"The last six months I've just been off — hot flushes, poor sleep, shorter temper. Is this menopause?" It is a question that comes up often — asked with a slight hesitation, as though it might not count as a thing worth raising.

It does. This article is about how TCM views the changes of this stage, and the 5 things a practitioner asks about — and, just as importantly, when to see a gynaecologist first.

I. First: menopause is a life stage, not a disease

Worth establishing up front.

Menopause is a natural transition in a life stage, not an illness. Medically it is defined around the cessation of periods, and the transition around it varies in length from person to person. Whether you have entered that stage, and whether hormone-related treatment is appropriate, belongs to a gynaecologist's judgement.

The TCM view treats it as a period of transition in the body, and a consultation looks at the changes as part of the whole picture. How TCM understands that transition belongs to the theoretical framework of the organ systems and qi — a different kind of explanation from modern endocrinology. The two should not be conflated.

II. The 5 things a practitioner asks about

• Changes to the cycle — longer or shorter, changes in flow, when the last period was.
• Temperature-related changes — flushes, night sweats, changes in how hot or cold you run, which times of day are worst.
• Sleep — falling asleep, waking at night, getting back to sleep.
• Mood and energy — swings, concentration, how tired you are.
• Existing diagnoses and medication — your doctor's diagnosis, any hormone-related medication, bone density or lipid results, anything else you take.

That fifth matters especially. Blood pressure, lipids and bone density often start being tracked at this stage, and those belong to the medical side — follow your doctor's judgement.

III. How to describe it usefully

This table deliberately does not say what any answer means. TCM is not a self-assessment quiz — distinguishing is what a practitioner does after a consultation.

IV. See a gynaecologist or doctor first in these situations

• Any bleeding after menopause — always get this checked; this is the one that cannot wait
• Before menopause: bleeding between periods, after intercourse, or a sudden marked increase in flow
• A lump you can feel in the breast or abdomen
• Chest pain or palpitations with breathlessness or a cold sweat — call 999 now, or go to the nearest emergency department
• Persistently low mood, anxiety that is hard to control, or loss of interest in things — tell your doctor; this needs professional support
• Concerns about fracture risk, or a fracture from a minor fall
• Taking or considering hormone-related treatment — this belongs to your doctor's judgement; follow their advice and never stop or adjust it on your own

A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.

V. Fitting it into life in Malaysia

• Air-conditioning and flushes. Strong office air-conditioning against the heat outside makes for a large swing across the day — part of what gets asked.
• Track two weeks first. How many flushes a day, at what times, how often you wake at night. Far more accurate than recall.
• Routine test reports. Blood pressure, lipids, bone density, breast screening — mention any you have had.
• Supplements from family. Plenty gets recommended at this stage; say what you are actually taking.
• What else is happening at home. Caring for elderly parents, children's exams, work pressure — several things often stack at this stage, and it is worth saying so.

On preparing: what to prepare before an online consultation. On what the consultation covers: what TCM gynaecology covers.

In closing

✅ Worth remembering:

1. Menopause is a life stage, not a disease — but "natural" does not mean "endure it".
2. A practitioner asks about cycle changes, temperature-related changes, sleep, mood and energy, and existing diagnoses and medication.
3. Hormone-related treatment belongs to your doctor's judgement — follow their advice.
4. Any bleeding after menopause needs checking. That is the one that cannot wait.
5. Blood pressure, lipids, bone density and screening are not replaced by a TCM consultation.

❌ Better not to:

1. Treat bleeding after menopause as a sign of renewed youth and leave it uninvestigated.
2. Stop hormone medication on your own because you have started TCM care.
3. Write off persistent low mood as "everyone's like this at this age" — tell your doctor.

👉 If you would like to set the changes out for a practitioner, you are welcome to book an online consultation with HansMed, where a practitioner registered under the T&CM Act 2016 can assess it with you; if anything in section IV applies, see a doctor or a gynaecologist first.

Reviewed by Ms. Koo Shuang, a TCM practitioner registered with Malaysia's Traditional and Complementary Medicine Council under the T&CM Act 2016, practising in gastroenterology, dermatology, respiratory and women's health.

Sit with a licensed TCM practitioner from wherever you are.

HansMed Modern TCM

「医师，我这半年整个人不太对劲——热潮、睡不好、脾气也变差，是不是更年期到了？」这是不少读者常问的一类问题——提问时带着一点犹豫，好像不确定这算不算「一件事」。

它是。这篇讲的是中医观点下这个阶段的身体变化，以及问诊时医师会了解的 5 件事——还有，同样重要的，什么情况必须先看妇产科。

一、先分清楚：更年期是一个阶段，不是一个病

这一点值得先说清楚。

更年期是生理阶段的自然转变，不是疾病。医学上以停经为界，前后的过渡期长短因人而异。是否已进入这个阶段、是否需要荷尔蒙相关的治疗，属于妇产科的判断范围。

中医的观点是把这个阶段视为身体的一段转变期，问诊时会把出现的变化放在整体里看。至于中医怎么理解这段转变，属于脏腑与气血的理论框架，与现代内分泌学的解释不是同一回事，两者不应混为一谈。

二、医师会了解的 5 件事

• 月经的变化：周期变长或变短、量的改变、最后一次是什么时候。
• 体温相关的变化：热潮、盗汗、怕冷或怕热的改变、什么时段最明显。
• 睡眠：入睡、夜醒、醒来后能不能再睡。
• 情绪与精神：情绪起伏、专注力、疲倦程度。
• 已有的诊断与用药：医生的诊断、荷尔蒙相关用药、骨密度或血脂检查、正在服用的其他药物。

第五项特别重要。这个阶段常同时开始追踪血压、血脂与骨质，这些属于西医的范围，请以医生的判断为主。

三、一张表看懂：怎么描述才有用

这张表刻意不写「哪一种代表什么体质」。中医不做自我对号入座——分辨是医师问诊后的判断。

四、这些情况请先看妇产科或医生

• 停经之后出现任何出血——请务必就医，这是不能等的一项
• 停经前出现非经期出血、性行为后出血，或经血量突然大增
• 摸到乳房或腹部的肿块
• 胸痛、心悸伴随气促或冒冷汗——请立刻拨打 999，或前往最近的急诊部
• 情绪持续低落、焦虑难以控制，或对事情失去兴趣——请让医生知道，这需要专业协助
• 骨折风险相关的疑虑，或曾经轻微跌倒就骨折
• 正在服用或考虑荷尔蒙相关治疗——这属于医生的判断范围，请以医生的建议为主，切勿自行停药或自行加减

小提醒：本段仅为一般知识说明。相关情况请以西医的诊断与治疗为主，并在需要时及时就医。

五、大马生活里怎么安排

• 冷气与热潮：办公室冷气很强、外面很热，一天里温差很大，这些是问诊会问到的内容。
• 先记录两周：热潮一天几次、什么时段、晚上醒几次。这份记录比回忆准确得多。
• 例行检查的报告：血压、血脂、骨密度、乳房筛检——做过的一并说明。
• 家人给的补品：这个阶段常有人推荐各种补充品，请一并说明您实际在吃的。
• 家里的节奏：照顾长辈、孩子升学、工作压力——这个阶段常常同时叠着几件事，值得说明。

问诊前的准备方式，可参考：线上问诊前该准备什么。妇科问诊涵盖的范围，可参考：中医妇科看些什么。

结语

✅ 记住这几点：

1. 更年期是生理阶段，不是疾病；但「自然」不等于「只能忍」。
2. 医师会了解月经变化、体温相关变化、睡眠、情绪精神、已有诊断与用药。
3. 荷尔蒙相关治疗属于医生的判断范围，请以医生的建议为主。
4. 停经后的任何出血都要就医，这是不能等的一项。
5. 血压、血脂、骨密度与筛检，中医问诊不能取代。

❌ 不要这样做：

1. 不要把停经后的出血当成「回春」而不去检查。
2. 不要因为开始中医调理就自行停掉医生开的荷尔蒙药。
3. 不要把持续的情绪低落当成「这个年纪都这样」——请让医生知道。

👉 如果您想把这个阶段的变化完整说给医师听，欢迎透过汉方中医的线上问诊，由依 2016 年 T&CM 法令注册的医师为您评估；若有第四节列出的情况，请先看医生或妇产科。

本文由 邱双 医师 撰稿审阅。邱双 医师依 2016 年 T&CM 法令于马来西亚传统与辅助医药理事会注册执业，专长为肠胃科、皮肤科、呼吸科与妇科。

无论身在何处，与持证中医师对坐。

汉方现代中医