Classical Formulas for Menopausal Hot Flushes

October 2, 2019

Hot flushes are experienced by about 70% of women undergoing menopause. Fluctuating amounts of estrogen upset the temperature thermostat and the brain signals that the body is too hot which results in opening of pores and, hence sweating.

Hot flushes are often the most bothersome symptom of the ‘change of life’. There are many factors in a woman’s life that impact the intensity of hot flushing and other signs of menopause. It’s often a complex situation with many hormonal changes going on at the same time. Whilst menopause is not a condition, it’s an intense phase of the body’s attempt to adjust to a situation where the ovaries no longer produce estrogen. But because estrogen is important for many bodily functions, it can be sparse, and the body requires time and transition to this important hormone being produced elsewhere.


Every woman experiences menopause differently and in my opinion they require different formulas. It’s not always a case of deficient heat and the application of Liu Wei Di Huang Tang (Enriches the yin and nourishes the kidney, Formulas & Strategies, 2nd edition, Scheid, Bensky, Ellis, Barolet, 2009) Ba Wei Di Huang Wan (Tonifies yin, nourishes blood and stops sweating, Formulas & Strategies, 2nd edition, Scheid, Bensky, Ellis, Barolet, 2009) Qi Ju Di Huang Wan (Kidney and liver yin deficiency, Formulas & Strategies, 2nd edition, Scheid, Bensky, Ellis, Barolet, 2009).

It’s not always the case of Er Xian Tang (Warms the kidney yang, tonifies kidney essence, drains fire from the kidneys and regulates the penetrating and conception vessel, Formulas & Strategies, 2nd edition, Scheid, Bensky, Ellis, Barolet, 2009) either.  

As a classically trained herbalist (thanks to ICEAM and Dr Arnaud Versluys team), I now also consider the following formulas from the Jin Gui Yao Lue (Essential Prescriptions of the Golden Cabinet, Translation & Commentaries, Wiseman, Wilms, 2013).

Chapter 20 of this book is dedicated to herbal treatment for pregnant women.

Gui Zhi FU Ling Wan: Blood Stasis in the Chamber of Blood

JG 20.2: For women who have pre-existing mass disease, and the interruption of the period has not yet reached three months, after which there is incessant leakage, with fetal movement above the umbilicus, then it is damage to consolidated mass. When in pregnancy there is stirring at six months, and the three months prior to the pregnancy was uninhibited, then this is the fetus. If there is bleeding. If there is bleeding after the menses had stopped for three months it is due to bad blood. The reason why the bleeding does not stop is because the mass is not expelling. For one should purge the mass, and Gui Zhi Fu Ling Wan governs.

Chapter 22 discusses Women’s Miscellaneous Diseases.

Wen Jing Tang: Blood Stasis in the Chamber of Blood Due to Cold Stagnation

JG 22.9: Question: “When a woman of about fifty years of age suffers from vaginal bleeding for several tens of days, without stopping, with heat effusion at dusk, lesser abdominal urgency, abdominal fullness, vexing heat in the palms of the hands, and dry lips and mouth. What is this?” The Master says: “The disease is ascribed to disorder below the girdle. How is it caused? [The woman must have] previously experienced a miscarriage as a result of which static blood is present in the lesser abdomen, instead of having been eliminated. How can you know this? You know this by the sign of dry lips and mouth. Use Wen Jing Tang to govern it. [This formula] also governs women’s lesser abdominal cold and chronic failure to conceive; it also helps to eliminate blood from flooding or excessive menstrual bleeding or failure of the menses to arrive [at their proper] time.

Chapter 8 talks about Running Piglet Qi and I have used the following formula from a range of four formulas.

Ben Tun Tang: Reversal of qi (ascending of yang within conception vessel)

JG 8.2: In running piglet Qi surges upward to strike the chest, with abdominal pain, and alternating hot and cold, Ben Tun Tang governs.

Lastly, I have also used a formula from chapter 6 which is on blood impediment (characterized by numbness in parts of the body) and deficiency taxation (chronic debilitation).

Gui Zhi jia Long Gu Mu Li Tang: Xu Lao (deficiency taxation)

JG 6.8: If patients suffering from seminal loss present with string like tension in the lesser abdomen, yin-head cold, dizzy vision, hair loss, and a pulse that is extremely vacuous, scallion-stalk like and slow, this means clear grain, blood collapse, and seminal loss. Whenever you see a pulse that is scallion-stalk and stirring or faint and tight, this means seminal loss in men and dreaming of intercourse in women, Gui Zhi Jia Long Gu Mu Li Tang governs.

You might not be familiar with these formulas but might find them helpful if Liu Wei Di Huang Tang or Er Xian Tang is not working for menopausal hot flushes.



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