I intended to write a post on menopause, an issue close to me, so consulted Sabine Wilms’s translation of the Qi Zhongfu’s 1220 text ‘Hundred Questions on Gynecology’. It references the classical stages of women first recorded in the Su Wen (Simple Questions) over 2000 years ago:
'When women reach the age of 2 times 7, their kidney qi is at its peak, and the Chongmai (Sea of Blood) and Renmai (Sea of Yin) stream and flow through. The menstrual blood gradually builds up and descends in response to its proper timing. Because menstruation takes place specifically following the descent of the Qi of heavenly perfection, we call it ‘heavenly water (tian gui)’. With Yin being still and the Sea being full, because these two are able to rely on each other, this allows women to bear children…..At the age of 7 times 7, the Renmai is depleted and the Great Chongmai is debilitated, and the tian gui is exhausted, and the pathway of earth (conception and birth) is no longer passable’.
In other words, the cessation of menstrual periods is simply part of the natural flux and flow of the energies, particularly Yin and Blood, in a woman’s life. The tian gui, or heavenly water, that flows with the onset of menstruation is derived from our Essence, or Kidney Jing. Since menopausal symptoms (especially vaginal dryness, hot flushes and night-sweating) are due to the decline in oestrogen occurring at this time, from the Chinese point of view, they are due to the normal and natural physiological decline of tian gui. While one form of oestrogen reduces dramatically, our bodies still create oestrone. This can be sufficient to maintain our Yin balance.
The only menopausal disorder described in Qi Zhongfu’s gynaecology text is when the bleeding that should have ceased, returns unexpectedly. That is, menopause itself is not traditionally seen as a condition requiring special care or medical treatment, although the menstrual cycle definitely is.
This illustrates a major difference between western medicine and traditional Chinese medicine. In Chinese medicine many physical and emotional disturbances relating to the menstrual cycle are seen as pathological and in need of treatment to restore that ‘proper timing’ and free flow in sync with heaven and earth. Those of you who have consulted with us will know of our endless interest in the colour, amount, consistency, timing, emotions and sensations associated with the cycle. In contrast, western medicine tends to rely on pain killers or hormones to override the problems rather than aiming to address and heal them. Maybe this is one reason menopause is less of an issue in traditional Chinese texts (which do contain many other conditions ‘below the belt’) – underlying imbalances have already been addressed, and do not surface at menopause.
The explanation the ‘Hundred Questions’ offers for irregular post-menopausal bleeding, is that it could be from overwork, maybe excessive anger or joy, potentially against a background of depletion over the longer term. The famous doctor Sun Simiao from the 7th century wrote that ‘The reason why women have special formulas is that they are different because of pregnancy, childbirth, and landslide collapse damage (heavy vaginal bleeding)’.
The years leading up to menopause are full on, with demands from everywhere, and it is too easy to put ourselves down the priority list. This is a great way to induce ‘landslide collapse damage’, something much better avoided. This time of life reflects the shift from the active, externally focussed life, towards a life closer to our own heart-centred truth and creativity. This can be something we have almost lost sight of over the years of running around, looking after our work and others. But it has always been there, waiting for us. In Chinese medicine our Liver helps our qi to flow freely and strongly and propels us through life changes. When our Liver qi is strong, clear, and not stuck in emotional blockages, the transition through to a new hormonal balance is much smoother.
There are a few times in a woman’s life that a window for potential change opens and invites us in. Menopause is one of those. When there is unfinished childbearing it can be greeted with deep anguish and despair. Moving beyond society’s ideals of youth and superficial beauty can be confronting. The end of managing periods and fertility can also be liberating. No matter what our situation it can be a time of transition towards a heart-centred life.
If you have got this far, you might like this youtube treat: