Menopause is the cessation of menstruation that usually occurs between the ages of 48-55. The menopause transition, and post-menopause itself, is a natural life change for every woman, not a disease state or a disorder. Perimenopause is the term describing the menopause transition years. In women who have a uterus, perimenopause describes the years both before and after the final period (although it is only possible to determine in retrospect which episode of flow was indeed the final period). During perimenopause, ovarian function slowly declines and there is a delayed response to gonadotropins. This delay results in a decrease in follicles that release estrogen to circulate in the body. The decrease in estrogen can lead to symptoms of hot flashes, irregular menstrual cycles, headaches, mood swings, insomnia, an inability to concentrate, weight gain, and vaginal dryness. Production of progesterone and testosterone also diminish and become more irregular. During the perimenopause years, fertility diminishes, but is not considered to reach zero until the official date of menopause is determined retroactively 12 months after the last menstrual cycle. The duration of perimenopause with noticeable bodily effects can be a few years, ten years or even longer. At least one year’s absence of menstruation signals a woman’s postmenopausal state. The conclusion of menopause can lead to an increased incidence of cardiovascular disease and osteoporosis due primarily to the decline of estrogen.

Chinese medicine views menopause as a natural physiological process that can be reflective of the state of the body’s internal climate and "essence" or prenatal constitution. The essence is intricately linked to reproduction, ovarian function and the state of the kidneys. Just as the follicular number of each woman is predetermined, so too is the quality of her essence. A woman’s lifestyle through puberty and her reproductive years greatly influences the ease through which she will move through menopause. Excessive work, stress, and a poor diet are extraordinary contributors to poor ovarian function and a difficult menopausal transition. Treatment may include either one or a combination of acupuncture, herbal medicine, massage, nutritional guidance, and/or specific exercises or lifestyle recommendations.

Acupuncture attempts to encourage the body’s endocrine system to adjust more quickly to fluctuating levels of estrogen and progesterone, thereby restoring equilibrium in a more gentle way with fewer side effects. It encourages the restructure of hypothalamus hormonal triggers, thus helping the body to acclimate to the rapid temperature changes associated with vasodilation and perspiration (hot flashes). Acupuncture also releases endorphins, hormones which can positively affect mood and sleep patterns.

Chinese herbs nourish the kidney and essence while calming an unquiet mind. Single herbs have documented cardiovascular effects helping to regulate vasodilation and constriction, ultimately having a positive effect in temperature regulation. A well composed formula will also contain herbs to stimulate the central nervous system, aiding in improved concentration and decreased anxiety.