Herbs for Menopausal Symptoms

A portrait of a smiling woman wearing a white shirt against a pastel yellow wall.
Picture of Natalie Chandra Saunders, BA(Hons)
Natalie Chandra Saunders, BA(Hons)

LicAc graduated from the College of Traditional Acupuncture, UK, with a Batchelor of Arts degree and Licentiate in Acupuncture with further training at Heilongjiang University

Menopause is the term used to describe the end of menstruation. It officially occurs 12 months after the final menstrual period, and the average age of menopause in industrialized countries is 51. The lead up to menopause is known as perimenopause and can last for several years before the final menstrual period occurs.

Menopause is a natural phenomenon rather than a disorder but is associated with a variety of symptoms that can have a significant impact on daily life. They occur due to decreasing levels of estrogen and other reproductive hormones. These symptoms may appear during perimenopause and continue for several years after the final menstrual period. They include hot flashes, night sweats, anxiety, insomnia, and more.

In traditional Chinese medicine (TCM) menopausal symptoms are often attributed to a decline in Kidney yin and Essence (jing). However, the reality is a little more complex and several different organs may be involved.

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Menopause According to TCM Theory

In TCM theory, the organs most frequently associated with menopause are the Kidneys. This is because the Kidneys store a substance known as jing, which is responsible for growth, development, maturation, and aging. Jing is said to transition through seven-year cycles in women and eight-year cycles in men. In women, two of the most crucial milestones are the ages of 14 (2×7 years) and 49 (7×7 years).

According to the Chinese medicine classic the Su Wen, at the age of 14 the Tiangui, or “heavenly water” arrives, signifying the onset of menstruation. Then, at 49, the Tiangui is exhausted, signifying menopause.

Jing is a yin substance and is very closely related to Kidney yin. Therefore, in simple terms, menopausal symptoms can be attributed to a decline in both jing and Kidney yin. This decline causes an imbalance between cooling Kidney yin and warming Kidney yang, leading to excess heat in the body and symptoms like hot flashes and night sweats. In some cases, Kidney yang can decline alongside Kidney yin, leading to symptoms like fatigue and low libido.

Several other organs are also implicated in the development of menopausal symptoms, especially the Heart, the Liver, and the Spleen. Each of these has a close relationship with the Kidneys and can be affected by declining Kidney yin and yang. Some of the most common patterns include:

Heart and Kidneys Not Harmonized

The Heart and Kidneys are governed by fire and water, respectively, and they rely upon one another to keep the body in a state of harmony. The Heart warms the Kidneys allowing them to function, while the Kidneys cool the Heart to prevent it from overheating. When Kidney yin becomes deficient, it can no longer cool the Heart effectively. This leads to symptoms such as hot flashes, insomnia, and anxiety.

Kidney and Liver Yin Deficiency

The Liver is governed by wood and relies on the water of the Kidneys to nourish it. Therefore, declining Kidney yin can also affect Liver yin significantly. When Liver yin becomes deficient, it can no longer restrain Liver yang, which may flare upwards resulting in irritability and headaches.

Moreover, Liver yin is closely related to Blood. Menopausal patients often already experience Blood deficiency due to many years of monthly menstruation. This can be exacerbated by Liver yin deficiency and reduced Spleen function (see below) and leads to symptoms such as insomnia, memory problems, and dry skin and hair.

Spleen Qi Deficiency

The Spleen is one of the key digestive organs in TCM and works closely with the Kidneys, Lungs, and Heart to generate qi and Blood. Spleen qi naturally declines with age and is also impacted by factors such as diet and eating habits. When Spleen qi is deficient, it cannot effectively extract nourishment from food, leading to symptoms such as fatigue, weakness, and digestive issues.

Western Medicine Physiological Mechanisms

Menopause is usually associated with declining estrogen levels, but several other hormones are also involved. Progesterone and androgens tend to decline alongside estrogen, as does another hormone called inhibin B.

Inhibin B is produced by the ovaries and plays a crucial role in the menstrual cycle. It communicates with the pituitary gland and tells it when it has produced enough luteinizing hormone (LH) and follicle stimulating hormone (FSH) each month. Because inhibin B levels decrease during perimenopause, the pituitary gland no longer receives these signals and continues to produce LH and FSH. Therefore, levels of these hormones become elevated throughout the menopausal transition.

These dramatic changes are responsible for a wide variety of menopausal symptoms. They also mean that the risk of several chronic conditions, including osteoporosis, heart disease, and dementia, increases significantly following menopause.

TCM Treatment Options

There are several TCM treatment options that can help in the management of menopausal symptoms. They include herbal medicine, acupuncture, and taichi or qigong.

A 2019 review published in Plos One journal found that Chinese herbal medicine was similar to menopausal hormone therapy in its effectiveness for treating hot flashes. Moreover, the authors concluded that it is safe, with only mild gastrointestinal side effects reported.

Meanwhile, a 2018 review published in the Journal of Alternative and Complementary Medicine found that acupuncture could safely and effectively reduce hot flashes and improve health-related quality of life.

Finally, a 2017 review published in Worldviews on Evidence Based Nursing found that taichi had several benefits for perimenopausal women, including reduced pain, improved vitality, enhanced mental and general health, and increased bone mineral density, which may reduce the risk of osteoporosis.

Herbal Treatment for Menopausal Symptoms

There are many different herbs and formulas that can be used to treat menopausal symptoms. The most suitable ones will vary from person to person depending on their predominant symptoms, physical constitution, and underlying TCM patterns. Therefore, it is crucial to consult a qualified TCM practitioner to learn which herbs will be best for you.

That said, there are a few different herbs that might be beneficial to anyone who is transitioning through menopause. They include the following:

Goji Berries

Goji berries on sprinkled over a wooden board.
Imagen de vesiraja en Pixabay

 

In TCM, goji berries (Lycium barbarum) are known as Gou Qi Zi. They have a sweet flavor and neutral nature, and are used to replenish Kidney and Liver yin, nourish jing and Blood, mildly tonify yin and yang, and improve the vision.

In the West, goji berries are often viewed as a “superfood” thanks to their powerful antioxidant properties. They are also packed with nutrition, including B vitamins, vitamin C, and essential minerals like copper, magnesium, manganese, and selenium.

Moreover, goji berries contain a unique compound called zeaxanthin, which is known for its protective influence on the eyes.

Dosage: The recommended dosage of goji berries is 8-10g. They can be brewed as a decoction, by simmering for 20 minutes in water, or used as an ingredient in tea, soup, or congee. Although some people in the West eat dried goji berries raw, TCM practitioners consider it necessary to cook them before consuming.

Wild Jujube Kernel

A plate filled with jujube kernels

Wild jujube kernels are known as Suan Zao Ren in TCM and are the seeds of Ziziphus jujuba var. spinosa fruit. They have a sweet and acrid flavor and neutral nature, acting on the Heart, Liver, and Gallbladder. They tonify yin, nourish the Heart, Liver, and Gallbladder, and calm the mind. They are often used as a treatment for insomnia, as well as to replenish body fluids and stop sweating.

They contain flavonoid glycosides, triterpenoids, saponins, and organic acids, and benefit the nervous, cardiovascular, and immune systems. They have been shown to have sedative and hypnotic effects in scientific studies.

Dosage: The most common way to use this herb is cooked as a decoction or congee. The recommended dosage is 10-15g. It can also be ground into powder and taken orally at a dosage of 1.5-3g each time.

Cordyceps

Two hollow wood pieces and a spoon filled with cordyceps fungus laying on a white surface.
Image by Tú Nguyễn Thanh from Pixabay

 

Cordyceps (Cordyceps species) is a fungus that is known in TCM as Dong Chong Xia Cao. Its Chinese name means “winter worm, summer grass” and comes from the fact that these mushrooms act as a parasite on caterpillars that live in the foothills of the Himalayas. However, it is now possible to find cordyceps that have been cultivated ethically, without the need for a living host.

Cordyceps is a powerful tonic with a sweet flavor and neutral nature. It influences the Kidneys and Lungs to tonify yin and yang, reinforce qi, and supplement jing. It is most often used to treat respiratory issues but also for fatigue, low libido, and to promote longevity.

In Western terms, cordyceps contains several beneficial compounds, including polysaccharides, lipids, and nucleosides. One of the best-known nucleosides is cordycepin, which is thought to be responsible for many of cordyceps’ benefits. It also contains phytoestrogens, which act like estrogen in the body. Cordyceps has been shown to possess antiaging, antidiabetic, and anticancer properties, as well as enhancing physical performance and protecting the kidneys, liver, and lungs.

Dosage: The recommended dosage of cordyceps is 2-10g. This was traditionally taken as a large pill, known as a bolus, or as a powder. Nowadays, it is mostly used as powder, which is often made into capsules for convenience.

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