Is it Hot in Here or is it Just Me? Acupuncture, a Safe, Effective Approach to Menopause.

This month’s article will discuss the conventional and Traditional Chinese Medicine (TCM) approach to menopause.

Is it Hot in Here or is it Just Me? Acupuncture, a Safe, Effective Approach to Menopause., Hoku Integrated Healthcare in Westshore Colwood, Victoria BC

It is September, and the kids are back in school.  Now that the summer holidays are over, it is time to focus more on our health. Fall, the Metal element in TCM, is a time for letting new ideas into our lives and letting go of what does not serve us.  Soon the trees will shed their leaves, trusting in the spring they will again be adorned with their green beauty.

Some of you in your mid 30’s or 40s are entering perimenopause, a time when cycles become problematic, and PMS worsens. If you are 50 and above, menopause with its endless “power surges” or “hot flashes” are wearing you down. Many women find nights uncomfortable, often waking several times, drenched with sweat and blankets hurled to the other side of the bed. Moods may be volatile, and memory, a fog. Lack of sleep can lead to fatigue, decreased motivation, and weight gain.

Since the 1940’s, Premarin, isolated from pregnant mare urine, had been the mainstay of treating unwanted symptoms. The Women’s Initiative Trial, launched in 1991 changed this.  Three years into the trial, results showed that Premarin and Provera (medroxyprogesterone), hormones used commonly in menopause, caused an increase in heart attack, stroke, and breast cancer, to the extent that the trial needed to be stopped. Women were taken off hormones, and symptoms returned. In 2007, the data was revisited, and it was agreed that bioidentical estrogen was safest, when given to young women for the shortest duration of time. Bioidentical progesterone was still given to protect the uterus from estrogen’s effect, for it’s calming properties, and alone when women were considered to be estrogen-dominant as often seen in perimenopause.

In 2017, The North American Menopause Society (NAMS) issued a current statement on hormonal therapy (HT). In short, HT is most effective for hot flashes, vaginal atrophy, and osteoporosis. Therapy must be individualized regarding dose, route, sole or combination therapy with bioidentical estrogen, and/or progesterone, be initiated in women without contraindications whose menopause occurred less than 10 years ago, and be monitored regularly for effectiveness and harm. HT does increase the risk for coronary artery disease, stroke, venous thromboembolism, and dementia, especially in older women. For vaginal dryness it is recommended that lubricants such as Replens® be tried before initiating vaginal estrogen.

I have treated many women going through perimenopause and menopause with acupuncture, helping decrease or eliminate hot flashes, night sweats, mood swings, and fatigue. I’ve also seen that symptoms get worse with stressful events, and once an acupuncture series is given, they then improve.

With osteoporosis, herbs must be given, and bone density monitored, just as we do when you are prescribed drugs. For vaginal dryness and atrophy, first the lubricants are given on a regular basis. Chinese herbs and a diet high in okra can be helpful.

For women whose power surges and mood swings are not relieved by acupuncture alone, herbal formulas are given.  Individualized variations of Liu Wei Di Huang Wan, and Xiao Yao wan, processed in labs with high quality control, can have a positive impact without the worry of serious adverse effects associated with HT.

This article appeared in the September Edition of the Rural Observer under the heading "The garden is in but my back is Out" (error in title)