Yin Yang Balance for Menopause

Setting Sail

The Basics of Menopause and Sasang Medicine

Why do some women serenely sail through menopause while others seem to suffer through every symptom? Why does Brook, who is in great physical shape, suffer from hot flashes and insomnia, while Cindy, who does not exercise and eats everything in sight, makes menopause look easy? Shouldn’t optimum physical and emotional health guarantee a smooth transition? For many women, menopausal symptoms are unpredictable, often catching them off guard. While the female body has been transitioning through menopause since the beginning of humankind, the menopausal experience varies according to the individual.

MENOPAUSE AND YOUR BODY TYPE

Because innate emotional and physical strengths and weaknesses influence how a woman reacts to menopause, every woman responds to the menopause transition in her own unique way. Discovering your body type can help you identify your strengths and weaknesses, and making modifications according to your type can help you adapt to hormonal changes within your body and within your environment.

Even though some women are born healthier or take better care of themselves than others, health alone does not account for the differences described above. I’ve seen numerous patients who are otherwise in great physical and emotional shape experience intense hot flashes, fatigue, insomnia, and/or depression. These individuals often explain how, out of the blue, emotions start to spiral out of control, or sweat pours from their skin for no apparent reason. Trying our best to stay healthy can make any change in life relatively easier, but sometimes this just isn’t enough to ensure a smooth transition.

There is no “secret” to optimizing your menopausal health and ensuring that you’ll be symptom-free, but there are effective ways to help you navigate your way through the choppy waters. You are about to embark on a journey of self-discovery in which a deeper understanding of your emotional and physical strengths and weaknesses unfolds. Through this discovery comes the ability to control how your mind and body feel at any given moment.

Yin Yang Balance for Menopause emphasizes the ability to address menopausal issues naturally, by balancing your mind and body. It does not offer ways to increase your estrogen or progesterone or ensure a symptom-free menopause; rather, it guides you through the process of balancing the hormones already within you and provides the tools necessary to recognize and address changes along the way. This book isn’t designed as an alternative to hormone treatment or as a companion to it. Instead, it focuses on optimizing emotional and physical health, whether you are receiving hormone treatment or not.

With the introduction of a four-body-type system, the Sasang medical approach offers insight into why and how your menopausal journey is the way it is. It explains why hot flashes occur when they do, why insomnia is suddenly an issue, or why depression has taken over. As the upcoming pages unfold, you’ll discover the different psychological and physiological aspects of each body type and how they affect the menopausal transition and learn about body-type-specific foods, herbs, and exercises.

WHAT EXACTLY IS MENOPAUSE?

The quick answer to the above question is in the name: meno is Latin for “menses” and pause refers to a cessation. Yet there is nothing “quick” about menopause, since it is a process that takes up to seven years as the body’s yin energy, in the form of estrogen, starts to decline, potentially causing physiological and psychological changes along the way. Officially, however, it occurs after a woman’s monthly cycle has been absent for twelve months, and it cannot be explained by other health issues.

In Sasang medicine, health is dependent on the ability to adapt to our surroundings by harmonizing our inner environment, which is influenced by the relative strength of our organ energies. During the menopausal transition, our stronger and weaker organs have to reassess their relationship, just as marriage asks us to do every now and then to keep love alive. This relationship is tested every seven years for women and every eight years for men during a time when the body’s circadian clock resets its rhythm. Menopause is considered the seventh of seven (7 x 7) phases, and at age forty-nine, a female undergoes the most significant change in her lifetime—the closing of one door and opening of another.

In the East, this is viewed as a “year of renewal,” which is in stark contrast to the predominant Western idea that menopause is simply another step closer to death as the body loses its precious hormones and their ability to support our biological functions. In the East, life is not interpreted as a linear process from birth to death but rather as a continuous cycle in which the death of one phase brings life to a new one. The Sasang approach is not based on artificially reversing the aging process but on balancing and adapting harmoniously to each of life’s phases.

Accordingly, menopause is an opportunity to reignite one’s passion for life, as the time and energy devoted to producing and then raising a newborn is transferred into energy to be reborn and discover oneself anew. As with most cultures, seven signifies rest and rejuvenation. In Chinese culture, it signifies the end of one cycle and the beginning of another. The seventh day of the week, for example, is an opportunity to recharge and gear oneself up for the following week. Hence seven multiplied by seven is a significant time in a woman’s life when she can take a step back and reevaluate, rediscover what is precious, and shed unnecessary fears and unhealthy thoughts. It is an opportunity to reflect on and distinguish between what is precious and what is expendable.

Menopause is often blamed for the anguish women may feel during an intense time in life when their nest is emptied, their parents are getting older or have passed away, they no longer have a day job, and/ or they are left to grope their way through all of this without anyone to guide them. But keep in mind that, as I just mentioned, it is all about adjusting, and the guide you need in such times is nowhere else but within you. Yet simply telling yourself that everything is going to be all right usually doesn’t cut it when you are in the midst of a hot flash or experiencing emotional ups and downs. Adjustment requires deep insight into your situation and the ability to detect why you react the way you do. The Sasang approach goes beyond the image of menopause as a roller coaster of fluctuating hormones and delineates how women react and adjust in different ways depending on their innate strengths and weaknesses.

WHAT IS SASANG MEDICINE?

The Korean word sasang means “four types” in English and signifies the classification of all people into four major body types. This medical system was first established by a Korean doctor named Lee Je-ma (1837–1900), who was well versed in the Eastern medical tradition, which is a system that focuses on the balance of yin and yang energy to treat emotional and/or physical illness. He was distraught from seeing that certain patients suffering from the same symptoms improved quickly, while others suffered longer despite adequate treatment. Sasang medicine was born from his ability to cater to these differences while emphasizing the unique constitutional requirements of each patient.

As previously mentioned, the Sasang medical system is based on the idea that each individual is born with varying emotional and physical strengths and weaknesses depending on his/her body type. These tendencies have a direct influence on how we react to the external world and our body’s internal environment. It holds that the hormonal changes and fluctuating energies that a woman experiences during menopause aren’t what make her feel this way or that; rather, it is a woman’s response to these changes that dictates how she feels. For instance, it is easy to claim that depression is caused by a drop in estrogen and relative excess of progesterone. Actually, depression is an inability to adapt to these changes. How do we know this? Because, to put it simply, not everyone who experiences these changes in hormone levels is depressed!

According to Sasang medicine, our response to life’s changes highly depends on how we relate to our own innate emotional and physical strengths and weaknesses. A child with anger issues may eventually learn how to curb that anger. An individual with an introverted nature may choose to interact with others more often rather than feel alone. We do not have to be experts in Sasang medicine to recognize, strengthen, and modify these traits. Yet these innate strengths and weaknesses are often difficult to detect, and even if we do detect them, it may be difficult to know how to proceed in handling them. We all have unique but untapped strengths that are hidden within, awaiting an opportunity to come out. Yet other traits, which often manifest too easily, require modification, restructuring, or disregarding, especially when we are experiencing difficulties or going through a vulnerable time in life. Menopause may be the perfect excuse for emotions like anger and sadness to appear. It may also unlock the door for excessive heat or stored emotions to find their way to the surface. When accumulated energy within works its way outward, you need to be prepared or else be in for a rude awakening!

Yin Yang Balance for Menopause is a key that unlocks your greatest potential by facilitating deeper insight and giving you the tools to modify your unique body-type-specific strengths and weaknesses.

After getting to know the Sasang approach, you’ll be able to do the following:

Avoid the emotional ups and downs of menopause and strengthen your inner self.
Recognize your innate strengths and weaknesses and make the most of “now.”
Make wiser choices about which foods to eat for an easier transition through menopause.
Avoid guessing whether or not this or that supplement works for your type.
Choose the right herbs and forms of exercise.

YIN AND YANG THEORY

Before we jump into the discovery of your body type, let’s take a deeper look at a few basic Sasang concepts. First of all, with 7.3 billion people on the Earth, you may be wondering why they fall into only four body types. To answer this, we first have to return to the basics of Asian philosophy, which holds that all things emerge from a central source, referred to as the Taiji, which then branches into yin and yang or two opposing energies, and then again into the so-called Four Manifestations, also known as the Four Symbols, which we will discuss shortly.

Even though yin and yang are often referred to as opposites, it is only when they are used in a specific context that we grasp their meaning. If we say the moon is yin, then we are only comparing it to things that are more yang, like the sun. If we say the sun is yang, we mean that it is relatively more yang than the moon. Actually, our sun may be more yin compared to the sun of a different galaxy! Dark describes a degree of darkness rather than the complete absence of light. When we say that something is moving slowly, we are comparing it to something in faster motion. Yet there are surely things that move more slowly! Hence yin and yang serve as symbolic images that help express the different degrees of relativity and how all things are intricately related rather than existing in isolation. Table 1.1 provides several natural phenomena that are represented by either yin or yang.

TABLE 1.1. YIN AND YANG NATURAL PHENOMENA
Yin	Yang
Moon	Sun
Dark	Light
Night	Day
Cold	Hot
Down	Up
Moist	Dry
Back	Front
Slow	Fast
Feminine	Masculine

YIN YANG BODY TYPES

Yin and yang do not have any meaning in themselves, since there is no such thing as pure this or pure that. Only when they merge and dance together do they have meaning. This dance begins when yin mingles with yang and yang with yin, giving rise to four possibilities— referred to as the Four Symbols, or Sasang (four types): yin within yang, yang within yang, yin within yin, and yang within yin. These represent the most fundamental division of all things that exist in time and space, such as the four seasons, four cardinal directions, four basic DNA proteins that produce every gene in the body, and so on. In Sasang medicine there are four body types: two yin types and two yang types. Each of these body types represents one of the above yin and yang combinations. Table 1.2 lists each of the types in English and Korean.

Pronunciation Key

So is pronounced like the English word so.

Ya in yang is pronounced as it is in yacht.

Tae rhymes with day. Eum rhymes with loom.

Because of the intermingling of yin and yang, figuring out your body type is not as simple as black and white. The yin and yang body types all have different degrees of yin and yang. Although, as would be expected, the two yang types share more yang traits, and the two yin types share more yin traits, the yang types always have yin traits, and the yin types naturally have certain yang traits. By now you may be asking yourself, what exactly are yin and yang traits? Table 1.3 provides some answers.

TABLE 1.3. YIN AND YANG TRAITS
Yin	Yang
Complacent	Active
Gets cold more easily	Gets hot more easily
Stronger lower body	Stronger upper body
Relaxed	Tense
Night owl	Morning person
Slow metabolism	Fast metabolism
Slow motion	Quick motion
Follower	Leader
Higher estrogen, lower progesterone levels	Lower estrogen, higher progesterone levels

YIN YANG AND THE THREE HORMONES

Menopause-related books often discuss the decline of estrogen and progesterone levels within the body. Yet the pitfalls of hormone therapy show us that simply toggling these hormones does not always provide an untethered solution. According to Sasang medicine, menopausal health is primarily dependent upon the balance of yin and yang energy rather than hormone quantity. Modern research has led many of us to think that fluctuations in hormone levels automatically cause our mind and body to react this way or that. Yet less-mentioned studies demonstrate how the opposite is also true and that happiness, meditation, joy, anger, and so forth cause the secretion and suppression of various hormones in the body. Estrogen levels are also affected by exercise and emotional state.

Sasang medicine explains how our emotions and hormones affect one another but emphasizes that our innate emotional inclinations have a greater effect on how we feel than our hormone levels. Hormones may be considered environmental—as opposed to constitutional—factors that influence us but don’t control how we feel. Among the various hormones within the body, estrogen and progesterone are arguably the most influential of menopause’s environmental factors. Each has specific yin and yang qualities that vary according to each body type and individual.

Estrogen, or the “female” hormone, correlates with yin and is associated with cold, moisture, nourishment, and softness. Its main function is to develop female sexual characteristics, such as the breasts and the inner lining of the uterus—a yin (feminine) quality. Progesterone exhibits both yin and yang traits and is primarily responsible for preparing the uterus for pregnancy by thickening and vascularizing the wall of the uterus—a yin (nourishing) quality—and for increasing the body temperature to enhance fertility—a yang (warming) quality. Testosterone, or the “male” hormone, is the least discussed hormone of the female body because of its role in developing male sexual characteristics. Yet keep in mind that every woman has a significant amount of this hormone, and it is associated with increasing her libido—a yang characteristic—at the beginning of the monthly cycle.

From the standpoint of Eastern medicine, estrogen is considered to be more yin compared to progesterone, and progesterone to be more yin than testosterone, which is almost purely yang. As estrogen decreases after menopause, testosterone is reduced at a slower pace and thus is given a chance to flex its muscles. A pronounced decrease in estrogen often results in testosterone-dominant, heat-related symptoms such as hot flashes, dry skin and hair, osteoporosis, muscle and tendon tightness, and even acne—considered in Eastern medicine to be a result of excess heat within the body rebelling upward. Rising heat may also cause red blotches on the skin that occasionally burst, like a bubble rising to the surface of boiling water. Anger is also an example of excessive heat within the body that rises from the spleen, its source.

Excessive moisture and stagnation of fluid are the result of yin dominance—a common occurrence when estrogen levels increase in one’s teens and right before they start to plunge during perimenopause. This condition is often balanced by increasing yang through the release of progesterone and/or testosterone, yet during the menopausal transition, these hormones may also be on the decline.

In Eastern medicine, hormonal imbalance is seen as an internal battle between yin and yang. Yet all hope is not lost! Asian philosophy interprets this battle as a phase that inevitably precedes balance and harmony. And before you throw in the towel, know that there are other ways to increase and balance yin and yang during and after the menopausal transition, such as balancing your emotions and consuming yin/ yang energy foods and herbs. These methods will be discussed in detail in the following chapters.

Table 1.4 provides a number of other examples of symptoms that can occur when one hormone is dominant (present in higher amounts than the other hormones).

YIN YANG AND THE HORMONE PHASES

Estrogen and progesterone levels fluctuate extensively throughout the monthly cycle and as we age. The first half of a cycle, starting from the first day of menses, is said to be estrogen dominant, and the latter half is progesterone dominant. In between these hormonal fluctuations is ovulation, a phase in which yin transforms into yang, marked by a sudden decrease of estrogen and increase of progesterone, causing the release of an egg (ovum) from the ovary. The fluctuation of hormone levels during the cycle (see fig. 1.1 below)—estrogen yielding to progesterone and progesterone handing its authority back to estrogen—closely resembles the ebb and flow of yin and yang, where yin gives rise to yang and yang gives rise to yin. When yin and yang are balanced, this process goes smoothly, but when one abuses its power or the other stages a coup d’état, uncomfortable symptoms arise. For instance, higher levels of progesterone (yang) may cause sudden flashes of heat after ovulation or during perimenopause, a time when estrogen (yin) drops rapidly. Excessive levels of estrogen may instigate sudden bouts of depression during the first fourteen days of the cycle or during early to mid-stage perimenopause, when progesterone is comparably lower.

Fig. 1.1. The ebb and flow of hormones during the monthly cycle

Both estrogen and progesterone levels increase rapidly in a female’s teenage years, with estrogen levels relatively higher. They peak in adulthood, with progesterone occasionally higher than estrogen, and in later years they steadily decrease, with progesterone decreasing faster. This pattern is also seen with yin and yang, which increase significantly during menarche (one’s first menstrual period and the second of the seven-year cycles), reach their prime in one’s twenties (the third of the seven-year cycles), and decline during and after perimenopause (the sixth and seventh of the seven-year cycles). Estrogen and progesterone levels tend to fluctuate rapidly during puberty and perimenopause, often contributing to both yin- and yang-related symptoms such as depression, breast tenderness, cramps, and weight gain, which are associated with yin, and hot flashes, flushing, and irritability, which are associated with yang. The continuous fluctuation of hormone levels within the body may give you the feeling that you are at the mercy of their ups and downs. Thankfully, however, you are more than just a collection of chemical reactions. Your mind (or heart, as we say in Sasang medicine) inevitably calls the shots, and if you learn to control your mind, then you can learn to balance the flow of hormones, blood, energy—you name it!

HORMONES AND THE YIN YANG BODY TYPES

Since the body types have varying levels of yin and yang, they also have differing levels of estrogen, progesterone, and testosterone. Generally speaking, the yin types have greater relative levels of estrogen, while the yang types have more testosterone and progesterone. Hence the yin types tend toward estrogen-dominant symptoms such as sensitivity to cold, gaining weight, and so on, while the yang types have more progesterone/testosterone-dominant symptoms such as sensitivity to heat, anger, and acne. With more estrogen, the yin types often experience later menopausal onset than the yang types. There are more cases of estrogen-fed fibroids among the yin types, and progesterone-related issues such as amenorrhea or lack of ovulation among the yang types. Yet as we mentioned above, yin and yang are not absolute, and hence the yin types may occasionally experience testosterone-dominant symptoms, and the yang types estrogen-dominant symptoms. The trick is to discover the underlying cause of dominance by familiarizing yourself with the ebb and flow of yin and yang within your body, which you’ll do as the following chapters unfold.

OUR ORGAN SYSTEMS DETERMINE OUR BODY TYPE

As shown above, each body type is born with different degrees of yin and yang: the yang types with more yang, the yin types with more yin. Also mentioned was the concept of yang correlating with the upper body and yin with the lower body. Sasang medicine identifies four major organ systems within the body: lungs, spleen, liver, and kidneys. The lungs and the spleen are considered yang organ systems because they govern the function of the upper body, while the liver and kidneys are considered yin organ systems because they control the lower body functions.

The lungs, as the uppermost of the four major organs, have the most yang and are the strongest organ of the Yang Type B. This organ controls the flow of energy and blood to the chest, neck, and brain. The spleen, situated directly below the lungs, is the strongest organ of the Yang Type A and governs the flow of energy and blood through the upper digestive tract, such as the pancreas, stomach, and spleen area. The liver, situated below and to the right of the spleen, is the strongest organ of the Yin Type A and controls the gallbladder and small intestine functions. Finally, the kidneys, residing below the liver, are the Yin Type B’s strongest organs and govern the function of the bladder, kidney, and large intestines. Table 1.5 shows a breakdown of the organ systems, their functions in Sasang medicine, and their corresponding body types.

Since yin and yang oppose one another, the stronger a yang organ system is, the weaker its correlating yin organ system becomes, and the stronger a yin organ system is, the weaker its correlating yang organ system becomes. Hence the Yang Type A, born with a stronger spleen system, has weaker kidneys, and the Yin Type B, born with stronger kidneys, has a weaker spleen system. The Yang Type B, born with stronger lungs, has a weaker liver, but the Yin Type A, born with a stronger liver, has weaker lungs. The relative strengths and weaknesses of the lungs, spleen, liver, and kidneys determine our body type and play a major role in menopause. The different levels of organ strength are what contribute to energy flow within the body. Health depends on the smooth flow of energy from our stronger to our weaker organs. Life’s challenges may cause our stronger organs to greedily hoard their energies, leaving the weaker organs to fend for themselves.

Do our organ energies equalize when we are healthy? Actually, energy couldn’t flow from one place to another within the body if all of our organs were created equal. Just as particles in areas of high pressure flow to areas of low pressure, energy naturally flows from the stronger organs to the weaker ones. It’s only when the higher pressure of our stronger organ groups accumulates and explodes or when the lower pressure of our weaker organs collapses that our health is impeded. Let’s take a deeper look at how each of these organs influences our everyday life and menopause.

According to Sasang medicine, our emotional inclinations—namely, anger, sorrow, joy, and calmness, referred to herein as “predominant emotions”—are what determine which organ systems are stronger and weaker. Sorrow, for instance, sends energy to the lungs, and a propensity toward sorrow produces a stronger lung. Too much sorrow, however, can injure the lungs. Anger feeds the spleen, and an inclination toward anger gives rise to a stronger spleen. Yet if anger gets out of hand, it destroys the health of the spleen. Joy nourishes the liver but can also injure it, and calmness pumps up the kidneys but can congest them too. In our culture, joy and calmness are usually interpreted as positive emotions. Yet, as illustrated in our discussion of yin and yang, our emotions also need to be balanced in order for energy to flow smoothly. Anxiety, for instance, is only a small step away from joy, since they both may cause our heart to race and palms to sweat. Calmness can easily morph into complacency if the family room couch is too enticing!

The four predominant emotions determine how we feel from moment to moment. Stress, trauma, and—you guessed it—menopause influence our predominant emotions in different ways depending on our type. Table 1.6 shows the temperament of each body type.

TABLE 1.6. YIN YANG BODY TYPES AND THEIR PREDOMINANT EMOTION
Body Type	Predominant Emotion
Yang Type A	Anger
Yang Type B	Sorrow
Yin Type A	Joy
Yin Type B	Calmness

Can My Body Type Change?

For better or for worse, your body type is here to stay. Think of it as a diamond in the rough that shines abundantly after being polished. Sure, it may be a bit dirty at first, but that doesn’t mean you have to throw it out and exchange it for a new one. Our body type is a precious gift that never gets overused or outdated; it is the source of renewed energy and health. Listen to it and it will teach you; ignore it and it will still teach you—the hard way. The menopausal years are a time when, once again, you must take a deeper look at yourself, your body type, and your inner world. The more you discover about yourself, the more you can improve and modify your response to the menopausal transition. This happens naturally when we discover aspects of ourselves that don’t serve us well. Sometimes we may feel too “yingy” or “yangy” and decide to become a yin-like yang type or a yang-like yin type. Nothing is wrong with challenging yourself in this way as long as you don’t lose track of who you are. Cultivating your strengths instead of getting caught up with your weaknesses brings about profound change.

Let’s review a few key Sasang principles:

While fluctuating hormone levels contribute to menopausal discomfort, they do not cause it.
How our mind and body react to hormonal fluctuation is what determines the intensity and frequency of our discomfort.
No matter how uncomfortable your menopausal symptoms are, you can improve your condition significantly by balancing how you react to your environment.
How we react to hormone changes is influenced by our inherent organ energies and their correlating emotions.
The recognition of our innate strengths and weaknesses is the first step toward a smooth transition.
The next step is the modification of our lifestyle through body-type-specific foods and herbs and balancing our predominant emotions.

MENOPAUSE AND THE FOUR ORGAN SYSTEMS

Each of the four organ systems plays a major role throughout every moment of our entire lives, influencing how we feel emotionally and physically. Menopause is a time when these systems undergo significant changes and it becomes crucial for women to keep their stronger and weaker organs in balance. The stronger lungs of the Yang Type B, for example, have a tendency to steal energy from the rest of the body during menopause, making shortness of breath and chest fullness a common issue as excessive pressure accumulates there. The Yin Type B’s stronger kidneys tend to rob energy from the other organs, often leading to urinary discomfort during the menopausal transition.

Menopause-related symptoms are not always body-type specific. The Yin Type As and Yang Type As, for instance, can both experience hot flashes. Yet each body type has its own underlying cause and method of treatment. The Yin Type A’s hot flashes are a result of a hyper-developed liver, whereas the Yang Type A’s hot flashes are from a hyper-developed spleen. When addressing hot flashes, the Yin Type As are routinely prescribed herbs that address liver heat and the Yang Type As herbs that cool spleen heat. If herbs that clear spleen heat were given to the Yin Type A or herbs that clear liver heat to the Yang Type A, they may experience temporary relief, but hot flash symptoms would eventually worsen.

As discussed earlier, perimenopause marks the time in a woman’s life when yin and yang energy rapidly fluctuate back and forth. While some may experience this process as an unpleasant shock, others may view it as an awakening, as if their life were shifted into high gear. Each of the body types responds differently when yin estrogen or yang progesterone/testosterone energy dominates. When yang energy dominates, it may feel like a double whammy of heat and anger for the yang types, while the yin types suddenly feel bouts of energy they haven’t felt before, occasionally propelling them into drastic action. When yin energy dominates, the yin types may feel groggy, bloated, and depressed, while for the yang types, it may help them slow down a bit. When all is said and done, if you can’t beat it, well . . . I guess you have to join it.

An ancient Chinese story tells of Yu the Great, a sage who was the only one in more than one hundred years who could tame the raging Yellow River and stop it from flooding. His simple but effective solution was to respect the river and dig it a path around a large mountain standing in its way, instead of building trenches as his forefathers had done. Menopause does not require trenches; it needs to be honored and respected and allowed to flow smoothly. Knowing about the four organ systems is like observing the Yellow River and seeking guidance from it.

Let’s take a look at each organ system to see how it may affect the menopausal experience.

The Lung System

Table 1.7 provides a snapshot of the lung system’s functions along with its balanced and imbalanced effects during menopause.

Born with weaker lungs, Yin Type As often have difficulty sweating. Yet the tides change during perimenopause, when excessive heat accumulation in the body escapes from their hyperactive liver, pushing through the skin’s pores. During this phase, the Yin Type A may go from being a nonsweater to a sweat factory. Trauma to the lungs from smoking or other irritants can also be a culprit behind excessive or deficient sweating, no matter what the body type. Weakened lungs may encourage the onset of immune-related disorders during perimenopause or after menopause, such as common colds, rashes, joint inflammation, or allergies. “Foggy brain,” or a lack of mental clarity and loss of memory, is another common symptom of lung deficiency during menopause. Whereas Western medicine equates this with menopause-related hormone loss, Sasang medicine relates it to a deficiency of the lungs and their ability to pump energy upward to the brain. See chapter 12, “Sailing through the Mist,” for more details on foggy brain.

Each emotion, according to Eastern medicine, has its important role to play in encouraging energy to flow within the body. Excessive emotions, however, cause energy to either flow too quickly or stagnate and accumulate. As we’ve seen, sorrow is the basis of the Yang Type B’s actions. When balanced, sorrow helps the lungs push energy upward to fill the upper body and brain. Yet unbalanced sorrow can send shockwaves of energy upward, interfering with brain function and leading to depression and lack of clarity. If Yang Type Bs learn to control their sorrow, then optimum health awaits them.

The Spleen System

Table 1.8 provides a snapshot of the spleen system’s functions along with its balanced and imbalanced effects during menopause.

Weight gain is another common occurrence during the menopausal years. Hormone loss, by itself, cannot be blamed since other factors such as emotion, diet, and exercise play a significant role. In Sasang medicine, the spleen is in charge of metabolism and hence its weakness may result in weight gain or other digestive issues such as stomachaches, a sensation of fullness after meals, and/or diarrhea. Both yin types have a tendency to gain weight and suffer from digestive issues as a result of a weaker spleen system, especially around menopausal age, when metabolism switches into low gear. The spleen is also responsible for keeping our body warm, causing the Yang Type A to overheat easily and the Yin Type B, born with a weaker spleen, to freeze. The other body types tend to flip-flop between feeling hot and cold, pushing off the covers after a hot flash only to shiver with cold shortly afterward.

Anger originates from the spleen, assisting in the circulation of energy throughout the chest. Yet unbalanced anger in the form of rage can cause energy to stagnate in the chest, interfering with heart and stomach function. If Yang Type As learn to control their predominant emotion of anger, then optimum health will be theirs.

The Liver System

Table 1.9 provides a snapshot of the liver system’s functions along with its balanced and imbalanced effects during menopause.

For the most part, the Yin Type A’s stronger liver does an efficient job of filtering toxins from the blood. Yet excessive strength often throws things off, since enhanced liver absorption soaks up everything in sight. During perimenopause, our stronger organ may go berserk, frantically attempting to balance rapidly shifting hormones and bodily energies. The stronger liver will eventually respond by becoming engorged with the very toxins it is supposed to let go of, resulting in fat accumulation in the lower abdomen—its home. Excessive absorption may also cause the bowels to stagnate or harden. Weight gain and constipation are often the culprits behind an uncomfortable menopause transition for the Yin Type A.

Joy is associated with the liver and helps it to fill the upper abdomen with fresh blood and energy. Yet unbalanced joy can lead to congestion and abdominal issues. Excessive joy, or the extreme desire for joy, can also cause liver toxicity. If Yin Type As learn to balance their predominant emotion of joy, then they can experience optimum health. Born with a weaker liver system, Yang Type Bs have difficulty seeing the light at the end of the tunnel; hence sorrow rather than joy is their predominant emotion. For Yang Type Bs, menopause is often a time when they come face-to-face with sadness as it works its way to the surface. While Yin Type As may also have to clean a few sorrowful skeletons out of their menopausal closet, unexpected moments of profound joy also manifest. The key is to strike a balance between joy and sorrow and not let either emotion steer you astray.

The Kidney System

Table 1.10 provides a snapshot of the kidney system’s functions along with its balanced and imbalanced effects during menopause.

The kidneys are the Yin Type B’s strongest organ, providing strong legs and a healthy urinary system and lumbar spine area. They come in handy during menopause by cooling the body to resolve hot flashes. Yet if the other organs have trouble getting along with one another, the kidneys may struggle to mediate the situation, resulting in kidney-related symptoms. During the change of life, even Yin Type Bs may notice a reduction of energy in their lower body or have urinary difficulties, but the kidneys are usually the last organ to give them trouble. The Yang Type A’s weaker kidneys, on the other hand, are prone to chronic urinary issues such as difficult or frequent urination or recurring urinary tract infections (UTIs) that may worsen during the menopausal transition. Thus, Yin Type Bs have to be significantly ill before they experience kidney-weakness-related symptoms, while for Yang Type As they may be commonplace.

Calmness, associated with the kidneys, helps fill the lower body with fresh blood and energy. Yet unbalanced calmness, or the extreme desire for it, can sink the energy downward, causing diarrhea and extreme fatigue. If Yin Type Bs learn to control their predominant emotion of calmness, then optimum health awaits, but if they try too hard to achieve it, then even their stronger kidneys cannot escape illness. Born with a weaker kidney system, Yang Type As have difficulty calming down; hence anger rather than calmness is their predominant emotion. For the Yang Type A, menopause is a time when anger often rages out of control. While the Yin Type B may also experience bouts of anger during menopause, an overall sense of calmness always seems to cool things down. The key is to strike a balance between calmness and anger and not let either emotion get the best of you.

THE FOUR SENSES AND MENOPAUSE

Did you know that many women experience a heightened sense of smell during perimenopause? This phenomenon, which is seldom discussed in the literature, also tends to occur during the early stages of pregnancy and may have to do with your body type! In Sasang medicine, the sense of smell correlates with the liver. Since Yin Type As are born with a stronger liver, they have a stronger sense of smell. Actually, the sense of smell is how they relate to the world around them. The Yin Type A can “smell a rat” when others are not truthful, or be attracted to someone because of how they smell. Whenever the mind and body go through a major transition (such as pregnancy or menopause), our strongest organ has to work harder to keep us on our toes, so its correlating emotion and sense are enhanced. The Yin Type A’s predominant emotion of joy, which is associated with the liver, is also enhanced during the change of life and offers bouts of utter delight and rejuvenation. Despite these benefits, unfortunate circumstances and rancid odors are unavoidable, and unsustainable joy or stinky perfume may drive the Yin Type A crazy. The nose is also a great conduit for healing, as it is a portal through which the introduction of pleasant scents can enter weaker lungs and make them stronger.

The Yin Type B’s stronger kidneys provide them with an enhanced sense of taste, which increases during perimenopause. This can do funny things to a Yin Type B’s taste buds. In some cases it may give them a renewed interest in food, but in others it can induce food sensitivities and an aversion to certain flavors. The Yin Type B’s sense of taste extends beyond food, providing them with a sensitive “taste” in music, theater, photography, and so forth. For this type, menopause may be a chance to enhance an interest in the arts and further natural abilities.

A stronger spleen gives the Yang Type A keen eyesight that heightens during menopause. We’re not talking about the ability to see with the eyes per se, but rather to see with the mind, or with insight. Even if their eyesight fails them, Yang Type As are still capable of “seeing through” people or “reading between the lines,” an ability that comes from the eyes, according to Sasang medicine, which are associated with the spleen.

Thanks to a pair of stronger lungs, the Yang Type B can hear the sound of the Earth rotating on its axis . . . well, metaphorically at least. The lungs, associated with the ears, connect us with the universe and heavens above. Menopause for Yang Type Bs is a time of enhanced intuition and psychic capability as their stronger lung energy gets a boost. Yet it’s also a time when they have difficulty keeping their feet on the ground and relating to others. They may “hear” voices in their head or be extremely sensitive to certain sounds.

Table 1.11 provides each body type’s strongest sense and correlating organ.

We are more than just a vessel of hormones lost at sea, fighting the rough waves of menopause. Instead, we carry a unique combination of yin and yang, emotional and physical strengths, and heightened sensitivities. By providing us with a map and compass and the coordinates to determine where we are, the Sasang approach offers abundant opportunities for self-discovery and well-being along the way.

Now that we’ve dipped our feet into the basics of Sasang medicine, it’s time to figure out your body type and apply these concepts to your own menopausal journey.