chinese Medicine. Churchil Livingston. P.46.
[ii] Scott, J, & Scott, S (1991). Natural medicine for women. Gaia Books Ltd. p.168.
[iii] Welch, C. (2011). Balance your hormones, balance your life. Da Capo Press. p.20