Menopausal syndrome according to Chinese Medicine

In opposition to patterns related to Kidney Essence Deficiency, this is an Excess type of menopausal syndrome as it is due to Blood Stagnation (sometimes paired with Qi Stagnation). It often happens in Liver and it normally results from emotional factors such as anger, frustration, resentment, irritation, worry or anxiety. 

According to some TCM gynecology books, women who have the most severe menopausal syndrome are often these with long history of Liver Qi and Blood Stagnation.

If the patient also suffers from Kidney Essence Deficiency at the same time, it is recommended to first treat Blood and Qi Stagnation. 

The treatment principle is to invigorate Blood, move Qi, eliminate Stagnation and calm the Mind.

Read more about Qi and Blood Stagnation here

This pattern often appears among young women with premature menopause. The symptoms are due to Phlegm or Dampness accumulating in the Lower Burner instead of the more typical decline of Kidneys Essence, normally the key cause for menopausal syndrome. As for absence of menstruation, Spleen Qi Deficiency is the fundamental reason leading to Phlegm. This is because the Spleen rules the transformation and transportation of Body Fluids. The malfunction of this Organ leads to the accumulation of these fluids and eventually they coagulate and Phlegm appears.

Sometimes there is the case of having both Phlegm and Kidney Essence Deficiency together. In this case it is suggested to first treat the Phlegm or Dampness and deal with other patterns later. 

The treatment principle is to resolve Phlegm, fortify the Spleen, move Qi and eliminate Stagnation.

Read more about Phlegm here

Decreasing of Kidney Essence is the fundamental cause for all menopause-related ailments. It can take the form of Kidney Yin Deficiency, Kidney Yang Deficiency or a combination of these two patterns. 

The Kidneys govern the bones and generate the marrow. In case of Kidney Yin Deficiency,  the Yin and Essence fails to nourish the lower parts of the body properly, therefore the lower back and knees become weak and sore. It can even result in some atrophy of the lower extremities the most severe cases. Body Fluids is a Yin elements and it dries up in case of Kidney Yin Deficiency. It is not able to moisten the body: the throat, mouth and tongue - which are located along the Kidney Channel - become dry and red. The Yin Deficiency also causes Empty Heat and thus some hot symptoms like malar flush may appear. 

Emotional stress is one of the most significant causes of Kidney Yin Deficiency as a cause of menopausal syndrome, especially when the stress lasts for years before the start of the menopause. The Kidneys' functions can be greatly influenced by worry, anxiety and fear. The situation gets worse if the patients also work excessively without proper and sufficient rest. Finally, having too many children too close to each other also affects the Kidney Yin negatively. 

The treatment principle is to nourish Kidney Yin, subdue Yang and clear Empty Heat with appropriate herbal formulas. A more relaxed lifestyle with reduced emotional stress is also obviously recommended.

Read more about Kidney Yin Deficiency here

According to Chinese Medicine, both Spleen and Kidney Yang Deficiency are interlinked reasons behind menopausal syndrome. It is because the Spleen Yang originates from the Kidney Yang so a deficiency in one will cause a deficiency in the other. In turn the Spleen supplies the Kidneys with postnatal Grain Qi and the Blood it transforms from food and drinks.

When the Spleen Yang is deficient due to Kidney Yang Deficiency, its ability to generate sufficient grain Qi, Blood and Post-Heaven Essence decreases. This means the Kidneys have no other option than to consume the reserves of Pre-Heaven Essence they store. Essence is a critical ingredient to generate periods. If the situation last for a while, the Kidneys' Essence gets depleted and premature menopause and premature aging follow. 

The treatment principle is to tonify and warm the Kidneys, tonify Yang, strengthen the Spleen and warm the Centre. 

Read more about Kidney Yang Deficiency here

The symptoms under this pattern are very similar to those under Kidney Yin Deficiency but the condition is much more severe. The Kidney Yin is so Deficient that it dries up the Liver Yin. 

Prolonged Yin Deficiency leads to Liver Yang Rising, as the Yang can not be kept under control. Sometime it can even agitate Liver Wind Internally. Then symptoms such as dizziness, tics, headache and tinnitus appear. Blurred vision is also a typical sign, as Liver opens into the eyes. The Liver houses the Ethereal Soul which, with that condition, has no place to rest at night; hence the insomnia and dream-disturbed sleep.  

Deficiency of both Kidney and Liver Yin together can cause spontaneous emissions as both Organs can not store Essence. Premature graying or loss of hair are other consequences.

This pattern often occurs due to excessive exercise or sex, prolonged physical exertion without proper rest, Blood Deficiency such as chronic menorrhagia or prolonged emotional stress such as anger, resentment or frustration. 

The treatment principle is to nourish both Kidney and Liver Yin, subdue Liver Yang, calm the Mind and settle the Ethereal Soul.

Read more about Kidney and Liver Yin Deficiency here

This pattern is sometimes not listed as a separate pattern under menopausal syndrome by many TCM gynecology books, because it is another variation of Kidney Yin Deficiency with Empty Heart Heat. 

Emotional stress is one of the most critical reasons leading to menopausal syndrome, especially when the high level of stress lasts for a long period of time. The situation is made worse if the patient also overworks and is exhausted as a result. Worry, fear and anxiety harm the Kidneys and result in its Yin Deficiency, which can further deplete Heart Yin and cause Heart Empty Heat. Because Heart houses the Mind, there are Heart related symptoms such as palpitations, mental restlessness or poor memory. 

The treatment principle is to nourish Kidney Yin, calm the Mind and clear Empty Heat.

Read more about Disharmony between Heart and Kidneys here

The fundamentally reason for menopausal syndrome is due to Kidney Essence decreasing. It can take the form of Kidney Yin or Yang Deficiency or the combination of these two. The combined pattern is actually quite common among women over 40s. It is more the rule than the exception. 

Depending on the predominant type (i.e. Yin or Yang Deficiency), the tongue color will be red (for Yin Deficiency) or pale (for Yang Deficiency). The pulse can be Floating-Empty or Fine-Rapid if Yin Deficiency predominates or Weak-Deep if Yang Deficiency predominates. 

Patients can be given two type of herbal formulas simultaneously to treat this combined pattern but each with a reduced dosage. For example, a Yang-nourishing formula can be given in the morning and a Yin-nourishing one for the evening. The volume should be adapted based on the  predominant type: a higher dose of Yin-nourishing formula if Yin-Deficiency is more severe and vice versa. 

The treatment principle is to nourish the Kidneys, nourish Yin, gently tonify Yang and calm the Mind.

Read more about Deficiency of both the Kidney Yin and Yang here