“I’m only forty-six. Surely this isn’t menopause yet.” The heat rises at four in the morning, the covers come off, then go back on. Periods have started arriving early or late. Sleep that used to be solid now breaks every night.
Menopause is one date, the last period. The changes around it start years before that date and can carry on for years after. Those years are the part that affects daily life, and they are the part worth treating.
ONE WORD, SEVERAL CHANGES
What does “menopause” actually cover?
The same word is used for changes that feel quite separate, and they do not arrive in the same order for everyone.
Hot flashes during the day, heat rising to the face and chest, night sweats that wake you.
Waking in the small hours, sometimes with heat first, sometimes with a racing mind.
A pounding heart, a shorter fuse, a low mood that was not there before.
Swollen fingers in the morning, aching joints, weight settling around the middle.
Which of these leads, and which follows, shapes the plan.
AT DEAR
What happens at your first visit?
- The heat, on a timetable
When the flashes come, how often, how long they last, and whether night sweats wake you.
- Your cycle and your sleep
How your periods have changed, and how your nights break.
- The rest of you
Heart, mood, digestion, swelling and joints, plus your blood pressure.
- Treatment
Acupuncture after heat or gentle electrical therapy, and a herbal prescription written for your pattern.
I ask about every medicine and supplement you take, including hormone therapy, and about your most recent health check-up. The goal is set from all of it, not from the hot flashes alone.
The herbs are Korean-grown and meet the Ministry of Food and Drug Safety standard for herbal medicines, and I prescribe for about fifteen days at a time so the prescription can follow how you respond.
CASE
What does improvement look like?
Hot flashes and night sweats almost gone in three months
A woman in her late 40s · heat and sweating in the small hours · a changing menstrual cycle
Heat rising to the face and upper body before dawn, covers off and on again, and sleep turning light.
Her recently changed cycle, heat that also came during the day, and the pattern of sweating at dawn.
Sleep improved, and the morning swelling in her fingers and her joint aches eased too.
Identifying details have been removed. This describes one patient’s course; results differ from person to person.
Read what patients say about DEAR
TIMING
Why not simply wait it out?
Across 1,449 women followed through the menopause transition.
When symptoms began while periods were still regular, they lasted a median of more than 11.8 years.
Waiting for the last period can mean years of broken sleep first.
“It will pass” is true, but for many women it passes slowly. Seven years of broken nights is a long time to carry through work and family. If the heat and waking have started, the useful moment to treat is now, not after the last period.
EVIDENCE
Does acupuncture help hot flashes?
Each had four or more hot flashes or night sweats a day, and received up to 20 sessions over six months.
In the comparison group without acupuncture, they rose by 6.0% over the same period.
Several quality-of-life measures improved alongside.
The trial was run in ordinary community practice, much like a course of treatment in a clinic, and the effect built over weeks. That is why I plan a course at the first visit rather than judging by a single session.
NIGHTS
Does the heat wake you, or do you wake and then feel the heat?
It sounds like a fine distinction, and it changes the treatment. When the heat comes first and wakes you, the night sweats are leading. When you wake first, with a racing mind or a pounding heart, and the heat follows, tension and sleep are leading.
Asleep easily, or too warm to settle?
Heat first, or awake first?
Stiff fingers, damp sheets?
A hot flash at the desk?
An example of the questions, not a diagnosis.
I ask you to notice which comes first for a few nights before your visit. That one detail tells me more than a list of symptoms.
HERBAL MEDICINE
Why does one woman’s prescription differ from another’s?
“Menopause” does not come with one prescription. A woman whose nights are dominated by heat and sweating, a woman whose tension and racing heart lead, and a woman who is simply worn down after years of work and caring for others all need different herbs.
So I write the prescription for the pattern I find, and review it about every fifteen days against your heat, your sleep and your days.
HEART
A racing heart at night or at work
A pounding heart at night or in the middle of a meeting often travels with the heat and the broken sleep. I ask when it starts, how long it lasts, what you were doing just before, and what comes with it: heat, sweat, a tight chest, dizziness. When it is needed, I add an autonomic function measurement to the consultation.
BODY
Swollen fingers and aching joints
Stiff, puffy fingers in the morning and joints that ache for no clear reason are easy to put down to age or to typing. In the patient above they eased along with the hot flashes, which is why I ask about them rather than treating the heat alone. I separate fluid that comes and goes during the day from pain in the joints themselves.
WEIGHT
Weight settling around the middle
Weight that gathers around the waist in these years is worth reading on a body composition report, not only on the scale: the visceral fat area, the fat around the organs, is the number tied to blood pressure, blood sugar and the liver. When weight is the main concern, I plan it the way I plan herbal weight loss at DEAR: no starving, enough protein, and a pace you can eat through.
BEFORE YOU COME
What to note before your first visit
A few days of notes make the first consultation far more precise: when the flashes come and how long they last, whether the heat or the waking comes first at night, the dates of your last few periods, and any medicine or supplement you take, including hormone therapy. If you have a recent health check-up, bring it.
Talking about night sweats, a changing cycle or a low mood is easier with someone who will listen to the whole story. I see you myself at every visit, and there is no coordinator in between.
HORMONE THERAPY
What if you take, or are considering, hormone therapy?
Hormone therapy is prescribed and monitored by your gynecologist. Tell me whether you take it, since when and at what dose, and I plan around it. Whether you prefer not to take hormones, cannot take them, or already take them, we start from the same consultation.
If the heat and the broken nights have started, message us. I will see you myself, in English, and we will start from what your days and nights actually look like.
DEAR KOREAN MEDICINE CLINIC
About a 10-minute walk from Gangnam Station Exit 5 · +82-2-3486-1777
- Mon·Tue·Wed·Fri10:00–20:00
- Lunch13:00–14:00
- Thu14:00–20:00
- Sat10:00–15:00
- SunClosed
FAQ
Frequently asked questions
Can I come if I take hormone therapy?
Yes. Tell me whether you take it, since when and at what dose, and I plan around it. Hormone therapy itself is prescribed and monitored by your gynecologist.
How many sessions will I need?
I plan a course at the first visit. In a randomized trial, women received up to 20 acupuncture sessions over six months, and the reduction in hot flashes held for six months after treatment ended.
Is it covered by insurance?
Acupuncture is covered by Korean national health insurance if you are enrolled, at the same fee as for Korean patients. Visitors without Korean insurance pay the uninsured fee, which we explain before treatment. Herbal medicine is not covered; I explain its cost before anything is prescribed.
Can I have my consultation in English?
Yes. Director Minji Kim consults directly in English, Japanese and Chinese, so you won’t need an interpreter.
How do I book?
Appointments are given priority, so we recommend booking before your visit. The most reliable way is an Instagram DM to @dearhani__, or you can call us at +82-2-3486-1777.
Sources
- Avis NE, Coeytaux RR, Isom S, Prevette K, Morgan T. Acupuncture in Menopause (AIM) study: a pragmatic, randomized controlled trial. Menopause. 2016;23(6):626–637.
- Avis NE, Crawford SL, Greendale G, et al. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern Med. 2015;175(4):531–539.
This article provides general health information and does not replace an individual diagnosis or treatment. Results differ from person to person.