Menopausal Symptoms and Their Causes
Q1: What is menopause?
A:
Menopause is not a disease, but rather a natural transition in a woman’s life. By understanding the changes occurring within the body and learning how to adapt, women can confidently embrace the next stage of life.
Ms. Chen, a woman in her forties, recently experienced persistent dry mouth, night sweats, irregular menstrual cycles, vaginal dryness and itching, dyspareunia (pain during sexual intercourse), and a constant craving for cold water. After several weeks of Traditional Chinese Medicine (TCM) treatment, her mood stabilized, night sweats diminished, and her vaginal discomfort resolved.
These are common manifestations of the menopausal transition.
Menopause refers to the transitional period during which ovarian function declines, resulting in irregular menstrual cycles that ultimately cease. During this time, ovarian production of female sex hormones decreases, leading to a variety of physical and psychological changes collectively known as menopausal syndrome or menopausal symptoms.
The following symptoms are commonly associated with menopause; however, not every woman experiences all of them, and symptom severity varies considerably among individuals.
Menopause most commonly occurs between the ages of 45 and 55 years. Genetics also play a significant role. Women who wish to estimate their likely age of menopause may find it helpful to ask their mother or older sisters about their menopausal experiences.
Q2: What are the common symptoms of menopause?
A:
Vasomotor Symptoms
Hot flashes and night sweats are among the most common menopausal complaints.
In TCM, herbs such as Moutan Cortex (Mu Dan Pi), which clears heat and cools the blood, and Rehmanniae Radix (Sheng Di Huang), which nourishes Yin and clears heat, may be prescribed. Common herbal formulas include Zhi Bai Di Huang Wan, Jia Wei Xiao Yao San, Dang Gui Liu Huang Tang, and Qin Jiao Bie Jia Tang.
Menstrual Changes
Menstrual cycles may become irregular, with alterations in frequency, duration, and bleeding volume before menstruation eventually ceases.
For women approaching menopause who also experience heavy menstrual bleeding due to uterine fibroids or prolonged postmenstrual spotting, TCM formulas that promote the resolution of masses and blood stasis may help alleviate symptoms.
The author once treated a menopausal woman whose uterine fibroids caused recurrent urinary frequency and lower abdominal fullness. After receiving herbal treatment, her abdominal discomfort improved significantly, and postmenstrual spotting was markedly reduced.
Sleep Disturbances
Difficulty initiating sleep, maintaining sleep, or insomnia secondary to night sweats is common.
In TCM, formulas such as Jia Wei Xiao Yao San and Dang Gui Liu Huang Tang may help address insomnia, constipation, and anxiety simultaneously.
Patients may also benefit from acupressure at Fengchi (GB20) and Shenmen (HT7) to improve circulation and promote relaxation.
Mood and Cognitive Changes
Symptoms may include emotional lability, depressed mood, anxiety, irritability, memory impairment, and reduced concentration, often referred to as “brain fog.”
TCM practitioners may prescribe Yi Qi Cong Ming Tang, while increased consumption of legumes may provide additional lecithin to support cognitive function.
Physical Symptoms
Common complaints include muscle and joint pain, headaches, palpitations, weight gain, dry or itchy skin, and breast tenderness.
Acupuncture at Sanyinjiao (SP6), Zusanli (ST36), and Yinlingquan (SP9) may be utilized. Palpitations may additionally be managed with Tian Wang Bu Xin Dan or Biota Seed (Bai Zi Ren).
Genitourinary Symptoms
Symptoms may include vaginal dryness, dyspareunia, decreased libido, recurrent urinary tract infections, and urinary incontinence.
TCM approaches may include Si Wu Tang or Cuscuta Seed (Tu Si Zi) to nourish the blood and tonify the kidneys.
The author once treated a menopausal woman who complained of painful intercourse. Following herbal therapy, her symptoms improved substantially, and even her partner encouraged her to continue treatment consistently.
Q3: Why do menopausal symptoms occur?
A:
Menopause results from progressive ovarian insufficiency, leading to declining levels of estrogen and progesterone.
As ovarian follicles decrease because of aging and natural depletion, hormone production diminishes.
- Declining estrogen disrupts the feedback mechanisms involving the hypothalamus and pituitary gland, resulting in elevated levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
- Loss of hormonal regulation affects menstrual control, thermoregulation (leading to vasomotor symptoms), sleep, mood, and genitourinary health.
- Estrogen deficiency particularly affects estrogen-sensitive tissues, including the vaginal epithelium, skin, brain, and skeletal system, resulting in many of the characteristic symptoms associated with menopause.