The Treatment of Menopausal Palpitations with Chinese Medicine
By Bob Flaws, LAc, FNAAOM (USA), FRCHM (UK)
Many women from the Baby Boomer generation are experiencing (or rapidly approaching) menopause, and are looking for alternatives to conventional Western medical care for this transition in life.
More women are turning to Chinese medicine for a holistic alternative and complement to standard Western medicine. Chinese medicine is the oldest secular, literate, professional, continually practiced medicine in the world today, and it is a holistic medicine par excellent. This is because professional practitioners of Chinese medicine don't just treat diseases; they treat the whole person.
The methodology of Chinese medicine is based on bringing the person back to a state of healthy, dynamic balance. Symptoms of disease are indications of imbalance. Over 2,500 years, professional practitioners of Chinese medicine have identified approximately 300 different patterns of imbalance humans may manifest. Since these patterns often combine to form even more complex patterns, the possible patterns of imbalance humans can manifest is almost unlimited. Therefore, in Chinese medicine, every patient receives his or her own individualized treatment. Because that treatment is meant to bring all elements of the patient's being back into balance, Chinese medicine heals without any intended or acceptable side-effects. Side-effects, whether short- or long-term, are like robbing Peter to pay Paul. You cannot achieve true health by throwing one part of the body out of balance while trying to heal another.
Menopausal complaints, such as hot flashes; heart palpitations; night swats; fatigue; depression; irritability; and irregular menstrual bleeding, are all symptoms that something is out of balance in a woman's body. Menopause itself is not a disease; in fact, many women go through menopause without any negative symptoms. When symptoms do accompany menopause, it is an indication that this change in life is not going as smoothly as it should: that the woman has gotten "hung up" in the process and has not come out on the other side.
According to Chinese medical theory, menopause (or the climacteric) is the body's very wise attempt to slow down the aging process. When Chinese doctors treat menopausal complaints, they must first determine how or where the woman has gotten stuck in this transition. Once they know this, they can then supply various natural therapies such as acupuncture, Chinese herbs and Chinese dietary therapy, to correct that imbalance and help the woman successfully complete her transition.
There is a large body of published research in Chinese medical journals on the Chinese medical treatment of menopausal complaints. Therefore, Western women do not simply have to try Chinese medicine "on a wing and a prayer." For instance, Ma Yue-hong published an article, "The Treatment of 40 Cases of Female Climacteric Heart Palpitations with Bu Xin Dan Jia Jian (Supplement of the Heart Elixir with Additions and Subtractions)" in the February 1998 issue of Beijing Chinese Medicine.
Of the 40 women in this study, the youngest was 46 years old; the oldest, 55. The shortest course of disease was four months; the longest course was three years. Menstruation had ceased in 33 cases and was chaotic in the other seven. Most of the women were professionals, such as teachers and cadres. Electrocardiograms were performed on all the women. There were five cases of slight degree ST-T segment change, and five cases of premature heartbeats. In addition, there were four cases of high blood pressure. All of the women were screened to rule out coronary artery and organic heart disease.
Clinically, the main symptoms were: heart palpitations and lack of calm; hot flashes; sweating; and scanty sleep. If severe, they included insomnia; dizziness; tinnitus; emotional lability; tension; agitation; easy anger; either chaotic menstruation or cessation of menstruation; possible heat in the hands, feet and heart; low back soreness and low back weakness; a red tongue or red tip with thin, yellow or scanty fur; and bowstring and fine, fine and rapid, fine and bound, or regularly irregular pulse.
Based on the author's belief that most menopausal palpitations involve a heart qi and yin vacuity, all of the women in the study received various modifications of the Chinese herbal formula known as Heavenly Emperor Supplement the Heart Elixir (tian wang bu xin dan). This basic formula consisted of uncooked radix rehmanniae (sheng di); radix angelicae sinensis (dang gui); tuber ophiopogonis japonici (mai dong); semen biotae orientalis (bai zi ren); semen zizyphi spinosae (suan zao ren); radix pseudostellariae (tai zi shen); radix scrophulariae ningpoensis (xuan shen); radix salviae miltiorrhizae (dan shen); sclerotium poriae cocos (fu ling); radix polygalae tenuifoliae (yuan zhi); fructus schisandrae chinensis (wu wei zi); bulbus lilii (bai he); and concha margaritiferae (zhen zhu mu).
This basic formula was then modified to fit each woman's particular pattern. If there was more serious qi vacuity, radix astragali membranacei (huang qi) was added. If there was concomitant qi stagnation and blood stasis, fructus citri aurantii (zhi ke) and radix ligustici wallichii (chuan xiong) were added. If night sweats were severe due to vacuity of heat, fructus levis tritici aestivi (fu xiao mai) and rhizoma anemarrhenae aspheloidis (zhi mu) were added. If there was high blood pressure due to hyperactivity of liver yang, semen cassiae torae (cao jue ming) and spica prunellae vulgaris (xia ku cao) were added. If heart vexation was severe and the pulse was rapid, racing or irregular due to heart fire, rhizoma coptidis chinensis (huang lian) and radix sophorae flavescentis (ku shen) were added. If there was low back soreness and lower leg weakness due to kidney vacuity, ramulus loranthi seu viscid (sang ji sheng) and radix dipsaci (chuan duan) were added. One packet of these herbs was administered per day as a tea, after being boiled in water.
In terms of treatment outcomes, cure was defined as the disappearance of palpitations or heart arrhythmia and return to a normal ECG. Improvement meant that the heart palpitations had decreased, or the duration between episodes had lengthened, and ECG findings had improved. No effect meant that there were no turns for the better in either palpations or ECG findings.
Based on the above criteria, 22 cases (55%) were judged to be cured; 17 cases (42.5%) were improved; and one case (2.5%) experienced no effect. Therefore, the total effectiveness rate was 97.5%. Of these, the fewest Chinese herb packets administered was 15; the greatest, 40. (Since one packet was given per day, this meant that cure was obtained in as little as 15 days!)
Representative Case History
The patient, a 50-year old woman, had had heart palpitations in 1992 for five months and had been hospitalized with more serious palpitations for two months. A half year previously, she had become forgetful, and her emotions were not good. She experienced vexation; agitation; easy anger; recurrent hot flashes; heart palpitations; restlessness; sweating; and insomnia. For the past two months, the heart palpitations and insomnia had been severe. She had chest oppression (a feeling of weight or oppression on the chest, making one want to sigh or breathe more deeply) and felt like her heart was going to jump out of her chest. When she could go to sleep at night, she had excessive dreams. There was heat in her hands, feet and heart; sometimes she was sad and desired to cry for no reason. Things got so bad that she was finally hospitalized. She was treated with tranquilizers and vitamins, but with no result. ECG showed 5-7 premature ventricular beats per minute. Her tongue was red with scant fur, and her pulse was fine and rapid.
The patient's Chinese medical pattern was categorized as kidney yin debility and vacuity, with vacuity heat harassing the heart. Therefore, she was given tian wang bu xin dan with individualized additions and subtractions. In addition, each evening she was given one tablet of a sedative. After administering two courses of treatment, her heart palpitations and heart vexation had decreased, and her sleep had improved. The sedatives were administered less often, and ECG showed her premature beats had lessened (sometimes they were there, sometimes not). Administration of the above formula was continued with additions and subtractions according to the symptoms for another 15 packets. By then, the patient's palpitations had basically disappeared; ECG showed the premature beats had disappeared; and the night-time sedatives were stopped after she was able to sleep five hours each night. The patient was judged to be cured, and was discharged from the hospital. However, she was told to continue taking tian wang bu xin dan to consolidate the treatment effect.
I believe the above research report is good evidence for the clinical effectiveness of Chinese medicine for menopausal heart palpitations. A total effectiveness rate of 97.5% is pretty good for any medicine, especially with no side-effects! I also think the accompanying case history gives a fairly clear picture of how real-life menopausal patients are diagnosed and treated by professional Chinese medicine.
Click here for previous articles by Bob Flaws, LAc, FNAAOM (USA), FRCHM (UK).