Menopause usually happens between 45-55 years of age. Due to declining and fluctuating hormonal levels, the body will under go a series of changes. When the body cannot adjust itself smoothly, signs like menstrual irregularities, hot flushes, insomnia, mood swings, vaginal and bladder problems will come and go during the period. This gradual transition process varies greatly among women; some may go through it easily while others may find their lives seriously disrupted. Western women may have hot flushes and night sweats as major complaints while Chinese women tend to have bone and joint pain, poor memory and fatigue.

In TCM experience, most menopause symptoms belong to functional disorders, a result of disrupted hormonal balance. Since the whole body is undergoing changes and many influential factors are involved, a wide array of symptoms can appear, and the frequency and intensity vary greatly. No two women experience menopause in the same way. TCM is able to use unique theories to interpret the diversified and subtle nature of the symptoms, and correlate them with internal disharmonies. For those who suffer significantly from menopause symptoms, physicians aim to focus on the disharmony pattern, including the major complaint and the accompanying symptoms. For example, most menopausal women go to see TCM physicians for treatment of their hot flashes, but these may also be accompanied by a variety of other symptoms. One may complain about frequent hot flashes but also have sweating, palpitations and dizziness; another may complain only about mild hot flashes, but experience more severe emotional distress or fatigue. All these combination of symptoms have significant implications for TCM diagnosis and treatment.

Generally, TCM physicians make reference to the disease categories of  "hysteria", "depressive syndrome", "palpitation", "insomnia", "dizziness", "headache", "metrorrhagia" or "menstrual irregularities" for diagnosis.

• Menstrual irregularities during menopause
• Vasomotor changes in menopause
• Mental and emotional changes of menopause
• Urinary and vaginal changes during menopause

In addition to the above changes that are direct result of hormonal imbalance, women have to face many other changes that are just a consequence of normal aging. For example, even though they eat less and exercise more, it is harder to maintain their body shape, because their spleen or kidney become less efficient; visual problems like blurred vision, tired eyes or aching behind the eyeballs or at the eyebrow regions are closely related to liver dysfunction and decline in essence and blood storage; marrow depletion in the brain leads to loss of mental sharpness or behavioral changes; constipation and puffiness are also more frequent as a result of the weakened transforming process.

To sum up, the menopause transition is not just a simple biological event, but a long and ongoing process involving almost every part of the body. The symptoms are lingering and complex that encompass emotional and intellectual as well as physical aspects. TCM stresses a comprehensive analysis on the whole presenting pattern. Furthermore, TCM physicians take into account other factors like heredity, general health, nutrition, medications, exercise, life events, and attitude when deciding on diagnosis and treatment.

Menopause at a glance