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by
Bob Flaws, Dipl. Ac. & C.H., FNAAOM
Keywords: Chinese medicine, Chinese herbal medicine, male menopause, Dan Zhi Xiao Yao San
According to "The Treatise on Previous Ancients’ Heavenly Truths" at the beginning of the Nei Jing Su Wen (Inner Classic: Simple Questions), women’s growth, development, and eventual decline is governed by a seven year cycle. At seven times seven or approximately 49 years of age, the kidneys are depleted, the tian gui is exhausted, menstruation ceases, and women can no longer get children, i.e., become pregnant. These statements of Chinese medical fact are typically used to explain female menopause. However, the same passage in the Su Wen also gives a parallel description of the growth, development, and decline of males based on an eight cycle. According to the author(s) of the Su Wen, at seven times eight in males, "The liver qi is declining, the tian gui is exhausted, the essence is scanty, and the kidney viscus is in decline." In both instances, the tian gui refers to kidney water or yin. Because it is also axiomatic in Chinese medicine that men and women are essentially identical (except for the facts that women have a uterus and, therefore, menstruate, gestate, give birth, and lactate), this has led to many practitioners of Chinese medicine to question if there is a male analogue to menopausal syndrome. In both modern Western and Chinese medicines, menopausal syndrome (more rightly perimenopausal syndrome) refers to a constellation of physical and psychological disturbances which may occur in women before, during, and after the cessation of menstruation. Such symptoms include hot flashes, night sweats, abnormal uterine bleeding, fatigue, depression, anxiety, forgetfulness, heart palpitations, and insomnia. So the questions are, "Is there a male climacteric syndrome and can Chinese medicine treat it if there is."
According to You Song-qing in an article titled, "The Treatment of 58 Cases of Male Climacteric Syndrome with Dan Zhi Xiao Yao San (Moutan & Gardenia Rambling Powder) plus Er Zhi Wan (Two Ultimates Pills), which appeared in issue #5, 2001 of Bei Jing Zhong Yi (Beijing Chinese Medicine) on pages 19-20, there is a male climacteric syndrome analogous to female perimenopausal syndrome and Chinese medicine can, in fact, successfully treat it. (This is only one of four articles on the treatment of male climacteric syndrome published in Chinese medical journals since 1995.) According to Dr. You, this syndrome is seen in men 55-65 years of age and is associated with a decline in function due to age in the body’s endocrine glands. Because of the gradual decline of the kidney qi, essence and blood become insufficient and the tian gui becomes exhausted. This then leads to loss of regulation and balance between yin and yang. In particular, because of kidney yin insufficiency, water does not moisten wood. Thus the liver channel becomes depressed and depression may transform heat. Because heat is yang in nature, it may ascend to harass the heart spirit. These disease mechanisms result in such clinical manifestations as tidal flushing of the face, hot flashes, spontaneous perspiration, a depressed affect, melancholy, profuse doubts, a susceptibility to worry, insomnia, profuse dreams, vexation and agitation, easy anger, low back and knee soreness and limpness, seminal emission, and impotence.
Cohort description:
Fifty-eight men, all out-patients, were examined over a five year period. All were between 55 and 65 years of age with an average age of 58. These patients’ course of disease had lasted from three months to five years. Sixteen cases had suffered from the above complaints for three months to one year, 24 had suffered for one year plus to three years, and 18 cases had suffered for more than three years to five years. Neurological examination revealed no abnormalities.
Treatment method:
The basic formula administered to these 58 patients consisted of: Radix Angelicae Sinensis (Dang Gui), Radix Albus Paeoniae Lactiflorae (Bai Shao), Radix Bupleuri (Chai Hu), Rhizoma Atractylodis Macrocephalae (Bai Zhu), Sclerotium Poriae Cocos (Fu Ling), Cortex Radicis Moutan (Dan Pi), Fructus Gardeniae Jasminoidis (Zhi Zi), uncooked Rhizoma Zingiberis (Sheng Jiang), Herba Menthae Haplocalycis (Bo He), Fructus Ligustri Lucidi (Nu Zhen Zi), and Herba Ecliptae Prostratae (Han Lian Cao).
If there was kidney yin vacuity, Fructus Corni Officinalis (Shan Zhu Yu), Fructus Lycii Chinensis (Gou Qi Zi), and uncooked Radix Rehmanniae (Sheng Di) were added. If kidney yin vacuity had resulted in concomitant kidney yang vacuity, then Herba Epimedii (Xian Ling Pi), Radix Morindae Officinalis (Ba Ji Tian), and Rhizoma Curculiginis Orchioidis (Xian Mao) were added. If there was qi vacuity, uncooked Radix Astragali Membranacei (Huang Qi) and Radix Codonopsitis Pilosulae (Dan Shen) were added. If there was blood vacuity, cooked Radix Rehmanniae (Shu Di) and Radix Polygoni Multiflori (He Shou Wu) were added. If there was insomnia, Semen Zizyphi Spinosae (Suan Zao Ren) and Semn Biotae Orientalis (Bai Zi Ren) were added. If there was ascendant liver yang hyperactivity and high blood pressure, Ramulus Uncariae Cum Uncis (Gou Teng) and Rhizoma Gastrodiae Elatae (Tian Ma) were added.
One ji of these medicinals were decocted in water and administered internally per day. After the condition improved, one ji was administered every other day.
Treatment outcomes:
After 10-60 ji of the above medicinals, 38 cases (665) were judged cured. This was defined as complete disappearance of all symptoms with no recurrence within one year. Eighteen cases (31%) were judged improved. This meant that their symptoms basically disappeared or markedly diminished. Only two case (3%) experienced no effect, meaning that there was no improvement in their symptoms or their condition got worse. Thus the total amelioration rate was 97%.
Conclusion:
The above article suggests that at least some men do experience a syndrome analogous to female perimenopausal syndrome and that, when men suffer such symptoms, Chinese medicine can frequently provide relief.
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