Exerpts from “A Practitioner’s Guide to Longevity Medicine for Women”
by Dr. Lia G Andrews, DAOM, L.Ac. from Oriental Medicine Summer 2015
Take Advantage of the “Golden Opportunities”
Jing is a term in Chinese medicine that refers to the combination of inherited and sustained resources of the kidneys, qi, and shen. Jing preservation is the primary goal when we discuss longevity. Jing can be leached away through overwork, regular stress, and poor diet, but is lost in greater quantities during procreation, or the potential for procreation, through the egg and sperm. Thus, men lose jing through ejaculation and women through menstruation and pregnancy. Most traditional cultures have prescribed ritual rest around menses and the postpartum month to protect women.[2] On the one hand, modern women enjoy greater freedom and gender equality, but on the other, there is no medical or cultural framework that acknowledges women’s transitions and cycles. I have seen in my practice infertility and premature menopause result from this lack. TCM practitioners are in a key position to educate the public on this matter. Symptoms during menses, after childbirth, and during peri-menopause are what most often bring women through the door. Fertility issues are typically linked to the menstrual cycle, and they may be complicated by poor recovery from a previous pregnancy.
Menstrual Care
Monthly menses signals more than just blood loss. The link between menstruation and longevity is seen in the concept of tian gui. The tian gui is related to hormonal and endocrine system maturation, manifesting in the sperm in men and in the menstrual blood and ova in women. Tian gui is intimately tied to jing essence and the ministerial fire[3]; women must carefully mitigate blood and jing loss during menses, and supplement afterwards. Menstrual care practices include diet and lifestyle. Women are advised to rest, stay warm, eat foods that support blood flow and nourish the body, and promptly address any imbalances in the menstrual cycle or flow with acupuncture and herbal treatment.
Postpartum Care
Pregnancy, childbirth, and breastfeeding represent a major depletion in kidney qi, blood, and jing. Postpartum care, known as zuò yuèzi 坐⽉月⼦子, is one of the single most important practices for a woman’s health. Like menstrual care, postpartum care includes diet and lifestyle recommendations, but stricter and lasting for the first month or more after delivery. Postpartum women are to rest, bind their abdomens, and eat special foods. This facilitates the passage of lochia, the return of the uterus and waist to normal size, and the production of healthy breast milk.
Peri-Menopausal Care
A major obstacle to peri-menopausal care is that most women refuse to associate with that term until their periods have stopped and their symptoms are unmanageable, while peri-menopausal care should begin much earlier. The Huangdi Neijing outlines womens’ seven year jing cycles and notes that jing begins to decline during the fifth cycle, at age 35. If a woman begins rejuvenation practices at this age she can delay menopausal symptoms and minimize their severity. She will reduce the temptation to use oral contraception to halt her periods as she approaches menopause, which is becoming common practice.[4] She will be less likely to rely on Hormone Replacement Therapy and cosmetic procedures. It is also easier for the practitioner, as the patterns are less entrenched, complicated, and difficult to resolve.
Treating Pre-Menopausal Jing Decline
In addition to the above mentioned practices, herbal medicine is very effective to promote longevity and rejuvenation. Perhaps the easiest way for patients to incorporate this on a daily basis is by using food herbs, also known as medicated diet or yàoshàn 药 膳. Food herbs are can be taken long-term without side effects, they taste good, and they are less intimidating to those afraid of “herbs”. There are a number of food herbs I recommend to women beginning at the age of 35 including shan yao (Rhizoma dioscoreae), hei zhi ma (Semen sesame nigrum), gou qi zi (Fructus lycii) and long yan rou (Arillus longan). In addition to food herbs, tonic herbs and formulas are required.
One of the most effective anti-aging herbs is ren shen (Radix Ginseng). TCM Dermatology and Cosmetology expert Dr. Yueying Yi, OMD recommends that women begin taking 1 gram of ren shen daily beginning at age 35 to delay onset of menopause and mitigate symptoms. [5] There are studies showing marked improvement in menopausal symptoms with Korean red ginseng[6] at slightly higher daily doses, even after the onset of menopause. A 1990 study on the effects of Korean red ginseng and menopause used 47 female subjects diagnosed with menopausal disorder. Each subject took 4.5-6.0 g/day of red ginseng powder orally for 8 weeks. By the end of the study, the women showed a marked increase in blood flow to the ovaries. The study concluded that Korean red ginseng powder was effective to treat anxiety, dizziness, ovarian dysfunction (promoted secretion of estrogen), digestion disorder, sexual function, and depression associated with menopause.[7] A 2002 study demonstrated significant relief in 30 menopausal subjects with a mean age of 57.3 years, taking 3g/day red ginseng powder with dang gui (Radix angelicae sinensis) and bai shao (Radix paeoniae alba) powder for 12 weeks.[8] A third, randomized, placebo-controlled, double-blind study in 2012 studied 72 women ages 45-60. The subjects took 3 g/day of red ginseng in capsule form for 12 weeks. The study analyzed changes in menopausal symptoms using the Kupperman index. Subjects showed remarkable improvement, particularly a decrease in cardiovascular risk factor and increase in estradiol level.[9]
Treating Peri-Menopause
As women near menopause it is common to experience increasingly irregular, and often heavy, menstrual cycles. The decline in Jing, which characterizes the onset of menopause, allows other imbalances to surface. Symptoms experienced during perimenopause are key to resolving a woman’s primary imbalances before she enters the latter half of her life. Peri-menopausal women typically present complex and changing patterns and thus need to rely more on TCM practitioners to guide them on diet and lifestyle and offer appropriate treatments and herbal medicine. As jing declines it can manifest as a yin and/or yang deficiency. Yin deficiency is more prevalent amongst women as they age, which is why hot flashes and dryness symptoms are almost universal during menopause. Self-care becomes paramount with age. Women must practice daily stress relief such as qigong, tai chi, meditation, and yoga. Additionally, they must balance rest with work and play. Women can no longer live an unbalanced lifestyle without consequences. As women enter the post-menopausal phase of life, generalized jing deficiency becomes more pronounced and emphasis is placed on tonification.
Promote a Different Model of Sexuality
Sexual cultivation offers a model of sexuality that is distinct from both the religious sexual shaming and pornographic disempowerment that are rampant in our culture. It transforms sexuality into a balancing force in one’s life. Women are far less at risk of injuring their jing during sex than men. They are advised to practice moderation in sexual frequency and avoid intercourse when intoxicated or during menstruation.[10] Though women are biologically resistant, cultural constructs surrounding women and sexuality can be highly injurious to health. Sexual intercourse before sexual maturity can deeply injure yin and affect menstruation and fertility later on in life.[11] Prostituted women, sexual violence victims, and molested girls are greatly injured by sex. Many women who have avoided these experiences may still suffer from body image issues or the burden of pleasing others. If women are taught to have sex only when their bodies, hearts, and minds are all in agreement, this naturally leads to sexual moderation that is appropriate for their bodies and lifestyles without the imposition of arbitrary rules. In addition to this attitude change, women’s sexual cultivation practices typically include breast massage, ovarian massage, vaginal strengthening, and the circulation of sexual energy throughout the body. The stimulation and circulation of sexual energy has a rejuvenative effect on the body and stimulates hormonal balance. Conclusion Longevity medicine is the foundation of our medicine, particularly in the specialties of cosmetic acupuncture, fertility treatments, and menopausal care. If TCM practitioners are to do more than offer relief from symptoms, we must educate our patients on how to live better. Longevity practices need to be taken from theory into practices that can be incorporated into patient lifestyle.
Dr. Lia Andrews, DAOM, LAc is an educator, author, and practitioner of Longevity Medicine. Her books include 7 Times a Woman, The Postpartum Recovery Program™, and Secrets of the Daoist Courtesan. She co-owns Cinnabar Acupuncture and coproduces The Lia Andrews Show. - See more at: http://www.pacificcollege.edu/news/blog/2015/07/22/practitioner%E2%80%99s-guide-longevity-medicinewomen#sthash.4xwsogS4.dpuf
