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+/- 49 years young, menses stop.  Around this time symptoms & signs start to appear.  Cycle becomes irregular, dizziness, blurred vision, tinnitus, hot flashes, red complexion coming & going in waves, very emotional (anger, irritated, sadness, anxiety, etc.), edema, low back & knee weakness / pain, digestive problems, cold limbs, & urinary disorders.  These do not come all at once, some women only get a few & some women encounter many.  This may last for weeks to years in some cases.  In Canada the average age when women make the wise woman transition statistically is 52.

TCM diagnosis can be divided into 3;

  1. menstrual cycle gets very irregular, bleed a lot, may be serious hemorrhage.  Then may experience very occasional menses until they cease completely.  May lose hair from blood .
  2.  Yang symptoms  Yang rises due to Yin  (relative Yang ).  WM says this is due to blood vessels contraction.  Sudden heat  break sweat (hot flashes), dizziness, palpitations & rapid pulse.
  1. emotional imbalances  easy to anger, sadness etc..  Manic behavior, depressed, abnormal, violence, & insomnia are all common.  A blood test may show high FSH meaning ovary function has ceased.



  1. KI Yin  - pregnancy, menses, breastfeeding & abortions consume Essence & Tian Gui (hormones), Chong & Ren can’t be nourished.  This creates hyper Yang rising.


  1. KI Yang  - use of a lot of KI Qi for pregnancy, menses, breastfeeding & abortion consume the Ming Men Fire  KI Yang is  & you see cold signs.



Pathogenesis Differentiation & Treatment

1. KI Yin

  • occasional menses  scanty  cease completely.  Vaginal dryness & itchiness (ph is not regulated properly anymore).

    Plus – Yin  sym.  dizzy, tinnitus, insomnia, night sweats, afternoon heat feelings, back/knee pain/weakness, hot flashes w/ sweating, whole body itchiness.  T- red w/ scanty coat  P- thin rapid

    P/T – nourish KI Yin

    Rx – Zou Gui Wan (essence)   or…
    Liu Wei Di Huang Wan + Huang Bai, Zhi Mu= Zhi Bai Di Huang Wan+ E Jiao, Gui Ban, Bie Jia, He Shou Wu, Nu Zhen Zi


  • Rx – BL 23 & KI 3, SP 6, Ren 3, HT 7, Si Shen Cong
    • irritable- PC 7

2. KI Yang  

  •  HEAVY periods, irregular uterine bleeding, then gradually finish menses completely, T- pale  P- deep thin


        1. Plus – Yang
        2.  sym.  cold, soft stools,  frequency of urine, incontinence, low back/knee weakness/pain, Edema of lower limbs &/or face.
        3. P/T – warm KI Yang – strengthen SP
        4. Rx – You Gui Wan + Li Zhong Wan

    Rx – BL 23, Ren 4, Du 4, with moxa, BL 15, SP 6

    1. poor digestion- BL 20, ST 36
    2. insomnia- HT 7


3. Combined KI Yin and Yang Presentation

    1. P/T – nourish KI Yin & Yang
    1. Rx – Er Xian Tang  (this may be taken long term)


Emergency Hemorrhage

  •  Rx – Shen Fu Tang

    + stop bleeding herbs (Xian He Cao, Ai Ye Cao, Bai Ji, Han Lian Cao)


    1. MOXA Du 20

 Alternative Treatment Methods

  •   auricular- endocrine, aubcortex, internal repro. organs, *KI, HT, Shenmen,        sympathetic, LR



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