Ancient and Contemporary Approaches to Treating Menopause
By: Bill Reddy, L.Ac., Dipl.Ac.
You’re sitting comfortably in a restaurant waiting for your appetizers to arrive when it happens. It feels as if someone abruptly set the thermostat 105 degrees Fahrenheit. Beads of sweat begin to form on your forehead and neck and you wonder if your face is getting beet red. Or maybe you’re at home watching TV and when a little boy hugs his dog in a commercial you suddenly feel like crying.
If this sounds like you, you’re not alone, although the symptoms are different for each woman. The most common are hot flashes, night sweats, insomnia, fatigue, forgetfulness, mood swings, vaginal dryness or itching and weight gain. Menopause usually occurs in women between the ages of 45 and 55, but can vary widely based on a number of variables.
A human female is born with 1-2 million follicles that will eventually develop into ova (eggs). By the time she reaches puberty and begins her menstrual cycle she has less than a ½ million remaining. Every month close to 1,000 follicles perish, with one or more developing into a viable egg for fertilization. When there are few remaining follicles, menstruation ceases and menopause begins. Some sources define menopause as the natural cessation of a woman’s period for one year.
MDs will often recommend Hormone Replacement Therapy (HRT) but this trend has decreased in recent years following studies suggesting that HRT may increase the risk for gallbladder disease, stroke, and cancers of the liver, uterus, and breast. 1,2
Natural Strategies to Ease Symptoms
A comprehensive and holistic approach can address the acute symptoms with with fast-acting herbs while also looking at lifestyle and dietary changes for long-term benefit. Modify your diet to avoid sugar, caffeine, alcohol, and processed foods, and emphasize a variety of whole foods such as lean proteins, vegetables, fruits, beans and healthy oils such as flaxseed, coconut, and fish oil. Eliminate sodas from your diet. The phosphoric acid in soda creates an acidic environment in your body. This, in turn, may cause calcium to leach from your bones, which can contribute to osteopenia or osteoporosis. Plant lignans are incredibly important against cognitive decline, cancer and hypertension (high blood pressure) and are found in whole grains, flaxseed and vegetables. Don’t underestimate the power of whole foods – they can change your life. Additionally, make sure to stay hydrated and to get 40-60 minutes of exercise that you enjoy each day, for optimal cardiovascular and bone health. These dietary and lifestyle additions will go a long way to improve your general sense of well-being and reduce symptoms.
Chinese dietary strategies
In traditional Chinese medical theory, the symptoms associated with menopause fall under the category of a Yin deficiency. Foods that build or “tonify” the Yin would include mung bean and mung bean sprouts, black sesame seeds, barley, kidney beans, fermented tofu, millet, black beans, seaweed, spirulina, string beans, and wheat germ.
Black cohosh is a common herb that can be effective in relieving menopausal symptoms such as hot flashes and mood swings. A recent study comparing the effectiveness of black cohosh extract to typical hormone therapy (transdermal estradiol) found that the two were equivalent in effectiveness in reducing hot flashes. In addition, the estrogenic effects of black cohosh have been demonstrated to have a positive impact on bone density without the risk of increasing the probability of estrogen receptor type cancers such as breast or uterine cancer. Begin with 20mg of the dried root powder twice per day, ramping up to 40 mg twice a day if no improvement in symptoms is noted within a week or two at this dosage. There are no known drug interactions that I’m aware of, and side effects of abdominal discomfort, dizziness, headaches and nausea are only reported at high doses (several thousand milligrams per day). It’s contraindicated for women who are pregnant or breast-feedingLicorice, root, depression and osteoporosis
Licorice root is one of the more popular herbs in the Chinese herbal pharmacopeia. The deglycyrrhized version, known as zhi gan cao, is found in most modern formulas and does not elevate blood pressure. It has been shown to reduce depression and slow the progression of osteoporosis. A study published in the Journal of Molecular Neuroscience evaluated compounds of the Isoflavene and isoflavan groups (contained in licorice root) and found that they had an effect on serotonin reuptake and may be beneficial for mild to moderate depression in pre- and post-menopausal women. An added benefit of licorice is that it helps support digestive health and can heal stomach ulcers.
Angelica sinensis, or dong quai is another example of a commonly used Chinese herb that manages gynecological conditions. A book entitled “Pharmacology and Application of Chinese Materia Medica” referred to a Chinese study involving dong quai among other botanicals in a specific formula that demonstrated a reduction in hot flashes and other menopausal complaints by 70%. Some sources refer to dong quai as a phytoestrogen (plant based estrogen like compound) but it actually is an adaptogenic herb. This means that it has a balancing effect on the female hormonal system. The only reported side effect is that it may cause fair skinned people to be sensitive to sunlight, and may interact with blood thinners such as Warfarin or Heparin. Before taking any Chinese herbs you should consult a Licensed Acupuncturist (L.Ac.) who is properly trained in traditional Chinese medicine to prescribe individualized herbal formulas.
Acupuncture has been well studied for its positive effect on menopausal symptoms. There are over 18,000 journal articles on the National Institutes of Health (NIH) PubMed database pertaining to acupuncture, and over 150 specific to acupuncture’s effect on menopausal symptoms. A review of clinical research regarding acupuncture and menopausal symptoms concluded that “The recent systematic reviews on acupuncture in menopausal symptoms suggest that acupuncture is an effective and valuable option for women suffering from menopause.” My personal experience supports this statement. A recent Iranian study stated: “Application of the combination of Chinese herbal medicine and acupuncture proved as effective as hormone therapy in the treatment of menopause-related symptoms, and it achieved better outcomes than herbal medicine alone.” I’m impressed with the fact that western (allopathic) medicine is trying so hard to study and understand the underlying mechanisms of acupuncture, but millennia of brilliant Chinese thought led to an ingenious holistic medical system that works. Instead of drugs, which interfere with the natural processes of the human body, it works WITH your body to accelerate healing, balance the endocrine system (responsible for hormones) and create homeostasis (balance and harmony).
Menopause is a natural part of life for women, but that doesn’t mean they must suffer through it. Nature offers a number of options to ease the transition, and working with an acupuncturist in addition to your doctor will help optimize your health and reduce the incidence of a variety of cancers, osteoporosis, and stroke.
Baker, C.E. (publisher) Physicians’ Desk Reference. Oradell, NJ: Medical Economics Co., 1982, pp 1899-1900
Bill Reddy is a nationally board-certified licensed acupuncturist who studied under graduates and professors from Beijing and Shanghai medical schools. He currently serves on the Board of Directors of the Integrated Healthcare Policy Consortium. He is the former President of the Acupuncture Society of Virginia and professor at the Virginia University of Oriental Medicine. He is the author of over 60 publications, lecturer, an avid practitioner of Qi Gong and Tai Chi, and practices at the Pinecrest Wellness Center in Annandale, Virginia.