Embracing your ‘Second Spring’: How Chinese Medicine Can Support you Through Perimenopause by Christina Tolstrup

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Menopause is a natural transition in a woman’s life. Unfortunately, it often carries negative connotations in our modern society. Inversely, Chinese Medicine refers to it as a woman’s ‘second spring’, a potentially positive transition. Understanding this phase, its related changes, symptoms, health risks, and where to seek help is key to experiencing it more positively.


Hi, I’m Christina. An experienced Chinese Medicine practitioner, passionate about providing healthcare, information and support to women of all ages and stages. At 51, I’m navigating my perimenopausal phase. Using my experiences and expertise, I aim to provide insights into how acupuncture and Chinese Medicine can support you, or the women in your life, through this inevitable, often unsettling, and significant life transition.



Do you remember the transformative experience of puberty? A significant phase that every individual, regardless of sex or gender, undergoes. Now, imagine navigating a similar transition later in life. That’s the reality for 50% of the population i.e. all women, as they go through perimenopause, often referred to as women’s ‘second puberty’. Unfolding gradually over several years, and driven by hormonal changes, perimenopause shares many similarities with puberty. It’s a transformative yet profound shift involving substantial physiological changes and it can be an emotional, psychological, and social rollercoaster, impacting all aspects of life including relationships and sexuality. Each woman’s experience is unique.

Puberty marks the beginning of a woman’s menstrual cycle and her reproductive years, which continue through perimenopause until menopause.



Menopause meaning the ‘pause’ (cessation) of menstruation marks the end of a woman’s reproductive life phase. It is the result of her ovarian function naturally and gradually winding down to a halt. Natural menopause is diagnosed retrospectively when a woman has not had a menstrual period for minimum 12 consecutive months.*

Beyond that very last period, a woman is post-menopause for the remainder of her life. In Australia, where the average life expectancy for women is 83.2 year, and menopause typically occurs around age 45-55 (average is 51), women may spend over 30 years, roughly a third of their lives being postmenopausal.

Perimenopause is a crucial time to mitigate health risks associated with post-menopause and later life. Hence understanding perimenopause is incredibly important.

Perimenopause is the phase leading up to a woman’s menopause. This varies widely from woman to woman in onset, duration, symptoms, and severity. Changes and symptoms typically begin in a woman’s 40’s, sometimes as early as mid-to-late 30s, and span 2-10 years prior to menopause.



Hormones are complex, especially the changes that occur during perimenopause, which are still not fully understood. To understand why perimenopause can be so impactful, with a myriad of symptoms, it’s sufficient to recognise that estrogen and progesterone, two of the primary female sex hormones, naturally decline (not always in a smooth manner) as women age. Estrogen levels can wildly fluctuate, spiking or plummeting haphazardly, while progesterone, which counter-balances estrogen and promotes calm, gradually diminishes. Eventually both hormones stabilise at much lower levels.

The roles of estrogen and progesterone extend far beyond a woman’s menstrual cycle, fertility and reproduction. They play critical roles in various (most) female bodily organ, systems and functions, including the brain, cardiovascular, musculoskeletal, urogenital, metabolic and digestive systems. As these hormone levels diminish the female body goes through a serious transition to function in new ways.



The (chaotic) hormonal changes of perimenopause can manifest in a diverse range of symptoms. Recognising the signs and symptoms is essential for diagnosis and management, as there is no specific test for perimenopause. Diagnosis is basically based on a woman’s age, health situation, context and symptoms, as well as by ruling out of any other potential causes for the symptoms**


The most common perimenopause symptoms include:
⭕ Changes to menstrual cycle e.g. irregularities or lighter or heavier flow.
⬆️ Increased PMS (pre-menstrual symptoms)
👙 Breast tenderness
🤒 Hot flushes or night sweats
💤 Sleep disturbances
😳 Mood swings

😳 Increased anxiety or depression

😳 Less tolerance to stress
⚖ Bloating & weight gain
💅 Changes to hair and nails
🤕 Headaches & Migraines
💕 Heart palpitations
🤔 Forgetfulness
😱 Brain fog & difficulties with concentration
🚽 Urogenital changes e.g. Frequent urination, UTI’s (urinary tract infections), dry vagina
⏬ Low libido (sex drive)

-Body aches

New allergies



Menopause Hormone Therapy (MHT), aka Hormone Replacement Therapy (HRT), is the primary conventional treatment option for perimenopause. When suitably prescribed MHT/HRT can help alleviate symptoms and potentially offer long-term health benefits, particularly for bone and cardiovascular health.

However, MHT/HRT is not for everyone, and it’s not recommended as a stand-alone treatment. Integrating medication with nutrition and lifestyle changes is crucial for comprehensive and effective care.

Given the varied and systemic impacts of perimenopause including physical, mental, cognitive, emotional, social, and even spiritual, a holistic approach is not just beneficial; it’s essential. A holistic approach focuses on treating the individual, considering her unique health history, environment, relationships, and life circumstances.

Chinese Medicine exemplifies this holistic perspective. With an emphasis on treating the woman, not just her symptoms, with safe, gentle, natural and effective methods, Chinese Medicine offers an invaluable component of a well-rounded perimenopause ‘toolkit’ treatment and management plan for this complex stage of life.



Chinese Medicine (CM) is a comprehensive medical, health and wellness system that originated in ancient China, where it has developed and been used for more than 2000 years. CM can explain everything in nature including human’s health through the simple yet all-encompassing concepts of Qi (energy) and Yin – Yang (opposing forces). Symptoms, pain and illnesses are interpreted as energy blockages or imbalances, caused or influenced by factors like, diet, lifestyle, trauma, genetics, and emotions.


Key features of Chinese Medicine:

  • It’s Holistic
  • Diagnosis through observation, questioning, and examining the tongue and radial pulse
  • Treatment methods: Acupuncture, Herbal Medicine, Cupping, Massage (Tuina), Moxibustion, Food Therapy, Exercise & Lifestyle Advice, Tai Chi/Qi Gong (meditative movement).
  • In Australia, CM practitioners are highly qualified and regulated by AHPRA (Australian Health Practitioners Regulation Agency)


Chinese Medicine views hormonal changes through a different lens using different terminologies. Understanding the interconnectedness of bodily functions and the mind distinctively from conventional medicine offers a unique perspective and provides alternative and complimentary solutions to health issues.

Transitions like seasons, puberty, pregnancy, and perimenopause are periods of potential instability, where existing imbalances can worsen, or new imbalances emerge. However, these transitions also present opportunities for correcting imbalance to relieve symptoms and for long term health benefits.

In CM perimenopause symptoms are signs of underlying imbalances. Whereas conventional medicine might treat symptoms like hot flushes, anxiety, migraines, and frequent urination as separate issues, CM finds a common root cause in the interconnected organ systems. By addressing the core imbalance, CM aims to alleviate multiple symptoms simultaneously, and at the same time enhance overall health and well-being more long term.



Chinese Medicine uses various treatment medthods to correct imbalances and provide relief, including:

  • Acupuncture
  • Chinese Herbal Medicine
  • Nutrition & Diet Therapy
  • Lifestyle Advice



Acupuncture uses fine needles at specific body points to promote circulation, regulation, balancing, relief and recovery. Acupuncture influences the body’s natural functions and regulatory mechanisms through complex reactions within the nervous and hormonal systems, thereby helping to correct imbalances like those experienced during hormonal fluctuations and transitions.

Midlife can be a stressful time in a woman’s life, when she may be juggling children, teenagers, career, mortgage, changing relationships, ageing or sick parents etc. One of the benefits of acupuncture is its ability to induce relaxation, calm the nervous system, and reduce stress.



Trained herbalists use mainly plants and mineral products tailored to address the individual’s unique complaints and imbalances. At Mornington Chinese Medicine we prefer to prescribe tailored herbal powders that are mixed with water, and you drink like a tea. This personalised approach enhances treatment effectiveness.

More research is still needed, but evidence so far indicate acupuncture and Chinese herbal medicine can help reduce and manage many of the symptoms related to perimenopause such as hot flushes, night sweats, headaches, migraines, pain, anxiety, depression, and sleep disturbances.***



Choosing acupuncture and Chinese Medicine for perimenopause means receiving holistic care.

During your initial 60-minute consultation we’ll thoroughly review your health history and symptoms, including tongue and pulse examinations. Based on this we develop a personalised treatment and treatment plan which include supplement, nutrition, and lifestyle advice.

Acupuncture sessions typically involve lying down and relaxing for 20 minutes with needles in place. Where the acupuncture needles are inserted will depend on your diagnosis, the desired treatment outcome, and your practitioner’s style of acupuncture. The effectiveness of acupuncture is cumulative, often requiring several sessions. Initially, we recommend 6-10 weekly treatments, followed by less frequent sessions until symptoms are managed. The exact number of treatments varies based on the individual’s response, symptom severity, and other personal factors.

Follow up sessions are usually 40-45 minutes, with the treatment plan tailored to your evolving needs and response to therapy.



Come to know more about perimenopause and menopause, understanding hormonal intricacies, and exploring the holistic benefits and treatment methods of Chinese Medicine, I hope you’ve gained valuable insights and a brighter perspective on this pivotal life stage.

The changes and transitions of perimenopause are natural and inevitable. Your personal experience of it can be shaped with knowledge, good support and care. Menopause is in CM referred to as the ‘Second Spring’, because it symbolises a time of renewal and transformation, a time when a woman can blossom anew.

Give us a call if you’d like our support or would like to know more.



*Menopause can occur early due to premature ovarian insufficiency (POI), surgery or medical treatments such as cancer treatments. It’s beyond the scope of this blog to go into further detail. The symptoms and the Chinese medicine treatment principles are often the same regardless.


**It’s important to have regular health checks in general, but especially if you’re experiencing one or more of the above-mentioned symptoms.


***Lund KS, Siersma V, Brodersen J, Waldorff FB. Efficacy of a standardised acupuncture approach for women with bothersome menopausal symptoms: a pragmatic randomised study in primary care (the ACOM study). BMJ Open. 2019;9(1):e023637. Published 2019 Feb 19. doi:10.1136/bmjopen-2018-023637


Christina is available at Mornington Chinese Medicine Tuesday’s 9am-2pm.

138 Tanti Avenue, Mornington, VIC

03 5973 6886