Acupuncture and Chinese medicine for weight gain and mood changes during perimenopause & menopause

UChicagoMedicine (2025)

Weight gain is a frequent occurrence during perimenopause and menopause. It is due to hormonal shifts, especially declining estrogen, which impacts metabolism and fat storage. Reduced muscle mass and physical activity with age also contribute. Concurrently, fluctuations in hormone levels often lead to mood alterations, which can manifest as anything from minor irritability to more significant anxiety or depression.

The role of oestrogen in weight gain

Lower oestrogen slows calorie burning and promotes abdominal fat storage, increasing the risk of metabolic syndrome and cardiovascular issues. Reduced oestrogen also decreases muscle mass, which is crucial for glucose storage. This can shift glucose metabolism and increase fat storage.

Additionally, oestrogen influences hunger hormones like leptin and ghrelin. Fluctuating levels may increase appetite and calorie intake. Moreover, hormonal changes can contribute to stress and mood swings, which may result in emotional eating. It is also observed that individuals in their 40s and 50s, often facing heightened stress due to career and family demands, may also have more disposable income, potentially leading to a greater inclination towards fine dining and higher calorie consumption, including alcohol.

The role of oestrogen in mood

Oestrogen significantly affects mood. Low or unstable estrogen levels may cause mood swings, irritability, anxiety, and depression. Oestrogen influences serotonin, a neurotransmitter vital for mood regulation, and can also impact cortisol levels, the stress hormone. Imbalances can increase stress and anxiety. 

The fluctuations of estrogen and progesterone throughout the menstrual cycle are particularly linked to conditions such as premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), potentially worsening their symptoms during this transition period. 

Hormonal imbalances can disrupt sleep, leading to disorders like insomnia and sleep apnoea, which in turn can exacerbate mood changes. Sleep and mood are closely connected. 

Low estrogen levels can also increase feelings of vulnerability and emotional sensitivity. It can manifest as heightened responses to stimuli, intense emotional reactions, and increased vulnerability to external influences. 

The 40s and 50s are often demanding due to complex family dynamics, social pressures, and career shifts. This period can sometimes lead to a "midlife crisis," with individuals questioning life choices or feeling dissatisfied. Divorce rates are highest for males aged 45-49 and for females aged 40-44 during this time.

The Theory of Traditional Chinese Medicine (TCM)

From the perspective of Traditional Chinese Medicine (TCM), perimenopause is often understood as a natural decline in Yin energy. Yin provides coolness, substance, and nourishment, while Yang provides warmth, activity, and energy.

When Yin energy decreases, Yang energy can become less regulated, leading to symptoms like hot flashes, night sweats, irritability, anxiety, and palpitations. Additionally, the moistening effect of Yin on tissues may diminish, causing dryness in various bodily tissues, including vaginal dryness. This may result in painful sex, low libido, and decreased sexual satisfaction. 

Our sleep is facilitated by Yang energy descending deeply into Yin energy; consequently, with less Yin energy to anchor Yang, you may experience frequent nighttime awakenings or early morning disturbances.

Acupuncture & Herbal Medicine

To address these symptoms, the approach is to nourish and increase Yin to balance Yang energy. Acupuncture can support organs in producing bodily substances like blood and fluids, with many digestive organs playing a role in this process. Additionally, herbal medicine can provide the actual materials your body needs to replenish its Yin.

Diet

To assist with maintaining Yin balance, it is advisable to consider moderating your intake of alcohol, chili, and coffee. Alcohol metabolism can lead to fluid loss and increased urine production, while spicy foods like chili may cause fluid loss through sweating and mucus production. Coffee, due to its diuretic effect and bitter flavor in TCM, is also noted for its drying properties. As alternatives, green tea may be beneficial, or if you enjoy coffee, organic decaf options or delaying your first cup until later in the morning could be considered. Adding milk or butter to your coffee may also help reduce its bitterness.

For weight management, it is recommended to be mindful of carbohydrate intake, prioritizing complex carbohydrates such as non-starchy vegetables, berries, and whole grains. Strategies to minimize sugar spikes are encouraged to prevent fat gain, and increasing your consumption of healthy fats and proteins can be advantageous. When structuring your meals, commencing with fiber-rich foods, followed by protein and fats, and consuming carbohydrates last, is suggested to prevent sugar spikes. 

Exercise

Increasing your muscle mass can help your body store glucose more effectively, preventing it from being converted into fat. A simple and effective exercise for building muscle, especially in the legs, is calf raises. Our leg muscles are particularly good at absorbing and utilizing glucose from the bloodstream.

You can easily add calf raises to your routine after meals or walk on a hillside for similar benefits, even without weightlifting.Given that perimenopause can lower energy, focus on low-impact, moderate-intensity exercises to build strength and endurance without causing exhaustion.

Mental Wellbeing

It is often observed that women may not consistently prioritize their mental health, largely due to societal expectations that emphasize their roles as caregivers, which can lead to neglecting their own needs. Cultural conditioning and the pressure to manage numerous responsibilities also contribute to the difficulty in prioritizing self-care. It is essential for women to understand that self-care is not a selfish act but a fundamental component of overall well-being. Seeking support from friends, family, or healthcare professionals is critically important.

Furthermore, it is important to recognize that menopause-related mood changes are a normal part of this life transition. Women should not blame themselves for experiencing these shifts. Understanding the hormonal basis of these changes and seeking appropriate support can significantly help in navigating this phase with greater ease and well-being.

I frequently see clients who have been experiencing a wide range of perimenopausal symptoms for years without realizing that these are often directly related to underlying hormonal imbalances. I firmly believe that increased awareness and understanding of hormonal health, particularly during the perimenopausal transition, could genuinely transform the lives of many women. Empowering women with this knowledge could lead to earlier intervention, more effective management of symptoms, and an overall improvement in their quality of life.

About the Author

Youngmi Choi

Ripple Acupuncture | Newcastle | New Lambton

As an AHPRA-registered acupuncturist with 15 years of nursing experience, I offer safe, effective, and holistic care. My special interests include pain management, psycho-emotional well-being, digestive balance, and women’s health & fertility. My approach is outcome-focused, and clients receive a clear care plan with personalized lifestyle advice.

If you have any questions about your (peri)menopausal conditions, please make an online booking, submit an online enquiry or call me on 0402 474 884. 

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