Nobody tells you this upfront: menopause is not an event. It is not a switch that flips at fifty and shuts everything down. It is a process -- one that can start in your late thirties and stretch into your sixties. And most women reach it knowing almost nothing about what lies ahead.

What Western Medicine Says

-- Dr. Sarai NIETVELT

Family Medicine Physician at Shanghai United Family Hospital,
Medical Advisor and Designated Physician to the French, Austrian and German Consulates in Shanghai

Dr. Sarai explained that menopause is not a single event but a natural biological process. She walked us through the three stages:

• Perimenopause (the transition years leading up to menopause),
• Menopause (the point when a woman hasn't had a period for 12 consecutive months),
• Postmenopause (the years after).

One of the most reassuring messages from her talk was this: every woman experiences menopause differently. Some women have many symptoms, others only one or two. Symptoms – such as hot flashes, night sweats, mood changes, sleep disturbances, and vaginal dryness – can start years before the final period and may last for months or even years. But she also reminded us that there are women who feel nothing at all. And that is completely normal too.

Dr. Sarai emphasized that while some women may benefit from medical treatments such as hormone therapy, others may manage well with lifestyle adjustments alone. The key is to understand what your body is telling you, not to suffer in silence, and to seek support when you need it.

What Traditional Chinese Medicine Adds

--Dr. Yuanwen ZHANG

TCM Physician at Shanghai United Family Hospital

Dr. Yuanwen Zhang, TCM Associate Chief Physician at UFH Fengshang Clinic, brought a 2,000-year-old framework to the same topic. She referenced the Huangdi Neijing and its seven-year female life cycle:

• Age 14: Tian Gui arrives. Menarche. Reproductive life begins.
• Age 28: Peak vitality. Hormonal stability at its strongest.
• Age 35: First decline. Energy and complexion begin shifting.
• Age 42: Repair capacity weakens. Perimenopause starts its quiet work.
• Age 49: The "Second Spring" -- not an ending, but a pivot where energy redirects from reproduction to self-nourishment.

In TCM, hormonal health rests on three organ systems. The Liver governs Qi flow and emotions; stagnation here shows up as irritability, breast tenderness, irregular cycles. The Spleen converts food into Qi and blood; when weakened by stress or poor diet, it produces that specific exhaustion where you are tired but cannot sleep. **The Kidneys** store Jing, the essence underlying reproduction; deficiency here maps onto low libido, hair thinning, and metabolic slowdown. When these systems are in balance, hormones follow suit.

Where East and West Agree

One doctor spoke of hormone receptors; the other of Qi and meridians. Their conclusions were nearly identical: listen to your body, do not normalize suffering as just part of aging, seek support early, and accept there is no single template. In a healthcare culture that forces you to pick a side, that alignment was the morning's most useful insight.

Tools You Can Use Today

Dr. Zhang demonstrated three acupressure points anyone can use at home, no needles needed:

• LV3 / Taichong (太冲) Top of foot, between first and second metatarsal bones. The release valve for Liver Qi. Good for irritability, stress, premenstrual discomfort.
• SP6 / Sanyinjiao (三阴交) Four finger-widths above inner ankle bone, behind shin. The hormonal hub -- connects three yin meridians. Used for uterine health and cycle regulation. Avoid during pregnancy.
• HT7 / Shenmen (神门) "Spirit Gate" at the wrist crease, ulnar side of tendon. For racing thoughts and sleep that will not come.

Attendees also sampled Rose Beauty Tea (美容茶) -- rose petals, aged tangerine peel, hawthorn, and fig. Formulated to support Liver Qi flow, aid digestion, and nourish Blood. Tastes better than it has any right to.

The Short Version

Menopause is not a disease. It is a transition -- sometimes uncomfortable, but manageable. Whether your toolkit comes from a lab or an ancient text, the advice is the same: understand what is happening, ask questions, and stop treating your body like a problem to solve. It has carried you this far. It deserves better than silence -- and so do you.

-- Sabeen Irfan

To learn more about Shanghai United Family Hospital's Family Medicine services or make an appointment at 400 891 9191.