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Breaking the Silence: An Integrative Approach to Genitourinary Symptoms in Menopause

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The silence around menopausal changes—especially the intimate, uncomfortable ones—has persisted for far too long. But with the newly updated 2025 guidelines from the American Urological Association (AUA), the tide is turning. We now have a comprehensive, patient-centered roadmap for addressing Genitourinary Syndrome of Menopause (GSM)—and the conversation finally includes the whole woman, not just her symptoms.

From the lens of Chinese medicine, menopause is not a disease to be managed but a sacred passage—a transformation in the flow of yin and yang, blood and qi. But when estrogen declines sharply, as it does in this transition, the delicate balance between the Kidney, Liver, and Spleen systems can falter, leading to symptoms such as vaginal dryness, urinary frequency or urgency, pain with intimacy, and recurrent infections. These are not just “local” issues—they ripple out into the psyche, emotions, and spirit. It’s time to care for them holistically.

A Modern Integrative Model: East Meets West

The AUA’s new guidelines offer something truly refreshing: a layered, individualized approach to GSM, including pelvic floor physical therapy (PFPT), localized hormones, and non-hormonal therapies. This is exactly the kind of integrative model that Chinese medicine complements beautifully.

🌿 Pelvic Floor Physical Therapy (PFPT): Strengthening Root & Gate

PFPT is now considered a first-line therapy for women experiencing pelvic floor dysfunction, incontinence, or painful sex. In Chinese medicine terms, the pelvic floor relates closely to the Gate of Life (Ming Men) and the Root of Qi. When these are weak, we see leakage, prolapse, and instability in the lower jiao.

Combining PFPT with acupuncture can further regulate qi and blood flow, tonify the Kidney and Spleen, and relieve pain and stagnation in the pelvic bowl. Studies show that PFPT improves muscle coordination and blood flow—principles long held sacred in Chinese medicine.

🌿 Vaginal Estrogen & DHEA: Supporting Essence Without Systemic Risk

The gold standard in Western care for GSM remains low-dose vaginal estrogen. From a Chinese medicine standpoint, estrogen nourishes the yin, and its loss can create dryness, atrophy, and what we call “empty heat.” When applied locally, estrogen or DHEA can restore this moisture without disturbing systemic balance.

For women with a history of breast cancer or those wary of hormone therapy, vaginal DHEA offers a gentler, non-estrogenic option that still nourishes yin and restores function. This mirrors our use of yin-tonifying herbs and therapies to regenerate essence (jing) without overstimulating yang.

🌿 Non-Hormonal Support: Moisture, Movement & Mindful Touch

The AUA highlights ospemifene, lidocaine, and high-quality moisturizers and lubricants for those who can’t or don’t want to use hormones. From a Chinese perspective, we would add:

  • Herbal formulas to tonify Kidney Yin and clear deficient heat

  • Acupuncture protocols to restore healthy tissue perfusion

  • Meditative bodywork or Gua Sha of the sacrum and lower abdomen to move stuck qi

Lifestyle factors matter, too: nourishing foods, gentle movement like qigong, and addressing emotional heat or grief stored in the pelvis can all help reclaim vitality and intimacy.

A Personal Invitation to Reclaim Your Power

No woman should have to suffer in silence—or choose between intimacy and comfort. Whether you’re newly menopausal or years past your last period, these symptoms are real, treatable, and nothing to be ashamed of.

If you’re experiencing vaginal dryness, discomfort with intimacy, urinary issues, or pelvic floor concerns, I invite you to schedule a free 15-minute telemedicine consultation with me. Together, we’ll explore a personalized path forward that integrates the best of East and West—rooted in science, guided by soul.

👉 [Click here to schedule your free consultation]

With warmth and respect for all you’ve carried,
Cally Huttar, PhD, LAc, FABORM
Depth Psychologist | Acupuncturist | Chinese Herbalist
Lotus Leaf Health & Wellness

Vaginal Health & Chinese Medicine: Honoring the Inner Waters

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Menopause and Libido: How Chinese Medicine Can Help You Reclaim Connection — Or Rest Easy Without It

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Acupuncture and Chinese Herbs for Menopause

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Women are pillars of strength

Treat Menopause Naturally with Acupuncture and Chinese Herbs

Chinese medicine views menopause as a natural process in life, a transitional period marking the cessation of menstruation in a woman’s body. Menopause occurs naturally between the ages of 45-55, beginning with a noticeable change in your menstrual cycle. This time of change may last a few months to several years, a stage called perimenopause, with symptoms varying from mild to severe.

Acupuncture and Chinese herbs have enjoyed a rich and extensive history treating a wide range of perimenopausal symptoms. This includes hot flashes and night sweats, in addition to insomnia, fatigue, weight gain, vaginal dryness, and irritability. Millions of women have successfully treated unwanted symptoms of menopause naturally with Chinese medicine through safe, noninvasive, and most of all, effective treatment for these often debilitating symptoms.

Menopause is a time where many women become Yin deficient, meaning that the cooling, moistening, and calming aspects of their physiology are weakening. You can read more about the various types of menopause on my website page here. The main treatment principles in Chinese medicine for menopausal women involves:

  • Nourishing Yin and/or Blood
  • Moving Stagnant Liver Qi
  • Clearing Heat
  • Calming the Spirit/Mind
  • Harmonizing the Yin and Yang

Stagnation that occurs over an extended time for weeks or months will generate heat which will burn Yin and lead to Yin deficiency. Yin deficiency and Qi stagnation can occur due to a number of reasons including:

  • Stress
  • Poor diet
  • Lack of exercise

While it is important to receive acupuncture, I cannot emphasize enough the importance of healthy food choices. This includes eliminating caffeine and sugar from your diet due to the inflammatory nature of these substances. This does not need to be forever, but at least until your symptoms are under control.

Acupuncture for Menopause

Acupuncture is a balancing therapy. The thin stainless steel needles used during treatment disperse Qi and Blood that is stagnant or nourish Qi and Blood that is deficient.

Many women report feeling better right after the needles are inserted, bringing them immediate relief and a sense of calm. The needles are actually opening certain areas that have become stagnant, which has created a build up of heat. Certain points are also used that have a direct effect on nourishing Yin, thereby rejuvenating the cooling and moistening aspects of one’s physiology.

Chinese Herbs for Menopause

Chinese herbs work together with acupuncture to create a state of continuity between treatments. I would highly recommend committing to this approach before using hormone therapy, as these natural options are free of side effects. Hormone therapy is quite controversial in terms of its long-term effects. While it has worked wonders for many women in the short-term, I have read references to increased incidence of ovarian cancer, fibrocystic breasts, and emotional fluctuations, therefore I cannot give it a raving endorsement.

Below is a list of several Chinese herbal formulas that I prescribe to treat hot flashes, night sweats, accompanied with various patterns of fatigue, irritability, vaginal dryness, anxiety, headaches, and digestive disturbances:

  • Zhi Bai Di Huang Wan:  This formula is a Kidney Yin tonic that clears Heat, which includes symptoms of low back pain, scanty dark urine, and low energy. It is safe, gentle, and can work well if it matches the patient’s constitution.
  • Jia Wei Xiao Yao Wan: This formula addresses hot flashes that are due to a Liver Depressive Heat pattern, which would include symptoms such as irritability, depression, high stress, red eyes, headaches, and indigestion.
  • Da Bu Yin Wan: This formula is for a pattern called ‘steaming bone syndrome’ in which the hot flashes feel as if they are penetrating into the depths of one’s bones. It is a Kidney Yin tonic that utilizes herbs that penetrate deep into the body to Clear Heat.
  • Tian Wan Bu Xin Dan: This formula is for a combination of Heart and Kidney Yin deficiency, which will manifest with symptoms such as insomnia, anxiety, irritability, thirst, and malar flush.
  • Er Xian Tang: This formula is for a combined pattern of Kidney Yin and Yang deficiency. Symptoms include a history of feeling cold with recent onset of hot flashes, low libido, fatigue, and low back pain.

It is important to keep in mind that herbs will only work if they address your specific constitutional pattern, rather than only your symptoms. It is important to have an evaluation and diagnosis from a licensed Chinese medicine practitioner before taking any Chinese herbal formulas.

Emotional Support

Most noteworthy, it is also natural to feel heightened emotions as you experience the sensations of heat, stagnation dryness, sleeplessness and fatigue. As a holistic and complete medical system Chinese medicine also addresses issues of depression and anxiety, as well as, anger, worry, and grief. Let your practitioner know about these underlying emotional concerns so that they can tend to your full body mind and spirit.

Research

Finally, the research showing the benefits of acupuncture for menopausal symptoms has been extensive. Hot flashes, night sweats, fatigue, and insomnia tend to respond very well to treatment with acupuncture and Chinese herbs. This is especially true when they are used together. These are a few important studies that show the benefits of using Chinese medicine for menopause:

  1. Cong HF, Gu XM & Wu WP. (2015). Clinical Observation of Acupuncture plus Medication for Perimenopausal Syndrome. Shanghai Journal of Acupuncture and Moxibustion. 34(4).
  2. Li Y & Huang KJ. (2014). TCM prescription in treating perimenopausal syndrome, 50 cases. Journal of Liaoning College of Traditional Chinese Medicine. 16(5): 203-205.​​
  3. Tan KP, Yao X, Li XW. Observation on clinical effect of acupuncture plus Zi Shen Tiao Gan Decoction for perimenopausal insomnia. Journal of Acupuncture and Tuina Science, 2015, 13 (1): 49-53. DOI: 10.1007/s11726-015-0822-1.
  4. Li, Rui-li, Jin-ying Fu, Ying-ying Deng, Wen-juan Shen, Hong-li Ma, Wei Li, and Xiao-ke Wu. “Review of acupuncture treatment for perimenopausal syndrome.” Journal of Acupuncture and Tuina Science 2, no. 13 (2015): 129-133.
  5. Shang YJ, Bhang Y, Kong LL, Wang YY, Wang DS, Li J. Clinical observation on combination of source point and Back-Shu point for treatment of perimenopausal syndrome. Zhongguo Zhen Jiu, 2009, 29(6): 444-448.
  6. Qin ZY, Ling H, Xia XH, Meng L, Wu ZJ. Effects of electroacupuncture of Sanyinjiao (SP 6) on genito- endocrine in patients with perimenopausal syndrome. Zhen Ci Yan Jiu, 2007, 32(4): 255-259.

In conclusion, I highly recommend seeking out the help of a licensed acupuncturist and Chinese herbalist to treat menopausal symptoms. I have worked for over twenty years in women’s healthcare, and particularly with women as they transition through menopause. Contact our clinic today if you are interested in scheduling an appointment. We would love to help you.

Yours in Health,

Cally Huttar, PhD, LAc