In Chinese medicine the menopause is the natural consequence of the decline in Jingwhich occurs in 7 year cycles in women. Hence the natural age of the menopausewould be expected to be at 49 years. Studies of groups of women from diversecultures all confirm that the median age of the menopause is between 50-51 yearsold151. The symptoms of the menopause are considered in general to be aconsequence of the decline in the Jing, in its Yin and/or Yang aspect, although theKidney deficiency may also be combined with excess patterns.
The patterns which can give rise to menopausal symptoms include Kidney Yin deficiency,Kidney Yang deficiency, Kidney and Liver Yin deficiency with Liver Yang Rising, Kidneys andHeart not harmonised, Accumulation of Phlegm and Stagnation of Qi, and Blood Stagnation.
HRT can benefit symptoms presumably because oestrogen is nourishing to the Spleen andto Yin (the Yin aspect of Essence), evidenced by its beneficial effect on fleshiness andfertility. However this effect may be suppressive in that it may be at the expense of drawingon deep reserves of Spleen Qi, Kidney Yin and Jing. The progestogen in HRT is oftenblamed for the common side effects which include headaches, fluid retention and weightgain. This suggests that progestogens (together with oestrogens) tend to causeAccumulation of Damp and Qi Stagnation. This fits with the physiological effect they have ofcausing the lining of the womb to become thicker and more oedematous. It is only onwithdrawal of the progestogen that breakdown of this thick lining occurs and bleeding takesplace. There is also an increased risk of breast and womb cancer with HRT. These alsosuggest that HRT induces Stagnation and/or Accumulation of Phlegm on a background ofKidney deficiency.