Tea Time with Jo | TCM &Perimenopause

Today’s blog post originated from a suggested topic that I was given from an Instagram follower. She wanted to know more about perimenopause and, more specifically, when it actually starts. Let’s get into it.

Perimenopause is known as 1 of the 3 “Golden Opportunities” in Chinese Medicine. Each “opportunity” refers to a moment in a woman’s life in which her body has to make major allocations of her Jing (often translated as “essence”). For context, the phases are: Menstruation, Postpartum and Perimenopause. How a woman handles this allocation sets the stage for her health during that phase of life and the phases thereafter. 

According to Chinese Medicine theory, women cycle in years of 7 with each cycle having a shift in Jing energy. For example, at age 7 her adult teeth start to come in, at age 14 menstruation is present, so one and so forth. Every 7 years, the phase is hallmarked by an important happening in the body. At age 35 (5th cycle of 7 years), the body begins its shift in how it produces hormones. At age 42 (6th cycle of 7 years), it further refines its preparation to cease menstruating. 

From a Western perspective, we see this change, most notably, with a shift in progesterone production (estrogen, testosterone and other hormones are also shifting). During our reproductive years, progesterone is mostly produced by the corpus luteum, a temporary structure created by the ovarian follicle that releases an egg during ovulation. As we start to shift into our perimenopausal years, progesterone production starts to rely more on the adrenals. When progesterone levels are challenged, we start to see shifts in the menstrual cycle. Mostly notably, the luteal phase becomes shortened which can cause periods to start more frequently than they used to (every 24 days instead of 28, for example). 

If progesterone production is greatly challenged, we start to see even greater changes with the menstrual cycle. Estrogen can become high during this phase since the progesterone isn’t strong enough to keep it in check during the cycle. Higher amounts of estrogen can lead to very heavy and prolonged bleeding with menstruation. There may also be other physical symptoms starting to present such as breast and nipple tenderness, insomnia and irritability. 

From a Chinese Medicine perspective, we can recognize that a huge shift in Jing allocation is happening in this phase and simultaneously, Yin and Yang are becoming more out of balance. This gives rise to symptoms discussed above as well as issues with regulating body temperature and potentially even vaginal dryness, just to name a couple. 

So what’s a woman to do during this phase? Well, Western Medicine, and even some well known holistic practitioners, are touting the benefits of HRT (Hormone Replacement Therapy). This approach basically says, “oh your body is lower in this hormone, we can just give you supplemental hormone to make up for the loss”. While this sounds like a logical idea, it completely ignores why the body is struggling to produce enough of the hormone to keep the woman symptom free. 

Chinese Medicine has a more holistic approach and zooms out to see the bigger picture. It asks the question: “Why is the body struggling to maintain balance?” and then looks for the answer. More often than not, even as the body is getting ready to slow down with the reproductive years coming to an end…most women are not slowing down at all! They are reaching the pinnacles of their careers, they are sending their kids off to college, they are getting a second degree, etc…and sometimes all these things are happening at once! [Western medicine side note: The toll this takes on body can manifest as what is often referred to as “adrenal fatigue”. While it can happen at any age, it will really rear its ugly head during perimenopause if it is present.]

This lack of alignment with the body’s natural shift in Jing allocation creates immense pressure to keep up with the demand. That means Jing has to be tapped into in order to keep things running at high performance. If you think of Jing as a savings account that has a finite amount of money in it, and its supposed to last you the rest of your life, you can see how it would be wise to slow down the spending as much as possible. Not doing so will manifest in symptoms of Jing depletion (graying of hair, weakness in the bones, constant dull lower back ache, etc). This will make for the transition to menopause come a lot faster with very little time to transition at all. The faster the transition, the more intense the symptoms tend to be. This phase, and its symptoms, become the culmination of living life burning the wick at both ends. 

The good news is, wherever you are in your journey, you can slow down the expenditure of Jing. This will require slowing down and finding balance between your busy life and adequate time for rest and restorative practices. I wrote more about this in my Yin Days blog a while back. 

So to answer the question of “at age does perimenopause actual start?”, the answer is, it depends. There is no arbitrary age in which all women’s bodies decide to go into perimenopause. How did you nurture your body when you were menstruating? How did you nurture it during pregnancy and postpartum? How much did you prioritize sleep and good nutrition? How much Jing did you inherit from your parents (aka, how much money did they invest in your savings account)? All of these things factor into when your body will shift into perimenopause. 

Fortunately, Chinese Medicine (and other ancient practices) has a lot of tools for helping you to slow down this transition and enter menopause with more ease and grace. However, no amount of Acupuncture, herbal medicine, Qigong, etc. can assist you if you don’t adjust your mindset. Perimenopause is a right of passage and all of the symptoms are check engine lights trying to alert you that your system needs maintenance in order to continue performing well. Rather than taking a bandaid approach, that is basically the equivalent of slapping a sticker over those check engine lights and pretending they don’t exist, embrace this phase of life and lean into the lessons that it is trying to teach you. Many cultures have a reverence for this phase and with good reason. Your Jing reserves are directly related to your health in your older years and you want to be able to pass on high levels of Jing to your children when they are conceived; a big investment in that finite savings account. 

If you have already had children, don’t fret, just like you, they can learn all the ways to preserve their Jing for their children (your grandchildren) and their old age as well. 

Please share this post with someone that might find it helpful. Remember that you too can suggest topics for me to cover in future posts. Simply send me an email or submit a topic idea via the contact form on my website. Thanks for spending time with me today :)