Menopause and the HRT Dilemma: Chinese Medicine Responds

Recent developments in hormone replacement therapy (HRT) have doctors and patients once again reassessing their treatment strategies. In July 2002 a HRT study of 16,000 patients (the Women’s Health Initiative) was halted due to findings that the health risks of a widely used hormone regimen were too high.

For decades, women have been told that the symptoms of menopause — hot flashes, night sweats, decreased libido and vaginal dryness making sex a painful ordeal — were burdens they should not have to bear. With hormone therapy, they would feel like the clock was quickly turned back. At the same time, they could protect themselves against osteoporosis, and even reduce their risk of heart attacks, strokes, colon cancer and bone fractures.

Accumulating data, however, indicated that even though hormone therapy can reduce cholesterol levels, women who took Prempro, a combination of estrogens and progestins, had increased incidences of heart attacks, strokes and blood clots. They also had more breast cancer. These risks exceeded the regimen’s benefits. The unsettling news finds many women looking at alternatives to managing their symptoms.

What exactly is menopause?

Menopause indicates the complete or permanent cessation of menstruation, usually for at least 6-12 months. Climacteric or peri-menopause refers to the transitional phase from the reproductive to the non-reproductive stage, a period of declining ovarian function and depletion of a woman’s follicles. This period can last from two to more than ten years, and the median age of menopause in industrialized countries is about 51. Of interest is that at the time that ovaries are formed in the fetus, there are six million primordial follicles each of which holds an egg (ovum). This number decreases to about 600,000 at birth, 300,000 at puberty to 10,000 at menopause. This suggests that menopause is not a sudden event but is a gradual physiological process that may be influenced by one’s lifestyle and habits.

With follicular depletion comes a decline in estrogen; and with cessation of ovulation comes a lack of progesterone. These are the two primary hormones given to women treated with HRT to treat the various symptoms associated with menopause.

How can Chinese medicine help?

First and foremost, Chinese medicine does not treat menopause as a disease. It is a normal physiological change in a woman’s life. Unfortunately, many women suffer discomfort through this transition, some quite severely. They are all too familiar with hot flashes and night sweats. But menopause can also bring on bouts of depression, anxiety, emotional stress, irritability, fatigue, palpitations, insomnia, menstrual irregularities, vaginal dryness and itching, decreased libido, osteoporosis, headaches, poor concentration and more.

There is a long history of Chinese medicine studying and successfully treating menopausal syndromes dating back to at least 100 BC with the publication of The Yellow Emperor’s Classic of Internal Medicine. With Chinese medicine a practitioner uses acupuncture and herbs to nourish the liver and kidney systems (said in Chinese medicine to govern develop-mental and aging processes). We also seek to boost the Qi (energy), moisten the tissues, strengthen and regulate the organs, and nurture the spirit of the heart. These areas are often found to be at the root of menopausal imbalances, from which symptoms originate.

Practitioners also typically advise patients on diet, exercise and lifestyle. We treat the whole person, moving toward balance in every aspect of the woman’s life.

Thus, in Chinese medicine, menopause is seen as a true change for a woman - rather than a pathological condition - from mother of her biological children to mother of her community. This is why, in traditional cultures, post-menopausal women are regarded as wise women. Their heart spirit is now nourished in new ways it was not before.

While HRT has its place — offering quick results in treating many of the symptoms – it clearly has its risks. Taking all the above factors into account, Chinese medicine, with its gentle and steady approach without side effects, can offer a safe, effective and logical alternative and/or complement to HRT.