I'm often asked how you can best prepare for menopause. An honest answer, however, is more complex than an Instagram message allows. Chinese Medicine, or TCM, has a very nuanced view of menopause and the years leading up to it — not only of this phase of life itself, but of you as a whole person and of the cycles that shape a woman's life.
A Woman's Cycles in Chinese Medicine
Chinese Medicine describes a woman's life in cycles of seven years. This idea goes back to the Huangdi Neijing, one of its foundational classics. At around fourteen, Tian Gui arrives — literally “heavenly water,” a subtle substance nourished by the Kidneys that makes fertility possible. Menstruation begins. At 28, the body reaches its peak. From then on, it changes gradually, and around age 49, menstruation ends.
At first, this sounds like a decline. The classic itself says that Tian Gui is depleted at this point. But the Daoist tradition, from which Chinese Medicine grew, looks deeper. In this view, the transition to menopause is nothing negative. Quite the opposite: it is a time of clearing out. Tian Gui no longer flows outward into fertility and monthly bleeding. It turns inward. In ancient Daoist practices for women, this was a deliberate goal: to stop losing blood and instead transform it into essence and spirit. In menopause, this transformation happens on its own. The blood a woman has lost every month for decades now stays in the body — and Tian Gui becomes a woman's wisdom.
Menopause as the Transition from Earth to Metal
In Chinese Medicine, menopause can be understood as the transition from the Earth element to the Metal element. Earth stands for the center, for nourishment and care. For many women, this is the season of family life, when so much revolves around others. Then the children leave home, relationships change, and sometimes they end. This is often painful.
The Metal element stands for letting go, but also for going into the pain rather than around it — because there is treasure to be found there. Metal is the element of all that is precious. Just as gold is only found when we dig deep enough, what truly makes us who we are often reveals itself only when we turn toward the pain.
Menopause is like a backpack you've been carrying for years. Now is the time to open it up and sort through it: this comes with me, this stays behind. Much falls by the wayside — and that is exactly where the treasure lies. Traveling light is easier. What truly makes you who you are gets to stay. Society's roles and expectations can safely be thrown overboard.
The Wood Element in Menopause
One element that shouldn't be overlooked in this phase is Wood. It often plays a central role, especially if you've been holding a lot in for a long time. Wood stands for growth, vision, and boundaries. When it gets stuck, this shows up as stagnation: everything irritates you, you've had enough, and inside you're stamping your foot.
Often, it's a vision that has been suppressed for a long time and now demands its place. Or it's the boundaries you never set, now bursting out of you. This can feel intense, for you and for those around you. At the same time, these boundaries are exactly what we so urgently need. How strongly Wood shows up during this time depends on your constitution, though — for some women it's the defining theme, for others it's barely noticeable.
Menopause and TCM: What This Means in Practice
Here, Chinese Medicine works the way it always does: with what is there. We change throughout our lives, and perimenopause and menopause sometimes simply reveal what had been building for a while and was ignored for too long. So there's no one-size-fits-all answer to what you can do for yourself. It depends on where you are right now.
The Kidneys are often at the center of it all. They store your foundational substance, the essence that carries you through life. This essence is depleted whenever you give more than you have the energy for. You can ignore the bill for a while — but the interest adds up. How this shows up in menopause depends on whether it's mainly Kidney Yin or Kidney Yang that is weakened. Often, both are involved.
Kidney Yin: Hot Flashes, Dryness, and Restlessness
In TCM, menopausal symptoms are often attributed to Kidney Yin deficiency. Yin is the cooling, moistening, and nourishing aspect within us. When it runs low, the body loses its ability to cool itself: hot flashes, night sweats, dry mucous membranes, dry skin, inner restlessness, and light sleep can be the result.
Not sure which pattern is keeping you up at night? The free mini workbook What Keeps You Awake? walks you through all five organs and how each one can disturb your sleep.
Yin is nourished above all by rest. Getting enough sleep, ideally going to bed before midnight, is one of the most important things you can do. Your diet can lean toward cooling and moistening foods — black sesame, millet, tofu, and stewed pears are classic examples. It's worth going easy on hot spices, coffee, and alcohol, since they fan the flames.
Kidney Yang: Cold, Exhaustion, and the Fire of Life
But symptoms can just as well stem from Kidney Yang deficiency. Yang is the warming, driving fire within us. Chinese Medicine calls its origin Ming Men — the “Gate of Life,” a fire between the Kidneys that warms all the organs and keeps everything moving. When it fades, the body grows cold: cold feet and a cold lower back, exhaustion even first thing in the morning, low motivation, water retention, frequent urination, or a lower libido.
That's why it's so important to look closely. Weak Kidney Yang can also trigger hot flashes. When there's very little Yang left, the Kidneys can no longer anchor it — it rises and dissipates. The heat you feel then is not an excess of fire, but a sign that the fire is losing its root. Cooling alone will only weaken the fire further. Yang needs warmth: keeping your lower back and feet warm, eating warm, cooked meals, and cutting back on raw food and cold drinks. Walnuts, leeks, fennel, lamb, and a pinch of cinnamon are among the foods that support Kidney Yang. In clinical practice, moxibustion is often used as well — warmth applied directly to specific points.
Spleen, Heart, and Liver in Menopause
But the Kidneys aren't the only organs at play during this time. A Spleen that was already weak won't have an easier time during and after menopause — this can show up as fatigue, a feeling of heaviness, digestive issues, or sugar cravings. With Heart Qi deficiency, emotional challenges, restlessness, or heart palpitations may come to the forefront. And Liver Qi stagnation may show up as high blood pressure. Of course, these symptoms should also be checked by a doctor — Chinese Medicine can then help you understand the pattern behind them.
Your Body Speaks Louder During Menopause
Your body doesn't completely transform during menopause. Existing patterns become stronger and much louder. A system that is already out of balance now expresses itself more clearly. And that always holds an opportunity. It's not about getting through this time as quietly as possible. It's about working with what is there and listening to your body before it has to shout.
The Five Elements as Companions Through Menopause
Menopause touches all Five Elements. The Water element, with the Kidneys, holds your essence and your inner fire. The Wood element, with the Liver and Gallbladder, calls for the vision and boundaries that have waited so long. The Fire element, with the Heart, reflects the state of your joy and inner calm. The Earth element, with the Spleen and Stomach, reminds you that you need nourishing too — not just everyone else. And the Metal element, with the Lungs and Large Intestine, invites you to let go of what no longer belongs to you and to find the treasure underneath.
In Chinese Medicine, it's always the whole picture that counts. A hot flash, restless sleep, or high blood pressure are each just one piece of the puzzle — only together do they reveal the underlying pattern and what you really need. Which element is most present for you during this time is different for every woman.
If you'd like to go deeper, the DaoSense membership offers workbooks on each element and its organs — with background knowledge, recipes, acupressure points, Qi Gong, and practical ideas for everyday life. Step by step, you'll come to understand what your body is telling you right now and move through this time alongside the Five Elements. Membership is €12 a month or €120 a year. You'll find all the details here: DaoSense membership
What are you still carrying in your backpack that you don't really need anymore?
