Menopause: Irritable, Hot Flashes, Sweating, Insomnia, Forgetfulness? Kun Bao Wan (Kunbao Pills): Nourishing the Liver and Kidney, Calming the Spirit, and Nourishing Blood to Free the Channels

Patient search terms: menopause / hot flashes / night sweats / irritability / insomnia / forgetfulness / irregular periods / premature ovarian failure / premature menopause / tinnitus / liver-kidney yin deficiency / Kun Bao Wan / Kunbao Pills / Tong Ren Tang

Opening: In the name “Kun Bao Wan” is hidden Chinese medicine’s understanding of women

Today Doctor Luo Dalun talks about a particularly famous ready-made Chinese medicine — Kun Bao Wan (Kunbao Pills). You can find it in many pharmacies, and Tong Ren Tang has kept it in production all along. So what does it actually treat? The answer is already written in its name.

💬 Note from Doctor Luo: Look at the character kun (坤) in “Kun Bao Wan” and you’ll understand at once — it has to do with women. In ancient China, people said the female represents the earth, which carries and nourishes everything, so “kun” is tied to women. “Kun Bao” means: woman is a treasure. The original purpose of this formula is to treat the various imbalances a woman’s body develops around menopause and the years just before and after her periods stop. If you use it to reset the body during this stage, it can do a great deal.

Menopause arrives: the body suddenly becomes “a different person”

Menopause is a special phase in a woman’s life, usually around fifty — right around the age of “seven times seven, forty-nine.” Many women feel exactly the same way: as menopause approaches, the body begins to change in ways completely different from before.

💬 Note from Doctor Luo: The first change is emotional — irritability and quick anger. Many women reach this age and their husband is the first to notice: “Why are you so easy to set off these days?” One wrong word and the temper flares up, and it flares easily — a woman who used to be gentle and composed suddenly loses her temper at the slightest thing. Others suddenly get hot flashes: “whoosh” — a heat like fire surges up, you feel scorching hot, and then comes a flood of sweat. Then there’s insomnia and forgetfulness: sleep used to be wonderful, why are you suddenly staring at the ceiling all night? Your periods become increasingly irregular. You often feel dizzy, your ears ring. Some women suddenly run out of energy — the morning at work is fine, but by the afternoon all strength is gone, and you feel you can barely go on. Add a dry throat, thirst, aching arms and legs… the whole body begins to fall into disorder.

Many women have no preparation at all. They suddenly discover they are “a different person,” and their first thought is: I’m sick. They go to the hospital, and the doctor tells them: this is menopause syndrome — you have entered menopause.

Why does the body suddenly change? Western and Chinese medicine each have their own answer

From the Western point of view, the body’s hormone secretion suddenly begins to shift, certain hormone levels drop, and the body reacts with all kinds of discomfort.

💬 Note from Doctor Luo: How does Chinese medicine see it? We believe this has to do with insufficiency of kidney essence and kidney qi (shen jing, shen qi bu zu) — that is the most important cause. A person spends a whole lifetime being consumed. What is consumed? Kidney essence. Where does kidney essence come from? First, the innate essence (xian tian zhi jing) inherited from our parents; second, the acquired essence (hou tian zhi jing) formed from the clear breath we take in and the finest substances of the food we eat. The two combine to form kidney essence, which is stored in the kidneys — the foundation of our entire life, governing growth, reproduction and so on. As the years pass, kidney essence is continuously consumed. When kidney essence runs low, kidney qi begins to run low too — because kidney essence generates kidney qi, and kidney qi in turn generates kidney yin and kidney yang. When kidney essence and kidney qi are insufficient, the body develops a whole series of problems.

Tian gui: the body’s “countdown” has reached the end

Women also have a concept of their own — tian gui (heavenly tenth). The Huang Di Nei Jing (Yellow Emperor’s Inner Classic) says: a girl at seven has flourishing kidney qi, her teeth change and her hair grows; at fourteen (two times seven), the tian gui arrives, the conception vessel (ren mai) opens, the thoroughfare vessel (chong mai) flourishes, and her monthly periods come on time.

💬 Note from Doctor Luo: Tian gui is a substance generated from kidney essence that is connected with reproduction and related functions — it promotes a girl’s sexual maturation and development and is closely tied to fertility. As we age, tian gui gradually diminishes; around forty-nine (seven times seven), it begins to dry up, and the conception and thoroughfare vessels begin to decline — because essence and blood are running short. At this point the body enters an imbalanced state, and the reaction is especially obvious in women who had insufficient kidney essence and slightly imbalanced yin and yang all along.

Irritable and quick to anger — why can’t you simply soothe the liver and move qi?

When a menopausal woman has a hot temper, most people’s first reaction is “soothe the liver and move qi.” Doctor Luo says: at this stage, soothing the liver alone does not work well.

💬 Note from Doctor Luo: At this time the pattern is dominated by deficiency. Soothing the liver and moving qi requires spending qi and blood — and qi and blood are already insufficient. If you stir them up again, the result is actually worse. Why do the emotions suddenly turn bad? This is what we call heart-kidney non-interaction (xin shen bu jiao) — kidney essence cannot stay hidden and calm, kidney yin is insufficient and cannot rise to nourish heart fire, heart fire cannot descend to warm kidney water, the heart and kidney drift apart, the spirit loses its anchor, and a person becomes irritable and restless. Heart fire blazes above with no kidney water to meet it — water and fire fail to unite — and the emotions are especially easy to disturb. So once you understand this, you see the key is to tonify the kidney — fill up the kidney qi and kidney essence, and the emotions gradually recover.

Hot flashes, sweating and joint pain — all of it is “deficiency” at work

Sweating and joint pain may look alike, but the mechanisms behind them differ; still, the root of both is “deficiency.”

💬 Note from Doctor Luo: Hot flashes and sweating come from kidney essence deficiency progressing toward kidney yin deficiency — most menopausal women move in that direction, because both essence and blood are depleted. When yin can no longer contain yang and deficient yang floats outward (xu yang wai yue), the body feels hot on the surface and sweats. At that point you tonify kidney essence and add herbs that nourish kidney yin, pull the yang back in, and the deficient heat disappears. Joint pain, on the other hand, comes from blood deficiency (xue kui) — when qi and blood are deficient, especially blood, the blood can no longer nourish the four limbs and joints. Problems hidden since youth (wind, cold and dampness absorbed at thirty) were once held down by sufficient qi and blood; now that qi and blood are running low, they burst out — in severe cases even the rheumatism markers climb. So here too you tonify kidney essence, but steer in the direction of nourishing blood.

Formula design (1): the first line of troops — tonify kidney essence first

So which formula should be used? Chinese medicine has countless formulas; today’s star is Kun Bao Wan — the classic ready-made medicine produced by Tong Ren Tang, especially suited to women with insufficient menstrual blood leaning toward yin deficiency.

💬 Note from Doctor Luo: Such a formula must center on nourishing, so it contains a great many herbs that nourish the essence of the liver and kidney — above all kidney essence. For example, shu di huang (prepared rehmannia) — the classic choice for filling kidney essence. Nv zhen zi (glossy privet) and han lian cao (eclipta) — these two together are the famous Er Zhi Wan (Two Solstices Pills), which tonify the kidney, fill essence and nourish yin; they were once used with excellent results for premature gray hair from yin deficiency, and Kun Bao Wan contains both. Then there are fu pen zi (raspberry) to tonify kidney essence, tu si zi (dodder seed) to tonify kidney yang, gou qi zi (wolfberry) to nourish the essence of liver and kidney… the first group of herbs is entirely kidney-tonifying.

Formula design (2): kidney essence is the root; the direction is adjusted to the pattern

Once the kidney-essence herbs are in place, which direction should the formula develop? Here we come to the wisdom of the great Ming-dynasty physicians such as Doctor Zhang Jingyue.

💬 Note from Doctor Luo: I’ve explained before that if you add kidney-yang-tonifying herbs to kidney essence tonics, the formula develops toward tonifying kidney yang; add yin-nourishing herbs, and it develops toward nourishing kidney yin. Many great Ming-dynasty physicians — masters like Doctor Zhang Jingyue — mastered this idea: the kidney essence is fixed and immovable, and the direction of development is adjusted at will according to the patient’s condition. Kun Bao Wan basically targets kidney essence and kidney yin deficiency in women, so it steers toward nourishing yin: it adds gui ban / gui jia (tortoise plastron) to nourish yin, restrain yang and retreat deficient heat, plus mai dong (ophiopogon) and shi hu (dendrobium) to nourish yin. And because women at this age easily develop deficient heat, it also adds bai wei (cynanchum), zhi mu (anemarrhena), sang ye (mulberry leaf), di gu pi (wolfberry root bark), sha shen (glehnia) and other herbs that nourish yin and retreat deficient heat — tonifying on one side while clearing the deficient heat above, and the heat is drawn back in.

Formula design (3): nourish blood and free the channels — women are raised by blood

There is another line of troops devoted to nourishing blood — herbs that tonify essence combined with blood-nourishing herbs develop the formula in the direction of nourishing essence and blood.

💬 Note from Doctor Luo: Ji xue teng (millettia) nourishes blood and frees the channels at the same time — when qi and blood are insufficient, the blood cannot circulate, and stasis is sure to appear. Often we see the blood stasis but fail to see the deficiency behind it. Bai shao (white peony) nourishes yin and softens the liver; chi shao (red peony) frees the channels; dang gui (angelica) nourishes blood and frees the channels. Prepared rehmannia plus peony and angelica is in fact the foundation of Si Wu Tang (Four Substances Decoction) — it lacks only one herb, chuan xiong. Women are raised on blood — the old saying goes “men are governed by qi, women are raised by blood” — so any woman regulating her body must consider nourishing blood. When the liver and kidney are insufficient and kidney essence is depleted, the blood is certainly insufficient; and it is the insufficiency of essence and blood that makes the qi and blood of the thoroughfare and conception vessels (chong mai, ren mai) decline, producing menopausal symptoms. Once the blood is sufficient and the channels free, the body’s state improves enormously.

Formula design (4): settle the liver and calm the spirit — “reel in” the temper

The last line of troops calms the emotions — settles the liver and quiets the spirit. With a menopausal hot temper, you must not rush to soothe the liver and drain liver fire; the approach should be nourishing and calming above all.

💬 Note from Doctor Luo: The formula pairs bai shao to constrain and soften the liver; suan zao ren (sour jujube seed) — the sour flavor enters the liver, constraining liver qi and nourishing liver blood. The famous Ming-dynasty physician Doctor Miao Xiyong’s clinical insight was that “nourishing blood requires suan zao ren” — for a woman who needs her blood nourished, a generous dose of suan zao ren gives excellent results. Then zhen zhu mu (mother-of-pearl) — a heavy, settling herb that, like tortoise plastron, pulls deficient heat downward and steadies the spirit; and ju hua (chrysanthemum), sang ye (mulberry leaf), bai wei and zhi mu to clear deficient heat. Once the deficient fire in the heart is cleared, the irritability disappears and the temper stops flaring so easily.

When can you use it? Remember the four characters “liver-kidney yin deficiency”

Kun Bao Wan’s indications boil down to eight characters: nourish the liver and kidney, calm the spirit and settle the mind, nourish blood and free the channels — for the liver-kidney yin deficiency pattern in women around the cessation of their periods.

💬 Note from Doctor Luo: Everyone should remember that this is tied to yin deficiency: irregular periods; hot flashes and heavy sweating; insomnia (tossing and turning like a pancake on a griddle); forgetfulness (when blood fails to nourish the heart, everything slips your mind); irritability and anger (kidney water cannot rise to meet heart fire, heart fire blazes alone, and with liver yin and blood insufficient, liver fire rises easily); dizziness and tinnitus (when liver-kidney yin is insufficient, deficient fire sits above — this kind of tinnitus is especially sharp, growing louder the more you cover your ears, louder at night, buzzing like a cicada until you can hardly bear it); a dry throat and thirst (the kidney channel ends at the throat, so kidney yin deficiency dries the throat); aching joints in the four limbs (yin blood is too scanty to nourish the limbs and joints). If these symptoms appear, Kun Bao Wan is worth considering. But if yang deficiency is pronounced, it is not suitable — warming herbs must be added.

Not only menopause: women whose periods stop at thirty-odd, and men too?

Does this formula work only for menopause? Doctor Luo says: no.

💬 Note from Doctor Luo: Women who have not reached menopause but already show liver-kidney deficiency leaning toward yin deficiency can also use it. Modern women are drained far more than women of ancient times — busy work, late nights. I have seen women whose periods stopped in their early thirties, with symptoms identical to menopause — that shows the deficiency has already become severe — and of course they can use it: when the pattern is present, use the medicine. What about men? This medicine does not really distinguish between men and women. As long as there is kidney essence insufficiency, essence-blood deficiency leaning toward yin deficiency, restlessness and vexation, it can be used. That is why I always say: look at the formula, not the name — don’t look at “Kun Bao Wan” and assume only women can take it, or read “regulates menopause” on the package and conclude you surely can’t use it. If it matches the pattern, you can use it.

A final word: learning to use ready-made Chinese medicines is learning to protect yourself

Formulas like this one can generally be bought in pharmacies all over the country — at Tong Ren Tang in particular, it is right there on the shelf.

💬 Note from Doctor Luo: If you understand this knowledge and meet these symptoms, using the medicine lets the body recover slowly — that is protection for your own body. Every piece of Chinese medicine knowledge we talk about is meant to help you know how to protect yourself, to have it at hand whenever you need it, so your body is not harmed. That is a blessing for your family, and a blessing for you personally. In the future I will keep sharing more knowledge about women’s health and more classic methods.

Menopause is not an illness — it is the “gear-shifting” moment when the body enters a new phase. Recognize it, understand it, and help the body shift smoothly with the right methods — that is the best care you can give yourself.

Compiled from Doctor Luo Dalun’s Chinese medicine lecture series — the ready-made Chinese patent medicines series: Kun Bao Wan (nourishing the liver and kidney, calming the spirit, and nourishing blood to free the channels), the classic formula for regulating women’s menopause (the various disorders around the cessation of periods).