healthy free woman smallerMenopause is a normal physiological time of transition, but if you are depleted or your hormones are out of balance, these changes can cause upheaval. During perimenopause – the years leading up to menopause – periods can become unpredictable, almost like going through puberty in reverse.

Menopausal symptoms can range from annoying to debilitating, including:

  • hot flushes
  • low energy
  • night sweats
  • adrenal fatigue
  • insomnia
  • sluggish metabolism
  • anxiety & mood swings
  • low libido

At Four Gates we take a whole-systems integrative approach to menopause, identifying any imbalances that may be stirring up symptoms. For example, people who tend to “run hot” will often suffer worse hot flushes, while those who tend to retain fluid may find that their night sweats are as bad as the hot flushes themselves. Higher stress levels will make the body more sensitive to heat, as the body’s temperature regulation system is impacted by stress and its effects on the nervous system.

So what is causing the hot flushes?

The 5-10 years before menstruation ceases is known as perimenopause, a time of rapidly fluctuating hormone levels. Ovarian function slows down, leading to irregular or unpredictable periods, and estrogen and progesterone levels drop and fall out of balance. Other hormonal systems are also affected – a sluggish thyroid can slow metabolism and cause mood swings, and the adrenals are more sensitive to stress, making it harder to concentrate, and harder to fall and stay asleep. Long-term stress also aggravates hormonal imbalance.

Hot flushes are one of the most disruptive symptoms of menopause. Dropping levels of estrogen are thought to affect the brain region responsible for controlling body temperature, the hypothalamus, narrowing its “thermoregulatory zone”. In other words, a small rise in outside temperatures, such as walking into a heated room, is now interpreted as overheating, and the response is to try and cool the body by suddenly increasing blood flow to the skin, which women experience as a hot flush. Hot flushes can be associated with sweating, night sweats and disrupted sleep, chills, anxiety and even heart palpitations.

People with tired adrenals (often from years of overuse, overwork, and stress) can experience worse symptoms during perimenopause – as the ovaries slow down the adrenals should take over to continue to regulate hormones, but if adrenals are depleted the body will find it harder to adjust. When these deep reserves of energy are strengthened, the transition into menopause is smoother.

Acupuncture can help the body relax and manage stress better, and this is good news for addressing hot flushes. Studies show that higher stress levels seem to be linked to increased hot flushes and temperature sensitivity. Women experiencing menopausal hot flushes may have an overactive sympathetic nervous system (responsible for the “fight-or-flight” response to stress), while the parasympathetic nervous system (responsible for returning the body to a state of relaxation and restoring digestion and other key processes) is less active. Acupuncture has been found to regulate the parasympathetic nervous system, as it stimulates the vagus nerve, and is an easy way to reduce the effects of stress and bring the body back to a state of cool and calm. Most women notice a reduction in the frequency and intensity of their hot flushes and night sweats and improved sleep, energy, and moods.

When I work with women to help smooth this transition, lifestyle changes are also important to maintain your results – the top three to reduce are coffee, alcohol and spicy food. To find out how we can support you to feel more like yourself again, with renewed health and vitality, email Mary-Jo at or call the clinic on (03) 9988 2141.

Further reading

Chui, HY et. al. Effects of acupuncture on menopause-related symptoms and quality of life in women in natural menopause: a meta-analysis of randomized controlled trials. Menopause: 2015 Feb;22(2):234-44.

Chen, R et. al. Traditional Chinese medicine for chronic fatigue syndrome. Evidence Based Complementary Alternative Medicine. Mar 2010, pp 3-10.

Menopause-related Symptoms: Traditional Chinese Medicine vs Hormone Therapy. Azizi, H et. al., Alternative Therapies in Health and Medicine: 2011;17(4):48-53.

The Hormone Cure – Sara Gottfried (Scribner, 2013)