Acupuncture and Nutrition Clinic – Houston

This is a comment I had from a recent patient.

“I went into a regular doctor to get my hot flashes treated and they ended up prescribing antidepressants which I chose not to fill and chose not to proceed with because I’m not a depressed person.”

There are some antidepressants that doctors prescribe for hot flashes and symptoms of menopause that seem to help some people. But of course taking antidepressants is not for everybody and they are not without side effects. My preferred approach to treating menopausal issues is with acupuncture and herbal therapy.

When I was learning about menopause and hot flashes during my studies, it was as if a light bulb went off. It was that special aha moment. An interesting way to understand hot flashes is to first get the concept of Yin and Yang. One of my previous blogs talks about Yin and Yang.

To reveiw briefly, Yin, our moist, cooling energy and Yang, our hot, rising energy should be in relative balance. As we age, our Yin and/or Yang energy becomes deficient. For many who experience the internal heat sensations of hot flashes, it means that the cooling energy has become depleted causing a relative excess (too much) of the Yang, hot energy. The heat is not coming from the outside, but from the inside and rises up into the head and face area.

Treating the hot flashes in Chinese medicine is more about strengthening the Yin energy thereby cooling the relative excess of Yang (hot) energy. It’s not about trying to trick the body into thinking we are younger hormonally again by giving hormone replacement. It’s more about tonifying or strengthening the Yin, cooling energy which has become depleted over time.

When I learned that, I said, “Wow! What an interesting common sense way to understand the mechanism of hot flashes in menopause!” The treatment goal in Chinese medicine for hot flashes is to tonify or strengthen what has become depeleted. We increase the Yin, cooling, moisturizing part of us to put the Yin and Yang back in balance. The goal is not necessarily to reduce the Yang by itself because it’s only elevated due to too little of the Yin. It’s better to treat the root of the problem (too little Yin) rather than treat the symptom (too much Yang). It’s a beautiful way to treat the symptom while treating the root of the problem. So what I do is I put needles and give herbs to help tonify and strengthen the cooling mechanism so the Yin and Yang are in balance and the hot flahses are reduced or eliminated.

I love treating menopause because along with hot flashes comes disturbed sleep, irritability and mood swings. Acupuncture can help regulate a lot of those problems.

What’s important to understand with Chinese medicine and menopause and hot flashes is that our goal as acupuncturists when a woman comes in is to help a woman through this time in her life. It’s to help balance them so their life isn’t defined by menopause.

I have a lot of patients who do not want to take hormone replacement. The acupuncture helps. I have helped women wean off of hormone replacement who didn’t want to take it anymore. So it’s certainly a very viable option to try. It makes sense because the heat comes from inside. It makes complete sense that your cooling mechanism is off.

When we diagnose in TCM (Traditional Chinese Medicine), we observe a person’s expression,  facial characteristics,  appearance of the body,  tongue shape, color, coating and markings and feel the pulses on both wrists. We listen to what the patient says, ask specific questions about the working of the body and palpate areas the patient is complaining about. All of the above helps give a picture of what is going on inside the body. The answers and observations during the interview help form a TCM diagnosis.  The diagnosis will include an assessment of the quality and balance of Qi (pronounced chee), Blood, Yin and Yang. In this blog, I will be discussing the concepts specifically of Yin and Yang. Subsequent blogs will explore  the meaning of Qi and Blood,  what we look for in examining the tongue and pulses, facial diagnosis and more.

The concept of Yin-Yang is considered one of the most important theories in Chinese medicine. It is said that all the functions of medical physiology, pathology and treatment can be reduced to Yin-Yang. Yin-Yang and Qi (pronounced chee), are the main concepts that have been explored over the centuries of Chinese Medicine. Yin and Yang repesent opposite but complementary qualities as I will describe below.

The functions of Yin are to cool, nourish, moisten and to allow us to be restful. When Yin and Yang (warm energy, see below) are in balance, the body temperature is even. When Yin and Yang are out of balance the body will have uneven flow of energy which will create pain and/or disease. Yang functions to warm the body,  transform energy and protect the body from external pathogens (like viruses) by providing a strong Defensive Qi (life force).

Yin is associated with the female gender, is colder in temperature, and has a sinking, inward, heavier energy. It is strongest at midnight and tends to affect the lower body, the interior of the body and abdomen. Yin seasons are Autumn and Winter.

Yang is more male, with a hotter temperature, and is associated with a lighter energy. It has an upward, outward movement and is reflected on the upper body, exterior of the body and back. Maximum Yang is noon. Yang seasons are Spring and Summer.

So based on this information, one can understand how a deficiency of Yin might lead to dry mouth and throat (not enough moisture), low grade fever or flushing (cooling mechanism not working) and night sweats. A deficiency of Yang (warming energy) would give rise to an aversion or strong dislike of cold, pale complexion and a preference for warm/hot beverages and layers of clothing.

When there is too much Yin (cold energy, too little Yang, warm energy) one may feel listless, apathetic, sad or discouraged. Muscle tone is usually poor and the body/skin is cold. Quite often there is a flat affect (lack of expression) and a generally weak body energy. This weakened state results in a slower metabolism (compensatory mechanism to spare the body) and circulation and a pattern of sleeping too much. Hands are colder than feet and face is cooler.

An excess of Yang (too much hot energy, too little cold) manifests with a more aggressive and boisterous personality. Muscle tone is usually firm with a ruddy complexion. The body tends to feel warm, with fast, strong movements and gestures. Metabolism and circulation are normal to rapid and there tends to be problems with insomnia and agitation. The  upper body is generally warmer with cold feet.

Are you finding a pattern for yourself? Maybe you have some of both? Human beings are more complex than just Yin or Yang excess or deficiency. We usually have a combination of too much of one,  too little of another or too little of both. Throw into the mix a concurrent imbalance in Qi and Blood and you can understand how complicated a treatment strategy can be. The challenge for the practitioner is to address the most immediate and acute problem and then treat for the underlying (usually a chronic condition) problem while working to gently adjust the Yin and Yang, Qi and Blood to a more balanced energy flow.

Yin and Yang as described above are opposites. However, as opposite as they seem, there is also a relativity to the concepts. As nothing is completely Yin or completely Yang. Each has a part of the other. Yang is considered hot and Yin is cold. But hot and cold are still relative to each other. For example: in Houston, one might consider 40 degree weather as cold. But relative to Chicago, that level of cold might be considered moderate.

Yin and Yang although opposites are also inter-dependent on each other. One cannot exist without the other, even though they are mutually exclusive. Day does not exist without night, activity requires rest.

Yin and Yang have a dynamic balance. When one is out of balance, the other is affected. If we have too much Yang, there is inadequate Yin. Too high a fever (Excess Yang) creates a deficiency of cooling, moist energy (Yin).

Lastly Yin and Yang do not stay the same. They have the ability to transform into each other. The changes of the seasons or day into night are examples of how Yin and Yang transform into each other.

A forthcoming blog will discuss some of the health  issues that arise from an imbalance of Yin and/or Yang, Qi and Blood. So, stay tuned…