By Shihan Mary Bolz
Master of Science Oriental Medicine
Doctoral Fellow, FBU
Master Martial Arts Instructor
It is very interesting to see what is available on the Internet concerning the subject of menopause. There are many headings; among them is “Menopause: causes and treatment.” This is very curious. That seems to be analogous with, “Menstruation: causes and treatment. Do you think this sounds strange? The term “treatment” is usually used when referring to diseases.
Menopause is a word given to the phase in the female’s life when the menstruation has stopped. Here is another curiosity about the word itself. If the menses have stopped, why isn’t it called “menostop” or “menoquit?” Doesn’t the word “pause” mean a period of cessation before something will resume? At any rate, let’s talk about this stage of life and how we can all live with it when and if there are adverse happenings to our health; physically, mentally, and emotionally, during this time.
Normally, this is just another phase of life. If the person is in balance, the person just goes on living their joyous life without interruptions or feelings of not being well. There are cases, however, more and more in modern times it seems, that it is not a very pleasant time of life. One can tell by the number of commercials and advertisements in all forms of media for medications or “natural” remedies to alleviate the unwanted symptoms, which some women experience.
Menopause is the time when the ovaries no longer produce the female hormones of estrogen and progesterone. If the person’s body is very well balanced, everything is adjusted automatically and the person will experience no interruption in her life. However, if other factors are not working well and the person is not in the best of health, the transition can be mildly difficult to very difficult. All other bodily functions must be optimal for a smooth transition. When the transition is not smooth, that means other nutrients or health factors are missing that enable a smooth transition.
Almost everyone is aware, that is interested in this subject, that the allopathic medicine approach of the past has been deemed an error; that is, hormone replacement therapy. Now days, instead of that, allopathic medicine is popularly prescribing drugs like “Fosamax” to help ensure that there will be minimal bone loss in the menopause years. Since menopausal and postmenopausal women do have trouble with losing bone mass, we can see that progesterone and estrogen had many roles to play as a nutritional component. The physiology of life is very complicated and intricate.
Although we seem to know much about physiology from science, we still know so very little in the scheme of it all. What are some of the unwanted symptoms that women can go through? Anything!! There are the classical symptoms or irritability, hot flashes, depression, anxiety, insomnia, etc. Then there are non-classic symptoms. For example, pain.
Allopathic (Western) medical doctors overlook the power of the female hormone system as related to musculoskeletal pain. They are quite familiar with headaches and migraine headaches being related to the female hormone system, but they do not seem to realize that all neuromusculoskeletal pain can be worse or better depending on the rise and fall of the hormones, especially estrogen and progesterone before, during and after the menses, peri menopause, menopause and post menopause. In reality, any symptoms that a person has had before may be enhanced with the onset of the menses and then enhanced around perimenopause and after. Hormones play a great role in all of our metabolic functions, which also affect the neuromusculoskeletal system.
Let us look at the Traditional Chinese Medicine (TCM) approach to helping people who are experiencing varying degrees of difficulty during this period of life. One of the chief causes of imbalance in women during menopause is KidneyYin deficiency with deficiency heat. You are going to ask, “What does that mean?” When we talk about the Kidneys in Oriental medicine, we mean the kidney system. Included in the kidney system are: the kidney organ itself, the adrenal glands and the endocrine system. The “Yin” refers to the blood and fluid balance of the body, when compared with the “Yang” part of the body. The Yang part would be the energy, the metabolic reactions within the body and the “fire” of the body.
When the KidneyYin and the Yang are weak it leads to symptoms of hot flashes, mood swings and night sweats. The Kidney Yang, the “fire” or root of life, is weak; the heat in the body can begin to rise. The Yin, or the fluid part of the body is weak and begins to leak, and it will manifest as sweating. There can be a factor of Heart Yin deficiency as well, which will manifest with symptoms such as insomnia, palpitations, and feelings of anxiousness. When the l Liver is involved, there can be irritability, anger, and depression. There can indeed be many other patterns of imbalance in all of the internal organs. However, whatever those are, there is always a factor of imbalance in the Kidney yin and yang energy. It has never been necessary for the ancients of TCM to define these actions in terms of the hormones; it has been looked at in broader terms and is treated very successfully. However, we can understand both so that we can see the rationale of both the Eastern and Western theories.
So many women and thus allopathic medicine doctors have heard of black cohosh being used to treat hot flashes. This has been used in Europe for a long time. In Oriental medicine, before any herbs are taken, the person will find out from a qualified TCM doctor what their particular pattern of imbalance is. Then, an herbal formula, not a single herb, is prescribed which treats an individual’s main pattern imbalances. Even though the symptoms may be the same in many women, each person’s individual imbalance is different. Therefore, customization of a formula is important and a very wide and in-depth knowledge of diagnosis according to the TCM theory and knowledge of the pharmacology of the herbs is detrimental.
Here is an example of how a formula can be set up according to a diagnosis: A lady comes to the doctor with the following symptoms: Cold hands and feet, generalized fatigue, pale complexion, swelling of the ankles, low back pain and sciatica, hot flashes and night sweats. She also noticed that her back pain had recently become more severe and the sciatica so severe that she could not stand, sit, or even sleep for even short periods of time. She also had been experiencing leg cramps at night.
After a complete history and questioning period about her bodily functions and lifestyle, taking her pulses, reading the tongue and other body signs, the TCM practitioner diagnosed her as Blood Deficient and Kidney Yin deficient with Yin deficient heat. The treatment principle was: Tonify and build the blood, support the kidney yin and clear the heat, resolve the pain. The treatment modalities were acupuncture and traditional Chinese medicinal herbs. At this time, we are going to talk about only the herbal therapy portion of the treatment.
A formula was specifically mixed for her of the following herbs: Bai Shao (Radix Paeonia Alba), Bai Zhu (Rhizoma Atractylodis Macrocephalae), chuan xiong (Rhizoma Liguistic Chuanxiong), Dang Gui (Radicis Angelilcae Sinensis), Fu ling (Poria), ze xie (Rhizoma Alismatis), Fu xiao mai (Semen Tritici Aestivi Levis), Gan Cao (Radix Glycyrrhizae), huang lian (Rhizoma Picrorhizae), Mu Dan Pi (Cortex Moutan), Shou di Huang (Radix Rehmanniae), xiao mai (fructus tritici) , zhi mu (Radix Amenorrhea).
Explanation of the formula: According to traditional Chinese medicine, blood is generally considered the root of female physiology. Deficiency of blood is characterized by anemia, dizziness, and generalized weakness. Stagnation of blood is characterized by pain and cramps and poor circulation of blood may lead to water accumulation and edema. So, one must focus on nourishing the blood and regulating blood circulation.
One of the pairs of herbs in this formula includes dang gui (Radicis Angelicae Sinensis) and chuan xiong (Rhizoma Ligusticum Chuanxiong). They are used here to nourish the blood (build blood) and invigorate its circulation. Dang gui treats the blood deficiency and chuan xiong regulates the blood circulation to relieve pain. Another herb, bai shao has analgesic effects to relieve pain and inflammation. It also has antispasmodic effect to alleviate the spasms and cramps. We cannot discuss all of the herbs in this formula so we will focus on only one, its functions and actions accordingly to Eastern medicine and its pharmaceutical action.
In TCM, dang gui is sweet, pungent and warm in property. It has an affinity for the liver, heart and spleen. Its actions in TCM are to nourish the blood and to invigorate the blood circulation. It is emollient and laxative. It is used for anemia, abdominal pain, dysmenorrhea, amenorrhea and other menstrual disorders. It is used for traumatic injury, arthritis, coronary heart disease and angina pectoris. It is used for constipation of the elderly and debilitated.
Chemical components: Essential oil of various acids, falcarindio, furo-coumarin, vitamin B (nicotinic acid, folic acid, vitamin B12) and vitamin A. Pharmaceutical actions: It can increase the contraction of the uterus and it can also relax the muscle of the uterus. It prevents the decrease of liver glycogen and protects the liver. It prevents deficiency of vitamin E. It treats pernicious anemia because of the concentration of folic acid and vitamin B12. It lowers blood cholesterol. It increases the flow of blood to the coronary artery and prevents myocardial ischemia caused by pituitrin. It is used for coronary heart disease, thrombophlebitis (blood clots in the veins), cerebral arteriosclerosis, and constrictive arteritis. It is antibacterial in function and inhibits the growth of Bacillus dysenteriae, B. typhi, B. cholerae, hemolytic streptococci, etc. It is sedative and analgesic, anti-inflammatory and has an action similar to quinidine because it has therapeutic effect on auricular fibrillation induced artificially by ACTH or electricity. These actions have been studied and concluded by researchers in China using the conventional scientific method of research.
Clinically, dang gui has been used to treat blood clots and poor microcirculation of blood, preventing necrosis (death of the tissue) and it promotes the healing process. There is no female sex hormone action. However, it is has been used extensively for centuries in Asia for all sorts of female disorders, including perimenopause and menopause symptoms. Traditionally, Asian women even cooked soup using this herb, drinking the soup and eating the herb along with other vegetables or/and chicken. In spite of the fact that no known female hormone action has been discovered, it is one of the important herbs to treat the imbalance of hormones. What that tells us is that many, many factors and components of the herbs are involved in their therapeutic effects. It does not have to be a hormone to balance the hormones. In fact, in nature it is usually a component of quite a different nature that balances another component. It is too bad that allopathic medicine did not realize that instead of trying to give the body hormones after it stops producing them. There is a reason nature does everything. It does not make practical sense to try to put hormones in the body when they were not supposed to be there in the first place. Nature did not make a mistake. It knows what it is doing.
Finally, allopathic medicine was shown they could not do this without severe consequences in the health of the person. Therefore, we must go back and realize that if you follow nature, you will be healthy. Go against nature and you will not be. It is too simplistic just to replace parts. Nature does not want those added hormones; they are not supposed to be there after a certain period in life. There are other imbalances and other factors missing that make it difficult for the body to adjust to the decreasing levels of estrogen and progesterone. Those factors need to be adjusted, not hormones added. The above example is a mere sampling of how TCM can help the transition in this time of life, and is meant for educational purposes about TCM. A person should not go out and buy herbs on their own or follow this formula on their own. Each individual should have his or her own formula.
Things you can do on your own: Eat a diet high in vegetables, fruits and whole grains. Wild yam is very helpful to nourish yin and reduce menopause symptoms. It can be cooked in soups and eaten. Stay away from dairy products and red meat, as they promote hot flashes. Avoid alcohol, sugar, spicy foods, and caffeine as they trigger hot flashes and aggravate mood swings. Increase the intake of soy products such as tofu, soymilk, tempeh, natto, and edamame and miso soup. Eat gou qi zi (Fructus Lycii) (common name wolf Berry) on a daily basis by mixing it with cereal or trail mix to nourish the kidney yin and the liver blood. Foods that are especially good for menopause are: black beans, sesame seeds, soybeans, walnuts, lycium berries, mulberries, yams, licorice, lotus seeds, and chrysanthemum flowers. Avoid stress, tension and all stimulants. Exercise on a regular basis.
Good sources of calcium are seaweeds, especially hijiki, Other good vegetarian sources of calcium are wakame, kelp, kombu, dried wheat or barley grass, agar-agar, nori, almonds, amaranth grains, hazelnuts, parsley, turnip greens, brazil nuts, watercress, black beans. Avoid the calcium inhibitors: coffee, soft drinks, excesses of protein, especially meat, refined sugar or too much of any concentrated sweetener, alcohol, marijuana, cigarettes, excess salt. Too little or too much exercise inhibits the absorption of calcium. The nightshade vegetables inhibit calcium: tomatoes, potatoes, eggplant, and bell peppers. Tomatoes inhibit the most. These vegetables contain solanum, a calcium inhibitor. You can be healthy and enjoy a smooth transition and you do not need somebody else’s hormones or manufactured hormones to do it.
Note: Martial Arts Plus Acupuncture Equals Health, Inc. does have many of these food grade herbs available for sale to anyone as food for use in cooking. Herbal formulas are prescribed only after an evaluation by a licensed practitioner of acupuncture and TCM.