What is Perimenopause?

Acupuncture for perimenopause offers an effective treatment for managing the transition period around menopause, where hormonal and physiological changes occur. Perimenopause refers to a period around menopause, which marks a transition period of female’s sexual function from maturity to decline or to the end of reproductive time. This transition period usually starts in the mid-40s, but some females might even start this process as early as their late-30s. Perimenopause is actually a normal process for females to have some physiological changes. Due to body constitution differences, and social and psychological factors, females who could not adapt to this physiological transition smoothly, would develop perimenopausal syndrome accordingly.

What Causes Perimenopausal Symptoms?

Perimenopause involves a series of clinical symptoms caused by endocrine (i.e., reproductive endocrine and neuroendocrine) disorders and autonomic dysfunction which are triggered by decreased estrogen level. As ovarian function declines to complete loss, both blood estrogen and progesterone levels drop, which breaks up the balance of hypothalamus-pituitary-ovarian axis, and thus leads to autonomic dysfunction.

Common Symptoms of Perimenopause

Typical symptoms are irregular periods (i.e., the coming period is unpredictable as the length of time between two periods varies dramatically).

Popular clinical symptoms include sleep disorders (i.e., insomnia, shallow sleep, easy to wake up, dreaminess), sweating after hot flashes, fatigue, palpitation, dizziness, ear ringing, irritability, depression, anxiety, joint pain (osteoarthritis), low back sore, and heel pain.

Other common clinical symptoms include forgetfulness, breast fullness, abnormal skin sensations, knee weakness, decreased sexual desire, intercourse pain, etc.

The symptoms vary in severity and may show up partially or entirely in some severe cases.

Acupuncture and Perimenopause in Traditional Chinese Medicine (TCM)

According to TCM theory, the degeneration of the kidney’s function is the fundamental pathogenesis. Deficiency of the conception vessel and penetrating vessel leads to disharmony between qi and blood, yin and yang. It is also related to heart, liver and spleen function. There are a few typical patterns listed here:

  1. Liver and kidney yin deficiency: Symptoms include irregular periods with very red blood, dizziness, ear ringing, sweating after hot flashes, irritability, low back soreness, and knee weakness. 
  2. Spleen and kidney yang deficiency: Symptoms include irregular periods with light red blood, fatigue, lack of appetite, forgetfulness, nocturnal enuresis, and decreased sexual desire. 
  3. Disharmony between heart and kidney: Symptoms include irregular periods, insomnia, palpitations, dizziness, ear ringing, sweating after hot flashes, irritability, and anxiety. 
  4. Kidney yin and yang deficiency: A combination of all the symptoms mentioned above.

How Can Acupuncture Help With Perimenopause?

Acupuncture could be used to regulate hormone levels, enhance immune function, rebalance autonomic disorders, postpone the aging process of cells, and reduce blood total cholesterol (TC) level and low-density lipoprotein cholesterol (LDL-C) (which are potential cardiovascular risk factors) according to a few clinical studies 1-12. Two out of these ten studies further suggested acupuncture could affect rebalancing hypothalamus-pituitary-ovarian axis 7-8.

The acupuncture method is slightly different between the early to middle perimenopause stage and the late perimenopause stage. During the early to middle stage, acupoints used to soothe the liver and calm the mind were selected as key points, adding up one or two acupoints focusing on reinforcing the kidney. In the late stage, acupoints focusing mainly on reinforcing kidney yin and/or yang were selected. Besides, it is also quite common that many females may have blood stasis inside their bodies. Thus, one or two additional acupoints for activating blood circulation may be added to the existing acupuncture formula.

When Should You Start Acupuncture Treatment?

It is strongly recommended to start acupuncture intervention in the early stage of perimenopause (i.e., as soon as the period starts to become irregular and/or a few symptoms are observed frequently), as acupuncture could maximize its therapeutic effect (i.e., reduce symptoms frequency and severity, and thus improve quality of life).

Combining Acupuncture With Other Therapies

It is highly recommended to start a cocktail treatment plan, which includes acupuncture, herbs and ear pellets. The comprehensive method is expected to achieve a better therapeutic effect than one method alone and to preserve this effect longer, to help our clients get through this period more smoothly. The acupuncturist collaborates with the naturopathic doctors in the clinic to offer the most suitable and highly individualized treatment plans for every client.

How Many Acupuncture Sessions Are Needed?

Sessions could vary from person to person based on your body constitution and the Perimenopause stage when you come to resort to the practitioner. In general, it is recommended once a week for eight weeks or twice a week for four weeks, and then the practitioner will reassess the client’s body constitution to discuss the next step. Usually, a few more follow-ups will be advised with longer Intervals between two sessions (i.e., once every two weeks, or once every month to once every two months). As the practitioner will acquire your feedback on each follow-up session, more details will be discussed then.

What Are the Precautions When Trying Acupuncture?

As always, please do not come for acupuncture with either a complete empty stomach or a complete full stomach, as the former condition could trigger dizziness while the latter condition would trigger nausea or even vomit. Drinking alcohol is also not encouraged before your acupuncture appointment.

For more information about us and how Innate Wellness can support your journey to better health with treatments like acupuncture for perimenopause, feel free to contact us and discover our personalized care options to help you feel your best.

References:

  1. Avis, N. E., Coeytaux, R. R., Isom, S., Prevette, K., & Morgan, T. (2016). Acupuncture in Menopause (AIM) study: a pragmatic, randomized controlled trial. Menopause, 23(6), 626-637.
  2. Avis, N. E., Legault, C., Coeytaux, R. R., Pian-Smith, M., Shifren, J. L., Chen, W., & Valaskatgis, P. (2008). A randomized, controlled pilot study of acupuncture treatment for menopausal hot flashes. Menopause, 15(6), 1070-1078.
  3. Chiu, H. Y., Pan, C. H., Shyu, Y. K., Han, B. C., & Tsai, P. S. (2015). Effects of acupuncture on menopause-related symptoms and quality of life in women in natural menopause: a meta-analysis of randomized controlled trials. Menopause, 22(2), 234-244.
  4. Fang, Y. R., Wang, L. J., & Zhou, X. (2004). The changes of serum sex hormone levels, free radicals, and lipid content in perimenopausal women. Shiyong Fuchanke Zazhi, 20(3), 151-152.
  5. Kim, K. H., Kang, K. W., Kim, D. I., Kim, H. J., Yoon, H. M., Lee, J. M., … & Choi, S. M. (2010). Effects of acupuncture on hot flashes in perimenopausal and postmenopausal women-a multicenter randomized clinical trial. Menopause, 17(2), 269-280.
  6. Kim, T. H., Lee, M. S., & Alraek, T. (2017). Acupuncture for the management of menopausal and perimenopausal symptoms: Current clinical evidence and perspectives for future research.
  7. Li, G. A., & Yu, Y. (2002). Research on acupuncture treatment of female climacteric syndrome. Shang Hai Zhen Jiu Za Zhi, 21(3), 6-8.
  8. Painovich, J. M., Shufelt, C. L., Azziz, R., Yang, Y., Goodarzi, M. O., Braunstein, G. D., … & Merz, C. N. B. (2012). A pilot randomized, single blind, placebo-controlled trial of traditional acupuncture for vasomotor symptoms and mechanistic pathways of menopause. Menopause (New York, NY), 19(1), 54.
  9. Porzio, G., Trapasso, T., Martelli, S., Sallusti, E., Piccone, C., Mattei, A., … & Marchetti, P. (2002). Acupuncture in the treatment of menopause-related symptoms in women taking tamoxifen. Tumori, 88(2), 128-130.
  10. Sunay, D., Ozdiken, M., Arslan, H., Seven, A., & Aral, Y. (2011). The effect of acupuncture on postmenopausal symptoms and reproductive hormones: a sham controlled clinical trial. Acupuncture in Medicine, 29(1), 27-31.
  11. Wyon, Y., Lindgren, R., Lundeberg, T., & Hammar, M. (1995). Effects of acupuncture on climacteric vasomotor symptoms, quality of life, and urinary excretion of neuropeptides among postmenopausal women. Menopause: The Journal of the North American Menopause, 2(1), 3-12.
  12. Xu, T. S. (2004). Research on auricular acupuncture combined with body acupuncture for menopausal syndrome. Xiandai Zhongxiyi Jiehe Zazhi, 13(17), 2269-2270.