The Silent Shift: Understanding Perimenopause Through TCM and Western Lenses
Perimenopause — the transitional years before menopause — often begins quietly in your late 30s to mid-40s, with more noticeable changes between 42–49. For some women, it can start even earlier, especially due to high stress, chronic illness, or surgical intervention.
As oestrogen and progesterone begin to fluctuate, this hormonal recalibration can bring on a range of symptoms — many of which are often misunderstood or dismissed.
Common Symptoms of Perimenopause
While hot flushes and irregular periods are well-known, many women experience lesser-known symptoms that can feel confusing or isolating:
Tendonitis or joint pain, particularly in shoulders, hips, or hands
Anxiety, often accompanied by a racing mind or heart palpitations
Insomnia, particularly waking between 2–4am
Mood swings, irritability, low motivation, or unexplained sadness
Shorter, heavier, or more erratic cycles
Gut issues such as bloating, sluggish digestion, or constipation
Increased inflammation, fatigue, and body tension
If you've been feeling "off" but can't quite name it — this may be why.
TCM View: What's Happening Energetically?
In Traditional Chinese Medicine, perimenopause is considered a natural decline in Kidney Jing (essence) — the vital force that governs reproductive vitality, brain function, bone health, and the ageing process.
This decline in essence can disrupt the balance of Yin and Yang, especially impacting the Liver, Heart, and Spleen systems. These energetic imbalances may show up as:
Liver Qi stagnation → mood swings, digestive tension, breast tenderness
Kidney Yin deficiency → insomnia, hot flushes, dryness
Heart Yin and Blood deficiency → anxiety, palpitations, poor sleep
Spleen Qi deficiency → bloating, fatigue, loose stools
Liver imbalance affecting the tendons → joint stiffness, tendonitis
Rather than seeing these as isolated symptoms, TCM views perimenopause as a call to nourish, rebalance, and support your body's natural transition.
There's a Lot You Can Do
Perimenopause is not just a hormonal phase — it's a whole-body shift. And there are many ways to support yourself naturally:
Nourish with intention
Prioritise protein, omega-3s, vitamin D, and magnesium to support hormone balance, mental clarity, muscle and joint repair, and reduce inflammation.
Support your gut
Gut health plays a key role in hormone detoxification, mood stability, and immune function. Consider adding fermented foods, fibre-rich vegetables, and reducing inflammatory triggers like alcohol or processed sugar.
Move mindfully
Reassess how you exercise and rest. Overtraining can deplete energy reserves during this time. Instead, combine strength training, walking, yoga or Pilates, and restorative practices that nourish your nervous system.
Protect your energy
Focus on nourishing routines, especially in the days leading up to your period. This includes sleep hygiene, stress reduction, and creating space for rest rather than pushing through.
Try acupuncture and TCM
Acupuncture and lifestyle-based Traditional Chinese Medicine approaches can help restore internal balance, calm the nervous system, improve sleep, and regulate cycles. At Nuha Collective, we tailor treatments to your unique constitution and symptoms.
Consider herbal support
Certain herbs can offer targeted relief when prescribed appropriately:
Dang Gui (Angelica sinensis) is often used in TCM to nourish blood, support circulation, and relieve period-related discomfort.
Gui Pi Tang, a classical TCM formula, may be recommended to address fatigue, poor sleep, anxiety, and gut-related symptoms tied to Spleen Qi and Heart Blood deficiency.
Chaste Tree (Vitex agnus-castus) is a Western herbal ally that may help regulate erratic cycles and support progesterone balance, especially in the earlier stages of perimenopause.
It's important to consult a qualified herbalist, naturopath, or TCM practitioner to find the right formula for your unique needs.
Don't Wait to Seek Support
Perimenopause isn't something you need to "push through." It's a biological recalibration — and one that's easier to navigate with the right guidance and care.
If you're feeling off — emotionally, physically, or hormonally — don't wait. Reach out to a Chinese medicine practitioner, GP, naturopath, or women's health specialist. Getting the right support now can make all the difference in how you feel for years to come.
At Nuha Collective, we understand this transition intimately. Our acupuncture and TCM treatments are designed to meet you exactly where you are — supporting your body's natural wisdom while easing the discomfort of change.
You deserve to feel strong, grounded, and understood — even during transition.
Ready to explore how TCM can support your perimenopause journey?
Book an acupuncture consultation at Nuha Collective, Byron Bay.
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