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The Sixth Seven: 

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How Chinese Medicine harmonizes Perimenopause 

Quite often, patients arrive with similar complaints in clusters.

Last week was clearly International Perimenopause Week. I’m joking, but only a little. The women I worked with had complaints of frequent periods, vaginal dryness, brain fog, hot flashes and digestive upset.

In Traditional Chinese Medicine (TCM), a woman’s life follows the natural rhythms of seven-year cycles, with significant transitions occurring every seven years. These cycles are closely tied to the Kidney energy (Jing), which governs growth, development, fertility, and aging. Each cycle marks an essential stage in a woman’s physical and emotional health, culminating in a profound shift during perimenopause.

The Seven-Year Cycles and Perimenopause

According to ancient TCM texts, at age 7, a girl begins to develop Kidney Qi. By age 14 (the second cycle), the Tian Gui (menstrual essence) matures, signaling the onset of menstruation. These cycles continue to influence reproductive health, with each subsequent cycle bringing new changes.

The sixth cycle starts at age 42. This is about when most women are feeling changes in their bodies. Changes we call ” Perimenopause”. By the seventh cycle, around age 49, a woman’s Kidney essence naturally declines, which leads to the gradual cessation of menstruation and the onset of perimenopause. This transition is viewed as a reflection of the body’s shifting energy from reproduction to self-cultivation and wisdom. While this process is natural, imbalances in Kidney essence can cause common perimenopausal symptoms such as irregular menses, hot flashes, night sweats, and emotional fluctuations.

Kidney Jing and Perimenopause

During perimenopause, the decline of Kidney Jing results in weakened hormonal regulation, affecting both the physical body and emotional well-being. Symptoms such as brain fog, low libido, and breast enlargement often signal this decline, as Jing is the foundational energy for reproductive health and overall vitality. Therefore, nourishing Kidney Jing is essential in TCM to ease the transition into menopause and promote long-term well-being.

By understanding the seven-year cycles and focusing on strengthening the Kidney essence through holistic practices like diet, herbal medicine, and lifestyle changes, you can ease perimenopausal symptoms and transition more smoothly through this critical life stage.

Perimenopause can be a confusing and challenging time for many women. The transition typically starts in your 40s, but sometimes as early as in the 30s, and can last anywhere from a few years to a decade. We’d say that this was in the 5th to 6th Seven.

With fluctuating hormone levels, it’s no wonder women experience a range of symptoms such as brain fog, low libido, breast distention, and irregular menses. Fortunately, holistic approaches can make this transition more manageable and even empowering. By addressing diet, Chinese medicine, and lifestyle adjustments, you can support your body through these changes and regain balance.

Perimenopause, like menstruation, childbirth, and menopause, is not a disease. They are just life processes. But these body shifts are not always smooth. Not every menstruating person experiences these changes as disruptive, and it’s a different experience for every woman. 

Fortunately, we have a small arsenal of helpful strategies. 

Understanding Perimenopause from a Chinese Medicine Perspective

In Traditional Chinese Medicine (TCM), perimenopause is often seen as a decline in Kidney essence (Jing), which is a concept that governs aging, fertility, and vitality. As this essence diminishes, imbalances can arise in the body, leading to symptoms like hot flashes, mood swings, and irregular periods. To help restore balance, we focus on nourishing the Kidney energy, harmonizing the Liver, and ensuring the smooth flow of Qi and Blood throughout the body.

Dietary Recommendations for Perimenopause

Your diet can play a huge role in easing perimenopause symptoms. Focus on foods that are nourishing, cooling, and support hormone regulation.

1. Phytoestrogen-Rich Foods:** Incorporate foods like flaxseeds, tofu, and tempeh, which contain plant-based estrogens that can help balance fluctuating hormone levels.

2. Healthy Fats: Omega-3 fatty acids found in fatty fish, walnuts, and chia seeds support brain health, which is vital for combating brain fog. They also help with inflammation and hormone balance.

3. Whole Grains and Complex Carbs: These stabilize blood sugar, which can reduce mood swings and irritability. Quinoa, oats, and brown rice are excellent choices.

4. Dark, Leafy Greens: Foods like kale, spinach, and bok choy provide essential vitamins and minerals (especially magnesium and calcium), which can help with breast tenderness and muscular tension.

5. Chinese Herbs and Foods: Incorporating Chinese foods like goji berries, black sesame seeds, and jujube dates nourishes Kidney and Liver energy. In contrast, herbs like Dong Quai (Dang Gui) and He Shou Wu support Blood flow and hormonal balance.

Balancing Estrogen Dominance

One common issue during perimenopause is **estrogen dominance**—a condition where estrogen levels are higher relative to progesterone. This can lead to breast tenderness, bloating, heavy periods, and irritability. Estrogen dominance can be addressed through food and supplementation, which help detoxify excess estrogen and support progesterone production.

Foods to Balance Estrogen Dominance:

1. Cruciferous Vegetables: Broccoli, cauliflower, Brussels sprouts, and cabbage are high in compounds like DIM (Diindolylmethane), which support the Liver in metabolizing excess estrogen. Aim for at least 1-2 servings of cruciferous vegetables per day.

2. Fiber-Rich Foods: Estrogen is eliminated through the digestive tract, and adequate fiber intake ensures healthy bowel movements and reduces estrogen reabsorption. Foods like oats, chia seeds, flaxseeds, beans, and fruits are excellent sources of fiber.

3. Liver-Supportive Foods: The Liver plays a central role in detoxifying excess estrogen. Foods like beets, artichokes, garlic, turmeric, and leafy greens are rich in antioxidants and nutrients that support liver health and aid in detoxification, thereby helping to balance estrogen levels.

4. Organic, Whole Foods: Eating organic minimizes exposure to xenoestrogens—chemicals found in pesticides and plastics that can mimic estrogen in the body. Choose organic fruits, vegetables, and hormone-free meats to avoid hormone disruptors.

5. Healthy Fats and Protein: Wild-caught fish, eggs, avocados, and nuts are not only delicious but also rich in nutrients like omega-3s, which support hormone balance and reduce inflammation. Knowing that these foods are beneficial for your health can provide reassurance and confidence in your dietary choices.

6. Green Tea: Green tea contains antioxidants that help the Liver detox excess estrogen and fight inflammation. It also contains compounds that may aid in balancing hormone levels naturally.

Supplements to Help Balance Estrogen:

– DIM (Diindolylmethane): This supplement, derived from cruciferous vegetables, helps metabolize and clear excess estrogen from the body. It can be especially helpful for women with estrogen dominance.

– Calcium-D-Glucarate: This supplement supports the Liver’s ability to detoxify estrogen and other toxins, making it a good choice for reducing estrogen dominance.

-Magnesium: Magnesium plays a crucial role in hormone regulation and can help reduce symptoms like irritability, anxiety, and breast tenderness. Foods like dark leafy greens, pumpkin seeds, and almonds are excellent sources.

-Probiotics: Gut health is essential for hormone balance. Probiotics support the body’s ability to eliminate excess estrogen, helping to maintain a healthy hormonal balance. Probiotic-rich foods include kefir, sauerkraut, and yogurt.

– Vitex (Chaste Tree Berry): Vitex is a popular herb that supports progesterone production, which in turn helps to balance the estrogen-to-progesterone ratio. This balance is crucial for maintaining a healthy menstrual cycle and reducing PMS symptoms.

Chinese Herbal Medicine for Perimenopause Symptoms

Chinese herbal medicine offers targeted formulas that address specific perimenopausal symptoms by restoring balance in the body. The formulas listed below should be considered examples. We take time in the practice to match the formula to the pattern you experience. Further, we customize them so they precisely match your personal experience. Some common formulas include:

For Brain Fog:

  The herbal formula Gui Pi Tang is excellent for calming the mind and improving focus. It nourishes the Heart and Spleen, which, according to TCM, are essential for mental clarity and emotional stability.

– For Low Libido:

  Jin Gui Shen Qi Wan is often used to support Kidney Yang, which is crucial for reproductive energy and sexual desire. It also strengthens the lower back and knees, which can feel weakened during perimenopause.

– For Breast Distention and Irritability:

  Xiao Yao San is a go-to formula for soothing Liver Qi stagnation, which can manifest as breast distention, irritability, and mood swings. This formula harmonizes the Liver and Spleen, promoting a smoother emotional and physical flow.

For Irregular Menses:

  Ba Zhen Tang is a powerful Blood and Qi tonic that regulates the menstrual cycle. It is particularly effective if you experience fatigue and heavy or irregular periods during perimenopause.

Lifestyle Adjustments for Perimenopause

Incorporating lifestyle changes can make a significant difference in managing perimenopause symptoms:

1. Exercise: Moderate, regular exercise such as walking, swimming, or yoga helps reduce stress, improve sleep, and balance hormones. Exercise also supports cognitive function and libido.

2. Prioritize sleep: Poor Sleep can exacerbate symptoms like brain fog, irritability, and low energy. Create a calming bedtime routine with meditation, deep breathing, or drinking calming herbal tea like chamomile or passionflower.

3. Manage your Stress: Chronic stress weakens Kidney energy and Liver Qi, contributing to irregular cycles and emotional imbalances. Engage in mindfulness practices, whether meditation, tai chi, or simply taking time each day to reflect and relax.

4. Massage and Acupressure:Gentle massage, especially around the breast area, can help relieve distention and tension. Acupressure on Liver 3 (Taichong) and Kidney 3 (Taixi) supports hormone regulation and emotional balance.

5. Stay Hydrated: Dehydration can make symptoms like brain fog and fatigue worse. Drink plenty of water and hydrating herbal teas like nettle and dandelion to support detoxification and reduce bloating.

Perimenopause is a natural transition, but it doesn’t have to be overwhelming. You can regain a sense of balance and vitality by nourishing your body with the right foods, herbal support, and lifestyle practices. If this speaks to you, call us. We’d love to help you embrace this time of change with compassion and care, and your body will thank you!

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