Menopause and TCM

TCM explains how kidney yin and yang affect a woman at menopause
Oriental medicine practitioner Olivier Lejus explores the function of kidney yin and yang at this transitional time
The onset of menopause represents an important step in a woman's life. It is the point when menstruation stops permanently and, consequently, the ability to produce a child disappears forever. For many women, this hormonal change brings many unwelcome side effects. Chinese herbal medicine has been treating these symptoms successfully for many years, and it is becoming increasingly popular as an alternative to hormone replacement therapy.

In Traditional Chinese Medicine, the kidney is responsible for the prenatal energy, which we receive from our parents at conception. It is the leading force behind hormonal changes, our growth, and sexual maturity.

The onset of both puberty and menopause are a reflection of the rise and decline of this primordial force. It determines our basic constitution. It is our genetic footprint, and the material substance needed for the formation of sperm in men and ova in women. If that supply is inadequate, it leads to impotence, retarded growth and premature senility.

Following the principles of Traditional Chinese Medicine, each kidney is classified as either Yin or Yang. As previously mentioned, the kidney yin is regarded as the fundamental substance for birth, growth and reproduction, while kidney yang is the leading force being all physiological changes. Their mutual relationship could be likened to an oil lamp, with the oil inside the lamp representing kidney yin, and the flame providing the heat corresponding to kidney yang. When the oil decreases, so does the flame and vice versa, so we can't treat one successfully without treating the other.

Kidney yang, which is called the gate of vitality (Ming Men), provides the heat and energy needed for all functional activities in the body; it gives us our sexual drive. As the fire of the gate of vitality declines with the advancing years, the functional activity of our organs becomes impaired, leading to tiredness, depression, decreased libido and cold extremities. These unwelcome visitors would be very familiar to many menopausal women.

In Traditional Chinese Medicine, the kidneys also have an additional attribute; their essence is made up of a substance called the marrow, which is quite different from the bone marrow concept of Western medicine. This marrow substance makes up our spinal cord and assists in the development of our brain, and its functions. So there is a connection, in our oriental medical framework, between the role of the kidneys and our mental health.

Poor kidney essence at birth will result in mental retardation in children, and decline in kidney function in old age will lead to poor memory, difficulties with concentration, dizziness, and mental disturbances.

In addition, this form of marrow nourishes our bones and strengthens our teeth. Once again, a picture of poor physical development in children, and osteoporosis and teeth decay in old age comes to mind.

At treatment time, the oriental practitioner's approach will be entirely different depending on whether the main menopausal symptoms arise from a yin type deficiency, or from its yang partner.

The first pattern manifests as some of the following symptoms: dizziness, hot flushes, abnormal sweating, sore back and knees, a dry skin or mouth and a red tongue. In our selected treatment, some herbs will be aimed at strengthening the kidney yin and its essence, will others will target the liver, which is overpowering its kidney partner. Finally, there will be a few additional herbs called assistants, which, due to their cold nature, will be responsible for alleviating the hot flushes and excess perspiration.

Where a female patient is suffering from a deficiency of kidney yang (the flame in the oil burner), there will be mentions of cold sensations in the body, especially in the hands and feet. She will have low energy and poor libido. Often, her urination will be more frequent than it used to be and she might be complaining of diarrhoea and of a sore lower back. Also, due to the lack of heat in her body, her tongue will be pale and her pulse slower than expected.

For this patient, a totally different strategy will be adopted. Our herbal selection will include a few leading herbs that are experts at strengthening the kidney essence and supplementing the blood. They will be complemented by a few assistants who will target the liver and the spleen. These two organs have a powerful influence on the kidney function, so they will need to be kept in check. Finally, a few selected members from the warming squad will make up the rest of the team. They will provide the heat necessary to relieve the back pain, and assist the yang, providing the fuel to build up the fire again. This will facilitate the metabolism of water, eliminate the diarrhoea, and drain the excess urination that has been causing our patient so much grief.

Of course, other dysfunctions elsewhere will often have to be taken into account. This is what makes Chinese herbal medicine an art; the skill lies in the harmonious combination of herbs with different actions and flavours to provide a successful remedy that is unique for a specific patient at a specific time.

Olivier Lejus MHSc (TCM), BHSc (Acup.) is an accredited acupuncturist practising in Sydney