There's a sentence I hear a lot. It usually comes about halfway through a first consultation, and it's almost always said quietly. “I don't feel like myself anymore.”
She's often somewhere in her forties. Her sleep has gone strange. She's warm at night and cold by morning, her cycle has stopped behaving, she's snapping at people she loves, and she can't quite land on the word she's reaching for. More than once, she's been told her blood tests came back fine. Her bloods probably are fine, and that doesn't mean nothing is happening. What she's describing has a name most of us were never properly told about: perimenopause, the years of change that lead up to menopause.
The signs that don't get talked about
Most people think perimenopause is hot flushes, and that's the whole list. It can begin as early as your late thirties, and it often starts with something else entirely.
There's the temperature stuff. Warm at night, covers off, covers back on, then cold by morning. Waking at three and lying there. There's the head stuff. Brain fog, losing a word you've used a thousand times, reading the same line three times over. And there's the mood stuff. A shorter fuse than you've ever had, or flat for no reason you can point to.
Underneath all of it sit the two that wear people down most: sleep that won't hold through the night, and a cycle that has stopped being predictable. None of it is in your head, and none of it is simply something you have to see out. It's a stage of life with a recognisable pattern, and naming the pattern is often the first bit of relief.
Why the change of season can make it louder
Here on the Tweed Coast, I notice these things get louder at the turn of the season. In Traditional Chinese Medicine, winter is a holding season, when the body draws inward and conserves. Spring is the opposite. Energy rises again, and everything that was stored starts looking for somewhere to go.
For a body already working to find its balance, that changeover can be the bumpy bit. Sleep goes lighter, the fuse gets shorter, tension settles across the shoulders and jaw. It's a common pattern at this time of year, and it does settle.
Where acupuncture may fit
Acupuncture may assist with the relief of some of these symptoms, and it sits alongside whatever you're already doing with your GP, not instead of it.
In a session I'm not chasing one symptom on its own. I ask about your cycle, your sleep, your energy and your digestion, read your pulse and look at your tongue, and together we build a picture of the pattern underneath. From there we make a plan, and I'll tell you honestly what I think I can help with and what I can't.
It's worth saying plainly that there is clinical research in this area, including randomised controlled trials looking at acupuncture and the symptoms of the menopausal transition. I see acupuncture as one supportive part of a wider plan rather than a replacement for medical care. It's the same considered framework I use with everyone: our Levels of Care, matched to where you actually are.
When to see your GP
Some things belong with your GP first, and this stage of life is one where that matters most. Please start there if your bleeding is very heavy or much more frequent than usual, if it returns after your periods have stopped, or if you have bleeding after sex. Start there too if your mood or your sleep is affecting your daily life, or if you'd like to talk through menopausal hormone therapy and whether it's right for you.
Your GP can look at the whole picture, arrange the right tests, and help you weigh your options. Good care through these years is a team effort, and acupuncture works best as one part of that team.
A place to start
If any of this sounded like you, or like someone you found yourself thinking of as you read, you're welcome here. Book a first consultation and we'll take the time to map it out together, unhurried and with no pressure. And if it made you think of a friend, send it to her. That's genuinely how most people find us.
— Dr Mal