Hormone replacement therapy (HRT) drugs have been in the news in the UK lately, because of the shortage of some HRT products, particularly oestrogen. About one million women in the UK use HRT to cope with menopausal symptoms such as hot flushes, night sweats, insomnia, decreased libido, anxiety and poor concentration.

The good news is that Chinese medicine offers a safe and effective alternative to HRT. Systematic reviews and randomised controlled trials (which are the strongest types of research evidence) found that acupuncture is at least as effective as, and sometimes superior to, hormonal drug treatment. 

In my clinic I regularly give acupuncture treatment to women who need help for menopausal symptoms. About 30-70% of women in Western countries will experience vasomotor symptoms (related to constriction or dilatation of blood vessels) like hot flushes or night sweats. In extreme cases they might have been experiencing these for decades. The median duration for vasomotor symptoms is about four years, but in 10% of women, they last longer than 12 years. 

I see myself as walking proof of how Chinese medicine can help those transitioning through menopause, one of millions of women around the world. I manage the symptoms with regular acupuncture and Chinese medicine herbs, along with healthy food choices, regular exercise and stress reduction. And maybe more importantly, it's about appreciating this next stage in my life. Menopause doesn't have to be such a scary word. I'm older and wiser, and that brings with it confidence and serenity. 

Of course I am mindful that I am fortunate to enjoy good health. To some degree it's about luck (i.e. genetics), but there's a lot that middle-aged women can do to help ourselves.

Photo credit: yochim from Free Images

I don't know about you, but my family and I have been in coronavirus lockdown for 25 days (first in self-isolation, then in semi-lockdown along with the rest of the UK) and I am starting to feel a niggly ache in the back. And I am hearing this a lot when I talk to friends and colleagues, who say they have stiffness or pain in joints as a result of sitting a lot.

If we were already, as a society, sitting too much before, then this is certainly the case now as movements are restricted to however many rooms you have in your living space. In the UK, we're allowed to go out once a day for exercise, shopping for essentials, medical appointments, and essential work. Assuming we sleep eight hours a day, that leaves us 14-15 hours a day potentially sitting down a lot!

One solution is to invest in a standing desk. But if you look at amazon, for example, stands desks are neither cheap nor always in stock. Yesterday a friend of mine suggested using your bog standard ironing board as an adjustable desk for a laptop.  

I like to set an alarm so that every hour, I am reminded to get up, stretch and move. Make a cup of tea! Or better yet, offer to make others cups of tea. Everyone knows that a good cuppa is all you need to make it all okay.

In terms of supported exercise, of course you have a plethora of Youtube exercise channels and yoga webinars to choose from.

However, if you fancy doing a more gentle exercise that is good for circulating and generating energy and requires no specialist equipment, do give qi gong a try. Qi gong is a system of energetic and healing exercises from ancient China that integrates principles of relaxation, movement and breathing, especially helpful during these days of self-isolation. My colleagues and I at the School of Tai Chi Chuan London are running free weekly webinars at 6pm (London time) on Tuesdays. No previous experience necessary. 

If you'd like to give qi gong a try, please email me and I will send you a link to these online gatherings.

Day 2 in Locked-down London. I hope you're keeping safe and remembering your epidemiologically approved 2m distance. (Try saying that word three times in a row!)

Our professional body, the British Acupuncture Council, has advised members to stop practising acupuncture. How frustrating because in China, Chinese medicine doctors are very much in the frontline of the war against this novel coronavirus. But if we can't give acupuncture treatments, there are other ways to help.

We all know the importance of eating well and in moderation, doing enough exercise (Boris Johnson has given us all a pass to go out once a day!), and getting enough physical and mental rest. Those are all key to keeping your immune system strong. But because the coronavirus attacks the lungs, we can all do with specific exercises to strengthen the lungs.

Qi gong and tai chi are so-called internal exercises that were developed by the ancient Chinese and are very much part of the Chinese medicine universe, along with acupuncture, herbs, massage (tui na) and diet. Tai chi is a system of movement, meditation, and self-defence; the tai chi form consists of a sequence of postures, strung together in smooth, slow, continuous movement. In contrast, qi gong is co-ordinated body-posture and movement, breathing and meditation, and done standing or sitting.

You don't need to know the tai chi form to do qi gong. Both exercises are fabulous ways of circulating qi (translated as vital energy) around the body, which is essential to health. If you are interested in doing some qi gong exercises for strengthening the lungs, watch this lovely video of Peter Deadman, one of the pioneers of Chinese medicine in the UK. We all seem to have a lot of time nowadays!

Photo credit: Edward Johnson

Last week I attended what I thought would be an ordinary case study day -- where acupuncturists present difficult or challenging cases and explain their clinical reasoning and acupuncture points used. Like other clinicians, acupuncturists have to do a certain number of continuing professional development (CPD) hours a year, and this case study day was free to members of the British Acupuncture Council. 

I enjoyed the interesting cases, but by far the most thought-provoking presentation came from Sheria Chan, an acupuncturist who helped organise free emergency acupuncture clinics for victims of the Grenfell Tower fire in June 2017 (a fire in a 24-storey block of flats in west London that claimed 72 lives and shocked the UK).

I always knew that this 2,000-year-old medicine is used in disaster situations. I have heard of acupuncture used to help people suffering from post 9/11 trauma in New York City. Battlefield acupuncture is used by the US military to give rapid pain relief, enabling medical personnel to get wounded soldiers away from the battlefield quickly. I regularly treat patients for symptoms of trauma in my clinic. But as I listened to Sheria talk about the the immense challenges of setting up emergency acupuncture clinics in a chaotic disaster environment, I was moved and inspired. 

In the Grenfell case,  volunteer acupuncturists used ear acupuncture to treat shock, trauma and anxiety at three clinics for more than a year. This is an emergency measure, to help people caught up in the chaos after the fire, to help them cope until they can get formal treatment. It is a reminder of the power and flexibility of this ancient medicine.

My friend Lina and I (I'm on the left) spent a couple of hours this morning with a group of carers in north London to give a talk on complementary therapies. The event was organised by the Brent Carers Centre, which offers support and activities to carers in the local area. This is a very large group of people whose work often goes unrecognised in society. One in eight adults in the UK are carers, according to Carers UK. This really hit home a few years ago when my mother-in-law started caring for my father-in-law at home, which is effectively a 24-hour job.

I spoke about the benefits of acupuncture and Chinese medicine to address physical, psychological and mental conditions. This seems to have resonated deeply with the attendees and it was great to see such  level of interest, presumably because of the very high mental and physical toll on carers. Seventy-two percent of respondents to Carers UK's State of Caring survey said they suffered mental ill health as a result of caring, while 61% said they suffered physical ill health. Many of the attendees wanted to know what they can do to help themselves, whether that is getting treatment or learning tai chi or qi gong (Chinese exercises that are based on principles of relaxation, balance and breathing, among others). They had conditions such as migraines, sciatica and tinnitus that respond well to acupuncture.

Apart from anything else, it was great to team up with my friend Lina Ramchand, whom I first met in Hong Kong about 20 years ago when we were both copy editors at the South China Morning Post. She is now practising reflexology, Indian head massage and sekhem energy work, and I am now an acupuncturist so we can help patients and carers in so many ways.

Six weeks ago, I went to bed with an achey left shoulder, felt the pain getting more intense through the night, and woke up the next day to a frozen shoulder. Also known as adhesive capsulitis, frozen shoulder is exactly what it says on the tin — the shoulder gets stiffer and achier over a period of 2-9 months (freezing phase); the pain gradually subsides but the shoulder is stiff and movement is restricted, which lasts about 4-12 months (frozen phase); the shoulder becomes less stiff and range of movement increases, which takes 1-3 years (thawing phase).
 
No one knows why shoulders freeze, although previous shoulder injury or trauma plays a part. More women than men are afflicted. The incidence of frozen shoulder is 2 to 4 times higher in those with diabetes than in the general population. What I do know is: a) it is very painful, and b) everyday activities like washing your hair, putting on a shirt, and driving a manual car become impossible.
 
The irony is not lost on me that I spend a large part of my working day treating patients with painful necks, shoulders and backs, when I myself can hardly lift my left hand without grimacing!
 
But here is the upside (and because I am an inveterate optimist, there is ALWAYS an upside). I know that for me, regular acupuncture, osteopathic treatment, stretching/strengthening exercises, as well as my tai chi practice, are key to getting more movement and reducing pain and inflammation. I also have more empathy with patients in pain. Let’s face it, pain makes you grumpy. It has a way of reducing even the sunniest personality into a blubbering mess, I get that. 
 
I also understood that there is an emotional component to a frozen shoulder. When you are going through a difficult time — whether at work or at home — you might hold yourself tight and stiff without realising it. When this goes on for years and years, this means less blood and qi (energy) circulating, which means less nourishment for muscles, tendons, ligaments and joints. Over a period of time, a vulnerable shoulder freezes. 
 
During the very painful stage, my wise osteopath advised me to see my frozen shoulder not as a problem to be fixed but rather as a healing journey that I have to go on. I know now that it helps to have patience (it might takes years to resolve), be kinder to myself (what’s the use of asking what could have been done to prevent it), and rediscover my sense of humour (the advantages of not being able to do certain chores!).

​A recent study by scientists at the Hebrew University of Jerusalem found that sperm counts among men in the west have fallen by around 50% in four decades. There is nothing new in this study, as it was an analysis of more than 100 previous studies in the field. But it certainly highlights what fertility experts have known for decades – that more and more couples worldwide are having problems conceiving.
 
According to the NHS, one in seven couples in the UK may have difficulty conceiving. The causes of fertility are myriad, from polycystic ovarian syndrome (PCOS), endometriosis and thyroid problems for women, to lower quality sperm and low sperm count for men. But for 25% of couples with fertility issues, a cause cannot be identified.
 
In vitro fertilisation (IVF) has gained wide acceptance since the world’s first baby was born through IVF in 1978 (remember Baby Louise?). In the UK, more than 250,000 babies were born through IVF. In the western world, 1% (and rising) of all babies are born through assisted reproductive technology.
 
However, IVF cannot help everyone, with its high emotional, social and financial burden. Fertility drugs have side effects, from bloating and mood swings, to ectopic pregnancy and ovarian hyperstimulation syndrome. The success rate of IVF is highly dependent on the age of the woman undergoing treatment, as well as the cause of infertility.
 
Unless couples have very specific reasons for going down the IVF route, it’s best to try boosting fertility the natural way first. Some of the suggestions are well-known - get healthy, lose weight, don’t leave it too late, have fun with sex. Less well known is the importance of keeping calm and relaxed and not getting too anxious.
 
In Chinese medicine, the Uterus Channel or Bao Mai is the channel which connects the Uterus to the Heart. The Heart is particularly susceptible to emotional stress such as anxiety, which in turn can affect the health and receptivity of the uterus. Trying to have a baby can be very stressful, and when the body is in an anxious state, many physiological reactions can adversely affect your ability to conceive. Hormones are released, blood vessels are constricted, and blood moves away from the torso to the limbs as your body gets ready to flee in a fight-or-flight response. This means that blood supply to the pelvic organs, the uterus and ovaries is reduced.
 
Acupuncture helps boost fertility by improving blood flow to the pelvic organs, therefore promoting the growth of endometrial tissue, optimising ovulation, and regulating menstruation. Acupuncture is safe and has very few adverse side effects, when done by properly trained practitioners. 
 
Click here to see research on how acupuncture can help with female infertility and male infertility.

​What if I were to tell you that there is an acupuncture point on the wrist that helps make cigarettes taste bad? Aha, now that I have your attention, let me add that acupuncture not only helps with quitting smoking but with other addictions as well.
 
I like to use points on the ears as well as on the body. Why the ears? In the mid-1970s an auricular (ear) acupuncture protocol was developed in New York to treat many common drug addictions. The protocol is now referred to as the NADA protocol (NADA stands for the National Acupuncture Detoxification Association) and calls for the insertion of small, stainless steel and disposable acupuncture needles into five points on the outer surface of the ears.
 
When the auricular points are combined with acupuncture points on the body, the treatment aims to relax the patient, relieve anxiety, regulate the autonomic nervous system, and strengthen the lungs and immune system, among other things. And, yes, to make cigarettes taste bad!

January 16th this year is dubbed Blue Monday, that dreaded day in January when credit card bills come to remind you of your Christmas bingeing, the weather remains gloomy, and not a bank holiday in sight until Good Friday on April 14th. And if you started the year with lots of good intentions about watching your alcohol intake, eating more healthily and getting more exercise, what's happening two weeks into the new year?

If you've already broken a resolution, don't despair. Setting goals is great, but it's also important to be kind to yourself. If we want to make a change, we need to realise that it takes time to create long-lasting, sustainable changes. A few days alone will not do it. I read somewhere that it takes a minimum of 21 days of doing something consistently to create a habit. 

So whether you are ditching alcohol, avoiding sugar, going back to the gym, or sticking to your budget, take into account that it takes at least three weeks for a habit to form. And ask yourself, what kind of support do you need?

Chinese medicine is a great ally when it comes to supporting you with your health objectives. As an acupuncturist, I see my role not so much as a healer as much as an enabler or a supporter. 

Because Chinese medicine is such a flexible medicine, it can help with myriad conditions such as relieving stress, improving sleep, optimising your digestive functions (thus helping with weight loss), boosting immunity. This beautiful medicine treats the whole person, not just an illness. A patient (whom I've been treating for stress relief) told me the other day that because he felt less bloated and more energetic (and more relaxed), he was more motivated to exercise more and eat better. What a lovely way to start the year!

Transitions are a stressful time, whether it is divorce, death or losing a job. Even happy occasions such as starting a new job, moving home or giving birth are fraught with uncertainty and anxiety. These are moments when it can be very beneficial to be supported by acupuncture. I was reminded of this very recently while treating a patient who is getting ready to go back to work after a year’s maternity leave.
 
New mums returning to work are full of conflicting emotions, from worry regarding the logistics of getting her baby to childcare in the morning, to possibly guilt about having some time to herself again after having devoted herself to her baby full-time since birth. My son was born in Hong Kong, where maternity leave was a mere 10 weeks. Going back to work was a wrench, and I wish I knew then what I know now about how Chinese medicine can support new mums. 

For starters, acupuncture helps relieve stress by calming and strengthening you so you can cope with the situations that you find stressful. Acupuncture is believed to stimulate the nervous system and cause the release of neurochemical messenger molecules. The resulting biochemical changes influence the body’s homeostatic mechanisms, thus promoting physical and emotional well-being.
 
It is also common for patients to notice improvements with other niggling problems like sleep or digestion, during the course of treatments.
 
Click here to see the research evidence for stress and anxiety.