Acupuncture West London is a fully certified member of the Acupuncture Fertility Network (AFN). Membership to the AFN indicates a particular interest in the treatment of fertility with traditional acupuncture. All AFN practitioners have completed postgraduate-level training in gynaecology with a specific emphasis on training to support assisted protocols. AFN membership denotes a commitment to ongoing postgraduate study in the areas of fertility and gynaecology, working to maintain an understanding of all current treatment protocols.
WHAT DO OUR PATIENTS THINK?
“I was recommended to try acupuncture to help relieve menopausal symptoms and some digestive issues I’ve had over the last couple of years. I’m truly amazed at the results I’ve seen so far. No night sweats in a few weeks now. I really appreciate how much Ben has helped me in such a short time. He always takes his time to explain what he’s doing and to check in with me. I’m booked in for my next treatment next week.”
Jane, London
Menopause and Acupuncture: A Classical Chinese Medicine Perspective
What is Menopause?
Menopause is a natural physiological transition defined as twelve consecutive months without menstruation, provided that periods have not stopped for another reason, such as hormonal contraception. In the UK, the average age of menopause is approximately 51 years, although it can occur considerably earlier or later.
The years leading up to menopause are known as perimenopause, during which reproductive hormone levels fluctuate, and menstrual cycles often become increasingly irregular. Although menopause is a natural part of ageing, the physiological changes associated with this transition can produce a wide range of symptoms, varying considerably in their severity, duration and impact on everyday life.
Symptoms: what does menopause mean to you?
Most women experience some symptoms during perimenopause and menopause, although their nature and severity can vary considerably. For some, the transition is relatively uneventful, while for others, symptoms can be debilitating and have a substantial impact on their physical and emotional wellbeing.
Symptoms commonly begin several years before menstruation ceases and may persist long afterwards. According to the NHS, menopausal symptoms typically last between seven and nine years, although some women experience them for considerably longer.
Common symptoms and changes associated with menopause include:
- Hot flushes and night sweats (vasomotor symptoms)
- Mood changes, anxiety and depression
- Sleep disturbances and insomnia
- Reduced sexual desire (libido)
- Problems with memory and concentration, often described as brain fog
- Vaginal dryness, irritation and discomfort during intercourse
- Migraines and headaches
- Heart palpitations
- Joint stiffness, muscular aches and pains
- Changes in muscle mass and body composition
- Recurrent urinary tract infections (UTIs) and urinary symptoms
- Changes in digestion and bowel habits
The reduction in oestrogen associated with menopause can also accelerate the loss of bone density, increasing the risk of osteoporosis. Maintaining bone health is therefore an important consideration during and after the menopausal transition.
For women who experience menopause suddenly, for example following the surgical removal of the ovaries or certain cancer treatments, symptoms may be particularly pronounced because of the abrupt change in hormone levels.
Menopause and Western Medicine:
Within Western medicine, menopause is understood primarily in relation to changes in ovarian function and the associated decline in reproductive hormones, particularly oestrogen and progesterone.
Hormone Replacement Therapy (HRT) is one of the principal treatments offered to women experiencing troublesome menopausal symptoms. By replacing declining hormone levels, HRT can be highly effective in relieving hot flushes, night sweats and certain other symptoms, including sleep disturbances associated with vasomotor symptoms. It can also help prevent the loss of bone density associated with menopause. However, HRT is not appropriate for everyone, and its benefits and risks depend on several factors, including age, medical history, the type of hormones prescribed and the method of administration. For example, combined HRT is associated with an increased risk of breast cancer, while oral HRT carries a greater risk of blood clots than transdermal preparations such as patches and gels. For many women, particularly those under sixty without significant risk factors, the benefits of HRT are considered to outweigh the risks.
The NHS and National Institute for Health and Care Excellence (NICE) provide detailed guidance on the available treatments and their associated benefits and risks. Although HRT remains an effective and important treatment option, some women are unable or prefer not to take it, while others seek additional approaches to help manage symptoms that persist despite conventional treatment. Acupuncture is one such option.
Menopause in Classical Chinese Medicine: The Huang Di Nei Jing
The understanding of reproductive ageing within Chinese medicine extends back more than two thousand years. One of its earliest and most significant descriptions appears in the Huang Di Nei Jing (黃帝內經), or Yellow Emperor’s Classic of Internal Medicine, one of the foundational texts of Classical Chinese Medicine.
Unlike the Western medical model, which explains menopause primarily through changes in reproductive hormones, Classical Chinese Medicine considers this transition within a broader understanding of growth, reproduction, ageing, and the changing relationships between the body’s physiological systems.
Chapter 1 of the Huang Di Nei Jing Su Wen (素問), entitled Shang Gu Tian Zhen Lun (上古天真論), describes the development of women through successive seven-year cycles. In a discussion between the Yellow Emperor and his physician, Qi Bo, the question is raised as to why reproductive capacity diminishes with advancing age. Qi Bo responds by describing a series of physiological changes occurring throughout a woman’s life, from childhood and sexual maturation to the eventual cessation of menstruation.
At fourteen years of age, the text states:
“At twice seven, Tian Gui arrives, the Ren vessel opens, the Chong vessel flourishes, and menstruation comes at its appointed time; thus, she can bear children.” — Huang Di Nei Jing Su Wen, Chapter 1
The concept of Tian Gui (天癸) is particularly important in understanding reproductive physiology within Classical Chinese Medicine. Although frequently interpreted in modern discussions as having a relationship with reproductive hormones, Tian Gui is not synonymous with oestrogen, progesterone or any other single hormone. Rather, it describes an aspect of reproductive maturation and vitality associated with the development of Kidney Qi.
The Ren Mai (任脈), or Conception Vessel, and Chong Mai (衝脈), often translated as the Penetrating Vessel or The Sea Of Blood, are two of the Eight Extraordinary Vessels. Within the classical medical framework, both play an important role in the regulation of menstruation, fertility and reproductive physiology.
The text continues by describing further physiological development at the ages of twenty-one and twenty-eight, followed by the beginning of decline in the Yang Ming channels at thirty-five and the three Yang channels at forty-two. These changes are associated with alterations in physical appearance, hair and complexion, illustrating the gradual progression of ageing through successive stages.
Finally, at forty-nine years of age, Qi Bo states: “At seven times seven, the Ren vessel becomes deficient, the Chong vessel declines, Tian Gui is exhausted, and the menstrual pathway closes; the physical form declines and childbearing ceases.” — Huang Di Nei Jing Su Wen, Chapter 1
What is particularly interesting about this passage is that the cessation of menstruation is not presented as an isolated physiological event, but as the culmination of a gradual process beginning much earlier in life. Although the text identifies forty-nine as the final stage of the seven-year reproductive cycles, these ages should be understood as part of a classical model of development rather than precise biological milestones.
The emphasis is therefore not simply on the loss of reproductive capacity, but on the changing relationships between Kidney Qi, Tian Gui, the Extraordinary Vessels and the wider channel system. This provides an important foundation for understanding menopause within the classical Chinese medical framework.
The Kidneys, Jing and the Menopausal Transition
Within Classical Chinese Medicine, the Kidneys have a much broader physiological significance than the anatomical kidneys understood in Western medicine. They are associated with the storage of Jing (精), commonly translated as Essence, and play a fundamental role in growth, development, reproduction and ageing.
As we advance through life, the expression and availability of Jing change, influencing the body’s reproductive capacity and the functions associated with the Chong and Ren vessels. The gradual decline of reproductive function is therefore understood as part of the natural progression of life, rather than necessarily indicating disease.
However, it would be an oversimplification to attribute every menopausal symptom to Kidney deficiency. Although the Kidneys occupy an important position in the classical understanding of reproductive ageing, the Nei Jing also describes changes involving the Yang Ming and other Yang channels. Furthermore, the relationships between the Kidneys, Liver, Heart, Spleen and the movement of Qi and Blood can all be relevant when interpreting an individual’s symptoms.
For example, a woman experiencing pronounced hot flushes, night sweats and disturbed sleep may present a very different clinical picture from someone whose predominant symptoms are fatigue, low mood, digestive disturbances or a pronounced sensation of cold. Similarly, symptoms such as irritability, headaches, palpitations and anxiety may involve different physiological relationships within the classical medical framework.
Consequently, menopause alone tells us relatively little about the underlying Chinese medical diagnosis. A more detailed understanding requires consideration of the symptoms themselves, their development over time, and the relationships between the channels and organ systems involved.
Menopause: A Second Spring
Although the Huang Di Nei Jing describes the gradual decline of reproductive function, this should not necessarily be interpreted as a decline in a woman’s overall vitality, identity or capacity for personal development. Within contemporary Chinese medicine, menopause is sometimes described as a Second Spring, reflecting the possibility of renewal and transformation as women move beyond their reproductive years.
The concept suggests that the cessation of menstruation represents more than simply the loss of fertility. As the demands associated with reproduction diminish, this stage of life may offer an opportunity for a different expression of vitality, characterised by greater self-awareness, emotional maturity, wisdom and independence. Rather than attempting to return to an earlier stage of life, the emphasis shifts towards embracing the possibilities of a new one.
Although the expression Second Spring cannot be directly attributed to the Huang Di Nei Jing, the broader philosophical principles expressed in the text provide an interesting context for this interpretation. Chapter 1 of the Su Wen emphasises the preservation of Essence and Spirit, tranquillity of the mind, and the cultivation of a life lived in accordance with the natural progression of Yin and Yang.
Indeed, the opening chapter describes an ideal state of health in which:
“The heart is at peace and knows no fear.” — Huang Di Nei Jing Su Wen, Chapter 1
Although this passage does not refer specifically to menopause, it reflects the importance placed upon emotional equilibrium and the cultivation of the Spirit within classical Chinese thought.
From this perspective, menopause need not be understood exclusively through the language of deficiency and decline. While physiological changes are inevitable, they do not preclude the development of greater clarity, confidence or emotional resilience. For some women, the transition may coincide with a renewed sense of identity, greater assertiveness and an increased willingness to pursue their own interests and priorities.
The distinction is an important one. Menopause may signal the conclusion of reproductive life, but it does not necessarily represent the conclusion of vitality or personal growth. Rather, it can mark the beginning of a different and potentially rewarding stage of life.
The Benefits of Acupuncture: Treating the Individual
One of the defining characteristics of Classical Chinese Medicine is the importance placed upon understanding the individual rather than treating a diagnosis in isolation. Although two women may present with apparently similar menopausal symptoms, their underlying Chinese medical diagnoses may be quite different, and consequently, their acupuncture treatments may also differ considerably.
A consultation typically involves detailed questioning about the nature and progression of symptoms, alongside an assessment of sleep, digestion, temperature regulation, menstrual history, emotional wellbeing and other aspects of health. Classical diagnostic methods, including pulse diagnosis and palpation of the channels and abdomen, may also be used to develop a more comprehensive understanding of the clinical picture.
Treatment is then directed towards the channel and organ relationships considered relevant to the individual’s presentation. This may involve the use of acupuncture alone or, where appropriate, the inclusion of other classical techniques such as moxibustion.
Acupuncture may be considered alongside conventional medical treatment, including HRT, rather than necessarily as an alternative to it. The classical framework informs the assessment and treatment approach, while contemporary clinical research helps establish what benefits can reasonably be expected.
What Does the Research Say?
Research into the effectiveness of acupuncture for menopausal symptoms has produced encouraging findings, particularly in relation to hot flushes, night sweats, sleep disturbances and quality of life. However, interpreting this research requires an understanding of the differences between acupuncture as practised within Classical Chinese Medicine and the methods frequently employed in Western clinical trials.
One of the challenges in researching acupuncture is that many clinical trials employ standardised treatment protocols, in which participants receive the same selection of acupuncture points based on a Western medical diagnosis. While this approach allows researchers to investigate a reproducible intervention, it does not necessarily reflect the principles of Classical Chinese Medicine, where treatment is determined by the individual’s presentation, channel relationships and underlying physiological patterns. Two women experiencing apparently identical menopausal symptoms may therefore receive entirely different treatments, with point selection and treatment strategies changing as their condition develops.
This distinction has been recognised within the medical research community. A 2022 paper published in the British Medical Journal examined the methodological challenges associated with acupuncture research, including the difficulties of standardising an intervention that is frequently individualised and clinically complex. The authors highlighted the importance of designing studies that adequately reflect acupuncture as delivered in clinical practice, recognising that overly restrictive treatment protocols may limit the applicability of research findings.
Importantly, research has also investigated acupuncture using individualised Chinese medical diagnosis. In a 2016 randomised controlled study, Avis et al. investigated the effects of acupuncture on 209 perimenopausal and postmenopausal women. Treatments were based on traditional Chinese medical assessment, including pulse and tongue examination, with acupuncture points selected and modified according to each patient’s presentation. After six months, women receiving acupuncture experienced a 36.7% reduction in vasomotor symptoms, compared with a 6% increase in the waiting-list control group. Improvements were also observed in several measures of quality of life, with benefits largely maintained six months after treatment had ended.
Similarly, a 2019 randomised controlled study published in BMJ Open investigated seventy women experiencing moderate to severe menopausal symptoms. Following five weekly acupuncture treatments, researchers observed statistically significant improvements in hot flushes, sweating, sleep disturbances, emotional symptoms and several other measures. At the six-week assessment, 80% of women receiving acupuncture reported an overall beneficial effect. Unlike the study by Avis et al., this trial employed a standardised Western medical acupuncture protocol, demonstrating that even a relatively brief and fixed treatment approach may offer benefits.
An additional challenge in acupuncture research concerns the use of so-called sham acupuncture as a placebo control. Unlike an inactive placebo tablet, sham acupuncture frequently involves superficial needling, stimulation of alternative points or contact with the skin, all of which may produce physiological responses. Consequently, sham acupuncture cannot necessarily be regarded as an inert intervention, raising questions about the validity of treating it as a conventional placebo. Comparisons between genuine and sham acupuncture may therefore underestimate the overall therapeutic effects of acupuncture relative to an inactive control. This methodological limitation has been acknowledged in the medical literature, including a 2022 paper published in the British Medical Journal, which also highlighted the difficulties of adequately representing individualised acupuncture within conventional clinical trials.
Taken together, the available research suggests that acupuncture may offer a useful treatment option for some women experiencing menopausal symptoms. However, it is important to recognise that acupuncture is not a single, uniform intervention, and that findings from one treatment approach cannot necessarily be applied to every other style of practice. The distinction between standardised acupuncture protocols and the diagnostic principles of Classical Chinese Medicine is therefore particularly relevant when considering how research findings relate to individual clinical treatment.
Lifestyle Changes
Lifestyle can have a significant influence on how women experience the menopausal transition. Regular physical activity, adequate sleep, a balanced diet and appropriate stress management can all contribute towards maintaining health and wellbeing during this period. Weight-bearing and resistance exercise are particularly important for maintaining muscle mass and bone density, while reducing excessive alcohol consumption and identifying individual triggers for hot flushes may help some women manage their symptoms.
The importance of lifestyle is also reflected in the Huang Di Nei Jing, which places considerable emphasis on moderation, regularity and the relationship between daily habits and long-term health. In Chapter 1 of the Su Wen, Qi Bo describes those who cultivated health in ancient times:
“They regulated their food and drink, maintained regular patterns of living, and did not exhaust themselves through excessive exertion.” — Huang Di Nei Jing Su Wen, Chapter 1
Although expressed within a very different medical and cultural framework, these principles remain relevant today. An acupuncturist may therefore have a useful role not only in providing treatment, but also in helping patients understand their symptoms and supporting practical changes that may improve their quality of life.
Can Acupuncture Help Me?
Menopause is a natural physiological transition, but that does not mean its associated symptoms should simply be endured. While some women experience relatively few difficulties, others find that their sleep, mood, physical comfort and general quality of life are significantly affected.
Classical Chinese Medicine offers a framework for understanding the physiological changes associated with menopause and the different ways in which they may manifest. By considering the individual’s symptoms, medical history and classical diagnostic findings, acupuncture treatment can be directed towards the particular clinical presentation rather than menopause as a diagnosis alone.
Although the research evidence remains mixed, some clinical studies have demonstrated improvements in menopausal symptoms, suggesting that acupuncture may be a useful supportive treatment for certain women, including those already receiving conventional medical care.
For the most up-to-date research and evidence on the efficacy of acupuncture, please visit the British Acupuncture Council (BAcC) website.
If you would like to learn more about how acupuncture may be able to help you, please contact us today.
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