By Dr. Bernard Shannon

Originally published in Chinese Medical Qigong Therapy: Volume 4 - Prescription Exercises and Meditations, Treatment of Internal Diseases, Pediatrics, Geriatrics, Gynecology, Neurology and Energetic Psychology. Chapter 53, page 389 – 399. Published 2004
Republished Qi Journal, Summer 2005
Presented at the World Academic Society of Medical Qigong in June 2014

Introduction

Menopause is a natural biological event in the reproductive cycle of women. The importance of the stage of menopause increases as the post World War II “baby boomer generation” approaches fifty years of age. Because current life expectancy exceeds 85 years in the West, most women of this generation are expected to spend more than one third of their life in the phase of post menopause. [1]

It’s been estimated that over 60 million women will be menopausal in North America by the year 2020.[2] Additionally, the Office of Women’s Health states that by the year 2030, one in four American women will be over the age of 65.[3]

While Western medicine typically offers hormone replacement therapy (HRT) for the discomforts that can accompany menopause, many women cannot or do not wish to take hormones. Recent studies have also shown that HRT may lead to numerous diseases, including breast cancer, Heart disease, and stroke.[4] Women seeking advice about menopause have more options and better interventions for healthy menopausal years than ever before, although many clinically relevant questions remain unanswered.[5]

Medical Qigong and other forms of Complementary and Alternative Medicine (CAM) have been found to be very effective for treating menopausal symptoms, thereby providing many women with safe and effective alternative treatments. Instead of the standard hormone replacement therapy offered by most Western gynecologists, Medical Qigong practitioners treat each woman individually, taking into account the whole pattern of each patient’s physical and mental-emotional symptoms.

Discussed in this paper will be the overview of menopause and menopausal symptoms, Western medical treatments, traditional Chinese Medical Theory pertaining to menopause, and Medical Qigong treatment protocols and prescriptions for menopausal conditions, lifestyle, recommendations, and dietary suggestions.

Overview

Menopause is a normal and natural event that marks the end of menstruation. From the time a woman has her last period, some authorities consider menopause to be complete when it has ceased for one year.

Although some people think of menopause as the point when menstruation ends, menopause is not a single event. Instead, it is a series of changes that can start in a woman’s 30s or 40s, and last into her 50s or 60s. Natural menopause follows the course of these metabolic changes without medical intervention. While the average age for the onset of menopause is 51 in most industrialized countries, a large variation occurs (range: 39 - 59 yrs).[6]

In the third century B.C., the Yellow Emperor's Classic of Internal Medicine reached the same conclusion regarding the natural onset of menopause, "When a woman reaches the age of 49 she can no longer become pregnant and the circulation of the great thoroughfare pulse is decreased. Her menstruation is exhausted, and the gates of menstruation are no longer open; her body deteriorates and she is no longer able to bear children.”[7]

Traditionally, menopause has referred to the transition from reproductive fertility to the cessation of fertility. However, menopause has been divided to into two additional stages: perimenopause and post menopause. Perimenopause is the transition period from natural menstruation and fertility to menopause, with an average duration of 4 to 5 years (range: 1 - 9 yrs).[8] Post menopause is the stage of life that follows menopause, and lasts until the woman’s death.

For most women this process begins in their mid-thirties. During this time, the ovaries gradually produce lower levels of sex hormones, estrogen and progesterone. Estrogen promotes the development of a woman's breasts and uterus, controls the cycle of ovulation, and affects many aspects of a woman's physical and emotional health. Progesterone controls menstruation and prepares the lining of the uterus to receive the fertilized egg.

Although for most women menopause is a natural process, certain surgical or medical treatments can induce menopause. These include:

• Chemotherapy and radiation therapy. These cancer therapies can induce menopause. But they usually do so gradually, and a woman may have months or years of perimenopausal symptoms after these therapies before the onset of menopause.

Signs and symptoms

Although menopause is a natural transitional phase within the reproductive cycle, symptoms and manifestations during this change may require medical intervention. Distressing and painful symptoms may represent an underlying imbalance necessitating treatment to bring relief. Perimenopausal and menopausal symptoms vary from slightly noticeable to severe. Some women may breeze through menopause with few signs and symptoms. In fact, some experience a very smooth transition in which the only noticeable change is the cessation of menses. The healthier a woman is as she approaches menopause, the more likely she is to pass through this phase in her life with minimal discomfort. Other women may experience a number of physical and emotional changes, including:

[9]

• Irregular menstruation. Menses may stop suddenly, or gradually; the menstrual flow may become lighter or heavier and then stop. Other irregular symptoms are menstrual pain, fluctuations in Pre-Menstrual Syndrome symptoms , and breast distention. Varying patterns in menstruation may be the first clue to a woman that menopause is approaching.
• Decreased fertility. When ovulation begins to fluctuate, a woman is less likely to become pregnant. However, pregnancy is still possible until menstruation has ceased completely and a full year has passed .

• Sleep disturbances and night sweats. Night sweats are often a consequence of hot flashes. A woman may awaken from a sound sleep soaking wet with night sweats followed by chills. This typically leads to difficulty falling back to sleep or achieving a deep, restful sleep. Lack of sleep affects a woman’s moods and overall health.
• Hot flashes. In a review of 557 case studies, hot flashes occurred in 76.3% of menopausal women.[10] Hot flashes are a vasomotor flush that may occur as estrogen levels drop. Blood vessels may expand rapidly, causing skin temperature to rise. This can lead to a feeling of warmth or heat that moves upward from the chest to the shoulders, neck and head, followed by an increase in body temperature and profuse sweating. The face might look flushed, and red blotches may appear on the chest, neck and arms. Most hot flashes last from 30 seconds to several minutes, although they may last much longer. As the sweat evaporates from the skin, women have reported feeling chilled, weak and slightly faint. The frequency and duration of hot flashes vary. Other symptoms that may be associated with hot flashes include dizziness, vertigo, and tinnitus (ear ringing).
• Vaginal Changes. Tissues of the genital region that are dependant upon estrogen may begin to atrophy as estrogen levels decline. As a result, the vagina and urethra become more dry, thinner, and less elastic. This may lead to increased vaginal ulceration resulting in discomfort and an increased risk and frequency of infection. With decreased lubrication in the vagina, there may be burning or itching caused by vaginal dryness, which may make sexual intercourse uncomfortable or even painful. Diminished libido and stress incontinence may also manifest.      

• Psychological changes. During perimenopause and menopause mood swings, irritibility, and increased sensitivity may occur. Other psychological symptoms may include changes within the cognitive function, memory loss, loss of ability to focus, sudden irritability or anger, depression, anxiety, and agitation.

• Poor Digestion. As the metabolism changes with the decrease of hormone production, digestive symptoms may arise that include loss of appetite, indigestion, nausea, gas, bloating, loose stools or diarrhea, constipation, and weight gain.

Post Menopausal Complications

Several chronic medical conditions tend to appear after menopause. Awareness of the following conditions allows a woman to take preventative measures.

• Cardiovascular disease. Estrogen smoothes, relaxes, and opens blood vessels to aid circulation. It even helps to lower "bad" LDL cholesterol levels and to raise "good" HDL cholesterol, keys to keeping arteries clean and preventing Heart disease. Estrogen levels plummet as women age and pass into menopause, increasing their vulnerability to a host of Heart and artery ailments.[11]
• Osteoporosis. Osteoporosis causes bones to become brittle and weak, leading to an increased risk of fractures. Women can lose about 20 percent of their bone mass within five to ten years following menopause. After menopause, about half of all women suffer a fracture related to osteoporosis.[12] Postmenopausal women are especially susceptible to fractures of the hip, wrist and spine.Up to 20 percent of postmenopausal women will die within a year of fracturing a hip.[13]
• Urinary stress incontinence. Weakness of the bladder control muscles is a common symptom developing from loss of estrogen. Pressure from coughing, sneezing, or lifting can push urine through the weakened urethral opening. [14]

Western treatment: Hormone replacement therapy (HRT)

The primary changes of menopause in a woman’s body don’t require medical treatment, they are a natural process. Hormone Replacement Therapy (HRT) focuses on relieving painful symptoms and manifestations of menopause, and on preventing or lessening chronic conditions that arise during the postmenopausal years.

Few areas of women's health stir up as much confusion and debate as Hormone Replacement Therapy (HRT), which may be utilized by the physician when the first symptoms of menopause appear. Many primary care physicians believe that HRT is the standard therapy for menopause.[15] This therapy, which provides a low dose of estrogen, often in combination with progestin, has been shown to be effective in treating many of the symptoms and manifestations of menopause, including hot flashes, vaginal dryness and discomfort during intercourse. HRT taken as estrogen alone or as a combination therapy may help prevent bone loss and osteoporosis. HRT may be taken in a variety of forms including pill, patch, cream, or vaginal ring.[16]

 

HRT provides symptomatic relief and protection from osteoporosis for some women. However, one of the biggest dissadvantages associated with the use of estrogen is the staggering number of side-effects, many of them life threatening. These include but are not limited to increased risk of breast cancer, uterine cancer, ovarian cancer, endometrial carcinoma, malignant neoplasm, gallbladder disease, pulmonary embolism, stroke, or retinal thrombosis.[17] Progesterone may be prescribed with estrogen to minimize the risk of endometrial cancer. However, this can cause side effects such as an increase in cholesterol levels, edema, weight gain and bleeding.[18]

In 2002, a study being conducted by the Women’s Health Initiative, part of the National Institute of Health, was stopped three years prior to culmination. An independent advisory committee, the study’s Data and Safety Monitoring Board (DSMB), recommended the premature end to the clinical trials of estrogen plus progestin due to observed increases in life threatening diseases in the study’s participants. These diseases included an increased risk of invasive breast cancer, as well as increases in coronary Heart disease, stroke, and pulmonary embolism. Although there were noteworthy benefits of estrogen plus progestin, including fewer cases of hip fractures and colon cancer, in the final analysis the harm was deemed greater than the benefits.[19]

Many women are aware that HRT is dangerous to their health because of these adverse effects, and choose to seek other treatment. There are other viable therapies for menopausal symptoms other than HRT.

Gynecology is a highly effective Chinese medical modality for the treatment of women’s reproductive issues. The treatment of menopause is a particular area of competency and effectiveness. Medical Qigong is capable of early detection, prevention, and treatment of the energetic changes that are the precursors of symptoms, as well as fully manifested symptoms such as hot flashes, mental dullness, and irritability. Medical Qigong may be utilized as the sole therapy in the treatment of menopausal symptoms and resultant disease processes, or Medical Qigong may be used in concert with HRT or other TCM modalities

The Medical Qigong doctor’s treatment protocol will include individualized Medical Qigong exercises formulated to treat each woman according to her menopausal symptoms and underlying constitution. The most bothersome symptoms that are effectively treated are hot flashes, insomnia, night sweats, headaches, inability to concentrate, anxiety, depression, and weight gain.

Through Medical Qigong therapy, a woman may correct underlying organ deficiencies, excesses, and imbalances present in her body. Concerns regarding breast cancer, osteoporosis, and Heart disease may be discussed and evaluated, and if indicated, appropriately treated through the Medical Qigong treatment and prescription exercises. Preventative and remedial protocols to inhibit cancer, strengthen bones, or prevent cardiovascular degeneration may be prescribed.

Medical Qigong regulates, harmonizes, and balances the body safely and more gradually than hormone replacement therapy. Therefore, the menopausal patient needs to be made aware that results may not be instant, but will develop over the course of treatment. Increase or intensification of feeling or emotion may arise as underlying causes are relieved. However, the potential discomforts of treatment and self-treatment are quite mild compared to the original symptoms being treated, or to the potentially dangerous or even lethal side effects that may arise as a result of HRT.

When used accurately and as directed, Medical Qigong exercises gently and steadily regulate, harmonize and balance the organs and channels of the body, without adverse medical side effects.   For women who experience the unpleasant side effects of menopause, Medical Qigong may economically and significantly ease or eliminate these symptoms at their root cause, in accord with both ancient and modern Chinese medical practice.

Traditional Chinese Medical Theory Pertaining to Menopause

Traditional Chinese Medicine, TCM, teaches that health is based on the principles of balancing, regulating, and harmonizing the fundamental influences of Yin and Yang. Menopause can be viewed as an energy conservation mechanism in which vital energy is conserved in the woman’s body, instead of being depleted through monthly ovulation and menstruation. Rather than having a monthly period, a Yang activity that drains Kidney vitality, in menopause the flow of energy is reversed in the center of the body, and blood and Jing are directed up to the Heart. This reversal of energy flow is a Yin activity meant to conserve energy and prolong life.

The human body functions as an integral whole, with the internal organs constantly inter-promoting and inter-restraining each other. For example, a deficiency of the Kidneys will affect other internal organs, leading to disequilibrium in the functioning of the entire internal organ system. This disequilibrium gives rise to a series of symptoms.

Therefore, in treating menopause, it is first necessary to understand the role of the internal organs; that symptoms manifest by an imbalance of an internal organ; to ascertain whether the syndrome is caused by a deficiency or excess of Yin or Yang, or both Yin and Yang’; and lastly, to identify which organs and their systems have been affected by this imbalance.

According to TCM, there are three energetic organ systems and two energetic channels (also known as acupuncture meridians) primarily responsible for the onset, maintenance and cessation of a woman's monthly cycle. These are the organ systems of the Kidneys, Liver, and Spleen, and the Governing and Penetrating (Thrusting) Channels.

 

 

Kidneys

In Chinese medical theory, the Kidneys are the reservoir of the Jing (essence or energy), seen as the foundation of life and longevity. The Kidneys act as the “biological clock” that controls the orderly processes of growth, development, maturation and decline. Aging is considered to be due to a decline in Kidney Jing. Women’s reproductive power is stored in the ovaries, and is controlled by the Kidney Jing. Part of the Kidney Jing is also utilized to form menstrual blood. Throughout the period of perimenopause and menopause, women experience a gradual weakening of the Kidney energy.

Before menopause, estrogens and progesterones are produced by the ovaries and also by the adrenal glands. During menopause, as ovarian production declines, the adrenals become the major suppliers of these hormones. Without healthy Kidneys, the adrenals, which sit directly on top of the Kidneys and are controlled by the Kidneys, cannot efficiently take over their role as the major producer of estrogens and progesterones.

Protracted illnesses that impair the Kidneys, sexuality in excess of a woman’s constitutional ability, pregnancy and childbirth, or loss of blood can lead to deficiency of the Kidney Yin. An insufficient Kidney Yin cannot fulfil its function of harmonizing the “Heart fire.” As the equilibrium between the Heart and the Kidneys breaks down, a discord between Heart and Kidneys is created. A deficiency of Kidney Yin also affects Liver Yin. As Five Element Theory views the Kidney as the “mother” organ to the Liver, an insufficient Kidney Yin will also fail to nourish the Liver, causing insufficiency in the Liver Yin, leading to hyperactivity of the Liver Yang.

Deficiency of the Kidney Yang is usually the result of an inborn or constitutional insufficiency of Yang in the patient’s body. Other causes are mingmen huoshuai (a declined fire of the vital gate) in the aged, an excessive intake of cold foodstuffs, or the injury of the Kidney due to chronic diseases and intemperate sexuality.

The Kidney Yang regulates the “water metabolism,” warms the body, and energizes the Spleen for food digestion. Pathologically speaking, deficient Kidney Yang cannot warm the Spleen Yang, which resulting in a deficiency of both Kidney and Spleen.

Liver

In women’s physiology and menstruation, the Liver plays a crucial role, mostly through its relationship with the uterus and blood. The Liver is in charge of storing, releasing, and regulating the smooth circulation of blood and Qi. When the body is at rest, the blood returns to the Liver. When activity begins, the blood will be released for use. The regulating function of the Liver is the release of blood for the menstrual cycle. The Liver plays a powerful role in menstruation, menopause, and the overall reproductive system, because the Liver Channel spiral wraps and interpenetrates the reproductive organs, thereby controlling reproductive function. Stress or emotional problems easily disturb the Liver’s activity and likewise, a disturbed Liver will generate disturbed emotion. An energetic qi deviation can migrate down the Liver channel, producing stagnation and disharmony in the woman's reproductive system. This commonly leads to premenstrual tension and symptoms in younger women and is also one of the contributing factors to the problems associated with menopause.

Spleen

The Spleen is responsible for the digestion of food and the transformation of it into energy, which is the post-heaven root basis of the production of blood. When the Spleen has matured to the stage where it transforms sufficient food energy to produce an abundance of blood, there is sufficient blood to ensure an even monthly flow from the uterus and menstruation begins. As one ages, the Spleen becomes weaker and is no longer able to produce an oversupply of blood. This is one cause of the cessation of menstruation.

 

Energetic Channels

At menopause, the most important change is the decline of Kidney energy and the depletion and reversal of the Governing and Penetrating (Thrusting) Channels. These two channels are particularly important in the regulation of a woman’s physiology. The Penetrating Channel controls menstruation, and the Governing Channel controls the uterus. Both Channels originate in the Kidneys. Together they regulate a woman’s menstrual cycle; one controls Blood and the other Qi. A Medical Qigong practitioner will use these Channels and their points to treat problems relating to conception, fertility, menstrual irregularities, and menopause.

The Role of Estrogen and Progesterone in TCM
Western doctors may suggest that the symptoms associated with menopause are solely due to estrogen deficiency. According to Chinese medicine, estrogen, along with other hormones, is part of a larger category of internal fluids known as Essence (Jing). Stored by the Kidneys, Essence is the origin of all Yin (Blood and Moisture) and Yang (Qi and Warmth).

Ordinarily estrogen is considered to be a Yin fluid because it relieves conditions of Yin Deficiency (hot flashes, dryness) and produces conditions of Yin Excess (Dampness, Blood Stasis). Similarly, progesterone could easily be considered a Yang fluid because of its ability to enhance fat metabolism, thyroid function, and improving circulation of Blood and distribution of fluids.

However, in the context of developmental cycles, estrogen acts like a Yang agent because it promotes cell division and rapid growth, whereas progesterone acts like a Yin agent because it moderates growth by promoting cell differentiation and maturation. Pregnancy requires cell proliferation, differentiation, and maturation - both Yin and Yang functions. The dynamic of estrogen and progesterone can be compared to that of the Creative Cycle and Controlling Cycle in the Five Element theory.[20]

Differential Diagnosis and Qigong Treatment with Prescriptions

The internal organs interrelate and influence each other, exerting a determining influence on the smooth flow of Qi within the body. Deviations, stagnations, excesses and deficiencies within this complex system require specific organ therapy for restoration and balance. This therapy is designed to bring the specific organ or organ system back into balance by using various Medical Qigong treatments, meditations, visualizations, and breathing exercises.

Medical Qigong and Chinese medicine differentiate menopause into nine syndromes, each requiring specific treatment. Rather than seeing hormonal imbalance as the root of symptoms, Chinese medicine considers hormonal imbalance to be multiple syndromes occurring together.   Hormonal imbalance is one of many signs and symptoms that occur, which exacerbate pre-existing conditions.

When multiple syndromes occur together, disharmony patterns can generally be divided into two categories: Yin vacuity and Yang Vacuity with Kidney Yin and Yang Deficiency being the exception.

Yin Vacuity	Yang Vacuity
Kidney Yin Deficiency Kidney and Liver Yin Deficiency and Liver Yang Rising Kidney and Heart Not Harmonized Liver Qi Stagnation Blood Deficiency Kidney Yang Deficiency Kidney Yang and Spleen Yang Deficiency Jing Deficiency Stasis of Blood

The specific Medical Qigong treatments for menopause are always preceded by the standard general treatment protocol as taught by the International College of Medical Qigong.

Menopausal Yin Vacuity Conditions

In a general protocol for treating common menopausal excess conditions, Qi is emitted into the body, and Turbid Qi is removed.

Symptoms

Yang disharmonies arise when Yang energy is excess. Symptoms include:

Night sweats Hot flashes and sweating Insomnia Dizziness Tinnitus Irritability

Headache Sensation of heat in hands & feet Constipation Vaginal Dryness Dry mouth

 

 

 

Treatment

In the Yin Vacuity treatment, the goal is to nourish and sooth the Liver; tonify the Kidney Yin; and clear Deficiency Heat.

1. When the doctor’s preliminary “hook-up” and general dredging of the patient’s Wei Qi fields is complete, dredge the Yin and Yang meridians of the legs. The doctor stands at the feet of the patient and extends their right hand with fingers separated like a rake towards the patient’s right leg. The doctor dredges or “rakes” up the Yin meridians starting at the foot, moving towards the Lower Dantian. Once reaching the Lower Dantian, continue dredging with the right hand down the patient’s left leg Yang meridians from the Lower Dantian down to the left foot. The doctor will do the same procedure dredging with their left hand up the Yin meridians of the left leg and down the Yang meridians of the right leg. Repeat this method 9 times.
2. Access the patient’s Liver through direct energetic insertion into the Liver’s anatomical location. Extend Qi into the Liver for 24 breaths, stimulating this area with Tiger Kneading Palm technique, Pushing, Pulling, and Shaking the Qi techniques to purge Excess and/or Turbid Qi.
3. Then the doctor leads any remaining Turbid Qi from the Liver down the right Gall Bladder Channel and out of the patient’s body from GB-34.
4. Next, the doctor dilates the entire Gall Bladder Channel from GB-1 to GB-44 on the right side of the patient’s body using Leading and Guiding techniques to purge excess and/or Turbid Qi from the channel. Repeat on the left side.
5. Next, the doctor stimulates the Kidneys and Lower Dantian by using Extended Fan Palm technique over CV-7, emitting blue energy into the Kidneys for 9-18 breaths.
6. Then, the doctor stimulates the patient’s Kidneys and Lower Dantian through the Taiji Pole and Bubbling Springs (KD-1) points using sword fingers, extending energy through the bone marrow of the feet, legs, spine, and brain for 9-18 breaths.
7. Finally, the Qigong doctor regulates the body’s Yin and Yang Qi through running the Microcosmic Orbit (Fire cycle).

Treatment Modification

Kidneys and Heart Not Harmonized

Kidney Yin Deficiency fails to nourish the Heart Yin, which also becomes deficient. The warmth of the Heart must descend to warm the Kidney Water, and the Kidney wWater must rise to cool the heat of the Heart. Patients with the above disharmony may have Heart palpitations, poor memory, and mental restlessness, in addition to some of the Yang Excess symptoms.

The Qigong doctor will use the String of Pearls technique to increase the action of connecting and harmonizing the Heart fire and the Kidney Water, for 9-18 breaths.

Prescriptions and Homework

Exercises to Tonify and Regulate the Kidney Yin

Taking in the Blue Qi

Strengthening the Kidneys and Conducting the Qi with Chreee

Up the Yin Down the Yang Channels

Exercises to clear Excess Heat

            Pulling Down the Heavens using descending “Xi” ("she") sound

Exercises to Purge and Regulate the Liver

            Liver Organ Massage and Point Respiration

Old Man Searching for the Reflection of the Moon at the Bottom of the Tide Pool

Exercises to Regulate the Kidneys and the Heart

            Rolling the Ball

            Expanding and Contracting the Rings

Menopausal Yang Vacuity Conditions

The following is a description of a general protocol used for treating common menopausal deficient conditions. Qi is emitted into the body, Turbid Qi is removed, and Righteous Qi is emitted to tonify the deficient conditions.

Symptoms

Yin disharmonies occur when the Yang energy is deficient. In general terms, symptoms of these disharmonies may include:

• Loose stools
• Cold limbs
• Edema of the face and limbs
• Early morning sweats
• Weakness and soreness of the lower back and legs
• Decreased bone mass density

Treatment

The goal of the general Yang Vacuity treatment is to warm and reinforce the Kidneys.

1. Once hook-up and general dredging of the WeiQi fields is complete, the Qigong doctor stimulates and tonifies the patient’s Mingmen and Lower Dantian areas using the Vibrating Palm technique for 12 breaths.
2. Then, vibrate the energy using the Sword Fingers technique to tonify the Kidneys for 16 to 18 breaths.
3. Next, stimulate and tonify the patient’s SP-6 areas on each leg, leading the Qi up into the Lower Dantian for 12 breaths. Repeat using ST-36.
4. Finally, return back to the Mingmen and Lower Dantian areas using the Extended Fan Palm technique. Emit Qi for 24 breaths, rotating in a clockwise direction to gather the Qi in the Lower Dantian.

Treatment Modification

Kidney Yang and Spleen Yang Deficiency

The Spleen is the root of the Post-Heaven Qi. When it is deficient it fails to nourish the muscles, resulting in lack of strength. When Spleen Yang is deficient the limb may feel cold, as nourishment is not transported to the limbs. Furthermore, the deficient Kidney Yang implies a weakened Kidney fire, which cannot transform water and fluids. This condition may lead to edema. Other symptoms may include chronic diarrhea, abdominal distention, and mental listlessness.

In addition to the general Yin deficient treatment described above, the Qigong doctor will vibrate the energy using the Sword Fingers technique while emitting Qi into ST-25, which is used to stop diarrhea, for 16 to 18 breaths. Then, have the patient roll over so they are facedown. The Qigong doctor emits Qi into DU-4, strengthening Kidney fire using Vibrating Palm technique, for 12 breaths. Repeat this procedure for BL-20 to strengthen the Spleen.

Prescriptions and Homework

Exercises to Tonify the Kidney Yang

Wuji Standing Meditation

Beating and Drumming the Qi

Gathering Qi to the Lower Dantian

Up the Yin Channels Down the Yang Channels

Specifically, utilize this exercise while focusing on a warming energy being pulled up the legs from the Earth, into the Lower Dantian.

Exercises to Strengthen and Regulate the Spleen

            Spleen Organ Massage and Point Respiration

Exercises to Strengthen and Regulate the Spleen Yang and Kidney Yang

Small Turning and Winding Technique

            Turning and Winding Technique

 

Lifestyle Care

Having a positive and healthy lifestyle is important throughout a woman's life, and at no time is it more essential than when a woman is going through menopause.

According to Chinese medicine, the severity of menopausal symptoms primarily depends on the condition of the Kidney Qi (energy). A poor diet, lack of exercise, overwork, poor sleep, and high levels of stress weaken the Kidneys and the adrenal function, which worsens menopausal symptoms. The challenging symptoms of menopause will be greatly reduced through improving and regulating the woman’s lifestyle habits as outlined below:

 

Healthy Diet

Eating a balanced and nutritious diet with plenty of calcium, vitamins and minerals is especially crucial for menopausal women since two of the biggest health concerns, Heart disease and osteoporosis, are both directly affected by what a woman eats.

According to the National Heart, Lung, and Blood Institute, women who have reached menopause should have 1,500 mg of elemental calcium every day.[21] Unfortunately, most women between the ages of 50 and 65 consume only 700 mg daily.[22]

Menopause patients are encouraged to follow a diet with a high content of raw foods, fruits and vegetables, to help ensure that proper amounts of calcium, vitamins and minerals are consumed. Leafy green vegetables are rich in calcium, which can help to defend against osteoporosis. They also have a host of vitamins and minerals. A diet high in vegetables and fruits may aid in promoting digestion due to increases in fiber content. Fruits and vegetables have a stabilizing effect on the blood sugars, compared to many commonly enjoyed processed foods containing refined sugars and refined carbohydrates. Raw nuts and seeds are rich in proteins and healthy fats.

Eating foods high in plant oestrogens (phytoestrogens) may alleviate menopausal symptoms and lower cholesterol levels. Generous sources of plant oestrogens include lima beans, soybeans and soy products, nuts, seeds, fennel, celery, parsley and flaxseed oil.

Because the decrease in hormone production associated with menopause leads to a depletion of bodily fluids, maintaining proper hydration is especially important for menopausal women. To combat this, it is generally recommended for women to drink one (1) ounce of water for every two (2) pounds of body weight each day.

Menopausal women should reduce or completely avoid the following foods:

• Dairy products - may produce phlegm, bloating, and gas
• Red meats - are difficult to digest, and can contribute to arterial plague
• Alcohol - more than 1-2 glasses of wine, or 1-2 ounces of liquor per day may spike blood sugar and aid in Liver Qi stagnation
• Sugar - refined sugars overheat the Liver, overwork the Spleen, and may contribute to Spleen Deficiency, hot flashes, insomnia, and emotional challenges.
• Spicy foods - may contribute to hot flashes, and over fuel the digestive fire.
• Caffeine - drains Kidney energy

Additionally, many women will benefit by restricting carbohydrate consumption (grains, cereal, bread, potatoes, and pasta) to one meal a day, preferably at dinner. This will reduce the level of circulating insulin, enabling the cells to respond normally to thyroxin, progesterone, estrogen, testosterone, cortisol, and other hormones.

 

Exercise

Exercise is an important factor in maintaining a healthy lifestyle. The complaints of ageing include: joint stiffness from arthritis; weight gain due to lower metabolism; thinning bones from osteoporosis; muscle atrophy; and loss of balance and coordination. Many of these may be reduced with regular exercise. Even if women begin exercise programs later in life, many of the symptoms of these maladies may still be reduced.

Exercise may also offer relief from some common menopausal complaints. Sleep disturbances are reduced, as women who exercise tend to sleep better. Exercise also stimulates the production of endorphins, a group of proteins in the brain that makes people feel better. So, after a work out, women may feel less stressed and less likely to be affected by mood swings. Lastly, women with a sedentary lifestyle are more likely to have moderate or severe hot flashes, compared with women who exercise. [23] [24]

Exercise Can be Divided into Three Classifications

• Flexibility exercise: Stretching before exercise minimizes the risk of injury, stretches muscles, and mobilizes joints. It also improves balance and agility, which can then minimize the risk of bone fractures due to falls.

• Aerobic exercise: Brisk walking, swimming, dancing, and biking uphill strengthen the Heart and Lungs by widening the blood vessels. Aerobic exercise decreases the risk of coronary artery disease and high blood pressure by strengthening the Heart and Lungs. This in turn, improves the delivery of oxygen throughout body tissues.
• Weight-bearing exercise: Walking, hiking, stair climbing, weight training (lifting weights), and tennis increase bone mass since these exercises are performed against the force of gravity. This type of exercise, carefully and gently performed, reduces the risk of osteoporosis.

 

Stress Reduction

Women who are going through menopause may feel overwhelmed by stress. Adapting to physical and emotional changes certainly can be difficult. Menopause occurs during midlife when a woman may be coping with other stressful situations, such as the death of a spouse or parent, divorce, or empty nest syndrome. Some ways that menopausal women have been able to reduce the stress in their lives include:

• Taking part in enjoyable activities
• Meeting with friends
• Exercising daily
• Taking up a hobby
• Volunteering in a worthwhile cause
• Meditation
• Eating healthy foods
• Getting enough sleep
• Laughing
• Maintaining a positive attitude

If stress and anxiety are severe, professional help in the form of counseling or psychotherapy may be recommended.

Qigong’s Relation to Exercise and Stress Reduction

Using physical movement, breathing method, and mental intention to correct and restore the function in our bodies, Qigong helps to correct disruptions in the body’s energy which occur naturally throughout our lifetime as a result of injuries, surgery, chemical and environmental influences, emotional changes, and aging. People practice Qigong to maintain health, heal their bodies, calm their minds, and reconnect with their spirit.

           

Qigong can, depending on the exercise performed, provide the flexibility, aerobic, and weight bearing exercise that women need to maintain a healthy lifestyle. In practicing Qigong, women can realize the same benefits as conventional exercise. However practicing Qigong regularly will also enable the body to strengthen and regulate the internal organs, the nervous system and the immune system, relieve pain, regulate hormones, relieve stress, and release deep-seated emotions.

Adding Qigong to one's daily routine, regardless of ability, age, belief system, or life circumstances, may enrich one's life. Many people practice Qigong simply because it makes them feel good, perform better, and have higher levels of energy and stamina.

Other Self-Care

Fortunately, many of the signs and symptoms associated with menopause are temporary. The Mayo Clinic recommends the following self-care suggestions to help reduce or prevent the effects of menopause: [25]

• Schedule regular medical checkups. A woman should talk with her doctor about how often she should have mammograms, Pap tests and other screening tests.
• Cold and hot flashes. They shouldn’t be lived with passively. If a woman experiences hot flashes, get regular exercise, she should dress in layers and try to pinpoint what triggers her hot flashes. For many women, triggers may include sugar, emotional stressors, hot beverages, spicy foods, alcohol, hot weather and even a warm room.
• Decrease vaginal discomforts. For vaginal dryness or discomfort with intercourse, use over-the-counter water-based vaginal lubricants (Astroglide, K-Y Jelly) or moisturizers (Replens, Vagisil). Staying sexually active while utilizing these moisturizers and lubricants also helps minimize these problems.
• Optimize sleep. If a woman has trouble sleeping, avoid caffeinated beverages and exercise right before bedtime. Practicing relaxation techniques such as deep breathing, guided imagery and progressive muscle relaxation can be very helpful. Women can find a number of books and tapes on different relaxation exercises.
• Stay dry. If a woman experiences night sweats, wear cool cotton clothing to bed and keep an extra set handy.
• Don't smoke. Smoking increases a woman’s risk of Heart disease, stroke, cancer and a range of other health problems. Cigarette smoking may be related to hot flashes in menopausal women. Preliminary data have shown that women who experience hot flashes are more likely to be smokers.[26] Additionally, cigarette smoking or exposure to second-hand smoke should be avoided as they may dry up Yin and body fluid.
• Strengthen the pelvic floor. Pelvic floor muscle exercises, called Kegel exercises, can improve some forms of urinary incontinence. A woman should contract the pelvic muscles as if trying to close the vaginal opening. Hold the contraction for a count of three and then relax. Wait a few seconds and repeat. Fast Kegels (squeezing and relaxing muscles as quickly as possible) can also help. Performing several Kegels per day (try for 50) can improve bladder control and may enhance sexual pleasure.
• Acupressure. Massaging particular acupressure points along the energetic channels will help influence the flow of Qi through the meridians and strengthen the Kidneys, Liver and Spleen, and also support and soothe the Heart energy.

 

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[1] National Institute of Health. National Heart, Lung, and Blood Institute. Office of Research on Women’s Health. Giovanni Lorenzini Medical Science Foundation. International Position Paper on Women’s Health and Menopause: A Comprehensive Approach. NIH Publication No. 02-3284. July 2002. Pg. 23.

[2]US News and World Report.com. Making sense of Menopause: A Complete Guide. http://www.usnews.com/usnews/health/menopause/timeline/menotimeline.htm. Accessed June 11, 2004.

[3] Office on Women’s Health (OWH) within the Department of Health and Human Services . Older Women's Health. http://www.4woman.gov/owh/older.htm. Accessed June 11, 2004.

[4] North American Menopause Society. Estrogen and progestogen use in peri- and postmenopausal women: September 2003 position statement of the North American Menopause Society. Menopause: the Journal of The North American Menopause Society. Vol. 10, No. 6, pp. 497-506.

[5] NIH Publication No. 02-3284. July 2002. Pg.1

[6] Kenemans, Peter, MD. Menopause, Perimenopause & Postmenopause: Definitions, Terms & Concepts. http://www.obgyn.net/meno/meno.asp?page=/meno/news_articles/kenemans_0699. Accessed June 11, 2004.

[7] Veith, Ilza, The Yellow Emperor's Classic of Internal Medicine, pp. 98-99. Berkeley and Los Angeles: University of California Press, 2002.

[8] Kenemans.

[9] Zhang Da Ying, A Clinical Analysis of 557 Cases of Menopausal Syndrome. Tian Jin Zhong Yi (Tianjin Chinese Medicine), #3, 1994, p 7-8.

[10] Ibid.

[11] Levine, Samantha. Hormones and Heart: Many symptoms of menopause means many therapies. US News and World Report. 11/18/02. http://www.usnews.com/usnews/health/articles/021118/18heart.htm. Accessed June 11, 2004.

[12] Levine, Samantha. “Hormones and Bones.“ US News and World Report. 11/18/02. http://www.usnews.com/usnews/health/articles/021118/18bones.htm. Accessed June 11, 2004.

[13] Ibid.

[14] National Institutes of Health. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Menopause and Bladder Control. NIH Publication No. 04-4186. April 2004.

[15]Morrissey, Douglas R., MD and Jeffrey T. Kirchner, DO. Management of the climacteric: Options abound to relieve women's midlife symptoms. POSTGRADUATE MEDICINE. Vol 108, No 1, July 2000. http://www.postgradmed.com/issues/2000/07_00/morrissey.htm. Accessed June 11, 2004.

[16]May Clinic Staff, Menopause Treatment. http://www.mayoclinic.com/invoke.cfm?objectid=FDA7CB3A-4F3C-4FDB-9FDD926923BCDCB9&dsection=8. Accessed June 11, 2004.

[17] Ibid.

[18] Ibid.

[19] NIH Publication No. 02-3284. July 2002. Pg.19.

[20]Beinfield, Harriet, L.Ac. and Efrem Korngold, L.Ac Menopause, Hormones and Chinese Medicine. 2002

http://www.pacificcollege.edu/alumni/newsletters/winter1999/menopause_hormones.html. Accessed June 11, 2004.

[21] NIH Publication No. 04-4186. April 2004.

[22] IBID.

[23] Spetz, Ivarsson. Physical exercise and vasomotor symptoms in postmenopausal women. Mauritas 1998;29:139-46.

[24] Berg, Hammar. Does physical exercise influence the frequency of postmenopausal hot flushes? Acta Obstet Gynecol Scand 1990;69:409-12.

[25] May Clinic Staff, Menopause Treatment. http://www.mayoclinic.com/invoke.cfm?objectid=FDA7CB3A-4F3C-4FDB-9FDD926923BCDCB9&dsection=9. Accessed June 11, 2004.

[26]Staropoli, CA and JA Flaws. Predictors of menopausal hot flashes. J Womens Health 1998;7:1149-55.