Menopause occurs when the ovaries stop producing eggs, leading to a permanent cessation of menstruation. It usually occurs between the ages of 48 and 55, with a median age of around 51 in industrialized countries. Menopause is considered premature if it occurs before the age of 35. The age at which it occurs can be influenced by factors such as obesity, smoking, blindness, precocious puberty, and social class. The number of menopausal women in society is increasing due to the general increase in life expectancy and the increased number of hysterectomies performed. The decline in reproductive power is primarily due to a depletion of ovarian follicles. From the time of fetal development, the number of primordial follicles in the ovaries gradually decreases to about 10,000 at the time of menopause. This gradual decline suggests that the menopause is not a sudden event, but a reflection of a lifelong physiological process. Lifestyle and dietary habits can influence the severity of menopausal symptoms.
The decline in ovarian function during the menopausal transition leads to a decrease in the production of estrogen and other hormones. This hormonal imbalance can cause a range of symptoms, including hot flashes, night sweats, mood changes, and vaginal dryness. These symptoms can vary in severity and duration, and can be influenced by factors such as age at menopause, hormone levels, and general health.
Identification of Patterns and Treatments
Menopausal symptoms can be grouped into three main patterns: Liver Qi Stagnation, Kidney Yin Deficiency, and Damp-Heat. Each of these patterns has characteristic symptoms and treatment principles. For example, Liver Qi Stagnation is characterized by irritability, breast tenderness, and irregular periods, and is treated with herbs and acupuncture that move Qi and regulate the menstrual cycle. Kidney Yin Deficiency is characterized by hot flashes, night sweats, and insomnia, and is treated with herbs and acupuncture that nourish Yin and clear Heat. Damp-Heat is characterized by heavy periods, vaginal discharge, and urinary tract infections, and is treated with herbs and acupuncture that clear Damp-Heat and harmonize the Lower Jiao.
Clinical Manifestations and Treatment Principles
- Liver Qi Stagnation: irritability, breast tenderness, irregular periods; treated with herbs and acupuncture that move Qi and regulate the menstrual cycle.
- Kidney Yin Deficiency: hot flashes, night sweats, insomnia; treated with herbs and acupuncture that nourish Yin and clear Heat.
- Damp-Heat: heavy periods, vaginal discharge, urinary tract infections; treated with herbs and acupuncture that clear Damp-Heat and harmonize the Lower Jiao.
Prognosis and Prevention
The prognosis for menopausal women is generally good, as most women are able to manage their symptoms and maintain their quality of life. However, some women may experience more severe symptoms that can affect their daily activities and overall well-being. To prevent or reduce the severity of menopausal symptoms, it is important to maintain a healthy lifestyle and diet, avoid factors that can exacerbate symptoms (such as stress and alcohol), and seek treatment from a qualified healthcare provider. In some cases, hormone replacement therapy may be recommended to relieve symptoms and prevent complications.
In Western medicine, menopause is considered a natural part of the aging process, and is not typically treated as a medical condition. The hormonal changes that occur during menopause can cause a range of symptoms, and treatment is focused on managing these symptoms and preventing complications. Hormone replacement therapy is often used to relieve menopausal symptoms and prevent complications such as osteoporosis and cardiovascular disease. In addition, non-hormonal treatments such as lifestyle changes, herbal supplements, and over-the-counter medications may be recommended to manage specific symptoms. Overall, the goal of treatment is to help women maintain their quality of life during and after menopause.