Acupuncture and the Menopause Transition

Ahh, Menopause… and let’s not forget her sisters, Peri and Post! This unpredictable trio tends to arrive with a lot of baggage, they tend to cause a bit of a ruckus, and they stick around for a long time – a decade or more, which I think we can all agree is far too long for any guest!

The menopausal transition is a significant part of a woman’s life yet continues to be one of the more stigmatized and least understood phases of life. Whether triggered as part of the aging process or medically, it is a transition that 50% of the population will experience, and for many, that experience will go on for a decade or more.

While we as a society are getting more comfortable talking about some of the challenges women face during and after the menopausal transition - we can even joke about things like hot flashes and emotional ups and downs – it remains taboo and therefore much more challenging to talk about many of the genitourinary symptoms that can arise. We must find a way to open this conversation up, as these are issues that may begin in perimenopause, but can persist and worsen for decades, dramatically impacting a person’s quality of life and aging experience.

Genitourinary Syndrome of Menopause (GSM)

Genitourinary Syndrome of Menopause (GSM) was officially recognized in 2013 and refers to an array of symptoms associated with the physical impact of reduced levels of estrogen in the body. It includes symptoms like genital dryness and irritation, painful or unsatisfying intercourse, increased urinary urgency, and higher frequency of urinary tract infections (UTI’s).

These issues are rarely spoken of, and women are often forced to tolerate them in silence. They may feel a sense of embarrassment, guilt, or shame. They have been led to believe there’s nothing that can be done, and so they do what women always do – grin and bear it. But the physical and emotional effects of GSM can be absolutely devastating, leading to relationship challenges, social withdrawal and isolation, and in the case of UTI’s, severe infection and even sepsis. Sufferers and their caregivers may feel helpless as the person’s world gets smaller and their quality of life declines.

New Options for GSM Patients

This is why it is so important to share the news that new treatment options are emerging. In June 2025, the American Urological Association released new guidelines related to GSM. These guidelines offer clinicians new direction around screening, diagnosis, and treatment of GSM.

Hormone therapy and specifically the use of low-dose vaginal estrogen has been recommended for many of the conditions that can arise with GSM, and urologist Dr. Rachel Rubin estimates that this intervention in particular could dramatically reduce the incidence of UTI’s, thus saving immense suffering and healthcare expenditure (sadly, I don’t yet know Dr. Rubin, but she’s a wonderful speaker who somehow manages to make discussion of vaginal atrophy entertaining!).

This guidance from the American Urological Association offers new hope for millions of older women who have believed they must suffer quietly, as well as hope for those who care for them (and are probably on their own menopause rollercoaster).

Talk to Your Doctor

If GSM is a concern for you or for someone you are caring for, it is important to speak to your Primary Care Provider (PCP). Only they can determine whether these interventions are appropriate. Because this news is so new, and because they’re just as busy as the rest of us, they may not even be familiar with the new guidance yet. But that’s okay! You can share the guidelines with them and help spread the word!

Acupuncture is Great for Menopause Management!

While hormone therapy is the realm of your PCP, menopausal support also exists through acupuncture. Although we in the US are only just getting comfortable talking about menopause, it is a conversation that has been going on in Chinese Medicine circles for centuries. In fact, the first known medical text focused on women’s health, “The Complete Book of Effective Prescriptions for Diseases of Women,” was published in 1237 AD – almost 800 years ago. We acupuncturists have a wealth of information and insight to tap into and our treatment approaches have literally been tried, tested, and refined for hundreds of years!

And acupuncture and herbal medicine treatment options aren’t just history lessons - check out this article to learn about 15 symptoms we can treat with East Asian Medicine, and explore some of the clinical trials that support the interventions.

Menopause isn’t all Bad - and Acupuncture Makes it Better

For many, the transition into menopause comes with plenty of positives – in many ways, life is simplified, one’s focus and goals may be clarified, and women may have the space to focus on and invest in themselves in a way that was not possible during child-bearing (and raising!) years.

It can also be grueling. It lasts a long time, comes with many unpredictable changes, offers  symptoms that range from insomnia and anxiety to musculoskeletal pain and GSM. And then there are the things that are just pain weird, like phantom smells and changes to body odor! You do not have to go it alone, you do not have to keep it to yourself, and you do not have to suffer through it. Speak with your PCP and explore your options. Talk to your acupuncturist and be sure to tell them about all the seemingly unrelated stuff – odds are, it’s all connected, it’s all been identified over the centuries, and it will help us get to a clearer Chinese Medicine diagnosis and treatment plan. You deserve to enjoy the second half of your life even more than the first half and integrating acupuncture into your routine will help you feel more like yourself again. It is our privilege to join you on this path!