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Menopause

MENOPAUSAL HOT FLUSHES – CAN CHINESE HERBAL MEDICINE HELP ?
Menopause according to Traditional Chinese Medicine

Traditional Chinese Medicine (TCM) is so different from Western Medicine, that in order to use the possible benefits that it has to offer women at the time of the menopause, we must understand how its differences effect approaches to treatment. Menopause in Chinese medicine is seen to be a natural progression of aging, and not a disorder that needs correcting. The periods stop to help preserve the body from aging faster than it should. If the period is not lost each month, then the body’s store of jing-essence (vital substance which maintains the life activities) will not be depleted so quickly, as some essence is lost with the flow of the period. Chinese medicine theory believes death will occur when the body exhausts its supply of this Jing-essence. To “treat” at the time of the menopausal transition is to employ the practises of Traditional Chinese longevity.

Cause of Hot Flushes

Hot flushes can occur at the time of the menopause as part of the weakening function of the internal organs. Some organs are meant to keep one cool, others to keep energy flowing freely, others to produce useable energy and so on… If one feels upset or irritable, the free-flowing energy blocks, if some-one flushes, the cooling yin energy is not strong enough to stop the heat which flushes upwards (heat naturally rises). So when a practitioner goes to offer treatment, their task is to determine which organs according to Chinese Medicine are not performing their function properly. Treatment is as quick or slow as the vibrancy of the energy that creates symptoms. So if a problem has taken a long time to manifest, it will take a bit of time to respond to treatment. The extra time that treatment may take has the longer term benefit of attempting to address the cause of the symptom, not just suppress the symptom. So after a treatment course, symptoms are not expected to return if the cause has been correctly identified. Some conditions require maintenance after responding, with appointments becoming further apart and the total length of time for subsequent courses becoming less and less.

TCM treats the whole person, not just symptoms.

There is one other very big difference between ordinary medicine and Chinese Medicine. Because Chinese Medicine treats the whole person, not just one symptom of a person, treatment is based on determining the whole health pattern of each woman. Chinese Medicine does not treat diseases. It treats individuals.

In treating the health and well-being of the whole person, TCM takes account of the presenting symptomatic profile of the entire person as they relate to their environment, social situations and their personal emotional responses to these. In addition, physical symptom reporting, tongue and pulse diagnosis are also considered to determine the profile of each woman. The result means that one Western -named disease presentation may be classified into many Chinese Medicine patterns of disharmony, or conversely, many different Western-named pathological disease states may be explained by a single TCM pattern of disharmony . TCM therapy is based on recognising the symptom complex which indicates the whole health profile of the individual, rather than the naming of a disease which is the Western medical approach.

TCM Therapy- theoretical approach

Patients suffering from the same biomedically-defined disease may be given different TCM medicines, whilst patients with different diseases may be given the same TCM medicines. The full range of possible formulas for the treatment of hot flushes in Chinese Medicine is as varied as the whole-health pattern of each individual woman. This means that there is not just one formula to treat hot flushes. Chinese Medicine is not trying to mimic hormone therapy which continues to artificially maintain hormone levels , but instead, aims to treat women’s’ whole health and well-being . This is done by selecting the most suitable formula for each woman as she presents at this stage in her life process. Periods are not re-introduced with herbal medicine treatment of menopausal symptoms.

Alternative treatment choices to Hormone therapy?

Many women have contacted me about a study I did during the 1990s in Melbourne, for my Ph D research. It was reported in the Women’s Weekly many years ago. It was very common for women to tell me that they had self-prescribed many products which did or did not help. The most common supplements that women were using in the mid 1990’s included Evening Primrose Oil, Vitamin B Complex, Vitamin E and “Remifemin” an extract of Cimicifuga sold commercially, which is generally used for PMS.

Remifemin (“natural therapy”?), Naloxone (Non-hormone drug therapy) etc

It’s exciting to see natural therapies on sale as a choice. But what is “natural”? Remifemin for example is only a part of the natural plant substance that Naturopaths successfully prescribe (Cimicifuga -also known as Black Cohosh). Studies have shown that it does not appear to be as effective as hormone therapy, so women self-medicating with it may become disappointed. It appears to act more like other drug therapies that have been used for hot flushes which are documented to be not as effective as Hormone Therapies (e.g. Naloxone, Medroxyprogesterone). Maybe this weak effect means that it’s safe to sell over the counter, rather than being prescribed by a Naturopath.

Women want to make their own choices

It is important for women to feel they can make their own choices. When women describe their failed attempts at self-medication, it’s impossible to know the reasons for these failures. Only under controlled tests can we try to find the answers.

The need for clinical research

Chinese Herbal medicines have been recognised by an Act of Parliament in Australia since 1989 and are legally prescribed and sold here. They have yet to be clinically tested with controlled trials. Empirical evidence abounds on the effectiveness of Chinese herbal medicine, however controlled clinical trials are needed to make this data available for scrutiny of the scientific community. It is not known how effective herbs might be, without such testing. Individuals seeking private consultations have been using these herbs for years, and like those of us who use supplements or herbs at home, no one can take notice of any effects we may experience, because we don’t record our efforts My study was limited by the Medical faculty at university of Melbourne requiring me to test only ONE formula.. Overall Chinese herbs were more effective to decrease the severity of flushing while control subjects experienced a lessening number of flushes. The results were not conclusive.

Acknowledgments

This study was done for PhD research, in conjunction with the Key Centre for Women’s Health at the University of Melbourne, the Royal Melbourne Hospital, the Jean Hailes Menopause Centre, the Greville Street Clinic, the Women’s Clinic on Richmaond Hill and the Health Practice Unit of Victoria University of Technology. I wish to thank all the above institutions for their involvement during the Clinical phase of the study. A special thank you to Prof. Fumi Horiguchi and the late Peter Townsend.

o Herbal Medicines supplied by ChinaHerb Australia, Sydney
o Placebo – SunTen Pharmaceuticals, Taiwan

Postscript

If you want Chinese herbal medicine  treatment of hot flushes, please see a registered Chinese herbalist for your individualised assessment and access to the herbs.

If you want to READ my thesis, then please feel free to contact me.

I have a pdf of the literature review, which I personally think is the most interesting part of the study. It would be nice to know someone other than the examiners, my supervisors and my partner’s mother have read it…☺ The review traces the history of hot flushes from the first English language material I could access- in 1724, through the development of hormone replacement therapy last century up to 2005. It also explores the history and a politics of Altenative medicines in Australia. If you want to be bored with the results, statistics and discussion of the thesis, then that’s available too- although not so nearly riveting reading ☹ If you got this far, thank-you for reading to the end!