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Published in: Archives of Gynecology and Obstetrics 1/2016

01-07-2016 | Gynecologic Endocrinology and Reproductive Medicine

Traditional Chinese medicine valuably augments therapeutic options in the treatment of climacteric syndrome

Authors: Sarah Eisenhardt, Johannes Fleckenstein

Published in: Archives of Gynecology and Obstetrics | Issue 1/2016

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Abstract

Climacteric syndrome refers to recurring symptoms such as hot flashes, chills, headache, irritability and depression. This is usually experienced by menopausal women and can be related to a hormonal reorganization in the hypothalamic–pituitary–gonadal axis. In Traditional Chinese Medicine, originating 1000s of years ago, above-mentioned symptoms can be interpreted on the basis of the philosophic diagnostic concepts, such as the imbalance of Yin and Yang, the Zang-Fu and Basic substances (e.g. Qi, Blood and Essence). These concepts postulate balance and harmonization as the principle aim of a treatment. In this context, it is not astounding that one of the most prominent ancient textbooks dating back to 500–200 BC, Huang di Neijing: The Yellow Emperor’s Classic of Internal Medicine gives already first instructions for diagnosis and therapy of climacteric symptoms. For therapy, traditional Chinese medicine comprises five treatment principles: Chinese herbal medicine, TuiNa (a Chinese form of manual therapy), nutrition, activity (e.g. QiGong) and acupuncture (being the most widespread form of treatment used in Europe). This review provides an easy access to the concepts of traditional Chinese medicine particularly regarding to climacteric syndrome and also focuses on current scientific evidence.
Literature
1.
go back to reference Unschuld PU (2013) Antike Klassiker der Chinesischen Medizin. Cygnus Verlag, Berlin Unschuld PU (2013) Antike Klassiker der Chinesischen Medizin. Cygnus Verlag, Berlin
2.
go back to reference Fleckenstein J, Trinczek K (eds) (2011) QuickStart Akupunktur, vol 1, 2nd edn. McGraw-Hill Education Fleckenstein J, Trinczek K (eds) (2011) QuickStart Akupunktur, vol 1, 2nd edn. McGraw-Hill Education
3.
go back to reference Kaptchuk T (2000) Chinese medicine: the web that has no weaver, vol 2. New York Kaptchuk T (2000) Chinese medicine: the web that has no weaver, vol 2. New York
4.
go back to reference Ni M (2011) Der Gelbe Kaiser (trans: Fischer-Schreiber I). Knaur Taschenbuch, MensSana Verlag, 1 edn. Maoshing Ni Ni M (2011) Der Gelbe Kaiser (trans: Fischer-Schreiber I). Knaur Taschenbuch, MensSana Verlag, 1 edn. Maoshing Ni
5.
go back to reference Maciocia G (2010) Diagnose in der Chinesischen Medizin. Verlag Systemische Medizin, Bad Kötzting Maciocia G (2010) Diagnose in der Chinesischen Medizin. Verlag Systemische Medizin, Bad Kötzting
8.
go back to reference Peets JM, Pomeranz B (1978) CXBK mice deficient in opiate receptors show poor electroacupuncture analgesia. Nature 273(5664):675–676CrossRefPubMed Peets JM, Pomeranz B (1978) CXBK mice deficient in opiate receptors show poor electroacupuncture analgesia. Nature 273(5664):675–676CrossRefPubMed
9.
go back to reference Pomeranz B, Chiu D (1976) Naloxone blockade of acupuncture analgesia: endorphin implicated. Life Sci 19(11):1757–1762CrossRefPubMed Pomeranz B, Chiu D (1976) Naloxone blockade of acupuncture analgesia: endorphin implicated. Life Sci 19(11):1757–1762CrossRefPubMed
11.
go back to reference Zhang Y, Zhang RX, Zhang M, Shen XY, Li A, Xin J, Ren K, Berman BM, Tan M, Lao L (2012) Electroacupuncture inhibition of hyperalgesia in an inflammatory pain rat model: involvement of distinct spinal serotonin and norepinephrine receptor subtypes. Br J Anaesth 109(2):245–252. doi:10.1093/bja/aes136 CrossRefPubMedPubMedCentral Zhang Y, Zhang RX, Zhang M, Shen XY, Li A, Xin J, Ren K, Berman BM, Tan M, Lao L (2012) Electroacupuncture inhibition of hyperalgesia in an inflammatory pain rat model: involvement of distinct spinal serotonin and norepinephrine receptor subtypes. Br J Anaesth 109(2):245–252. doi:10.​1093/​bja/​aes136 CrossRefPubMedPubMedCentral
12.
go back to reference Goldman N, Chen M, Fujita T, Xu Q, Peng W, Liu W, Jensen TK, Pei Y, Wang F, Han X, Chen JF, Schnermann J, Takano T, Bekar L, Tieu K, Nedergaard M (2010) Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture. Nat Neurosci 13(7):883–888. doi:10.1038/nn.2562 CrossRefPubMedPubMedCentral Goldman N, Chen M, Fujita T, Xu Q, Peng W, Liu W, Jensen TK, Pei Y, Wang F, Han X, Chen JF, Schnermann J, Takano T, Bekar L, Tieu K, Nedergaard M (2010) Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture. Nat Neurosci 13(7):883–888. doi:10.​1038/​nn.​2562 CrossRefPubMedPubMedCentral
13.
go back to reference Irnich D, Beyer A (2002) [Neurobiologische Grundlagen der Akupunkturanalgesie] Neurobiological mechanisms of acupuncture analgesia. Schmerz 16(2):93–102CrossRefPubMed Irnich D, Beyer A (2002) [Neurobiologische Grundlagen der Akupunkturanalgesie] Neurobiological mechanisms of acupuncture analgesia. Schmerz 16(2):93–102CrossRefPubMed
14.
go back to reference Langevin HM, Bouffard NA, Badger GJ, Churchill DL, Howe AK (2006) Subcutaneous tissue fibroblast cytoskeletal remodeling induced by acupuncture: evidence for a mechanotransduction-based mechanism. J Cell Physiol 207(3):767–774CrossRefPubMed Langevin HM, Bouffard NA, Badger GJ, Churchill DL, Howe AK (2006) Subcutaneous tissue fibroblast cytoskeletal remodeling induced by acupuncture: evidence for a mechanotransduction-based mechanism. J Cell Physiol 207(3):767–774CrossRefPubMed
15.
go back to reference Dorsher PT, Fleckenstein J (2008) Trigger points and classical acupuncture points Part 1: qualitative and quantitative anatomic correspondences. Dt Ztschr f Akup 51(3):15–24CrossRef Dorsher PT, Fleckenstein J (2008) Trigger points and classical acupuncture points Part 1: qualitative and quantitative anatomic correspondences. Dt Ztschr f Akup 51(3):15–24CrossRef
17.
go back to reference Lin JG, Chen WL (2008) Acupuncture analgesia: a review of its mechanisms of actions. Am J Chin Med 36(4):635–645 S0192415X08006107 [pii] CrossRefPubMed Lin JG, Chen WL (2008) Acupuncture analgesia: a review of its mechanisms of actions. Am J Chin Med 36(4):635–645 S0192415X08006107 [pii] CrossRefPubMed
19.
go back to reference Ciechanowska M, Lapot M, Mateusiak K, Przekop F (2010) Neuroendocrine regulation of GnRH release and expression of GnRH and GnRH receptor genes in the hypothalamus–pituitary unit in different physiological states. Reprod Biol 10(2):85–124CrossRefPubMed Ciechanowska M, Lapot M, Mateusiak K, Przekop F (2010) Neuroendocrine regulation of GnRH release and expression of GnRH and GnRH receptor genes in the hypothalamus–pituitary unit in different physiological states. Reprod Biol 10(2):85–124CrossRefPubMed
20.
go back to reference Wyon Y, Wijma K, Nedstrand E, Hammar M (2004) A comparison of acupuncture and oral estradiol treatment of vasomotor symptoms in postmenopausal women. Climact J Int Menopause Soc 7(2):153–164CrossRef Wyon Y, Wijma K, Nedstrand E, Hammar M (2004) A comparison of acupuncture and oral estradiol treatment of vasomotor symptoms in postmenopausal women. Climact J Int Menopause Soc 7(2):153–164CrossRef
21.
go back to reference Johansson J, Stener-Victorin E (2013) Polycystic ovary syndrome: effect and mechanisms of acupuncture for ovulation induction. Evid Based Complement Altern Med eCAM 2013:762615. doi:10.1155/2013/762615 CrossRef Johansson J, Stener-Victorin E (2013) Polycystic ovary syndrome: effect and mechanisms of acupuncture for ovulation induction. Evid Based Complement Altern Med eCAM 2013:762615. doi:10.​1155/​2013/​762615 CrossRef
23.
go back to reference Stener-Victorin E, Waldenstrom U, Andersson SA, Wikland M (1996) Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture. Human Reprod (Oxford, England) 11(6):1314–1317CrossRef Stener-Victorin E, Waldenstrom U, Andersson SA, Wikland M (1996) Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture. Human Reprod (Oxford, England) 11(6):1314–1317CrossRef
24.
go back to reference Stener-Victorin E, Lundeberg T, Cajander S, Aloe L, Manni L, Waldenstrom U, Janson PO (2003) Steroid-induced polycystic ovaries in rats: effect of electro-acupuncture on concentrations of endothelin-1 and nerve growth factor (NGF), and expression of NGF mRNA in the ovaries, the adrenal glands, and the central nervous system. Reprod Biol Endocrinol 1:33CrossRefPubMedPubMedCentral Stener-Victorin E, Lundeberg T, Cajander S, Aloe L, Manni L, Waldenstrom U, Janson PO (2003) Steroid-induced polycystic ovaries in rats: effect of electro-acupuncture on concentrations of endothelin-1 and nerve growth factor (NGF), and expression of NGF mRNA in the ovaries, the adrenal glands, and the central nervous system. Reprod Biol Endocrinol 1:33CrossRefPubMedPubMedCentral
26.
go back to reference Cvoro A, Paruthiyil S, Jones JO, Tzagarakis-Foster C, Clegg NJ, Tatomer D, Medina RT, Tagliaferri M, Schaufele F, Scanlan TS, Diamond MI, Cohen I, Leitman DC (2007) Selective activation of estrogen receptor-beta transcriptional pathways by an herbal extract. Endocrinology 148(2):538–547. doi:10.1210/en.2006-0803 CrossRefPubMed Cvoro A, Paruthiyil S, Jones JO, Tzagarakis-Foster C, Clegg NJ, Tatomer D, Medina RT, Tagliaferri M, Schaufele F, Scanlan TS, Diamond MI, Cohen I, Leitman DC (2007) Selective activation of estrogen receptor-beta transcriptional pathways by an herbal extract. Endocrinology 148(2):538–547. doi:10.​1210/​en.​2006-0803 CrossRefPubMed
27.
go back to reference Grady D, Sawaya GF, Johnson KC, Koltun W, Hess R, Vittinghoff E, Kristof M, Tagliaferri M, Cohen I, Ensrud KE (2009) MF101, a selective estrogen receptor beta modulator for the treatment of menopausal hot flushes: a phase II clinical trial. Menopause 16(3):458–465. doi:10.1097/gme.0b013e31818e64dd CrossRefPubMed Grady D, Sawaya GF, Johnson KC, Koltun W, Hess R, Vittinghoff E, Kristof M, Tagliaferri M, Cohen I, Ensrud KE (2009) MF101, a selective estrogen receptor beta modulator for the treatment of menopausal hot flushes: a phase II clinical trial. Menopause 16(3):458–465. doi:10.​1097/​gme.​0b013e31818e64dd​ CrossRefPubMed
28.
go back to reference Dincer F, Linde K (2003) Sham interventions in randomized clinical trials of acupuncture—a review. Complement Therapies Med 11(4):235–242CrossRef Dincer F, Linde K (2003) Sham interventions in randomized clinical trials of acupuncture—a review. Complement Therapies Med 11(4):235–242CrossRef
29.
go back to reference MacPherson H, Vertosick E, Lewith G, Linde K, Sherman KJ, Witt CM, Vickers AJ, Acupuncture Trialists C (2014) Influence of control group on effect size in trials of acupuncture for chronic pain: a secondary analysis of an individual patient data meta-analysis. PLoS One 9(4):e93739. doi:10.1371/journal.pone.0093739 CrossRefPubMedPubMedCentral MacPherson H, Vertosick E, Lewith G, Linde K, Sherman KJ, Witt CM, Vickers AJ, Acupuncture Trialists C (2014) Influence of control group on effect size in trials of acupuncture for chronic pain: a secondary analysis of an individual patient data meta-analysis. PLoS One 9(4):e93739. doi:10.​1371/​journal.​pone.​0093739 CrossRefPubMedPubMedCentral
30.
35.
go back to reference Witt CM, Pach D, Brinkhaus B, Wruck K, Tag B, Mank S, Willich SN (2009) Safety of acupuncture: results of a prospective observational study with 229,230 patients and introduction of a medical information and consent form. Forsch Komplementmed 16(2):91–97. doi:10.1159/000209315 CrossRefPubMed Witt CM, Pach D, Brinkhaus B, Wruck K, Tag B, Mank S, Willich SN (2009) Safety of acupuncture: results of a prospective observational study with 229,230 patients and introduction of a medical information and consent form. Forsch Komplementmed 16(2):91–97. doi:10.​1159/​000209315 CrossRefPubMed
36.
go back to reference White A (2004) A cumulative review of the range and incidence of significant adverse events associated with acupuncture. Acupunct Med J British Med Acupunct Soc 22(3):122–133CrossRef White A (2004) A cumulative review of the range and incidence of significant adverse events associated with acupuncture. Acupunct Med J British Med Acupunct Soc 22(3):122–133CrossRef
38.
go back to reference Kim KH, Kang KW, Kim DI, Kim HJ, Yoon HM, Lee JM, Jeong JC, Lee MS, Jung HJ, Choi SM (2010) Effects of acupuncture on hot flashes in perimenopausal and postmenopausal women—a multicenter randomized clinical trial. Menopause 17(2):269–280. doi:10.1097/gme.0b013e3181bfac3b CrossRefPubMed Kim KH, Kang KW, Kim DI, Kim HJ, Yoon HM, Lee JM, Jeong JC, Lee MS, Jung HJ, Choi SM (2010) Effects of acupuncture on hot flashes in perimenopausal and postmenopausal women—a multicenter randomized clinical trial. Menopause 17(2):269–280. doi:10.​1097/​gme.​0b013e3181bfac3b​ CrossRefPubMed
39.
go back to reference Azizi H, Feng Liu Y, Du L, Hua Wang C, Bahrami-Taghanaki H, Ollah Esmaily H, Azizi H, Ou Xue X (2011) Menopause-related symptoms: traditional Chinese medicine vs hormone therapy. Altern Ther Health Med 17(4):48–53PubMed Azizi H, Feng Liu Y, Du L, Hua Wang C, Bahrami-Taghanaki H, Ollah Esmaily H, Azizi H, Ou Xue X (2011) Menopause-related symptoms: traditional Chinese medicine vs hormone therapy. Altern Ther Health Med 17(4):48–53PubMed
40.
go back to reference Nedeljkovic M, Tian L, Ji P, Deglon-Fischer A, Stute P, Ocon E, Birkhauser M, Ausfeld-Hafter B (2014) Effects of acupuncture and Chinese herbal medicine (Zhi Mu 14) on hot flushes and quality of life in postmenopausal women: results of a four-arm randomized controlled pilot trial. Menopause 21(1):15–24. doi:10.1097/GME.0b013e31829374e8 CrossRefPubMed Nedeljkovic M, Tian L, Ji P, Deglon-Fischer A, Stute P, Ocon E, Birkhauser M, Ausfeld-Hafter B (2014) Effects of acupuncture and Chinese herbal medicine (Zhi Mu 14) on hot flushes and quality of life in postmenopausal women: results of a four-arm randomized controlled pilot trial. Menopause 21(1):15–24. doi:10.​1097/​GME.​0b013e31829374e8​ CrossRefPubMed
41.
go back to reference Chiu HY, Shyu YK, Chang PC, Tsai PS (2015) Effects of acupuncture on menopause-related symptoms in breast cancer survivors: a meta-analysis of randomized controlled trials. Cancer Nurs. doi:10.1097/ncc.0000000000000278 Chiu HY, Shyu YK, Chang PC, Tsai PS (2015) Effects of acupuncture on menopause-related symptoms in breast cancer survivors: a meta-analysis of randomized controlled trials. Cancer Nurs. doi:10.​1097/​ncc.​0000000000000278​
42.
48.
go back to reference Walker EM, Rodriguez AI, Kohn B, Ball RM, Pegg J, Pocock JR, Nunez R, Peterson E, Jakary S, Levine RA (2010) Acupuncture versus venlafaxine for the management of vasomotor symptoms in patients with hormone receptor-positive breast cancer: a randomized controlled trial. J Clin Oncol Off J Am Soc Clin Oncol 28(4):634–640. doi:10.1200/JCO.2009.23.5150 CrossRef Walker EM, Rodriguez AI, Kohn B, Ball RM, Pegg J, Pocock JR, Nunez R, Peterson E, Jakary S, Levine RA (2010) Acupuncture versus venlafaxine for the management of vasomotor symptoms in patients with hormone receptor-positive breast cancer: a randomized controlled trial. J Clin Oncol Off J Am Soc Clin Oncol 28(4):634–640. doi:10.​1200/​JCO.​2009.​23.​5150 CrossRef
51.
go back to reference Cahill K (2012) The treatment of postmenopausal atrophic vaginitis and dyspareunia with acupuncture and Chinese herbs: a case study. J Chin Med 99:31–34 Cahill K (2012) The treatment of postmenopausal atrophic vaginitis and dyspareunia with acupuncture and Chinese herbs: a case study. J Chin Med 99:31–34
52.
go back to reference Jia M, Kluwe L, Liu HC, Tang QJ, Liu L, Wang ZZ, Tian LX, Zhao L, Chen YC, Friedrich RE, Sun ZJ, Xu LW (2015) Efficacy and side-effects of a semi-individualized Chinese herb mixture “Tiao Geng Tang” for menopausal syndrome in China. Vivo (Athens, Greece) 2(1):109–115 Jia M, Kluwe L, Liu HC, Tang QJ, Liu L, Wang ZZ, Tian LX, Zhao L, Chen YC, Friedrich RE, Sun ZJ, Xu LW (2015) Efficacy and side-effects of a semi-individualized Chinese herb mixture “Tiao Geng Tang” for menopausal syndrome in China. Vivo (Athens, Greece) 2(1):109–115
53.
go back to reference Fu SF, Zhao YQ, Ren M, Zhang JH, Wang YF, Han LF, Chang YX, Fan GW, Wang H, Huang YH, Zhai JB, Dong JY, Li X, Ai JQ, Zhang H, Zhu Y, Zhang BL, Sun LK, Fan X, Gao XM (2015) A randomized, double-blind, placebo-controlled trial of Chinese herbal medicine granules for the treatment of menopausal symptoms by stages. Menopause. doi:10.1097/gme.0000000000000534 Fu SF, Zhao YQ, Ren M, Zhang JH, Wang YF, Han LF, Chang YX, Fan GW, Wang H, Huang YH, Zhai JB, Dong JY, Li X, Ai JQ, Zhang H, Zhu Y, Zhang BL, Sun LK, Fan X, Gao XM (2015) A randomized, double-blind, placebo-controlled trial of Chinese herbal medicine granules for the treatment of menopausal symptoms by stages. Menopause. doi:10.​1097/​gme.​0000000000000534​
54.
go back to reference Rao YQ, Li J, Wang WJ (2015) Effects of Gengnianchun on learning and memory ability, neurotransmitter, cytokines, and leptin in ovariectomized rats. Int J Clin Exp Med 8(6):8648–8660PubMedPubMedCentral Rao YQ, Li J, Wang WJ (2015) Effects of Gengnianchun on learning and memory ability, neurotransmitter, cytokines, and leptin in ovariectomized rats. Int J Clin Exp Med 8(6):8648–8660PubMedPubMedCentral
56.
go back to reference Taylor-Swanson L, Thomas A, Ismail R, Schnall JG, Cray L, Mitchell ES, Woods NF (2015) Effects of traditional Chinese medicine on symptom clusters during the menopausal transition. Climact J Int Menopause Soc 18(2):142–156. doi:10.3109/13697137.2014.937687 CrossRef Taylor-Swanson L, Thomas A, Ismail R, Schnall JG, Cray L, Mitchell ES, Woods NF (2015) Effects of traditional Chinese medicine on symptom clusters during the menopausal transition. Climact J Int Menopause Soc 18(2):142–156. doi:10.​3109/​13697137.​2014.​937687 CrossRef
57.
go back to reference Li CC, Wang JJ, Chen C, Li YF, Zheng QS, Yang J, Liu HX (2013) Treating menopause syndrome by kuntal capsule and hormone replacement therapy: a meta-analysis of efficacy and safety comparison. Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine/Zhongguo Zhong xi yi jie he xue hui, Zhongguo Zhong yi yan jiu yuan zhu ban 33(9):1183–1190 Li CC, Wang JJ, Chen C, Li YF, Zheng QS, Yang J, Liu HX (2013) Treating menopause syndrome by kuntal capsule and hormone replacement therapy: a meta-analysis of efficacy and safety comparison. Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine/Zhongguo Zhong xi yi jie he xue hui, Zhongguo Zhong yi yan jiu yuan zhu ban 33(9):1183–1190
58.
go back to reference Hachul H, Garcia TK, Maciel AL, Yagihara F, Tufik S, Bittencourt L (2013) Acupuncture improves sleep in postmenopause in a randomized, double-blind, placebo-controlled study. Climact J Int Menopause Soc 16(1):36–40. doi:10.3109/13697137.2012.698432 CrossRef Hachul H, Garcia TK, Maciel AL, Yagihara F, Tufik S, Bittencourt L (2013) Acupuncture improves sleep in postmenopause in a randomized, double-blind, placebo-controlled study. Climact J Int Menopause Soc 16(1):36–40. doi:10.​3109/​13697137.​2012.​698432 CrossRef
Metadata
Title
Traditional Chinese medicine valuably augments therapeutic options in the treatment of climacteric syndrome
Authors
Sarah Eisenhardt
Johannes Fleckenstein
Publication date
01-07-2016
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 1/2016
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-016-4078-x

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