menopause Archives - Acupuncture in the Park

Heat, Hormones, and Chinese Medicine

Dear Acupuncture in the Park, why is it that some women have hot flashes into their seventies and even eighties? My poor mother still has what appears to be hot flashes several times a day, and she’s 76. She thinks she was just unlucky in the menopause lottery. What’s going on?

Answer: It’s not uncommon to see women who still struggle with hot flashes or night sweats many years after they have gone through menopause. Are their hormones to blame? Maybe, but it’s likely that there’s more going on than hormones run amok.

Within the framework of Chinese medicine, menopausal hot flashes have a lot to do with Yin and Yang. In your body, Yang acts like a warming pilot light. It maintains body warmth, transforms your food into nutrients, and keeps things moving. In contrast, Yin is more like a nourishing coolant that keeps the heat of Yang in check.

Menopause is all about hormones. There are some hormones that are more Yang in nature, like thyroid hormones. In contrast, sex hormones such as estrogen and progesterone are considered to be more Yin, and they are cooling, calming, and moist. When you go through menopause, Yin in the form of estrogen and progesterone drops, which is a bit like being down a quart of coolant. Yang flares up, and the result is heat, in the form of hot flashes and night sweats.

So far so good. But how do you explain hot flashes occurring decades after menopause? Well, for most women, this menopausal heat-producing imbalance between Yin and Yang regulates itself. Most women will balance out within a year or two (often less) of the onset of the heat. However, women who are Yin depleted in nature may not be able to balance out so quickly, if at all.

How can you tell if your Yin is depleted? It may take the help of your acupuncturist to figure it out. That said, there are a few clues. Remember that Yin and nourishing, moistening, and cooling, so if you are not those things, chances are that your Yin could be out of balance. Specifically, if you have dry skin, wake up with a dry and sore throat, tend to run hot in general, struggle with insomnia, have hot hands and feet, struggle with constipation or dry stools, or tend to feel agitated, irritated, or restless, you might be dealing with a Yin deficiency.

But back to your 76-year-old mother who is still flashing. There may be other reasons beyond a Yin depletion that’s making her hot. For example, stress has the ability to heat you up, regardless of the status of Yin and Yang. In your body, stress has a way of making things “seize up” which creates heat that can feel very much like hot flashes.

Other conditions that can create heat in your body include inflammation and infection. While the problem may be localized, the heat associated with these conditions can cause hot flash-like flushing. In addition, there are people who are just constitutionally hot. They never need a sweater, are warm to the touch, and their partners describe them as furnaces.

So, the answer to your question is that it’s possible to have what feels like hot flashes well into old age. They may have started during menopause, and just stuck around because Yin never came back into balance. It’s also possible that something else is going on that’s making her hot. My suggestion is to have your practitioner of Chinese medicine do a thorough diagnosis. It’s my belief that in most cases, acupuncture, dietary tweaks, and in some cases Chinese herbs, can help things cool down.

Sleep Apnea, Menopause, and Acupuncture

When I think about sleep apnea, I picture in my mind’s eye some big dude sawing wood, snoring up a storm, and thrashing around all night long. What I don’t picture is a woman going through menopause and struggling to get a good night’s sleep.

While it’s true that more men than women have sleep apnea, women do in fact suffer from this sleep disorder. Sleep apnea is an airway obstruction that occurs while you’re sleeping, forcing you to wake up and catch your breath. People with severe sleep apnea may wake up dozens of times during the night, making it impossible for them to get the deep restful sleep needed for good health. Congestive heart failure, high blood pressure, and daytime exhaustion are some of the health problems associated with sleep apnea.

For women who have sleep apnea, many of them develop it during or after menopause. A decrease in the hormones estrogen and progesterone are thought to be the culprit, as they help regulate and promote sleep.

In the clinic, I see women with sleep issues related to menopause who describe a pattern in which they can fall asleep easily. However, they wake in the wee hours and “surf” restlessly between sleep and wakefulness the rest of the night. This pattern is also similar to that of apnea, which is at its worst during the deepest REM sleep, when the work of breathing becomes a little more difficult. Ironically, since most REM sleep occurs during the last third of the night, apnea sufferers also find it the most difficult time to get sufficient deep sleep. The bottom line is that once REM sleep kicks in during the latter half of the night, apnea begins, causing frequent waking.

In Chinese medicine, menopause is most closely tied to your Chinese Kidney, which is responsible for your body constitution, growth, maturation, fertility, and how you will age.

Your Kidney system also houses the vital substances of Essence, Yin, and Yang, which frequently become depleted during menopause. This depletion is the underlying cause behind hot flashes, night sweats, and disturbed sleep.

There is good news in that sleep apnea that develops during menopause may be a temporary thing that resolves itself after the transition of menopause is over. In addition, if you are struggling to get a good night’s sleep, there are some things that you can do. Among them:

-Get a sleep study. Contact your health care provider to find a sleep clinic near you. They will measure the quality of your sleep and your breathing to determine if you are suffering from apnea. If you are, they can suggest solutions that will help you sleep better, which might include a CPAP machine to keep your breathing steady while you sleep.

-Sleep cool. Keep the room where you sleep cool, wear light moisture-wicking pajamas, and open a window if possible.

-Enlist some help from Chinese medicine. Many people use acupuncture to help them sleep better. In addition, Chinese herbs can help nourish your Chinese Kidney and offset some of the side effects of menopause. Interestingly, in some cases herbs can be more effective than acupuncture, as they are better at the job of nourishing your vital substances and regulating hormonal changes.

-Chinese food therapy may also help. Your practitioner can suggest foods that nourish your Kidney, as well as cool some of the heat of hot flashes or night sweats.

The bottom line is that while you may think that women don’t snore or have apnea, the reality is that they do, and it kicks in for many women during menopause. The quality of your sleep is important, because it affects your health in a number of ways. If you believe that you have obstructive sleep apnea, get some help.

Acupuncture for Hot Flashes and Night Sweats

Not long ago, I sent my sister a care package. It wasn’t packed with brownies and cookies and other goodies to eat. Her care package had only one thing; a Chinese herbal formula to treat the night sweats that are waking her several times every night.

How you experience menopause is different from every other woman. Your family history, physical and psychological makeup and overall health all play a role in whether or not you will have menopause symptoms or sail right through unaffected. Your views of aging and menopause, and those of the people around you, may also shape your experience. Over the past 50 years, with the availability of hormone replacement therapies, women have had the option of treating the discomforts associated with menopause medically. The upshot of this practice is that menopause if viewed by some as a disease or hormone deficiency, with hormone supplementation required to reestablish a healthy balance.

Practitioners of Traditional Chinese Medicine offer another paradigm in which to consider the experience of menopause. They understand that signs and symptoms associated with menopause are indications of some kind of imbalance deep within the body. In general, imbalances are years in the making, and physiological events, such as adolescence, childbirth, or menopause, magnify the imbalance and result in symptoms. With menopause, underlying imbalances can certainly affect your symptoms.

So what’s out of balance if you’re struggling with hot flashes and/or night sweats? Well, it could be a couple of things. First, your Essence could be depleted. Essence is one of the most important substances in your body and provides you with the energy you need to power all the functions of life. As you age, Essence slowly becomes depleted. This depletion causes many of the common signs of aging, such as gray hair, thinning bones, weakness in your back and knees, memory loss, and fatigue.

Depleted Essence can also cause menopause symtoms, too; here’s how: Essence is similar to estrogen, in that Essence is responsible for puberty, fertility, libido, and menopause. During menopause, Essence drops dramatically, and this loss can create an imbalance that is associated with a wide variety of symptoms. A common problem is that when Essence is depleted, it may lose the ability to keep Yang in check. Yang is the active and warming energy in your body, and when it flares unchecked, you may feel that warmth in the form of hot flashes or night sweats.

Another common scenario for women who are struggling with menopausal heat is an imbalance between Yin and Yang. If Yang is hot and active, Yin is the opposite; cooling and rejuvenating. In many ways, Yin is similar to Essence in that it is restorative and nourishing. During menopause, Yin also tends to drop, causing Yang to flare up and make you feel hot. The heat associated with this drop in Yin is frequently felt at night, which is the cool, restorative, and quite time of day–just like Yin. Against the backdrop of night, the active heat of Yang is more pronounced, resulting in night sweats.

It’s important to mention that stress can aggravate your heat symptoms. That’s because strong emotions, especially stress, have the ability to make your energy stagnate. Similar to a car engine seizing up without oil, your stress, anger, or frustration creates heat.

An untreated depletion of Essence or an imbalance between Yin and Yang will ultimately cause symptoms. So what can you do? First, you can protect your Essence through good diet, sleep, and balancing your work with rest. An over-the-top lifestyle, such as working long hours, late nights, and too much sex, drugs, and rock and roll will, in time, deplete your Essence.

You can also address depleted Essence or a Yin/Yang imbalance through acupuncture and Chinese medicine. After a complete evaluation, you acupuncturist will develop a treatment plan to address your specific imbalance(s). She can incorporate the use of acupuncture with herbs, diet, stress relief, and lifestyle changes to balance your body and alleviate your symptoms to help you sail through menopause in a natural and drug-free way.

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