Biomedical Review
Menopause is not a disease or pathology, but a natural physical transition in a normal woman’s life from repro period to non-repro period.
Biomedical Mechanism
During the reproductive period the monthly cycle works like this. Dr. Luo indicated in class that we need to understand this and be able to write it out.
1. Posterior pituitary gland secretes FSH (follicle stimulating hormone) and LH (luteinizing hormone. These stimulate the ovary to produce an egg, allows for egg maturation.
2. Egg produces estradiol. This stimulates pituitary to produce more FSH and LH.
3. When FSH and LH reach a certain level LH then causes the follicle to rupture. Egg is then released into fallopian tube at the same time progesterone is released.
4. Estradiol and progesterone now prepare the endometrium for implantation.
5. If egg is unfertilized by sperm, egg breaks down.
6. Estradiol’s negative feedback loop to the pituitary then decreases FSH and LH levels.
During menopause the function of the ovary decreases and there are no more eggs presented. Thus, estradiol and progesterone levels decrease, and the endometrium is not prompted to prepare for implantation.
Relating the biomedical model to TCM
Menopause Syndrome is thus related to a disharmony of Liver, Heart and Kidney. The brain (mood swings, sometimes decreased memory function during menopause, etc.) in biomedicine relates to the Heart in TCM which houses the spirit. The ovary in biomedicine relates to the Liver in TCM which controls hormones and secretion/discharge of the egg. The uterus in biomed relates to the Kidney in TCM.
Symptoms
Not everyone gets symptoms: 10% of patients have no symptom, 10% have severe symptoms. That said, the other 80% get some or all of the following:
Irregular cycles Early, late, or menorrhagia. This is followed by the cessation of the menstrual cycle.
o Hot flashes
o Night sweating
o Low grade fever
o 5 palm heat
o Dry mouth – not thirsty, but want to sip water to alleviate the dry mouth/throat
o Irritability
Emotional disorders occur. Very small thing stimulates strongly. Some of these symptoms include:
o Irritability
o Anger
o Restlessness
o Depression
o Stress
o Weeping
Bone/joint problems usually get better with rest and hurt more upon movement.
o Knee joint pain
o Heel pain
o Frozen Shoulder or “50’s shoulder”
o Sciatica
o Lower back pain
o Degeneration of the vertebrae
o Cervical spondylosis
o Osteoarthritis
Vaginal dryness and atrophy
Stages of Menopause:
Different people have different stages and they will express different ways. Here are the basic stages.
Pre-menopause That’s the period before menopause actually begins. This might take 3-4 years but doesn’t really count toward the time served!
Perimenopause 3 – 5 years prior to the actual start of menopause
Menopause 3 – 4 years. Most of the time this is what counts, biomedically, as menopause.
Post-menopause “Second spring.” In TCM this is the time following or coinciding with post menopause. The symptoms disappear and the energy returns.
TCM Etiology
1. Kidney Defiicency
2. Aging
3. Overwork
A course of acupuncture treatments was associated with significant reduction in vasomotor symptoms, as well as several quality of life measures, compared with no acupuncture, and that clinical benefit persisted for at least 6 months beyond the end of treatment.
