Menopause and Chinese Medicine: Managing the Big Three Symptoms

At Bodhi Health Acupuncture, I’ve had the privilege of supporting many women through all phases of menopause — perimenopause, menopause, and the postmenopausal years. Some women breeze through the transition. Others experience a range of symptoms that continue well into their 60s and 70s.

More recently, I’ve noticed a growing number of younger women — sometimes as early as 40 or 43 — presenting with early perimenopausal symptoms. Whether it’s due to modern stress, lifestyle demands, or environmental factors, this shift appears to be happening earlier than it once did. Thankfully, Chinese medicine is particularly well-suited to support this phase of life with a holistic, body-and-mind-based approach.

A Natural Life Transition

In traditional Chinese medicine (TCM), menopause is not viewed as a disease but as a natural “phase change” — a predictable and important shift in a woman’s physiology. Classically, the transition occurs around the age of 49, marking the end of the reproductive cycle and the beginning of a new energetic phase in life.

Rather than seeing it as something to suppress or override, we aim to support the body so this transition happens smoothly. And this is one of the areas where Chinese medicine, with its thousands of years of diagnostic and therapeutic insight, truly shines.

The Anchor: Hormones, Blood, and Cooling

One of the most important concepts I share with clients in this phase is the idea of the anchor.

In Chinese medicine, this refers to a combination of systems — Kidney Essence (Jing), Blood quality, Yin fluids, and marrow — that provide internal stability. This anchor keeps the mind calm, the body cool, and the emotions grounded.

During menopause, the anchor naturally weakens. Blood becomes less rich, Yin begins to decline, and this creates a kind of internal “lightness” — not the uplifting kind, but more of a loss of grounding. Heat, which is normally held in place and cooled by strong Yin and Blood, begins to rise. As this happens, the mind may feel more agitated, the sleep may become lighter, and emotional steadiness can feel harder to maintain.

The Big Three Symptoms We Often See

There are three main symptoms I often focus on during this phase — what I call the “big three threats” of menopause:

1. Insomnia

This often emerges first. Women may fall asleep easily but then wake frequently, or they may struggle to fall asleep at all. Sleep becomes lighter, more disrupted, and less restorative.

From a Chinese medicine perspective, this happens when the Heart is no longer being properly anchored by Blood and Yin. The Shen (spirit/mind) becomes unsettled. And without the restorative function of deep sleep, the entire system starts to feel less resilient.

2. Hot Flushes

With less Yin and Blood to cool the body, internal heat begins to rise unchecked. This is what we call deficiency heat. Many women experience this heat at night, but it can occur at any time — sudden waves of warmth, facial flushing, or night sweats.

The mechanism behind this, from a TCM view, is a loss of Kidney Yin (which cools) and a weakening of the anchor — allowing heat to rise and agitate the upper body, chest, and head.

3. Anxiety

Anxiety often follows from the other two. The Heart, in Chinese medicine, thrives on rest and rhythm. Without adequate sleep and internal cooling, the Heart becomes overstimulated, and the Shen loses its home. This creates emotional vulnerability — worry, restlessness, irritability, and anxiety that may seem to come out of nowhere.

These three symptoms are deeply interconnected. And for many women, they’re simply endured — sometimes for years — without seeking support. I’ve had clients tell me they haven’t slept well since menopause and just assumed it was normal. But Chinese medicine offers a different possibility.

How We Treat It

The goal is not to suppress menopause but to support the body through it.

Chinese medicine doesn’t treat menopause as a single condition. Instead, we look at the individual pattern: Does the person have more deficiency or more stagnation? Is the sleep light or broken? Is there more heat or more fatigue? Based on this, we craft a tailored treatment using both acupuncture and Chinese herbal medicine.

In clinic, treatment may include:

• Acupuncture to regulate the nervous system, calm the Shen, anchor Yang, and reduce internal heat.

• Chinese herbal formulas to nourish Blood, replenish Yin, cool deficiency heat, and stabilise mood and sleep.

Some of the classic formulas I use (depending on the individual) include:

• Liu Wei Di Huang Wan – Strengthens Kidney Yin and helps anchor rising heat.

• Jia Wei Xiao Yao San – Harmonises Liver and Spleen, clears heat, and smooths emotional tension.

• Gui Pi Tang – Nourishes Blood, supports the Spleen and Heart, and helps calm insomnia and anxiety.

If a woman is already using hormone replacement therapy (HRT), we work alongside that, making sure treatment is complementary and focused on whole-body support.

Every Woman’s Journey is Unique

Menopause doesn’t have a single path. Some women experience a smooth transition with minimal symptoms. Others follow a pattern similar to their mother or grandmother. In clinic, I’ve even seen cultural and family patterns — for example, some women of Dutch descent seem to go through menopause later in life.

If you have access to your family’s health history, it’s worth asking the women in your lineage what menopause was like for them. It can offer helpful clues about what to expect or prepare for.

You Don’t Have to Just “Get On With It”

One of the most common things I hear from women is: “I’ve just put up with it.” Sleepless nights, waves of heat, emotional lability — all normalised and pushed aside because that’s just what women do.

But it doesn’t have to be that way.

Chinese medicine offers a respectful, well-developed approach to helping you navigate this time of life with more ease, more rest, and better internal balance. It’s not about turning back the clock — it’s about helping you step into this next phase feeling well-supported and steady.

Need Support?

Whether you’re in the early stages of perimenopause or have been managing symptoms for years, acupuncture and herbs can help. Menopause is a major physiological shift — but with the right tools, it doesn’t have to be a struggle.

If you’d like to explore how Chinese medicine could support you, I’d be honoured to help.

Luke Paten – Bodhi Health Acupuncture / Sunshine Coast