The cessation of the monthly cycle is a natural occurrence in women between the ages of 45 and 55. This may stop suddenly, or there may be a decreased flow each month or the interval between periods may increase, until a final cessation. In most cases this process may last from one to two years. During this time the function of the ovaries is gradually declining, until they eventually stop producing ova (eggs) and the woman is no longer able to bear children.

There is generally a transitional period that varies from several weeks to several decades, during which a woman may experience a variety of uncomfortable physical, emotional and mental conditions while the body is adapting to these changes. These symptoms vary from being barely noticeable to severe. They include hot flushes, night sweats, insomnia, heart palpitations, anxiety, irritability, dizziness and vertigo, tinnitus, migraine headaches, fatigue, emotional volatility, forgetfulness, hypertension, low back pain, dry vagina and skin irritation.
However, it should be remembered that the menopause is a natural process and therefore any distressing symptoms should be regarded merely as signs of an underlying imbalance that requires treatment.

Perspective of Traditional Chinese Medicine

According to Traditional Chinese Medicine (TCM) there are three organ-systems responsible for the onset, maintenance and cessation of a woman's monthly cycle. These are the kidney liver and the spleen. The spleen is in charge of digestion and transformation, producing blood and Qi (energy) from our daily food. When the spleen has matured to the stage where it can produce an abundance of blood, there is sufficient to ensure an even monthly flow from the uterus and menstruation begins. As one matures, the spleen becomes weaker and is no longer able to produce an oversupply of blood and this is one reason for the cessation of menstruation. The liver is in charge of storing and releasing the blood. When the body is at rest the blood returns to the liver, to be released for use when activity begins. Part of this regulating function is the release of blood to the uterus for the monthly period. The liver's activity is easily disturbed by stress or emotional problems. This commonly leads to premenstrual tension in younger women and is also one of the contributing factors to the problems associated with menopause.

Underlying both of these processes is the controlling factor of the kidney, which acts as our 'biological clock'. Thus it controls the orderly processes of growth, development, maturation and decline. The kidney also has a direct connection with the uterus and sends some of its essence to nourish it, giving a woman the ability to reproduce. At around the age of 40 the kidney begins to decline, and by 50 the supply of essence ceases, bringing about the end of a woman's reproductive cycle. However, this is not the whole story. Nature always creates a balance, and 'where one thing is lost, another will be gained'. Instead of the blood being directed to the uterus, the flow is reversed, and now the blood, along with the kidney essence goes to nourish the heart. This has a profound effect on a woman, as the heart is the seat of the mind and spirit. Now instead of being centred on producing children, her body is focused on the nourishment of consciousness allowing for the growth and deepening of the spiritual side of her nature.
Both herbal medicines and acupuncture are used to correct imbalances and supplement and strengthen the body. The TCM practitioner will carefully examine the tongue and pulse in addition to taking a detailed case history. If necessary, certain pressure points ''ill be tested to assist the diagnosis. Once the basic type of imbalance has been identified, the treatment can begin. In addition to herbal medicine id acupuncture, certain lifestyle changes will be recommended, some of which are listed below.

Help Yourself

Make sure you have a balanced and nutritious diet with plenty of calcium, vitamins and minerals. Foods such as seaweeds, seeds, nuts and green leafy vegetables should be taken regularly. You should also avoid taking too much raw or cold food as this can weaken the spleen and kidney. If hot flushes are a problem then it is best to avoid strong spices (e.g. chilli) and deep fried foods. Oils and fats should be kept to a minimum and the meals should be small and more frequent if necessary.
Stress reduction is very important and there are a variety of approaches that may be suitable, such as meditation, relaxation techniques, changes in routine, bio-feedback, etc. If stress and anxiety are severe then professional help such as counselling or psychotherapy should be sought. It is important to maintain a positive outlook on life by developing new interests and remaining or becoming involved in the community. Regular and gentle exercise is recommended (e.g. walking, swimming, tai chi, qi gong or yoga) as this will help to maintain circulation, promote appetite and generate a feeling of well-being.