Managing Menopause with Traditional Chinese Medicine
By Bindi Zhu, M.D. (China) Ph.D. (Traditional Chinese Medicine)
A Women Health Initiative study has advised most postmenopausal women to stop taking hormone replacement therapy (HRT). In this report, statistical analysis supported findings of risks exceeding benefits, prompting the data and safety monitoring board to recommend an early end to the trial after 5.2 years. The data showed among the 16,608 participating women, an increased risk of invasive breast cancer, bone fractures, coronary heart disease, stroke, pulmonary embolism, endometrial, colorectal, and other cancers.[1]
Understandably, many women are at odds with this new study and find themselves struggling with how to handle menopause.
In China, most menopausal women use Traditional Chinese Medicine (TCM), particularly Chinese herbs, instead of hormone therapy. A history of long-time use and thorough documentation make it the treatment of choice for these menopausal women.
In America, an MD might send a menopausal woman to see a different specialist for each symptom. A qualified provider in TCM, however, will recognize these symptoms as a pattern-related syndrome. By treating the entire disorder, menopausal patients using TCM typically experience a dramatic reduction in all their symptoms.
What is Menopause? A Chinese Medicine View
How exactly does Chinese medicine treat menopause? First, to start a dialogue on this matter, one must have a sound definition of menopause.
With age, the ovaries become progressively less responsive to stimulation from the female body’s hormones. Secreted by the pituitary gland, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) cause the ovary to release estrogen and progesterone. These essential hormones govern a woman’s monthly cycle.
Consequently, as the ovaries slowly stop releasing eggs, the pituitary releases more significant amounts of FSH to kick-start the ovaries’ production of eggs. As a result, the menopausal female body experiences significant estrogen fluctuations comparable to girls’ experience during puberty. [2] Gradually, the body again finds its balance.
As an endocrine organ, the ovary shifts from a follicle-rich producer of estrogen and progesterone into a producer of androgens and estrogen. The postmenopausal ovary continues to respond to the pituitary, releasing increased testosterone levels and decreased levels of estrogen and the estrogen precursor, androstenedione. Most of the testosterone and androstenedione convert to estrogen through an enzymatic reaction initiated by aromatase, an enzyme found in muscle and fat. [3],[4] Certain Chinese herbs stimulate aromatase production, providing additional amounts of the catalyst for estrogen conversion.
Menopause is not a disease but part of the natural progression of each woman’s life. In light of the recent findings published in JAMA, it becomes exceedingly clear that women today need to be able to deal with the symptoms of menopause without the risk of cancer and other diseases.
The Chinese Medicine Approach
Chinese medicine emphasizes the differentiation of syndromes; even within the same “disease,” each stage (e.g., perimenopause, menopause, postmenopause) will require a different treatment type. Also, each individual develops symptoms in a way unique to their body’s constitution. Chinese medicine treats each person’s entire syndrome with a holistic approach that looks beyond symptoms to determine a more appropriate, and in many cases, a more effective manner of healing.
The human body exists in a state of relative balance described by the yin yang paradigm. Chinese medicine operates within that paradigm to bring each person to a balance defined by their body’s constitution parameters. With this perspective, the Chinese medicine doctor approaches menopause as a force needing balance, not as a disease requiring treatment.
The treatment protocol for reclaiming this balance ties into the individual’s constitution, immune system, stress level, emotions, and other illnesses. For example, although many women may come into the clinic diagnosed as menopausal, each may demonstrate a different combination of possible symptoms. Some typical symptoms include hot flashes, night sweats, palpitations, insomnia, heavy menstrual flow, skin and vaginal dryness, alternating chills and fever, mood swings, depression, poor memory, etc.
What Herbs Are Used To Treat Menopause?
Dr. Zhu may prescribe a variety of herbs to increase estrogen levels, reduce stress, invigorate blood flow and energy levels, and maintain emotional stability. Such herbs might include Radix Paeoniae Alba and Radix Glycyrrhizae, which increase estrogen by increasing the aromatase enzyme that converts testosterone to estrogen. A Chinese herbal formula used for hot flashes, liu wei di huang wan, elevated estrogen levels in menopausal women in clinical trials. Another formula, xiao yao wan, lowers estrogen levels in women with benign breast disease and may be safer for breast cancer survivors. [5],[6] However, each person reacts differently to herbs, and formulas often require modification to suit each woman’s individual need.
Is Chinese Medicine Right For You?
Each patient’s case is different, and Dr. Zhu will work with you to explain the best course of treatment based on his extensive knowledge of Chinese medicine.
Dr. Bindi Zhu has been practicing acupuncture and Chinese herbal medicine in Austin for over 20 years. He has medical and doctoral degrees from Heilongjiang University of Traditional Chinese Medicine and has taught at the university level in China and the United States. Formerly, He was the director of the division of integrated medicine at Heilongjiang University Medical Center.
[1] Rossouw, Jacques E. et al “Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopaus al Women.” Journal of the American Medical Association July 17, 2002; 288(3).
[2] Love, Susan M., Lindsey, Karen. Dr. Susan Love’s Hormone Book: Making Informed Choices About Menopause. Three Rivers Press: New York, 1998. p. 4-7.
[3] Hluijmer, A.V. et al. “Endocrine activity of the postmenopausal ovary: The effects of pituitary down-regulation and oophorectomy.” Journal of Clinical Endocrinology a nd Metabolism 1995; 80:2163-2167.
[4] Ushiroyama, T., and Sugimoto, O. “Endocrine function of the peri- and postmenopausal ovary.” Hormone Research 1995; 44: 64-68.
[5] Zhan g, G.I. “Treatment of breast proliferation disease with modified xiao yao san and er chen decoction.” Chung His I Chieh Ho Tsa Chih 1991; 11(7): 400-402, 388.
[6] Zhan g, J.P. and Zhou, D. J. “Changes in leukocytic estrogen receptor levels in patients with climacteric syndrome and therapeutic effect of liu wei di huang pills.” Chung His I Chieh Ho Tsa Chih 1991; 11(9): 521-523, 515.