SECOND SPRING: Chinese Medicine for Menopause

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A combination of acupuncture and herbs are recommended for treating menopausal complaints such as hot flashes and night sweats

Menopause is considered as a “second spring” in Traditional Chinese Medicine. This is distinct from the “summer heat wave” or “winter storm” that some women describe.

A woman has entered menopause when one year has passed since her last menstrual period. The transitional phase leading up to that time is called perimenopause, and it can last for many years – beginning anywhere from a woman’s late 30s to her 50s.

According to Traditional Chinese Medicine (TCM), women’s bodies follow seven-year cycles. From birth a young girl matures until the blood and energy in her body overflows and brings menarche (the onset of menstruation) at around 2 x 7 years of age. Then at about 7 x 7 years of age, the woman’s body needs to conserve energy and blood and therefore enters menopause. This is a natural progression and a sign of health dictated by the wisdom of the body. Menopause is a homeostatic mechanism that actually slows down the aging process in women.

Preserving Our Kidney Essence

An understanding of aging, according to TCM philosophy, is that it’s directly linked to the concept of “Kidney essence.” Essence represents our fundamental nature, that which is necessary for life. Once all of a person’s essence is depleted in the process of living, they die.

There are two types of Kidney essence – congenital and acquired. Congenital essence (known in the West as genetic material) is inherited from one’s parents. The quantity and quality of this essence depends on the vigour and age of the father and mother at one’s conception, as well as the health of one’s mother during pregnancy. Acquired essence comes from the air we breathe and the food and drink we consume throughout the course of our lives.

And equal in importance to how we receive essence, which underlies all of our body’s functions, is how we expend it. Unhealthy lifestyles and excessive stress take a toll on our body’s balance and essence.

Consider a line graph of a person’s life. At birth the person has a full complement of congenital essence. How quickly one uses up that essence depends on one’s lifestyle. The healthier the lifestyle the less steep the downward slope of the essence. Of course life is not always even, so this line will waver at those times in which essence is used up faster and times when it is used up more slowly – but the line will eventually lower to the bottom of the graph. Reaching the x-axis equals natural death.

In complementary opposition to the essence line, is the wisdom line referring only to that wisdom which is gained during life. At birth the wisdom line is down at the x-axis. As the baby grows and learns, this line rises. The slope of the line likewise depends on the choices one makes and opportunities one enjoys, but over time as wisdom accumulates, the line continually rises.

At some point, these two lines will cross. For a menopausal woman, this crossover represents a transition – wisdom is now predominant and the new focus of her personal potential; it is the time of her Second Spring – an opportunity for a rebirth of herself, for herself.

Embracing a Second Spring

Embracing a Second Spring requires our acceptance of aging and change. In our culture, we must contend with a great fear of death and aging that expresses itself in reverence for the fountain of youth. But in most Asian countries, many women do not suffer in menopause. This is partly explained by differences in diet and lifestyle, but I believe the main difference is that age is respected and valued in these cultures. This, of course, does not mean that at menopause one cannot be energetic, beautiful, and vibrant. Rather, it is possible to be all these things at any age. Chinese Medicine celebrates the natural stages of our lives, including menopause, and offers techniques for a smooth transition.

Many of the discomforts that women experience in perimenopause are an expression of imbalances that have already existed in their bodies for years, sometimes decades.

For women who enter menopause after a hysterectomy, chemotherapy, or some other medical intervention, the symptoms can be more dramatic. Balancing the body with Chinese Medicine is also recommended in these cases. Every situation is unique, as every woman’s experience is unique.

Chinese Medicine does not separate mind and body – the woman’s whole life situation and emotions are considered in a treatment plan. In perimenopause, various emotional issues can arise. Women often take a deep look at the meaning of their lives thus far and re-evaluate themselves, their relationships, and their work. Menopause marks the end of a woman’s childbearing years – a significant transition for women who have had children as well as women who have not. For some women, this transition requires time to grieve.

Menopause is an emotional, mental and spiritual transition in addition to the experience of physical changes.

Common Imbalances in the Menopausal Years

Below I will outline some of the more common imbalances described in TCM that bring discomfort in perimenopause and menopause (note that multiple imbalances can exist at the same time). I will then discuss some remedies offered by Traditional Chinese Medicine.

Kidney-Yin deficiency: Symptoms of this imbalance include dizziness, night sweating, hot flashes, sore back, dry mouth, dry hair, dry skin, itching, and constipation.

Kidney-Yang deficiency: Symptoms of this imbalance are hot flashes but cold hands and feet, night-sweating in the early morning, pale complexion, depression, chilly-ness, backache, and swelling of the ankles.

Kidney-Yin and Kidney-Yang deficiency: This is a combination of yin and yang deficiency which presents with symptoms such as hot flashes but cold hands and feet, night sweating, frequent pale urination, slight agitation, ringing in the ears, backache, dry throat, being flushed around the neck.

Kidney and Liver-Yin deficiency with Liver-Yang rising: Typical symptoms include irritability, dizziness, ringing in the ears, blurred vision, dry eyes, dry skin, hot flashes, ache in joints, night-sweating, sore back, headaches.

Kidneys and Heart not harmonized: Symptoms include hot flashes, palpitations, insomnia, night-sweats, blurred vision, dizziness, anxiety, restlessness, feeling of heat in the evening, dry mouth and throat, poor memory, dry stools.

Accumulation of phlegm and stagnation of Qi- obesity: Symptoms include oppression of the chest, a feeling of fullness of the stomach, swelling of breasts, irritability, belching, nausea, no appetite, moodiness, depression.

Stasis of Blood: Symptoms include hot flashes, mental restlessness, irregular periods with dark-clotted blood, insomnia, high blood pressure, abdominal pain.

Acupuncture, Herbs, Qigong for Menopause

ACUPUNCTURE AND HERBS – A combination of acupuncture and herbs are recommended for treating menopausal complaints. Treatment depends on the presenting patterns (see above) with the goal of clearing blockages, nourishing deficiencies, and relaxing excesses. The length and frequency of treatments depend on the individual’s condition. I recommend starting treatment once a week and then adjusting according to your needs. Once a week allows time for herbal remedies to take effect between treatments and is frequent enough that improvement can accumulate from treatment to treatment. As a woman is feeling better and incorporating lifestyle recommendations, treatments can be spread to once every two weeks, then once a month, and so on. Even when we are in optimal health, it is recommended that we receive acupuncture every season to support the body in staying healthy and making seasonal transitions smoothly.

QIGONG (GENTLE EXERCISES AND DEEP BREATHING) – Relieving stress and getting moving is good for both body and mind. Menopause is a wonderful time for women to connect more deeply with themselves. Deep breathing, mindfulness meditation, and yoga are all recommended. In Chinese Medicine, the practice of Qigong (“work with energy”) incorporates breathing techniques with gentle exercises and meditation. There are many different Qigong practices that deal directly with balancing energy in the body. Qigong exercises can help menopausal women to relax, clear excess heat, and balance yin/yang. These exercises are easy to learn and practice in almost any environment.

Menopause is a life transition that offers challenges and gifts. Like all things in life, it presents both its “yin” and “yang”. Chinese Medicine offers approaches and treatments that can ease the transition, supporting the journey that is ultimately a woman’s own.

Dawn Aarons has practiced acupuncture since graduating from The Institute of Chinese Medicine (Toronto) in 1996. She now spends much of her time in Melaque, a fishing village in Mexico. To share her love of the area and have an opportunity to invite guest teachers, she organizes retreats to Melaque.


  • Menopause with Science and Soul, Judith Boice, Celestial Arts, 2007
  • Obstetrics and Gynecology in Chinese Medicine,  Giovanni Maciocia, Churchill Livingstone, 1998
  • Menopause; A Second Spring, Honora Lee Wolfe, Blue Poppy Press, 1995
  • Menopausal Years; The Wise Woman Way, Susun S Weed, Ash Tree Publishing, 1992

Dawn Aarons has practised acupuncture since graduating from The Institute of Chinese Medicine (Toronto) in 1996. She now spends much of her time in Melaque, a fishing village in Mexico. Dawn can be reached at

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