JAMA Study Finds Holistic Therapies 85% Effective for Perimenopause

A new study on discontinuing MHT (menopausal hormone therapy) published in the July 13, 2005 issue of the Journal of the American Medical Association (JAMA), found that women who tried holistic techniques instead, such as acupuncture, chiropractic and massage, reported that these methods are 85% effective in managing perimenopausal symptoms, such as hot flashes, night sweats, pain and stiffness, headaches, insomnia, irritability and depression.
The study tracked women who had gone off MHT after a landmark study in 2002 showed increased health risks for women taking hormone replacements. Interestingly, the study found that even after being symptom free for up to six years on MHT, women had a resurgence of symptoms when they discontinued taking the hormone replacements.

In an interview for the NPR news magazine All Things Considered (July 14, 2005) study author, Dr. Judith Ockene says, “Women do need to go through some level of allowing their body to adjust to decreasing levels of estrogen in the body. They can‟t merely leap frog over or eradicate these problems, they may merely just alleviate them for awhile.”

The study also found that instead of using MHT, women are using a variety of holistic strategies to manage their symptoms, including increasing fluids and exercise, changing diets, and using alternative medical techniques, such as acupuncture, massage and chiropractic. 90% of women surveyed reported the treatments helped. These finding have prompted Dr. Ockene to begin a follow-up study to look at the potential benefits of holistic therapies to manage perimenopausal symptoms.

Dr. Diana Pettiti, an Epidemiologist at Kaiser Permanente, wrote an editorial in JAMA about Dr. Ockene‟s new study. In the NPR interview, Dr. Pettiti advised, “The study suggests that if you have bad symptoms now you will probably have bad symptoms when you withdraw, but that the symptoms are manageable with a variety of other alternative therapies. Women who are contemplating the use of HRT for these symptoms might try something else first. They might try one or two of these things first to see if it works for them.”

Interestingly, it is only women in Western countries who are troubled with menopausal problems. Women in Asian and underdeveloped countries are not plagued with these late in life problems. Why is this so? According to Traditional Chinese Medical (TCM) theory, perimenopausal complaints are due to the modern stressors that women in Western societies live with throughout their lives. Additionally, the high levels of phyto-estrogens consumed in the soy-based diet of Asian women protect them from experiencing perimenopausal symptoms.

In TCM theory menopausal symptoms are a result of how a woman has lived her life up to the time of menopause. In Western societies, as women have entered the workforce they are encountering new work stresses previously only incurred by men. Studies show that women in Western societies have a higher rate what were previously thought to be typically „male‟ diseases: stroke, heart attack, hypertension and high cholesterol. These women are now balancing careers, child-rearing responsibilities and managing household finances, creating more stress and leading to a face-paced, harried lifestyle.

How does this stress contribute to Perimenopausal Syndrome, and what can women do to prevent occurrence and alleviate these symptoms? The TCM explanation for menopausal complaints gets rather complicated. Briefly, these symptoms are due to something TCM calls Kidney Yin Deficiency. The TCM Kidney system includes the reproductive and the aging processes. Yin and Yang refer to polar opposites that TCM uses to describe diseases processes in the body. Yang refers to upward, male, heat, energy and daytime. Yin refers to feminine, quiescence, substance (such as flesh and blood), the cooling aspect that balances Yang body heat, and evening time.Stress and aging damage Yin; therefore symptoms of yin deficiency, such as hot flashes, night sweats and insomnia appear as menstruation ceases.
Chinese herbal formulas effectively address perimenopausal symptoms, such as hot flashes and night sweats by replenishing Kidney Yin. Acupuncture is especially useful for treating pain, stiffness and headaches. Both herbs and acupuncture stimulate hormone production.

Dietary changes, such as increasing consumption of soy products containing phyto-estrogens can relieve perimenopausal complaints by 80%, according to the JAMA study. Implementing lifestyle changes to reduce stress with activities such as yoga, meditation and walking will help reduce symptoms by 92%. As Perimenopausal Syndrome is caused by an accumulation of lifestyle choices made up to the time of the cessation of menstruation, dietary and lifestyle changes are especially important for disease prevention in younger women.


ACUPUNCTURE TREATS PERIMENOPAUSAL SYNDROME:A SAFE AND EFFECTIVE ALTERNATIVE TO HRT

When considering menopausal complaints, most women think of hot flashes as the chief symptom as they prevalent and uncomfortable. However, there are a myriad of other symptoms associated with cessation of menstruation that cause what is clinically defined as Perimenopausal Syndrome. These symptoms include hot flashes, night sweats, mood changes such as anxiety, irritability and depression, ear ringing (tinnitus), headaches, fatigue, poor memory, and low backache. Western medicine has associated these symptoms with the decline of estrogen and progesterone production used to regulate menstruation. As the menses cease, doctors prescribe Hormone Replacement Therapy (HRT) to eliminate unwanted symptoms. However, research on HRT shows that safe administration of these drugs is controversial. How then can these complaints safely and effectively be treated?

Interestingly, it is only women in Western countries who are troubled with menopausal problems. Women in Asian and underdeveloped countries are not plagued with these late in life problems. Why is this so? According to Traditional Chinese Medical (TCM) theory, perimenopausal complaints are due to the modern stressors that women in Western societies live with throughout their lives. Additionally, the high amounts of phyto-estrogens in the soy based diet Asian women consume offer protection from perimenopausal symptoms.

Perimenopausal symptoms may occur before, during or after menopause, and duration of symptoms varies from woman to woman. In TCM theory, menopause normally occurs after age 49, however, many Western women experience what Western MD‟s term „premature menopause‟. In these cases, perimenopausal symptoms, such as hot flashes and night sweats may be experienced by women in their mid 30‟s to early 40‟s. In Western society, these symptoms are considered a normal and unavoidable part of menopause; however, this belief is untrue. The absence of these symptoms in women in Asian and under developed nations shows that menopause can and should occur asymptomatically. Perimenopausal Syndrome is well addressed with Chinese Medicine, using acupuncture and herbal therapy.

In TCM theory menopausal symptoms are a result of how a woman has lived her life up to the time of menopause. In Western societies, as women have entered the workforce they are encountering new work stresses previously only incurred by men. Studies show that women in Western societies have a higher rate what were previously thought to be typically „male‟ diseases: stroke, heart attack and hypertension and high cholesterol. These women are now balancing careers, child-rearing responsibilities and managing household finances, creating more stress and leading to a face-paced, harried lifestyle.

How does this stress contribute to Perimenopausal Syndrome, and what can women do to prevent occurrence and alleviate these symptoms? The TCM explanation for menopausal complaints gets rather complicated. Simply put, when we are stressed, we feel tense and tighten up. Qi (pronounced chee) is our body‟s energy that moves our limbs, causes our brains to think, the heart to pump blood and the digestive organs to process food. When stress and tension cause us to tighten up, Qi stagnates, and does not circulate well throughout the body. When Qi is stuck and does not moving freely we feel pain, often in the low back, near the reproductive organs. When stuck Qi does not circulate properly, too much Qi can rise to the head, causing headaches, hot flashes, night sweats and ear-ringing. When we tense up due to stress, our emotions are affected causing mood changes such as irritability, anger and depression. As we age, our Qi weakens, so that we don‟t have the same energy we had in our twenties. When Qi (energy) is weak we get tired. Weak Qi cannot nourish the brain properly causing poor memory. Also, due to weak Qi, our ability to produce hormones declines.
Perimenopausal Syndrome is well treated with Chinese Medicine. TCM practitioners use acupuncture and herbs to increase Qi and hormone production and to get stuck Qi flowing properly, thereby reducing and eliminating perimenopausal symptoms. Qi flows in vessels (like blood) called meridians that flow from the fingers and toes through the torso and back to the head. These meridians have been photographed using infrared imaging1. Acupuncturists stimulate points on meridians to move Qi. Studies theorize that acupuncture needles stimulate muscle fibers to trigger nerve endings to send chemical signals to the brain. These signals cause the brain to regulate hormone levels2. Many Chinese herbs also regulate hormones levels. Dietary changes, such as increasing consumption of soy products containing phyto-estrogens can also help relieve perimenopausal complaints. Additionally, implementing lifestyle changes to reduce stress with activities such as yoga, meditation and walking will also help reduce perimenopausal symptoms. As Perimenopausal Syndrome is seen as an accumulation of how a woman has lived her life up to the cessation of menstruation, dietary and lifestyle changes are especially important for disease prevention in younger women.


1Yin Lo. What are Meridians? Can We See Them? Acupuncture Today March 2004; 5(3): 10, 12.
2Willis M. East Meets West. Acupuncture Gains Acceptance, Application in Western Medicine. ABC News.com 2004 ABC News Internet Ventures.