As women transition through perimenopause and menopause, the shifts aren’t just hormonal—they touch every layer of the body, mind, and spirit. Traditional Chinese Medicine (TCM), sees the Heart as the Emperor of the body, the residence of the Shen (our spirit and consciousness), and a vital player in how we experience joy, connect to others, and feel a sense of purpose. During times of great transition—like menopause—tending to the Heart becomes a sacred practice.

The Heart and the Emotion of Joy

In Chinese Medicine, the Heart is associated with the emotion joy. This isn’t the fleeting excitement of dopamine hits; it’s a deeper, more enduring sense of contentment, connection, and purpose. Joy nourishes the Shen. But too much stimulation, too much giving without boundaries, or unexpressed emotional pain can scatter the Shen, leading to anxiety, restlessness, insomnia, palpitations, and a sense of disconnection from oneself.

For women in menopause, this scattered Shen is all too familiar—racing thoughts at night, emotional overwhelm, difficulty concentrating, or feeling emotionally flat. While these symptoms are often attributed to hormonal fluctuations, in TCM, we look deeper: Is the Heart nourished? Is the Shen rooted in Blood?

The Healing Power of Laughter

In Traditional Chinese Medicine, laughter is the sound of the Heart and the natural expression of joy. It warms the spirit, moves Qi, and harmonizes the Heart’s energy. Genuine laughter is medicine. It relaxes the diaphragm, opens the chest, and releases emotional tension. In menopause, when emotions can feel raw and moods unpredictable, making space for daily laughter can help anchor the Shen and reawaken your connection to yourself and others.

Cultivating joy doesn't have to be complicated. Start with nurturing meaningful friendships and heartfelt connection—being seen and heard nourishes the Heart. Set healthy boundaries so your energy isn’t constantly drained by doing too much or saying yes when you mean no. And sometimes, the most healing thing you can do is watch a good comedy, laugh until your belly aches, and let your inner Fire shine.

Shen, Sleep, and the Role of Blood

In TCM, the Shen is housed in the Heart, and the Heart is nourished by Heart Blood. If the Blood is deficient—common in menopause due to aging, poor digestion, overwork, or emotional depletion—the Shen becomes unanchored. Sleep becomes disturbed, anxiety increases, and the capacity for joy dwindles.

This is why sleep and Blood are so intertwined. We say, “Qi is the commander of blood, and blood is the mother of Qi,” and healthy sleep is when the Shen returns to rest in the Heart at night. But if the Heart Blood is weak or the Heart Fire is too strong, sleep becomes elusive or restless. This is also where the connection to the Kidneys becomes important.

The Bao Mai: Heart-Kidney Connection

The Bao Mai is an energetic channel that connects the Heart and the Uterus, with the Kidneys playing a critical intermediary role. In menopause, as Kidney Yin declines (Kidney Yin being the cooling, nourishing aspect of the body), the Heart loses its grounding. This can manifest as Heart Fire blazing upward—leading to hot flashes, night sweats, insomnia, anxiety, and palpitations.

Maintaining a healthy Bao Mai connection means tending both to Heart Shen and Kidney Essence. This is also symbolic of aligning our emotional and reproductive selves—our capacity to love and be loved, and our creative, reproductive essence.

Setting Boundaries: A Spiritual Act

The Heart in TCM governs clear perception and discernment. If our Heart is healthy, we can make wise decisions, maintain emotional boundaries, and speak our truth. During menopause, many women feel called to re-evaluate their roles, relationships, and energy output. This is not selfish—it’s Shen preservation.

Boundaries are a form of Heart protection. When we say “no” to what depletes us, we say “yes” to what nourishes us.

Heart in the Five Element Framework

In the Five Element Theory, the Heart belongs to the Fire element and rules the summer season, laughter, the color red, and the bitter taste. It is nourished by Wood (Liver) and gives rise to Earth (Spleen).

This means when the Liver is stagnant (frustration, anger, resentment), the Heart can’t receive the flow it needs. Conversely, a joyful, balanced Heart nurtures the Spleen, improving digestion, memory, and focus. The Water element (Kidney) controls Fire, which reminds us again of the Heart-Kidney balancing act. All are connected.

The Heart and Small Intestine: Truth and Clarity

The Small Intestine is the paired Yang organ to the Heart. While the Heart discerns truth with the Shen, the Small Intestine separates pure from impure on a physical and mental level. It helps us digest not just food, but also information and emotional input.

When this pairing is strong, we can tell what’s good for us and what’s not—whether it’s a food, a habit, or a relationship. When the Small Intestine is overwhelmed, we may feel confused, or mentally sluggish.

5 Lifestyle Rituals to Support the Heart

Wind-down sleep ritual – dim lights, tech-free evenings, herbal teas like rose or jujube to calm the Shen.
Midday sun exposure – nourish Fire element with 10–20 minutes of sunshine.
Heart-centred journaling – gratitude practice, emotional check-ins, or boundary reflections.
Qigong or Tai Chi – gathering calming energy
Sacred pause – create moments daily to feel joy, even for 60 seconds. Let yourself smile, laugh, sing.

5 Shen-Nourishing Foods for the Heart

Goji berries (Gou Qi Zi) – nourish Blood and calm the Shen.
Red dates (Da Zao) – tonify the Spleen and nourish Heart Blood.
Beets – rich in iron, support Blood and circulation.
Rose tea – moves Liver Qi and gently opens the Heart.
Dark leafy greens – support Liver (Wood) to nourish Heart (Fire).

5 Acupuncture Points for Shen, Sleep, and Joy

HT7 (Shen Men) – Calms the spirit, nourishes Heart Blood, ideal for sleep and anxiety.
PC6 (Nei Guan) – Regulates the Heart, opens the chest, alleviates nausea and emotional pain.
KD6 (Zhao Hai) – Nourishes Yin, benefits sleep, and connects Heart and Kidney.
Yin Tang – Calms the mind, relieves tension headaches, great for overthinkers.
SP6 (San Yin Jiao) – Harmonizes Liver, Spleen, and Kidney, supports Blood and calms Shen.

Conclusion

The menopausal transition invites women to become more Heart-led—rooted in discernment, joy, and aligned living. In Chinese Medicine, this isn’t a decline but a return. A return to the self, to wisdom, and to what truly matters. By supporting the Heart, nourishing the Shen, and honouring the interconnectedness of all the Zang Fu organs, we rediscover not just sleep and calm—but deep, radiant joy.

The Heart of the Matter: Joy, Boundaries & Shen in Perimenopause and Menopause