The period before and after menopause in women includes menopause and late menopause. Menopause is also known as perimenopause. Female menopause is a physiological process that every woman must go through in her life course. When women reach the age of 50, their ovarian function gradually declines, hormone secretion decreases and is not sufficient to stimulate the endometrium, and menstruation stops from sparse to menopausal. What is perimenopause? It is the period before menopause and within 1 year of menopause, generally refers to the age of 40 years after the appearance of clinical manifestations such as internal division, biological changes and menstrual disorders, to within 12 months of menopause. The age of menopause varies greatly among individuals and is related to their health, physical condition, endowment and genetics, but not to race, geography and climate, generally between 45-55 years old. According to Chinese medicine, menopause in women is due to the ageing of the kidneys, which leads to the deficiency of the Qi of the Ren and Chong Channels, which are in charge of menstruation and fertility, resulting in the lack of the substance that produces menstruation. This is clearly described and documented in the ancient Chinese medical classic “Huangdi Neijing”: “At the age of seven, the Ren and Taichong veins are weak, the Tian is exhausted, and the Earth is not accessible, so the form is bad and childless.” This means that women between the ages of 42 and 49 will experience a decline in kidney energy, menstrual disorders, reduced fertility, emaciation, increased wrinkles, white hair and a series of other problems. According to statistics, among women aged 40-59, who account for about 11% of the total population in China, more than 50% have menopause-related symptoms or diseases of varying degrees, which is a large group. Modern women are more concerned about the quality of life and physical and mental health. Due to the special social role of women, coupled with richer, more delicate and sensitive emotions, their emotions in life are easily affected by external things and the environment, with more changes, ups and downs, and easily produce anxiety, irritability, pessimism, depression, loss and other adverse psychological reactions. Traditional Chinese medicine has always believed that people’s mood changes are closely related to the liver. People with liver qi are more impatient, and those with depressed liver qi are more sentimental, depressed and chesty. In menopausal women, the normal function of the liver is affected by kidney deficiency, so they tend to lose control of their emotions and become emotionally unstable. The clinical treatment of menopausal syndrome in Chinese medicine is based on tonifying the kidneys and regulating the liver. Kidney deficiency includes kidney qi deficiency, kidney yang deficiency, kidney yin deficiency, kidney essence deficiency, and even kidney yin and yang deficiency. Obviously the medication used naturally varies and there is a lot to learn. Of course, the clinical practice is not just to supplement the kidney and regulate the liver, but to consider and analyze the patient’s condition and symptoms as a whole, and to use different medicines according to the symptoms. Generally, menopausal symptoms begin to appear when menstrual disorders occur during the menopausal transition, and can last until 2 to 3 years after menopause, and only a few people can have their symptoms reduced or disappear only 5 to 10 years after menopause. Menstrual disorders, hot sweating, irritability, palpitation and insomnia, dizziness and forgetfulness, mental depression, abnormal emotions, chest tightness and sighing, foreign body sensation in the throat, swelling, loose stools, itchy skin, or ants and other abnormal sensations are common in menopause, which are called the symptoms before and after menopause or before and after menopause in Chinese medicine. The essence is endocrine changes. Menopausal symptoms cause mental suffering and increase the risk of hypertension, coronary heart disease, arteriosclerosis, and fractures due to osteoporosis. Attempts have been made to prevent menopausal syndrome with estrogen, and in the last fifty years, research into the therapeutic use of estrogen has received attention and recognition. However, because many drugs can increase the load of liver disease, blind application also has the potential to increase the risk of breast cancer or endometrial cancer. Therefore, estrogen-related tumors (breast cancer, endometrial cancer, melanoma), serious liver and kidney diseases, and patients with recent thromboembolism must be prohibited, and patients with diabetes, gynecological disorders or family history of breast cancer must be used with caution under the guidance of a doctor, which affects the widespread use of estrogen. So how should menopause syndrome be prevented and treated? In recent years, Chinese medicine has made promising progress by taking the advantage of holistic and constant action and evidence-based treatment. From the current research data on the treatment of menopausal syndrome in TCM, it is clear that TCM is not only comparable to estrogen in terms of efficacy, but also has been more than adequate in terms of safety. More importantly, Chinese medicine has a regulatory effect on the gonadal axis of menopausal syndrome, especially through intra-ovarian regulation to revive “dying” follicles and slow down ovarian aging, which is incomparable to the effect of estrogen in replacement therapy alone. Moreover, Chinese medicine can improve the immune function of menopausal syndrome and prevent osteoporosis. In Chinese medicine, the root cause of menopause syndrome is the deficiency of kidney essence, the failure of the heavenly sap, the lack of essence and blood, and the inability to pass through the rhythm. Therefore, although the origin of the disease is in the kidney, the symptoms are in the heart, liver and spleen. In particular, the heart and liver are more prominent. The deficiency of kidney essence is the root of the disease, the fire in the heart and liver is the standard, and phlegm and blood stasis are the standard. Treatment can be based on kidney, liver, spleen and kidney, or heart, liver and kidney, or phlegm and stasis. According to the different types of clinical evidence, diagnosis and treatment, Chinese medicine treatment can play the characteristics of multi-link, multi-level, multi-angle, multi-target action. Nourishing Yin, tonifying kidney, strengthening bone and filling marrow is the treatment at the root; relieving liver and depression, strengthening spleen and stomach are the countermeasures; benefiting Qi, resolving phlegm and invigorating blood stasis are the necessary measures to prevent further development of the disease. Through treatment, we can alleviate the symptoms, shorten the course of the disease, adjust the function of the patient’s hormonal-endocrine system, and improve the internal and external environment of the body, so as to alleviate or reduce the various symptoms of menopausal syndrome and bring it to a new dynamic balance.