Perimenopause: The Transformation to your authentic self
Image from Matthew Henry
I imagine you’re heard about perimenopause recently. Are you ready to hear the Chinese Medicine take? I think you’re going to like this better than the “oh we don’t know. No research has been done on that,” or “yeah, that’s just what it is to be a woman” that you hear from many medical practitioners. Unfortunately, female bodies and the changes they go through as our hormones decline haven’t been studied by modern medicine until recently and most doctors who have been practicing for a long time didn’t have any, or had very little training in perimenopause! This IS part of what it is to be a person with ovaries, but that doesn’t mean we should just grin and bear it!
My teacher, Yair Maimon, has a lovely way of wording how Chinese medicine sees this stage of life. He says, “the story of menopause is a story of creation, gaining wisdom, giving life, being grateful.” It is a time of transformation during which a person becomes their authentic self and gains greater wisdom. So let’s dwell on that, shall we?
The Huang Di Nei Jing, or the Yellow Emperor's Inner Canon, talks about the 7 year cycles women traverse in their lifetimes. At the age of around 49 or the 7th cycle, menstruation stops for a woman, and she can no longer have children. In western culture this is seen as a time when a woman becomes sort of washed up and unimportant. Like, so unimportant that medical students don’t really learn anything about treating this stage of life at all! We have only recently learned that many of the symptoms women of a certain age experience may be related to perimenopause and have only recently learned that this stage of life could last for about 10 years! Until recently, the only symptoms definitively linked to perimenopause were night sweats and hot flashes.
The symptoms that come along with perimenopause vary from person to person which makes it a little bit hard to really parse what is related to perimenopause and what is not. Does that matter to your Chinese medicine practitioner? NOPE. Because we have always treated you by listening to your unique set of symptoms and identified a pattern of imbalance, and then treated that pattern to return your body to its normal balanced rhythms. Can Chinese medicine stop perimenopause from happening? No! But it can certainly ease the transition.
The insomnia, memory lapses when you walk into a room and cant remember why you’re there, the weight gain, the rage 😡, the irregular cycles, the joint pains, the hot flashes, the fatigue, and the rest of it are a result of the decline in estrogen and progesterone that is slowly depleting in your body. It is not a simple decline in hormones, it is more of a hormone roller coaster as your body releases stimulating hormones to stimulate the production of more estrogen from a declining population of follicles in the ovaries. As Dr Mary Claire Haver, perimenopause-focused gynecologist and author of The New Menopause: Navigating Your Way Through Hormonal Change With Purpose, Power and the Facts explains, “Your ovaries’ functional capabilities begin to wane too, resulting in less reliable hormone production and decreased responsiveness to hormone signals. This decline in function will continue, causing disruptions to your cycle and creating symptoms of hormone withdrawal, which can signal the entry into the menopausal transition, aka perimenopause, and lead to irregular periods, hot flashes, increased anxiety, heart palpitation, and more.” (Haver, 2024).
Enter acupuncture and Chinese herbal medicine. Acupuncture has been shown to lower stress hormones like cortisol and HPO axis-related hormones like follicle stimulating hormone and luteinizing hormone in a study entitled Effect of Acupuncture on the Endocrine Axis in Patients with Perimenopausal Insomnia: A Case Series Study (Tang et al, 2022). The same study results showed an increase in estrogen after treatment. When cortisol is lower and estrogen is higher, perimenopausal women feel better and enjoy more normal body functioning. In another study entitled Acupuncture: A Promising Approach for Comorbid Depression and Insomnia in Perimenopause determined acupuncture is a promising treatment for comorbid depression and insomnia during perimenopause, likely because of its neuroendocrine modulating effects (Zhao et al, 2021).
Dr Haver recommends a multitude of support solutions to ease the transition, including anti-inflammatory nutrition, strength and endurance-building exercise, evidence-based pharmacology, strategic supplementation, stress reduction, sleep optimization, and community engagement.
Acupuncture not only has a positive effect on your hormones, but it can help improve sleep, reduce inflammation, reduce stress, and ease your transition through perimenopause.
Resources:
Haver, M. C. (2024). The new menopause. Rodale Books.
Tang, Y., Zheng, Q., Huang, J., & Chen, Y. (2022). Effect of acupuncture on the endocrine axis in patients with perimenopausal insomnia: A case series study. World Journal of Acupuncture - Moxibustion. https://doi.org/10.1016/j.wjam.2022.05.007
Zhao, F.-Y., Fu, Q.-Q., Spencer, S. J., Kennedy, G. A., Conduit, R., Zhang, W.-J., & Zheng, Z. (2021). Acupuncture: A Promising Approach for Comorbid Depression and Insomnia in Perimenopause. Nature and Science of Sleep, Volume 13, 1823–1863. https://doi.org/10.2147/nss.s332474