Kidney yang defiency

Before I offer some more complete suggestions I would like a little more information from a western perspective. You mention possibly trying hormone replacement therapy... Have you had blood work done and your hormone levels tested already? If so, is there anything "wrong" with you from a western perspective?

You are right that you should be seeing improvement after 20 treatments - after 7-10 at the most in reality. I think from a TCM perspective your diagnosis is most likely correct but as you may know the points that people may use will vary considerably from practitioner to practitioner. No judgement intended on your current practitioner, but it is more than likely time to work with someone else. Sometimes just another perspective is helpful even within the field (if you want to write me off line and tell me where you live I may be able to make some suggestions).

Acupuncture should be very helpful for you, but I would caution you on taking too many herbal supplements. You more than likely do not need them and they can aggravate your condition. Moxibustion (which you can do at home) on ST 36 would be a decent adjunctive to do and if you were to take herbs some very basic formulas - perhaps something with ginseng would be good. - We often use a formula called "energy enhancer" for these types of conditions which you can look at for the ingredients list to see how well it matches up with what you've been taking.

I guess my only suggestion is to see a different practitioner. You should have had at least some moderate improvement at this point. Also, people will argue this, but you don't need to be treated twice a week for a deficiency condition (or any condition really). Once a week, perhaps with some home moxibustion, for 1-3 months should bring you some improvement.