Recently, Professor Linhua Zhao’s team from Guang’anmen Hospital, China Academy of Chinese Medical Sciences, published an article entitled “Strategic framework to advance scientific innovation in clinically dominant diseases in traditional Chinese medicine: Menopausal syndrome” in the World Journal of Integrated Traditional and Western Medicine. Published as part of the journal’s special topic on clinically dominant diseases in traditional Chinese medicine, the article focuses on menopausal syndrome, a condition in which traditional Chinese medicine has demonstrated clinical strengths, and proposes a forward-looking strategic framework for scientific innovation and clinical translation.

Menopausal syndrome, also known as perimenopausal syndrome or menopause-related symptom complex, refers to a group of symptoms that occur as ovarian function gradually declines under natural physiological conditions. These symptoms are mainly related to autonomic nervous system dysfunction and neuropsychological changes, including hot flashes, night sweats, sleep disorders, anxiety, and depression. With increasing life expectancy, women are spending a longer period of their lives after menopause. As a result, perimenopausal health management is no longer limited to short-term symptom relief, but has become an important window for the early prevention and control of chronic diseases such as osteoporosis, cardiovascular disease, glucose and lipid metabolism disorders, and cognitive decline.

At present, menopausal hormone therapy is internationally recognized as one of the first-line treatments for menopausal syndrome, with the advantages of rapid onset and targeted efficacy. However, its use is limited by numerous contraindications and precautions, the need for long-term safety monitoring, and relatively low patient acceptance. For women who are unsuitable for or unwilling to receive hormone therapy, safe, comprehensive, and long-term non-hormonal interventions remain a major clinical need.

Menopausal syndrome is considered one of the clinically dominant diseases in traditional Chinese medicine. Traditional Chinese medicine emphasizes holistic regulation and syndrome differentiation, and has unique value in improving multiple systemic symptoms, including hot flashes and night sweats, sleep disturbances, mood changes, fatigue, and musculoskeletal discomfort. As a non-hormonal therapeutic approach, traditional Chinese medicine also has broad applicability. It may be used across different stages, including the menopausal transition, early postmenopause, and late postmenopause, and shows potential advantages in preventive treatment and full-cycle health management.

This study was based on the 21st Youth Academic Salon on Clinically Dominant Diseases, held by the China Association of Chinese Medicine in Beijing on April 18, 2023. More than 20 experts from traditional Chinese medicine, Western medicine endocrinology, gynecology, and interdisciplinary fields held in-depth discussions on the development patterns of menopausal syndrome, challenges in modern diagnosis and treatment, therapeutic advantages of traditional Chinese medicine, integrated TCM–Western medicine approaches, and future research priorities. On this basis, the authors developed a future research framework and strategic recommendations.

The article points out that although traditional Chinese medicine has accumulated certain clinical evidence in the prevention and treatment of menopausal syndrome, several key issues remain. First, high-quality evidence-based research is still insufficient. Some studies have limitations in randomization, blinding, sample size, follow-up duration, and safety monitoring. Second, clinical research design is not sufficiently aligned with real-world clinical questions, particularly in relation to long-term efficacy, recurrence, comorbidity prevention and control, and special populations. Third, the diversity and depth of existing evidence remain inadequate, and current studies have not fully reflected the strengths of TCM syndrome differentiation, individualized intervention, and symptom-specific advantages.

In response to these challenges, the article proposes four major priorities for advancing menopausal syndrome as a clinically dominant disease in traditional Chinese medicine.

First, the integrated TCM–Western medicine diagnostic and therapeutic model for menopausal syndrome should be optimized. The article recommends establishing stratified, precise, and practical intervention pathways based on symptom severity, patient characteristics, contraindications or precautions for hormone therapy, and patient treatment preferences. For patients with mild to moderate symptoms, traditional Chinese medicine may be considered as a primary approach to improve hot flashes, insomnia, and mood disturbances. For patients with moderate to severe symptoms, the organic integration of traditional Chinese medicine and Western medicine should be explored, rather than a simple combination of the two.

Second, a TCM-based comorbidity prevention and control framework for menopausal syndrome should be established. Menopause is not only a stage in which symptoms are concentrated, but also a critical period during which women face increased risks of chronic diseases such as osteoporosis, cardiovascular and cerebrovascular disease, glucose and lipid metabolism disorders, and cognitive decline. The article proposes that the TCM concept of “preventive treatment of disease” should be moved upstream to early screening, early diagnosis, and early intervention, shifting the focus from a disease-centered model to a health-centered model.

Third, the evidence-based system for TCM interventions in menopausal syndrome should be strengthened. The article emphasizes that future research should include large-sample, multicenter, long-term, high-quality randomized controlled trials and real-world studies. It also calls for the establishment of core outcome sets for TCM interventions in menopausal syndrome, and for comprehensive evaluation based on the biopsychosocial medical model, covering symptom improvement, quality of life, psychological status, long-term comorbidity risks, and safety.

Fourth, interdisciplinary collaboration in mechanistic research on TCM interventions for menopausal syndrome should be promoted. The article recommends building a closed-loop translational research model of “clinical-basic-clinical” research. Mechanistic studies should be guided by key clinical questions and integrated with frontier interdisciplinary technologies such as multi-omics, artificial intelligence, and network pharmacology, so as to clarify the material basis and mechanisms of action of traditional Chinese medicine in preventing and treating menopausal syndrome, and to promote the development of new Chinese medicines and clinical translation.

Article information

Article title: Strategic framework to advance scientific innovation in clinically dominant diseases in traditional Chinese medicine: Menopausal syndrome

Journal: World Journal of Integrated Traditional and Western Medicine

fulltext access : https://doi.org/10.70976/j.2096-0964.WJIM-2025-0036