HORMONES: TCM & INTEGRATIVE MEDICINE

Hormones, thyroid, perimenopause, and menopause are front of mind for a significant portion of the population these days, finally getting the bandwidth they deserve across many platforms - books, podcasts, blogs, supplements, skincare. Women finally feel less alone as they navigate this shift and validated to discover their unique symptoms are part of hormone shifts (think shoulder pain, anxiety, fatigue, etc) . Unfortunately, sometimes a barrage of new information can also lead to confusion.

I recently appeared as a guest on the podcast SMV, short for "I Shaved My Vag For This", hosted by the lovely Katie Thompson. In our talk, I expounded on the viewpoint of this shift in hormones through the lens of Chinese medicine - feel free to have a listen for more on this perspective here or here.

Lots of you have been asking me for referrals to hormone specialists, so I reached out to my followers in Austin to ask, who do you trust to guide you through the tests for hormone levels and options for 'balancing' when things test out of range. I have put the top recommendations below. I had one caveat, no 'pellets'. I know some will say, I did the pellets, love it. However, I have found for my patient population, outcomes have been a bit unpredictable especially relative to testosterone; once the hormones in the form of a pellet are in the body, the patient is left to ride out the dose with no recourse if it is impacting them negatively. And a few of my patients did indeed have negative experiences (this might be rare, but if it's you, it's pretty unpleasant). Some symptoms they experienced have not been clinically connected to pellet use, rather, they are anecdotal. That being said, brittle hair snapping off is not on anyone's bingo card, or breakthrough bleeding in your 50s, super hungry, and even hangry. So I opted for asking for something that can be finessed a little more easily.

In Austin, you reported you were pleased with the following practitioners:

Texas Medical Direct (subscription based) (link here)

Ways2Well* (link here)

Dr. Womack (concierge, internal medicine specializing in age management)( link here)

Wiseman Family Practice (Jamie Garza recommended, but might not be accepting new patients ) ( link here)

*I got a bit more of a deeper dive on how Ways2Well works, the tests they run, and I was impressed with their POV, such as exploring absorption capability for hormones rather than automatically increasing dosage. Otherwise, these are recs from my followers, and I have no further knowledge of their practice.

Here is the caveat.

TCM approaches menopause and the use of HRT with a focus on the individual's specific constitution and patterns of imbalance. A TCM practitioner would consider the individual's unique symptoms, medical history, and lifestyle when determining the appropriate course of treatment alongside, or instead of, HRT, to ensure we're treating the root cause of your individual symptoms.

From a Traditional Chinese Medicine (TCM) perspective, hormone replacement therapy (HRT) aims to address the hormonal changes associated with menopause, which TCM views primarily as a decline in Kidney energy, affecting the balance of Yin and Yang, especially Kidney Yin.

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Here are some comparisons of viewpoints (broad in scope):

1. Restoring Yin and Yang Balance (Partially):

• HRT's Goal: HRT aims to alleviate menopausal symptoms by providing the body with estrogen and/or progesterone, effectively supplementing deficient hormones. 

• TCM Perspective: TCM might see HRT as a way to address the Yin deficiency (manifesting as hot flashes, night sweats, vaginal dryness) associated with menopause, as estrogen is seen to have a cooling and nourishing effect similar to Kidney Yin. 

• Potential Effects: While HRT can potentially improve these symptoms, TCM would emphasize that it may not fully address the root cause of the imbalance, which is the decline in Kidney energy (which would have to be addressed eventually).

2. Addressing Hot Flashes & Other Symptoms:

• HRT's Goal: HRT can reduce hot flashes, vaginal dryness, and night sweats. 

• TCM Perspective: These symptoms are often seen as manifestations of Empty Heat due to Kidney Yin deficiency, and TCM has a long history of successfully treating for these symptoms, with research to back this up.

• Potential Effects: HRT's estrogen supplementation could help reduce the intensity of these symptoms.

3. Potential Side Effects & TCM Perspective:

• Western Medicine Concerns: HRT can have side effects like bloating, nausea, and breast tenderness, and may increase the risk of breast cancer (according to some research, but refer to your doctor for your risk), gallbladder disease, and other issues. 

• TCM Perspective: TCM practitioners might attribute these side effects to the disruption of the body's natural balance caused by the external introduction of hormones (similar to how we see birth control affecting your period and cycle).

• Potential Effects: TCM treatments like acupuncture or herbal medicine might be used to help mitigate these side effects and support the body's overall balance during HRT. 

  
  

4. Role of Acupuncture and Herbal Medicine:

• TCM Approach: Many women on HRT may also seek TCM treatments like acupuncture and herbal medicine. 

• Potential Benefits: Acupuncture may help deal with the side effects of HRT, rebalance Yin and Yang, and strengthen the systems. 

• Herbal Support: Herbal formulas may be prescribed to nourish Kidney Yin, regulate Qi and blood, and address specific symptoms, along with nutrition and breath work techniques. 

It is worth noting, TCM considers every aspect of a woman's life in order to make a diagnosis; lifestyle (past and present), diet, medical history, menstrual cycle history, trauma and stress levels. It is important to look at the whole person and not just symptoms.

From a Traditional Chinese Medicine (TCM) perspective, HRT primarily supplements declining Yin, Yang, or both, depending on the formulation. However, because it introduces external hormones rather than restoring balance naturally, it can create secondary imbalances over time. Some of the common side effects of HRT, when viewed through a TCM lens, include:

• Dampness & Phlegm Accumulation – Many women on HRT experience weight gain, bloating, fluid retention, and breast tenderness, which TCM might see as Damp or Phlegm accumulation, especially if digestion is sluggish.

• Liver Qi Stagnation & Heat – HRT can sometimes lead to irritability, mood swings, or headaches, which could be seen as Liver Qi stagnation, possibly generating Liver Heat.

• Blood Stasis – Some HRT regimens are associated with increased clotting risks or breast tenderness, which could be interpreted as Blood Stasis, especially if there are sharp pains or a sense of heaviness.

• Spleen Qi Deficiency – If digestion worsens, with increased bloating, fatigue, or loose stools, this could indicate that the Spleen is struggling to process the synthetic hormones.

• Kidney Yin Deficiency masking as Yin & Yang Imbalance – While HRT often helps with Yin Deficiency symptoms (hot flashes, night sweats), long-term use could create an artificial balance that doesn’t replenish the Kidneys at a deep level, leading to exhaustion once discontinued.

  
  

This is why some TCM practitioners prefer supporting the body with herbs, acupuncture, and lifestyle shifts that nurture the Kidney, Spleen, and Liver rather than relying on external hormones. If you’re leaning toward HRT but want to manage side effects holistically, you might focus on Damp-resolving foods, Liver-soothing herbs, and Kidney-supporting practices (see your practitioner for your customized recommendations).

We're happy to help you manage your hormones either way - in conjunction with your current therapies, or as a whole. We're definitely not here to judge your choices - you have to do what is best for you, with information provided to your satisfaction.

Some of this will not apply as much if you have medically induced menopause or have had a hysterectomy; that being said, we have immense support in this case as well.

I hope this helps you on your way!

If you have a practice to add, feel free to leave a comment for others.

Warmly,

Brooke

If you would like to explore hormone balancing through Chinese medicine, please book an initial consultation and treatment with one of our practitioners at The Desert Canary (my sister business upstairs) to get started. Alternatively, you can book an herbal consult with Raechel at our practice to do herbs long distance.

Book at The Desert Canary: LINK TO BOOK

Virtual Herb Consultation: LINK TO BOOK

Disclaimer:

This information is for educational purposes only and should not be interpreted as medical advice. It's always recommended to consult with both a Western medical doctor and a licensed TCM practitioner to make informed decisions about your health and treatment options. 

#menopause

#hormones