Menopause from the Chinese Perspective with Lesley Tierra by Julia Griffin

Why do some so many Western women experience uncomfortable emotional and physical symptoms during menopause?

In the American culture, menopause — the time when a woman's menses gradually cease, normally between age 35 and 60 — is often accompanied by flushing or hot flashes, mood swings, depression, insomnia, and thinning of bones, skin, and vaginal walls. In Western medical practice, this plethora of symptoms is treated with "hormone replacement therapy" (HRT): a regimen of prescription synthetic hormones.

Yet in the Chinese culture, hot flashes are uncommon.[1]

We interviewed Lesley Tierra, who treats menopausal symptoms in Western women using tradition Chinese medicine — herbs, acupuncture, and lifestyle recommendations — and has coauthored a book on this subject with her husband, Michael Tierra (see Lesley Tierra).

Julia: I understand from my research that hot flashes are rare in Chinese women. Can you give us some understanding as to why this is so?

Lesley: Many believe that the Chinese don't have the same menopausal symptoms as American women because of soy in their diets. But they don't necessarily eat that much soy. Overall, I'd say that their diets are much better than ours and don't have nearly the amount of caffeine products (coffee, black tea, chocolate, colas, for example) or alcohol as Americans do. Both caffeine and alcohol cause peri-menopausal symptoms.

Julia: In the West, doctors view menopause as a hormonal deficiency. How does the Chinese view of menopause differ from this?

Lesley: According to traditional Chinese medicine, during menopause there is a natural decline in what's known as "Precious Essence" — which is a "yin," or passive, feminine energy. (See also [2].) But while Precious Essence declines, Chinese medicine also sees a corresponding increase in "yang" energy, or active, masculine energy. That increase is an important part of the change that's happening.

So menopause can be a time of life when many women move from being passive to setting boundaries and becoming more goal oriented. Many women learn to speak their minds more easily. Women change. Their personalities change, their outlook on life changes. This is part of the process. This can be a rich time, and deep inward direction can come out of it.

Julia: You mention the Precious Essence concept. Could you tell us about this in more detail, please?

Lesley: In the Chinese view, Precious Essence is prenatal energy, stored in the kidney, that conveys the gifts of fertility, libido, regeneration of the body, and tissue elasticity and strength. The term Precious Essence stems from the idea that this energy is worth guarding, because its function is to maintain youth, and there is only so much of it.

Precious Essence is of two kinds: Pre-Heaven, representing inherited characteristics, and Post-Heaven, representing energy accumulated or lost through the way we live our lives. Pre-Heaven essence is not easily renewed, but it may be replenished through breathing and meditation exercises. Post-Heaven Essence can easily be renewed through lifestyle changes — exercise, balanced activities, and the intake of proper food, air, and water.

According to the Chinese, those who wisely protect their Precious Essence may live long without wrinkles and maintain a youthful appearance. From a lifetime of balance, it is even possible to achieve an excess of Precious Essence. (See also [3].)

Julia: I know that you use acupuncture and Chinese herbs to treat menopause in your patients. But is that enough? In other words, can Chinese medicine alone provide a cure for menopausal symptoms?

Lesley: Sometimes. But acupuncture and Chinese herbs strengthen or "tonify" the body by adding energy, so lifestyle and poor habits can dissipate the good this does. It is of little use to work on building energy in the body through acupuncture or herbs if the patient is going to throw it away through careless living.

So I spend a great deal of time discussing and recommending lifestyle changes to my patients, because that is the only way my work will be effective on a long-term basis. All acupuncturists are different, and not all of them will discuss lifestyle. But I think it is important.

Julia: What lifestyle changes do you recommend.

Lesley: To begin with, it is important to reduce stress. Both types of Essence are reduced by stress. Since Essence is stored in the kidneys, and the kidneys are affected by the adrenal glands, when the adrenals are depleted by too much work or sex, poor food, or lack of sleep, then essence is lost. (See also [4].)

So I recommend that women find time for renewal, balancing work with play. I suggest plenty of sleep, a nutritious diet, and the elimination of excesses of all kinds.

The key is balance. If balance exists, then illness disappears. And although menopause and the decline of Precious Essence is a natural process, many menopausal symptoms are caused by imbalance in the body.

Julia: What nutritional recommendations do you have for women experiencing negative symptoms of menopause?

Lesley: Women should eat lots of whole grains — rice, spelt, oats, and so on, but not bread or flour products — and lots of leafy green vegetables and seaweed. Add plenty of cooked vegetables to the diet. Choose foods that are high in vitamin and mineral content.

Fruit and fruit juices should be eaten only in moderation, prepared according to season: raw in the summer and cooked during the cooler months.

Also, traditional Chinese Medicine recommends eating fruits and vegetables that are grown locally and are in season. Eating the local foods of each season is part of living in harmony with nature.

Meat and fish should be eaten in small quantities, although the total amount of protein we need varies. Someone who is very active — for example, a gardener who is moving plants and rocks all day — will need more protein than an office worker. Dairy products also can be eaten, but again, in small quantities.

Julia: What foods should women avoid?

Lesley: I suggest the elimination of caffeine, alcohol, and cigarettes. Animal foods should be eaten, as we said, in small quantities only — and since most of them are full of hormones, it's important to find an organic source of organic meats and dairy products. Also, it's important not to eat processed foods, additives, sugar, or flour.

Traditional Chinese nutrition also advises all women to avoid avocados, fried foods, corn chips, and all types of nuts, as the fats that these foods contain can cause cysts.

Julia: You mentioned that only meditation and breathing exercises can restore Pre-Heaven Essence. Can you suggest techniques that would be of value here?

Lesley: Exercises such as Chi Kung (or Qi Gong) or Yoga are fantastic. They are energy-moving, and can strengthen the body. These exercises are wonderful for menopause. These are disciplines that can regulate the body and bring about rejuvenation. The deeply meditative exercises that have this effect are not normally taught, so you may have to search for a teacher who can help with this.

I also recommend taking a retreat for one or two hours each week.

Tolerance and forgiveness extended toward the self and others restores the Essence, as does the practice of devotion and honor. (See also [5].) This is the path of the Tao, of walking energetically between Heaven and Earth. Practices that lead to the Way restore the body's vital energies.

Chi Kung and Yoga are best learned from a qualified teacher. Both methods of exercise nourish the chi through breathing exercises, and they strengthen the body through the movement of energy. These are exercises that stimulate the endocrine system and lungs. Yoga and Chi Kung improve longevity while increasing the sense of harmony within one's self in relation to the world.

It takes years to truly cultivate the significance of these practices, but even beginners will develop a sensation of wellbeing and peace of mind. (See also [6].)

Julia: How does acupuncture help menopausal symptoms?

Lesley: Acupuncture balances energies, adding energy where it is needed, dissipating energy when it is too concentrated, moving energy that is stagnant. And it works directly on whatever organ you target. So acupuncture can work directly on the kidney and liver problems that are associated with menopausal symptoms.

As we said, it is the kidney that stores Precious Essence, and the kidney is the only organ that is both yin and yang. It rules the teeth, bones, hair, ears, reproductive functions, and growth or development of the body. (See also [7].) An imbalance of kidney energy might be determined outwardly from thin, dry hair, poor teeth, and a recent development of worry and paranoia.

Because acupuncture can help to balance energy, it is significantly helpful for symptoms of menopause. Acupuncture helps tremendously with hot flashes and can control or eliminate them.

Julia: Can acupuncture provide immediate relief?

Lesley: The rule of thumb is that it takes 10 treatments to tonify or strengthen an organ. Some people say they don't feel a thing after acupuncture, but the effect is cumulative. In other words, the energy from each treatment is retained by the organ system. And if it is not dissipated by one's lifestyle, it continues to build.

Also, acupuncture offers a "facelift" that's quite effective physically. By stimulating areas in the face related to the organs, the energy becomes unblocked, and the face looks more youthful. The entire body is treated from the face, so the function of the whole body is improved. Fine lines are often erased, deeper wrinkles may become less apparent, and the skin glows. (See also [8].)

Julia: What are some of the basic Chinese herbs used to treat the different patterns of menopausal symptoms?

Lesley: Herbal formulas are more than the sum of the ingredients. Because of this, a particular combination of herbs causes a powerful effect on the body system, and practitioners modify the formulas to meet the patient's needs, changing it as the body changes.

In other words, medicinal formulas are given on a highly individualized basis. Several different women experiencing hot flashes would perhaps each receive a different formula according to the individual's entire pattern. A prescription does not fit a symptom, but is chosen for the individual and her pattern.

So only a Chinese herbalist or acupuncturist can make a complete diagnosis and recommend a medicinal formula. Just by way of illustration, however, here are a few examples of menopausal symptoms and common herbal treatments.

Liver Stagnation is accompanied by clots, short or irregular cycles, breast tenderness and lumps, anger, frustration, depression, and PMS. In Chinese medicine, all depression is believed to be caused by liver stagnation. Elimination of all fats and oils in the diet helps with liver stagnation. Bupleurum formula can be used for this pattern.

Kidney and Liver Yin Deficiency is accompanied by hot flashes, sweat, palpitations, thirst, weak knees, and low back pain. Rehmannia 6 is the classic formula used for this condition.

Chi and Blood Deficiency is accompanied by dry skin, vaginal dryness, dizziness, insomnia, fatigue, digestive symptoms, muscle weakness, poor vision, scanty menses, or excessive bleeding. Dong Quai and Peony combination is a formula often used to tonify the blood.

Heart Fire is accompanied by forgetfulness, fear, anxiety, nightmares, hot flashes, and palpitations. Zizyphus Combination or Rehemannia 6 with variations is sometimes used for this pattern. (See also [9].)

Julia: So can we sum up what you are saying?

Lesley: Chinese women tend not to have menopausal symptoms because they are more likely to eat properly, and because their culture recognizes the importance of meditation and a balanced lifestyle.

In the West, acupuncture and herbs can help to start a positive healing trend. Then if women are willing to make lifestyle changes — engage in some form of meditation, eat properly, eliminate certain harmful substances from their diet — menopause can be a time of rejuvenation and positive change.

Longevity Herbs

According to Lesley Tierra, the following "longevity herbs," which tonify the kidney and build the immune system, can be taken without a diagnosis:

Reishi (Ling-zhi) Ganoderma lucidumi — Reishi is a mushroom thought by the Chinese to be a superior herb, meaning that it increases longevity and youth. Reishi is a mushroom. It builds health, prevents illness and powerfully affects the immune system. It is used for many chronic conditions ranging from allergies to circulatory system complaints to cancer.[10]

Dong Quai (Tang kwei) Angelica Sinesis — Dong Quai is sometime referred to as a ginseng for women. It is a blood tonic and has been used for many centuries to calm the symptoms of menopause. It prevents or aids with anemia. It helps to alleviate both tiredness and insomnia. (Dong Quai should not be taken during the menses as it will increase bleeding.)[11]

3) Schizandra Berries (Wu Wei Zi) Schizandra Chinesis — This herb was once valued as a sexual tonic. The herb was said to be used to preserve the appearance of the beauty of youth. It is an adaptogen. Schizandra is also used to remedy insomnia, mental fatigue and memory problems. It is used for respiratory, genito-urinary and digestive systems. It affects the liver and kidney.[12]

Lycii berries (Gou Qi Zi) Lycium Barbarum Chinesis — Lycii berries improve the memory and eyesight and calm the emotions. Lycii berries are a high quality blood tonic and tonify liver and kidney.[13]

Lesley Tierra, L.Ac., is a nationally licensed acupuncturist, herbalist, and teacher. She is the author of Herbs of Life, Chinese Traditional Medicine, volumes I and II, Healing with Chinese Herbs, and A Kid's Herb Book. She is a founding member of the American Herbalist Guild.

The website of Lesley and her husband, Michael Tierra, at PlanetHerbs.com, offers extensive information on Chinese and Western herbology. Lesley can be reached by phone at 831-429-8066 or by email at .