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TCM Herbal Treatment for Menopause Problems

Most women reach menopause between the ages of 45 and 55, however, the entire transition period can take 10 to 15 years. Because the hormonal changes are so erratic, a host of signs can appear and interfere with day-to-day life.

Menopause should be treated as a natural event, not a medical crisis. From a TCM perspective, menopause symptoms are the result of a disrupted balance between the internal organs, and therapies should be aimed to motivate the organs to shift into a new balance. The multiple components of herbal remedies can target the internal disharmony through different aspects of the body, such as various metabolic processes in the hypothalamus-pituitary-sex gland axis, and thus create a comprehensive regulating effect to maintain the stability of internal environment, ensure a slow, gentle and smooth hormonal transition.

Generally, TCM believes that principles like nourishing yin and tonifying kidney are essential to every treatment; when dealing with menopause symptoms, dispelling liver stagnation and reinforcing the spleen are important; while activating blood and qi (vital energy), as well as dissolving phlegm and stasis are necessary for complex conditions.

Therapeutic principle Nourishing the kidney and liver, replenishing yin and essence
Indications Hot flashes, sweating, hot sensations in the body, dizziness, ear ringing, poor memory, lumbar and knee weakness, fatigue, mood swings, restless mind, skin itchiness, numbness or crawling sensations, mouth dryness, constipation, yellowish urine, menstrual irregularities, vaginal itchiness, and red tongue with little coating

Commonly used ingredients
gou qi chi Chinese wolfberry fruit Fructus Lycii
he shou wu tuber fleeceflower root Radix Polygoni Mulitflori
shan zhu yu cornus fruit Fructus Corni
sheng di rehmannia root Radix Rehmanniae
shu di processed rhemannia rhizome Rhizoma Rehmanniae Praeparatae
bai shao white peony root Radix Paeoniae Alba
Sample prescription: Linking Decoction

Therapeutic principle Warming and augmenting the kidney and spleen
Indications A dull facial complexion, lassitude, depressive mood, breath shortness, sensitive to low temperatures, lumbar soreness, limb coldness, loose bowels, abdominal distention, poor appetite, puffiness, poor control of urination or passing stools. There may also have excessive thin vaginal discharges, prolonged or heavy menses flow which is thin in nature, bulky, glossy and pale tongue

Commonly used ingredients
dang shen pilose asiabell root Radix Codonopsis Pilosulae
bai shu largehead atractylodes rhizome Rhizoma Atractylodis Macrocephalae
fu zi monkshood Radix Aconiti
rou gui cassia bark Cortex Cinnamomi
du zhong eucommia bark Cortex Eucommiae
tu si zi dodder seed Semen Cuscutae
Sample prescription: Aconite Pill for Regulating the Middle

Therapeutic principle Nourishing blood and yin, calming the heart and benefiting the spleen
Indications Dizziness, blurred vision, palpitations, poor memory, insomnia or dream-disturbed sleep, panic, lethargy, fatigue, breath shortness, pale complexion, hot flashes, pale and bulky tongue

Commonly used ingredients
ren shen ginseng Radix Ginseng
fu ling poria Poria
shan yao Chinese yam Rhizoma Dioscoreae
shi chang pu acorus Rhizoma acori tatarinowi
suan zao ren sour jujube seed Semen Ziziphi Spinosae
yuan zhi polygala poot Radix Polygalae
long yan rou longan aril Arillus Longan
Sample prescription: Sedative and Heart Invigorating Pill

Therapeutic principle Communicating the kidney and heart, nourishing yin and depressing virtual fire
Indications Palpitations, insomnia or dream-disturbed sleep, irritability, mood swings, poor memory, hot flashes, sweating, dizziness, ear ringing, lumbar and knee weakness, mouth dryness or mouth sores, scanty urine and red tongue

Commonly used ingredients
wu wei zi schisandra Fructus Schisandrae
niu xi achyranthes root Radix Achyranthis Bidentatae
zhi mu anemarrhena rhizome Rhizoma Anemarrhenae
tian dong cochinchinese asparagus root Radix Asparagi
sheng di rehmannia root Radix Rehmanniae
dan shen red sage root Radix Salviae Miltiorrhizae
Sample prescription: Communicating and Tranquilizing Pill

Therapeutic principle Dispelling liver stagnation, harmonizing spleen, and regulating qi
Indications Depression, irritability, easily angered, belching, sighing, chest discomfort, distending pain in the lower abdomen, poor appetite, loose bowels, menstrual irregularities or severe PMS syndromes, red or bulky tongue with coarse coating

Commonly used ingredients
chai hu bupleurum root Radix Bupleuri
dang gui angelica root Radix Angelicae Sinensis
fu ling poria Poria
bai shu largehead atractylodes rhizome Rhizoma Atractylodis Macrocephalae
bai shao white peony root Radix Paeoniae Alba
chen pi dried tangerine peel Pericarpium Citri Reticulatae
xiang fu nutgrass flatsedge rhizome Rhizoma Cyperi
Sample prescription: Free and Easy Wanderer Plus

Therapeutic principle Nourishing blood, enriching yin, preserving body fluids, and lubricating
Indications Emotional or mental disorders such as anxiety, depression, and paranoia; insomnia, yawning, restless, palpitations, lassitude, constipation, a pale tongue with coarse coating

Commonly used ingredients
sheng di rehmannia root Radix Rehmanniae
gan cao liquorice root Radix Glycyrrhizae
fu xiao mai shriveled wheat Fructus Tritici Levis
da zao common jujube fruit Fructus Ziziphi Jujubae
bai he lily bulb Bulbus Lilii
wu wei zi schisandra Fructus Schisandrae
dang gui angelica root Radix Angelicae Sinensis
Sample prescription: Lily Bulb and Rehmannia Decoction

Therapeutic principle Reinforcing yang and replenishing yin
Indications Alternating hot flashes and chills, red cheeks, weakness, lumbar soreness, palpitations, excessive sweating, dizziness, ear ringing, hot sensations in the palms and soles, insomnia, paleness, fatigue, poor appetite, urinary dripping, low libido and menstrual irregularities, pale tongue

Commonly used ingredients
xian ling pi epimedium Herba Epimedii
ba ji tian morinda root Radix Morindae Officinalis
Xian mao common curculigo rhizome Rhizoma Curculiginis
mo han lian yerbadetajo herb Herba Ecliptae
nu zhen zhi glossy privet fruit Fructus Ligustri Lucidi
rou cong rong cistanche Herba Cistanchis
shu di processed rhemannia rhizome Rhizoma Rehmanniae Praeparatae
Sample prescription: Promoting Yin and Yang Decoction

Therapeutic principle Invigorating kidney, regulating extra meridians
Indications Irregular periods, absentmindedness, fatigue, lumbar and knee soreness, discomfort in the lower abdomen, limb coldness, poor appetite, irritability, dizziness, ear ringing, occasional hot flashes, pale or bulky tongue

Commonly used ingredients
tu si zi dodder seed Semen Cuscutae
rou gui cassia bark Cortex Cinnamomi
xu duan himalayan teasel root Radix Dipsaci
bai shao white peony root Radix Paeoniae Alba
lu jiao jiao Deer antler glue Colla Cornus Cervi
shan yu rou cornus fruit Fructus Corni
Sample prescription: Consolidating Thoroughfare Vessel Decoction

Therapeutic principle Resolving stagnation and phlegm, promoting qi circulation
Indications Mood swings, depression, anxiety or paranoia, sleeping difficulties, chest tightness, suffocating sensation in the throat, excessive throat secretion, obesity, weakness, belching and abdominal distention, bulky pale tongue with white greasy coating

Commonly used ingredients
chen pi dried tangerine peel Pericarpium Citri Reticulatae
ban xia pinellia tuber Rhizoma Pinelliae
fu ling poria Poria
zhi shi immature bitter orange Fructus Aurantii Immaturus
hou po magnolia bark Cortex Magnoliae Officinalis
ku xing ren bitter apricot kernel Semen Armeniacae Amarum
Sample prescription: Four Herbs Decoction for Clearing Stagnation

Therapeutic principle Activating blood, dissolving stasis, and removing meridian obstructions
Indications Slow mental response, anxiety, headache, chest oppression, pain in the chest or abdomen, dull complexion, general aching, insomnia or sleepiness, itchiness, limb numbness or joint stiffness, dark tongue/tongue with purplish spots

Commonly used ingredients
chuan xiong Sichuan lovage Rhizoma Ligustici Chuanxiong
dan shen red sage root Radix Salviae Miltiorrhizae
shao yao peony Radix Paeoniae
tao ren peach kernel Semen Persicae
hong hua safflower Flos Carthami
dang gui angelica root Radix Angelicae Sinensis
Sample prescription: Unblock the Orifices and Invigorate the Blood Decoction

Because of the wide variety of menopause symptoms, some herbs are added for relieving specific serious complaints. For example:

Excessive sweating or vaginal discharge
long gu fossil bone Os Draconis
mu li oyster shell Concha Ostreae

Sleeping difficulties
ye jiao teng tuber fleeceflower stem Caulis Polygoni Multiflori
he huan pi mimosa tree bark Cortex Albiziae

uneasy mind
long chi fossil teech Dens Draconis
hu po amber Succinum

Severe body heat
huang qin baical skullcap root Radix Scutellariae
huang lian golden thread rhizome Rhizoma Coptidis

Hot sensation in the palms and soles
di gu pi wolfberry root-bark Lycii Radicis Cortex
bai wei blackend swallowwort root Radix Cynanchi Atrati

Diarrhea or loose bowels
bu gu zhi psoralea Fructus Psoraleae
rou dou kou nutmeg Semen Myristicae

Skin itchiness
chan tui cicada slough Periostracum Cicadae
bai xian pi dictamnus root bark Cortex Dictamni Dasycarpi Radicis

Heavy menses
bu gu zhi psoralea Fructus Psoraleae
ai ye tan artemisia leaf (charred) Folium Artemisiae Argyi

Night urination
yi zhi ren sharpleaf glangal fruit Fructus Alpinae Oxyphylae
sang piao shao mantis egg-case Os Sepiellae Seu Sepiae

Dizziness and headache
tian ma tall gastrodia tuber Rhizoma Gastrodiae
gou teng gambir vine stem Ramulus Uncariae cum Uncis

Rich in clinical experience, TCM has formulated many herbal prescriptions for various health problems in women. Among those prescriptions for menopause, herbs for dispelling liver and regulating reproductive system such as white peony root, angelica root, rehmannia root and bupleurum root are the ones most selected; herbs for invigorating kidney such as epimedium and common curculigo rhizome are the second most popular choices, which help reinforce overall endocrine activities; herbs for invigorating the spleen such as largehead atractylodes rhizome, poria and liquorice root are also useful and can ensure material transformation. Other popular selections include herbs for suppressing hot flushes, such as anemarrhena rhizome and rehmannia root; herbs for nourishing heart and calming the spirit, include sour jujube seed, Chinese arborvitae kernel and polygala poot; abalone shell, nacre and oyster shell are for soothing the liver which helps stabilize the cardiovascular and neural functions.

Although TCM herbal remedies have not undergone full clinical trials, experiences over the centuries have testified to their efficacy. Nevertheless, herbs should be used cautiously, as they may contain potent ingredients that can cause a variety of harmful reactions, including diarrhea, allergic reactions and sometimes hallucinations. Always use herbs in moderation and under the guidance of professionals.

White peony root
Angelica root
Rehmannia root