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Second Spring: acupuncture for menopause

Updated: Feb 21

I have talked before about the beauty of the Chinese Medicine language when we looked at the 10 months of pregnancy.

Today I am looking at the other end of a menstrual cycle. Menopause, or in Chinese Medicine more aptly named 'Second Spring,' is a term that celebrates the next phase of a person's life.

Acupuncture for menopause, or second spring

"Between the ages of 49 to 55, women enter the water phase. The water phase is characterised by depth, wisdom and surrender"

Dr Lia Andrews 7 Times, a Woman

Because this doesn't have to be a time for a decline. It is a natural part of life.

Today's blog post is going to examine:

I hope you find it useful. As always my messages are always open to discussing anything about acupuncture.

Love from Andrea

UPDATE: 2nd June 2022

You can listen to a podcast episode I recorded with Clarissa from Thrive Thru Menopause about acupuncture and menopause here.


What is menopause?

Menopause is the natural ending of the menstrual cycle. It is specifically 12 months after the last bleed and occurs approximately at 51 years of age.

The time before menopause is perimenopause and it typically starts around 45 years of age.

During a menstruator life, there is a rise and peak of oestrogen at approximately 35 years of age. However, after this oestrogen will start to decline.

The rise and fall of oestrogen during a person's life

Oestrogen protects a number of different systems in your body: your brain, skin, bones, heart, urinary functions and the genital area – low levels of oestrogen can affect all these parts of your body.

And of course, with its decline, we may see the signs and symptoms which are considered "usual" during perimenopause and menopause.

What is oestrogen


The signs and symptoms of the menopause

Symptoms can include:

  • hot flushes

  • difficulty sleeping

  • reduced libido

  • night sweats

  • mood changes

  • joint stiffness

  • poor memory

  • osteoporosis

It is understood that 90% of menstruators will experience some of these symptoms, and research conducted by Newson Health Research and Education of 3,800 UK women found that:

  • 99% said their symptoms had led to a negative impact on their careers

  • 59% had taken time off work due to their symptoms: 18% were off more than 8 weeks.

  • Reasons for taking time off included reduced efficiency (45%), poor quality of work (26%) and poor concentration (7%).

  • Half (50%) of those who took at least 8 weeks off work resigned or took early retirement.

  • Overall, one in five (21%) passed on the chance to go for promotion they would have otherwise considered, 19% reduced hours and 12% resigned.

  • 60% of women said their workplace offered no menopause support.


Acupuncture for menopause

Considering that these signs and symptoms can last for months and even years I want to examine acupuncture for menopause. How acupuncture and Chinese medicine regards menopause, or second spring, but also the evidence for using acupuncture for menopause.

What is Yin and Yang?

Acupuncturists attribute many of the signs and symptoms of menopause to Yin deficiency. I liken Yin deficiency to who has turned the air conditioning off in our system?

However, as with every diagnosis your signs and symptoms indicate to your acupuncturist how we should treat you.

Below are some of the common patterns we might see with someone with perimenopausal symptoms. I have also included the treatment principle, as I know the acupuncturists who follow me will enjoy that!

Which one resonates most with you? Or what signs and symptoms are most prevalent for you?

Kidney Yin Deficiency

  • Trickling of blood after the period proper, late-cycle, fresh-red and watery blood, dizziness, tinnitus, weak knees, feeling of heat in the evening, night-sweating, hot flushes, malar flush, mental restlessness.

  • Tongue: Red without coating.

  • Pulse: Floating-Empty.

  • Treatment principle Nourish Yin, strengthen the Kidneys, stop bleeding

Kidney & Liver Yin deficiency

  • Irritability, dizziness, tinnitus, blurred vision, dry eyes, dry skin, hot flushes, ache in joints, night sweating,

  • Tongue: Red without coating.

  • Pulse: Floating-Empty, Wiry on the left-Middle

  • Treatment principle: Nourish Kidney- and Liver-Yin, subdue Liver Yang, calm the Mind, settle the Ethereal Soul.

Kidney & Heart Not Harmonised

  • Hot flushes, palpitations, insomnia, night sweating, blurred vision, dizziness, tinnitus, anxiety, mental restlessness, backache, a malar flush, feeling of heat in the evening, dry mouth and throat, poor memory, dry stools.

  • Tongue: Red body without coating with a redder tip.

  • Pulse: Rapid-Fine, or Floating-Empty, or Weak-Deep on both Rear positions and Overflowing on both Front positions.

  • Treatment principle: Nourish Kidney-Yin, calm the Mind, clear Empty Heat.

Kidney Yang Deficiency

  • Hot flushes but cold hands and feet, sweating in the early morning, pale face, depression, chilliness, backache, oedema of ankles.

  • Tongue: Pale.

  • Pulse: Fine, Deep.

  • Treatment principle: Tonify and warm the Kidneys, tonify Yang, warm the Centre, strengthen the Spleen.


The evidence of acupuncture for menopause

The pyramid of evidence

I am a proud member of Evidence-Based Acupuncture. I truly believe that good quality research i.e. randomised control trials or above is the foundation for understanding whether something works. The further up the pyramid, the better the quality of the study is considered.

Below I have added studies relating to some of the signs and symptoms of menopause and whether acupuncture is effective in helping.

Night sweats and hot flushes

In a meta-analysis of 869 participants, they found that acupuncture significantly reduced the frequency and severity of hot flashes. They also found that acupuncture effectiveness lasted for more than 3 months.

Depression and anxiety

In a systematic review of 605 participants, it was concluded that (but more clinical evidence needed)

acupuncture was “promising” as a therapy for menopausal women with depression

For anxiety, another study with 1,010 participants found that acupuncture provided positive outcomes, although again further research is required.

Sleep and insomnia

In a 2015 systematic review, they concluded that acupuncture is a safe complementary treatment for sleep and insomnia.


In a 2020 overview of systematic review, they found that acupuncture and moxa improved bone mineral density in patients with primary osteoporosis.

Cognitive decline

In a 2019 Systematic Review and Meta-analysis, they found that

acupuncture alone was better than conventional western medicines for the treatment of Alzheimer's Disease

I read a brilliant book called the XX brain, which is about giving women the tools to prevent Alzheimer's. Here is my blog post, which looks at how prevention is better than cure.


How can I help myself in the earlier years?

I decided, at the age of 39 to start preventative preparations for my menopause. I cannot guarantee that my efforts will lead to symptom-less menopause, but I have to use my knowledge to the best of my ability.

The menopause is a gradual physiological process throughout a lifetime, starting even before birth. The biological basis of the menopause is determined during a menstruators lifetime. Lifestyle & dietary habits from childhood onwards determine what kind of menopause you may experience


Of course, your parents or grandparents may provide you with information and a blueprint for how your periods and menopause will look. Have you ever asked them (if you can) about what menopause looked like for them?

Other things to consider, from an acupuncturists point of view, and for ways you can support yourself prior to menopause:


Building up year after year before the onset of menopause. Worry, anxiety and fear weaken the Kidneys and lead to Yin deficiency, especially when these emotions occur against a background of overwork.

In the long run, as Kidney-Yin fails to nourish Heart-Yin, they also lead to Heart-Yin deficiency and Heart Empty Heat.


Overwork, in the sense of working long hours without adequate rest usually combined with irregular diet and worry, is the most important and frequent cause of Kidney-Yin deficiency.

Lots of children

In Chinese medicine, lots of pregnancies close together weakens the Kidneys.

Acupuncture for menopause


Suggestions for managing menopausal symptoms according to Chinese medicine

Dietary advice

When you work with me I give you tailored advice around foods that will be both supporting and adverse for your presenting condition and your acupuncture diagnosis.

I have written a comprehensive blog here and this also particularly highlights the following:

  • foods specifically for yin deficiency

  • the salty flavour which is considered beneficial for the kidneys

  • the temperature of foods and foods to avoid or have only in moderation


Jo Darling is an acupuncturist, who has created Menopoised. This magnet is used for reducing the intensity or frequency of hot flushes and night sweats. In a small clinical study of 32 women with hot flushes, they found that 84.4% found relief by using the magnet.


Red flags in menopause

If you experience any bleeding in menopause (anytime after 12 months from your last period) then this is a red flag and an appointment should be made with your GP.


Some good news for menopause!

There are some amazing people who campaign fiercely for better treatment and recognition for menopause. You can see below for all those amazing people you can get advice from.

Their efforts meant that last week, the UK government agreed to cut HRT prescription costs, saving at least £200 a year for people who require it.


Other resources and suggestions

You know how I love to support local, so I am going to talk first about Anna Black, who runs the @40swoman

But other brilliant people to familiarise yourself with are:

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