Published on 11-22-2015
Perimenopause is the transition that women go through on their way to menopause - the cessation of menstruation and fertility. This transition can be a multi-year or even decade or longer process with the average being 4 years. Some women will experience minimal symptoms and others can have years of problematic symptoms. These symptoms are related to the lowering of estrogen levels as the ovaries reduce production throughout this process. Symptoms run the gamut from mildly irregular cycles, occasional hot flashes and fatigue to more significant issues such as frequent spotting, very short and/or heavy cycles, increased PMS, changes in mood and/or libido and more.
One of the more common western treatments for perimenopause is birth control pills, but this can be problematic for some women and obviously problematic for those still interested in conceiving. Other aspects of western treatment may be antidepressants, but obviously those are not dealing with the causes of the issues and only potentially help with a sub-set of issues.
A common form of western medical treatment in the 1960's and 70's was hormone replacement therapy (HRT), which is still used today. In recent years, however, these treatments are used far more sparingly and cautiously after seeing increases in cancer rates and other health issues arise from treatment. The issues potentially related to HRT are breast cancer, uterine cancer, bowel cancer, blood clots and/or stroke. While bioidentical hormones are arguably an improved mechanism for hormonal treatment, there are no long term studies indicating any greater safety than standard treatments. Either way, none of these treatments deal with your bodies ability to balance itself, which is the most positive outcome of treatment.
Acupuncture and Chinese Herbal Medicine have long been used to help treat a broad range of menstrual, hormonal and fertility issues. Example Chinese Medicine diagnoses and treatment protocols related to menopause can be seen on our acupuncture for menopause page. What you will see there is the range of more subtle diagnoses used to explore these symptoms vs. the western way of simply naming symptoms and doing baseline treatments that don't always respect the true dynamic nature of each individual woman. These more specific diagnoses are the crucial base of Chinese Medicine treatment.
There are techniques within Chinese Medicine that can be utilized with minimal education for certain conditions without a deep understanding of the clinical underpinnings of TCM that is required for acupuncture and proper Chinese herbal medicine treatment. One of these techniques is acupressure, for example HT 6 for hot flashes. Overall however, acupressure is somewhat limited in what you can accomplish for these range of symptoms. Another commonly used technique is moxibustion (or "moxa") - see "What Is Moxibustion?" for the basics. Moxibustion is the technique utilized in the study I will present below.
Researchers from Shanghai Jiangwan Hospital and the Shanghai University of Traditional Chinese Medicine recently conducted a study evaluating the clinical effects of moxibustion on the range of chemical and hormonal underpinnings of perimenopause. Utilizing 3 groups of perimenopausal rats, a control, a moxibustion treatment group, and a estrogen treatment group they began their exploration of the changes spawned on by the process of moxibustion.
The moxa treatment group received moxibustion at the following acupuncture points - 20 minutes daily for 6 days with 1 rest day.
The researchers found that moxibustion raised estrogen levels at similar levels to those with standard hormonal treatment. The moxa group also had lower follicle stimulating hormone (FSH) levels, similar to the hormonal treatment group but with results seen in early stages of the study. They also found that at 8 weeks in the moxibustion group there was a significant upregulating of estrogen receptors in the uterus. Finally, they found that there were significant decreases in ovarian tissue death (apoptosis).
In essence the researchers found that moxibustion can stimulate the body to increase estrogen levels and protect itself from cell death.
Of importance here is that this effect is largely modulated by your bodies response to moxibustion, not by chemical interactions that happen with herbal medicine or other ways of treating these issues. Clinically, in general, moxibustion has limited side effects when used properly as it is largely improving circulation and stimulating functions via certain acupuncture points. The only potential downside of moxibustion is that in some over stimulated people (lots of heat signs, palpitations, anxiety - i.e. kidney yin deficiency) it may overheat and/or further stimulate them. However, compared to what will happen with improperly prescribed Chinese herbal formulas (for example, stronger tonics such as you gui wan for kidney yin deficiency) the side effects would be minimal in most cases.
All in all, these responses are very interesting and help to deeply explain some of the beneficial effects of acupuncture and associated techniques such as moxibustion. Further studies should be done to evaluate the clinical effects of needling those points vs. moxibustion, perhaps even acupressure. All things considered, this is a simple technique to help your body restore its own hormonal levels without strong external intervention. Along with proper acupuncture and/or herbal medicine treatment, moxibustion is a crucial part of easing perimenopausal issues, particularly in women who are still interested in becoming pregnant.
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Formulas: you gui wan
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