What is perimenopause?
Perimenopause, meaning “around menopause,” affects many women in the years leading up to menopause. It’s a transitional phase of life when periods are still occurring but ovarian function declines and estrogen levels begin to drop. Most women begin to experience perimenopause in their 30’s and 40’s, and according to the Cleveland Clinic, perimenopause can start 8-10 years before menopause.
Symptoms
Some women experience only mild symptoms during perimenopause, while others notice significant physical, emotional and psychological changes as their body begins to feel the effects of estrogen withdrawal. Periods often become irregular and menstrual cycles shorter. Vasomotor symptoms such as hot flashes, skin flushing and night sweats can begin years before the onset of menopause. Mood changes, sleep disturbances and cognitive impairment are common, as are fatigue, weight gain, hair loss and vaginal dryness. Acupuncture and Traditional Chinese Medicine (TCM) can provide significant relief for some of the most problematic symptoms of perimenopause, without the potential side effects of pharmaceutical drugs.
How does Traditional Chinese Medicine (TCM) view perimenopause?
According to TCM, the body’s hormonal cycles are closely related to the energy of the Liver and Kidney systems. The Liver is the storehouse of the blood and is responsible for the smooth unfolding of the body’s cyclical process, including menstruation. The Kidneys store the jing, or vital essence, which naturally declines as we age. We all enter the world with a fixed amount of jing, which can’t be replenished once it’s depleted. The TCM approach to treating perimenopause usually involves tonifying the Kidneys and regulating the Liver.
How acupuncture helps
Acupuncture helps ease the perimenopausal transition by mitigating symptoms and restoring balance. Here are 5 science-backed ways acupuncture can help:
1. Hot flashes
Ah, hot flashes. It’s the first symptom that comes to mind when we think of a menopausal woman, and rightly so—it’s one of the most common symptoms of menopause and perimenopause. Hot flashes occur when the body’s cooling, yin energy declines, resulting in a relative excess of the body’s yang energy. Yang ascends to the upper body, causing heat sensations and red flushing of the skin of the face, neck and chest. Yin is naturally dominant at night, but if the body’s yin energy isn’t sufficient to anchor the yang, yang will become dominant, causing night sweats. The TCM approach is to boost the body’s yin energy so it keeps the yang in check, while clearing out excess heat.
Physiologically, acupuncture can help cool you down by promoting blood vessel dilation, stimulating the release of endorphins, and regulating the hypothalamus, your body’s internal thermostat. A recent study at Wake Forest University found that acupuncture reduced hot flashes and night sweats by 47%, and for a smaller group, the benefit was almost double. Another study found that 80% of women receiving acupuncture for hot flashes and other menopausal symptoms felt that the sessions had helped them after six weeks of treatment.
2. Mood changes
Irritability, anxiety, depression, even perimenopausal rage—the hormonal changes of perimenopause can have a significant impact on your mood. Estrogen affects the production of neurotransmitters like dopamine and serotonin that boost feelings of happiness. Less estrogen = lower neurotransmitter levels = more mood instability. One study found that irritability is the primary mood complaint for up to 70% of women during perimenopause.
According to TCM theory, the Liver system is at the root of perimenopausal mood disturbances. When the Liver system is out of balance, you’ll have greater fluctuations in your hormone levels. Additionally, each of the organ systems in TCM has an associated emotion, and the emotion of the Liver is…no surprises here…anger. So a Liver system gone haywire means erratic hormone levels and flares of anger. That’s right, perimenopause rage.
The good news is that acupuncture is incredibly effective at balancing the Liver system and stabilizing the mood. In addition to treating irritability and excessive anger, acupuncture has a proven track record in benefiting depression and anxiety.
3. Memory and mental focus
Having difficulty with memory and mental focus? You’re not alone. Studies have shown that up to 70% of peri- and post-menopausal women experience problems with memory and cognition. Another study found that women don’t learn as well during perimenopause. Estrogen affects brain function by promoting neuronal growth and survival, and supporting cognitive function of the prefrontal cortex. When estrogen declines during perimenopause, the brain feels the effects. Other perimenopausal symptoms such as hot flashes, insomnia and depression can also cause impairments in cognitive function.
The brain is known as the Sea of Marrow in TCM and is considered one of the six Extraordinary Organs. The brain is supported by the Jing of the Kidneys and nourished by the blood, which is made by the Spleen, stored in the Liver, circulated by the Heart and oxygenated by the Lungs. In essence, all of your organ systems play a role in supporting the Sea of Marrow and when any of them are out of balance, brain function suffers. Both animal studies and human studies have demonstrated a positive effect of acupuncture on cognitive impairment.
4. Fatigue
Tired all the time? Fatigue during perimenopause can be caused by a combination of factors, including fluctuating hormone levels and sleep disturbances.
When treating fatigue, an acupuncturist will usually focus on the digestive system and the Kidneys. The Spleen and Stomach are known as the Root of Post-Heaven Essence, meaning they extract nutrients from the food we consume to power our body’s metabolic processes. When the digestive system is weak, we have to dip into our reserve of Pre-Heaven Essence, or jing, which is stored in the Kidneys. Jing naturally declines as we age, and unlike like nutrients from the food we eat, jing can’t be replenished. So a healthy digestive system not only improves energy, it also prevents premature aging. Studies have shown that acupuncture can help boost energy levels and treat chronic fatigue. It also treats sleep disturbances, a common issue in perimenopause and a cause of low energy levels during the day.
5. Menstrual cycle changes
Menstrual cycle changes are often an early indicator of perimenopause. Skipped periods, shorter cycles, and heavier or lighter periods are all common. Although there’s no escaping the day when you’ll officially be in menopause—defined as one year without a period—acupuncture can help make your periods more bearable by increasing circulation to the ovaries and uterus and regulating the hypothalamic-pituitary-ovarian (HPO) axis, the feedback loop that governs the unfolding of the cycle. Acupuncture has also been shown to benefit polycystic ovarian syndrome (PCOS) and painful periods.
When treating menstrual irregularities with TCM, we’ll once again look to the Liver system, since it regulates the body’s cycles and stores the blood. Treatment may also involve supporting the Spleen, which makes the blood, and the Heart, which governs and circulates the blood.
Acupuncture helps with a host of other perimenopausal issues, including insomnia, changes to the skin such as acne and dryness, decreased libido, vaginal dryness, hair loss, and breast tenderness. Perimenopause is a natural part of life but it doesn’t have to be miserable! Think of it as an opportunity to forge a deeper connection with your own body and assess what’s really important in life. Acupuncture is a proven, effective treatment to manage the transition to your post-menopausal years and prepare you for your life’s next great adventure.
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