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Perimenopause and menopause are natural processes in a woman's life that involve the cessation of ovarian function and the end of menstruation. Perimenopause is a term which means “around menopause”. It refers to the time during which your body makes the natural transition to menopause, marking the end of the reproductive years. Perimenopause is also called the menopausal transition. Women start perimenopause at different ages.
According to a case study conducted by the Study of Women’s Health Across the Nation (SWAN), women experience various aspects of menopausal transition differently.
While hormonal therapy is often prescribed to manage these symptoms medically, you can also turn to acupuncture as an alternative natural healing treatment made available to you here in NZ.
In fact, Traditional Chinese Medicine has been documented as having a positive impact on assisting in managing and helping to alleviate menopausal symptoms including hot flashes, night sweats, vaginal dryness, heart palpitations, anxiety, and insomnia.
As ovulation becomes more unpredictable, the length of time between periods may be longer or shorter, your flow may be light to heavy, and you may skip some periods.
If you have a persistent change of seven days or more in the length of your menstrual cycle, it could be a sign that you are experiencing early perimenopause. If you have a space of 60 days or more between periods, it could mean that you are in late perimenopause.
Hot flashes are reportedly common during perimenopause. The intensity, length and frequency can all vary. Sleep problems can result from hot flashes or night sweats, but sometimes sleep can become unpredictable even without them.
Mood swings, irritability or increased risk of depression may happen during perimenopause. The cause of these symptoms may be sleep disruption associated with hot flashes. Mood changes have been known to result from factors not related to the hormonal changes of perimenopause.
When oestrogen levels diminish, your vaginal tissues may lose lubrication and elasticity, which can consequently, potentially make intercourse painful.
Low oestrogen could also potentially leave you more vulnerable to urinary or vaginal infections. Over time, the loss of tissue tone could be a contributing factor to the development of urinary incontinence.
As ovulation becomes irregular, generally your ability to conceive is believed to decrease. However, it is a generally accepted consensus that as long as you’re having periods, pregnancy is still possible. As a measure of precaution, if you wish to avoid pregnancy, use birth control until you’ve had no periods for 12 months.
During perimenopause, sexual arousal and desire may change. But if you had satisfactory sexual intimacy before menopause, it is likely that the same could continue through perimenopause and beyond.
With declining estrogen levels, generally, you start to lose bone more quickly than you replace it, increasing your risk of osteoporosis — a disease that causes fragile bones.
Declining oestrogen levels may lead to unfavourable changes in your blood cholesterol levels, including an increase in low-density lipoprotein (LDL) cholesterol — the “bad” cholesterol — which contributes to an increased risk of heart disease.
At the same time, high-density lipoprotein (HDL) cholesterol — the “good” cholesterol — decreases in many women as they age, which is also associated with increasing the risk of heart disease.
Acupuncture treatment is a Traditional Chinese Medicine that involves the insertion of fine needles into specific points on the body to stimulate the flow of Qi, or life force energy. It is based on the idea that imbalances or blockages in Qi can lead to illness and disease. Acupuncture has been medically used for centuries to treat a wide range of health conditions, including menopause-related symptoms in both men and women.
One of the ways acupuncture can help alleviate menopause symptoms is by regulating a woman’s hormonal balance. According to research done on TCM, menopause is caused by a decline in the kidney essence, which is responsible for producing and regulating hormones.
By stimulating specific acupuncture points, acupuncturists may be able to increase the production of oestrogen and other hormones, helping to alleviate symptoms like hot flashes and night sweats.
Approximately 60–80% of menopausal women experience hot flashes and sweating and the peak stage of onset occurs during the late menopausal transition and early menopause. It is believed in TCM that hot flashes are mainly caused by kidney Yin deficiency, resulting in excessive kidney fire and Yin deficiency in the liver and kidney, and ascendant hyperactivity of liver Yang. Hence, TCM methods for menopausal hot flashes mainly consist of nourishing Yin and clearing heat in order to regulate neuroendocrine functions.
The Chinese-patented medicine, Heyan Kuntai capsule (HYKT), is widely used to treat these menopausal syndromes. A dual-center, randomized, double-blind, double-dummy, parallel-controlled study was conducted for 3 months in which 147 women were enrolled and 123 completed the trial. Menopausal women were randomly divided into groups receiving either the Kuntai capsule or estradiol valerate. The modified Kupperman index, serum estradiol, and vaginal epithelial cell index were assessed as primary outcomes for evaluating treatment efficacy, and adverse events, such as vaginal bleeding and mastalgia, were also recorded. After treatment, both drugs reduced hot flashes in 92.3% and 96.5% of women, respectively, which was not significantly different (p > 0.05), suggesting that both HYKT and estradiol valerate were effective in alleviating hot flashes.
Another randomized, double-blind, placebo-controlled study was conducted on 31 postmenopausal women in the Netherlands, in which the Chinese medicine Zhibai Dihuang was administered for 12 weeks followed by 4 weeks of treatment discontinuation. At follow-up, researchers evaluated the effect of this treatment on vasomotor symptoms, including hot flashes and night sweating, and found that Zhibai Dihuang significantly improved symptoms compared to a placebo (p < 0.01).
The efficacy of acupuncture in the treatment of hot flashes has been verified by extensive data provided by Chinese and international studies. A prospective and multicenter cohort study using acupuncture to treat 175 patients with hot flashes found that, within 24 h, more than 62% of subjects in the acupuncture group reported improvements in symptoms, whereas only 27% of subjects in the control group reported an improvement.
Among menopausal symptoms, depression and anxiety are the main characteristics of the non-specific psychological syndrome and are considered menopausal mood disorders. The morbidity of mood disorders is higher in menopausal women than in their healthy counterparts in whom regular menstruation occurs during the childbearing age. Modern medicine posits that the cause of mood disorders may be related to a decline in ovarian function and a subsequent reduction in serum estradiol levels, which result in the elevation of serum monoamine oxidase levels. This can further cause increased degradation and metabolic inactivation of dopamine, norepinephrine, and serotonin, as well as the down-regulation of monoamine neurotransmitter activity. Currently, treatment mainly involves antidepressants; however, many studies have reported that hormonal replacement therapy improves mood and cognitive function in women. This can also raise fatigue.
Menopausal mood disorders belong to the TCM disease categories of ‘Lily disease’, ‘hysteria’, and ‘depression’. TCM believes that the pathogenesis of this disease is due to the gradual decline in kidney Qi, thereby resulting in kidney Yin deficiency and liver depression that progresses into liver fire, thus further excessive burning Yin fluid. Together, these conditions manifest as hot flashes, sweating, chest tightness, irritability, and insomnia. Moreover, heart Yin is damaged over time and reduces interactions between the kidney and heart, which aggravates depression and anxiety.
Saikosaponin, the active ingredient of the radix bupleuri in Xiangshao granules, has anti-inflammatory and anti-convulsion effects and can extend sleep duration. It has demonstrated good therapeutic efficacy against anxiety and depression, possibly by affecting serotonin activity in the central nervous system. Wang observed that Xiangshao granules regulated serum neurotransmitter levels, including serotonin, norepinephrine, and epinephrine, thereby indicating that Xiangshao granules may improve menopausal depression by balancing the neuroendocrine system.
A study observing the effects of bilateral acupuncture at the Feishu, Xinshu, Ganshu, Pishu, Shenshu and Geshu points on patients with menopausal depression found that the Hamilton Depression Scale scores at the 6th week of treatment were comparable between the acupuncture group and the fluoxetine hydrochloride group. Notably, acupuncture exhibited better outcomes (p < 0.05) at weeks 2 and 4.
TCM posits that the pathogenesis of sleep disorders in women during menopause is mainly due to kidney deficiency; reduced interaction between the kidney and heart; lack of Qi, blood and Yin essence; and disharmony of Yin–Yang. Accordingly, treatments, such as enriching the kidney, nourishing Yin, and soothing the mind have improved therapeutic efficacy.
A systematic review consisting of six randomized, controlled studies with a total of 510 patients comparing the efficacy and safety of JiaWeiSuanZaoRen soup and sleeping pills in the treatment of menopausal insomnia showed that JiaWeiSuanZaoRen soup showed comparable effects to diazepam and alprazolam tablets, whereas JiaWeiSuanZaoRen soup treatment showed better efficacy than estazolam (p < 0.05). Additionally, JiaWeiSuanZaoRen soup improved the quality of sleep, as indicated by the Pittsburgh Sleep Quality Index, when compared with alprazolam (p < 0.05). More adverse events were reported in the group receiving sleeping pills than in the JiaWeiSuanZaoRen soup group (p < 0.05, χ2 = 4.9246). In addition, a randomized, double-blind, placebo-controlled, small-sample study found that the sleep quality index was improved significantly after menopausal women (n = 18) received acupuncture therapy, and polysomnography indicated that the duration of deep sleep increased after treatment.
Along with the above benefits in regulating hormonal balance, acupuncture may also help treat mood-related symptoms of menopause, such as anxiety and depression. Studies have shown that acupuncture can increase the production of endorphins, the body’s natural feel-good chemicals, which can help improve mood and lower stress levels.
Acupuncture therapy may also help alleviate physical symptoms of menopause, such as joint pain. As stated earlier, by stimulating specific acupuncture points, acupuncturists may be able to increase blood flow to affected areas, reducing inflammation and pain. The experts also claim that this helps regulate the body’s circadian rhythms, promoting better sleep and reducing insomnia and fatigue.
In addition to acupuncture, our wellness acupuncture clinic in Auckland may also recommend dietary and lifestyle changes to help manage your menopause symptoms in case of heightened risks. These treatments may involve weekly sessions over a period of several weeks or months, depending on the severity of the pain, disease risks and the individual’s response to treatment.
In conclusion, acupuncture is proven to be a useful tool in managing the physical and emotional symptoms of perimenopause and menopause. By regulating hormonal balance, increasing endorphin production, and promoting better sleep and circulation, acupuncture may help alleviate hot flashes, night sweats, mood swings, and other common symptoms.
Combined with dietary and lifestyle changes, acupuncture may provide women with a safe and effective way to manage the challenges of menopause.
To get further information and make a booking, please don’t hesitate to contact us. We would be delighted to help you.