Ease into Perimenopause With These 3 Tips

Physician Amanda Kok As a woman approaches her 40s, familiar patterns can start to shift. Menstrual cycles may become erratic, with periods arriving unpredictably heavy or light. Hot flashes might strike without warning, leaving her flushed and unsettled. Furthermore, those once restorative nights of sleep are frequently interrupted by insomnia, tossing and turning until dawn. If this sounds like your recent experience, you may be navigating the transitional phase called perimenopause. Typically beginning in the 40s, though sometimes occurring earlier in the 30s, perimenopause marks the gradual process leading to the last menstrual cycle and the end of fertility. During this time, ovarian reserve declines and the ovaries slow production of hormones like estrogen and progesterone[1]. This hormonal shift can trigger physical and emotional symptoms, disrupting a woman’s sense of balance and well-being in daily life. While a natural process, the impacts of perimenopause on mental health, energy levels, and overall quality of life can feel overwhelming. Symptoms of Perimenopause Some of the most commonly experienced symptoms of perimenopause include: Irregular periods One of the earliest signs of perimenopause is a change in menstrual patterns. Periods may become longer or shorter than normal as ovulation becomes irregular. Some women experience skipped periods or periods that arrive closer together. This irregularity is caused by fluctuating ovarian hormone levels. Hot flashes and night sweats Hot flashes are hallmarks of the menopausal transition, experienced by up to 80% of women[2]. They are characterised by sudden feelings of intense heat, flushing and sweating that can last from 30 seconds to several minutes. Occurring at night, extreme perspiration can lead to soaked pyjamas and bed sheets. Sleep disturbances While night sweats can disrupt slumber, other hormonal effects like anxiety, depression, and body aches also contribute to fragmented sleep and insomnia during the perimenopausal window. Anxiety and depression The hormonal roller coaster can directly impact neurotransmitters like serotonin, leading to feelings of anxiety, agitation and mood swings. Similarly, chemical fluctuations may trigger or exacerbate depression. Fatigue, sadness, and loss of motivation are common. Vaginal dryness As estrogen levels decline, vaginal tissues can become drier and less elastic. This may cause discomfort during intercourse, affect libido levels and increase susceptibility to infections. Weight gain Many women struggle with weight gain, particularly around the abdomen, as their metabolism slows and hormones shift during perimenopause. Urinary Issues Lower estrogen levels can lead to a higher risk of urinary tract infections as well as increased urgency and frequency of urination. Joints and muscle aches The drop in estrogen impacts many tissue types, including supportive joint and muscle tissues. This can lead to stiffness, body aches and increased risk of conditions such as arthritis. Although most symptoms will eventually stop without medical intervention, for some, the perimenopausal phase can be a long and distressing journey lasting up to 10 years[3]. Western treatments for perimenopausal symptoms include Hormone Replacement Therapy (HRT) and antidepressants. While they work well for certain people, they could also bring about side effects such as an increased risk of blood clots, stroke and dementia[4]. Those with certain conditions such as breast cancer are also advised against HRT. This has led many women to seek alternative approaches like Traditional Chinese Medicine (TCM) to safely and effectively manage their perimenopausal symptoms. Perimenopause from a TCM perspective In TCM, a woman’s reproductive and menstrual health is closely linked to the Kidney system. According to TCM, the Kidney is the most vital and foundational system in the body, in charge of growth, development and reproduction. As a woman enters perimenopause, the Kidney Yin essence which has been consumed over the years through ageing and reproductive activities becomes depleted. This deficiency in Kidney Yin fails to properly nourish the body, leading to the classic symptoms of dryness, night sweats and insomnia. As Yin energy is also involved in the production of Blood, an imbalance of Yin leads to irregular menstrual cycles. At the same time, without sufficient Yin to counterbalance it, the Kidney Yang energy becomes excessive and disruptive. This relative increase in Yang energy produces symptoms like hot flashes, irritability and hormonal imbalances. By understanding perimenopause through the lens of TCM, specific therapies like acupuncture, herbal formulas and lifestyle adjustments can be employed to tonify Yin, clear excess heat and restore balance to your body. Tip 1: Regulate Qi and Blood flow with Acupuncture During menopause, the declining Yin essence fails to properly nourish the Blood in the body. This can lead to stuck or congealed Blood that disrupts Qi flow. Stagnant Qi and Blood may present as periodic sensations of heat, agitation or irritability. When Qi and Blood become stuck and unable to move freely through the meridians and vessels, it obstructs the body’s natural harmonising abilities. Acupuncture aims to remove these blockages by stimulating specific points along the meridian pathways. Inserting fine needles at certain acupoints helps re-establish the flow of Qi and Blood. This restored circulation alleviates symptoms caused by stagnation and restores balance in the body. Common acupoints used to regulate Qi and Blood for perimenopausal concerns include:   San Yin Jiao 三阴交 (SP6) Nourishes Blood, regulates menstruation, alleviates night sweat Guan Yuan 关元 (RN4) Harmonises Chong Ren vessels, regulates hormonal imbalances, relieves hot flashes Tai Xi 太溪 (KI3) Boost Kidney Qi, nourish Yin, promote sleep Shen Men 神门 (HT7) Calms the mind, relieves insomnia and irritability Tai Chong 太冲 (LV3) Soothes Liver Qi, improves mood and relieves breast tenderness Research shows that acupuncture treatment using points like these was highly effective in reducing the frequency and severity of hot flashes without any side effects [6]. Beyond just addressing acute symptoms, regular acupuncture can help re-establish harmony in the body’s energy flow. By regulating the flow of Qi and Blood, it supports a graceful, balanced transition through perimenopause changes. Tip 2: Nourish Yin and Tonify Kidney Essence with Herbal Medicine According to TCM, the root imbalance driving many perimenopausal symptoms is Kidney Yin deficiency. Herbal medicine targeted towards replenishing depleted Yin and Kidney essence is an effective