Balance (Heat)™

TCM herbal formula for menopause with heat manifestations — clears deficiency heat; nourishes yin; calms the shen (spirit); stops perspiration; balances female hormones; antidepressant; sedative; osteoprotective

⚠️ Contraindicated in cases of cold and deficiency. Allergy warning: Xiao Mai (Fructus Tritici) contains wheat — persons with wheat allergy should not take this product.

CLINICAL APPLICATIONS

* Menopause and its associated conditions:

— Hot flashes

— Night sweats

— Insomnia

— Mood swings, emotional instability, and irritability

* Related symptoms: restless sleep, crying spells, and disorientation

Background: Menopause is the cessation of menses (amenorrhea) for at least one year due to decreasing ovarian function. Clinical symptoms include hot flashes, night sweats, mood swings, emotional instability, irritability, and osteoporosis. Menopause generally begins at approximately 49–50 years of age, and the transition may last 3–5 years.

TCM perspective: The chief cause of imbalance during menopause is Kidney yin deficiency with deficiency heat. Treatment focuses on clearing deficiency heat and nourishing yin to address hot flashes, mood swings, and night sweats. Irritability and emotional instability are addressed by spreading stagnant Liver qi.

Balance (Heat) vs. Nourish: These are the two most commonly used formulas for menopause. Balance (Heat) is stronger to clear deficiency heat and relieve symptoms such as hot flashes and emotional disturbance. Nourish is more effective to tonify the underlying Kidney yin deficiency and alleviate conditions such as thirst, dryness, and atrophy of genitourinary tissues. Generally, Balance (Heat) is given first to alleviate symptoms — when the condition is under control, switch to Nourish to tonify yin and consolidate the effect. Both formulas are safe and can be used throughout the entire menopause period.

Key herb-level clinical data:

— Gan Cao + Xiao Mai + Da Zao (Gan Mai Da Zao Tang / Licorice, Wheat, and Jujube Decoction): the three principal herbs — nourish Heart blood and moisten internal organ dryness; clinically: 133 menopause patients — 92.7% effective for insomnia, 84.1% for perspiration, 94.4% for tidal fever, 86.85% for headache, 67.8% for irritability and restlessness, 70.2% for abdominal fullness; 54 menopause patients — complete relief in 35, improvement in 14, no effect in 5; 22 of 30 women (73.3%) significant relief; also effective for insomnia (74.2%), neurasthenia (92%), hysteria (88.8%), and zang zao restless organ syndrome (92.1%)

— Xiao Mai (Fructus Tritici / Wheat Grain): nourishes the shen (spirit) of the Heart; treats excessive worrying and anxiety; works with Chai Hu to regulate nervousness, irritability, and mood swings

— Chai Hu (Radix Bupleuri / Bupleurum): spreads stagnant Liver qi; regulates nervousness, irritability, and mood swings; sedative — reduces spontaneous motor activity and prolongs sleeping time

— Qing Hao (Herba Artemisiae Annuae / Sweet Wormwood / Artemisia): clears deficiency heat; reduces hot flashes and heat sensations; regulates body temperature; relieves warm body sensations and fever

— Zhi Mu (Rhizoma Anemarrhenae / Anemarrhena): clears deficiency heat; antidepressant — sarsasapogenin markedly increases noradrenaline and serotonin levels in the hypothalamus and hippocampus; osteoprotective — suppresses descent of bone mineral density; corrects decreased calcium and E(2) in serum; promotes bone formation without inhibiting bone resorption

— Mu Dan Pi (Cortex Moutan / Moutan / Peony Bark): clears deficiency heat; reduces hot flashes and heat sensations

— Bie Jia (Carapax Trionycis / Turtle Shell / Softshell Turtle): nourishes Kidney jing (essence); replenishes vitality lost through normal aging

— Di Huang (Radix Rehmanniae / Rehmannia): nourishes Kidney jing (essence); antiosteoporotic — potently stimulates osteoblast proliferation to increase bone mass density; regulates endocrine system and hormonal balance

— Fu Xiao Mai (Fructus Tritici Levis / Light Wheat Grain / Floating Wheat): stops abnormal perspiration and night sweats

— Shou Wu Teng (Caulis Polygoni Multiflori / Polygonum Vine / He Shou Wu Stem): nourishes Heart blood; pacifies nerves; treats insomnia and nervousness; sedative — prolongs sleeping time

— Da Zao (Fructus Jujubae / Jujube / Red Date): nourishes Heart blood; moistens internal organ dryness; sedative — reduces spontaneous motor activity

— Di Gu Pi (Cortex Lycii / Lycium Root Bark / Wolfberry Bark): drains yin-deficient fire; controls hot flash flare-ups; regulates body temperature; relieves warm sensations and fever

— Huang Bo (Cortex Phellodendri Chinensis / Phellodendron): drains yin-deficient fire; controls hot flash flare-ups

— Bai Shao (Radix Paeoniae Alba / White Peony): nourishes yin and blood; calms the Liver

— Gan Cao (Radix et Rhizoma Glycyrrhizae / Licorice Root): nourishes Heart blood; moistens internal organ dryness; harmonizes the formula; regulates endocrine system and hormonal balance

WESTERN THERAPEUTIC ACTIONS

* Endocrine / hormonal balance — Di Huang + Zhi Mu + Gan Cao (endocrine system regulation, hormonal balance during menopause transition)

* Antidepressant — Zhi Mu (sarsasapogenin — noradrenaline↑, serotonin↑ in hypothalamus and hippocampus)

* Sedative — Da Zao + Chai Hu (spontaneous motor activity↓, sleep prolonged); Shou Wu Teng (insomnia, nervousness)

* Antipyretic / clears heat — Qing Hao + Di Gu Pi (body temperature regulation, warm sensations↓, fever↓); Zhi Mu + Mu Dan Pi + Huang Bo (deficiency heat↓, hot flashes↓)

* Stops perspiration — Fu Xiao Mai (night sweats, abnormal perspiration)

* Osteoprotective / antiosteoporotic — Di Huang (osteoblast proliferation↑, BMD↑); Zhi Mu (BMD↓ suppressed, calcium↑, E(2)↑, bone formation↑)

CHINESE THERAPEUTIC ACTIONS

* Clears deficiency heat; reduces hot flashes and heat sensations (Qing Hao, Zhi Mu, Mu Dan Pi, Di Gu Pi, Huang Bo)

* Nourishes Kidney jing (essence) and yin (Bie Jia, Di Huang, Bai Shao)

* Spreads Liver qi; regulates emotional disturbance (Chai Hu, Xiao Mai)

* Nourishes Heart blood; calms the shen (spirit); treats insomnia (Gan Cao, Xiao Mai, Da Zao — Gan Mai Da Zao Tang; Shou Wu Teng)

* Stops abnormal perspiration and night sweats (Fu Xiao Mai)

DOSAGE

Standard: 3–4 capsules three times daily on an empty stomach with warm water. Take the last dose half an hour before bedtime if hot flashes, insomnia, restless sleep, or night sweating are especially worse at night. Severe conditions: gradually increase to 8–10 capsules three times daily until symptoms are controlled. Maintenance: reduce to 3–4 capsules daily after relief of symptoms.

Supplementary formulas: Tonify Kidney yin and reduce deficiency heat — add Nourish. Tonify Kidney yin and jing only — add Kidney Tonic (Yin). Emotional instability, irritability, mood swings — combine with Calm. Severe shen disturbance with insomnia — combine with Calm (ES). Stress, insomnia, and fatigue — add Calm ZZZ. Depression or crying spells — add Shine. Vaginal dryness — add Balance Spring. Vaginitis — add V-Support. Osteoporosis prevention and treatment — add Osteo 8. Fibrocystic disorders of female reproductive organs — use Resolve (Lower). Benign breast tumors, mastitis, and nodules — use Resolve (Upper). Hair loss — combine with Polygonum 14. Constipation — use Gentle Lax (Deficient). Lack of libido or Kidney yang deficiency — add Vitality. Poor memory and forgetfulness — use with Enhance Memory. Hypertension — add Gastrodia Complex. Thirst and dryness due to Lung and Stomach yin deficiencies — add Nourish (Fluids).

Nutrition: Encourage a diet high in raw foods, fruits, and vegetables to stabilize blood sugar. Wild yam is very helpful to nourish yin and reduce menopause symptoms. Increase intake of nourishing roots: radishes, potatoes, carrots, melons, cucumbers, beets, turnips, malanga, celeriac, taro, and rutabaga. Increase soy products (tofu, soymilk, soy nuts) — regulate estrogen levels and are beneficial for menopause. Increase cooling foods: tofu, tomato, celery, asparagus, bamboo, seaweed, kelp, bitter melon, cucumber, winter melon, oranges, pear, banana, watermelon, white radish, napa cabbage, and bamboo sprout. Take Gou Qi Zi (Fructus Lycii) daily — mix with cereal or trail mix to nourish Kidney yin. Gan Mai Da Zao Tang (Licorice, Wheat, and Jujube Decoction) can be used as tea on a daily basis. Avoid spicy, pungent, and aromatic foods that are warm and may aggravate the condition: mango, durian, lychee, longan, pepper, garlic, onions, basil, rosemary, cumin, fennel, anise, leeks, chives, scallions, thyme, saffron, mustard, chili pepper, and wasabi. Avoid artificial coloring, dairy products, and red meat — they promote hot flashes. Minimize processed meats (lunch meats, hot dogs, sausages) — nitrites are associated with inflammation and chronic disease.

Tao of Nutrition (Dr. Maoshing Ni and Cathy McNease): Eat black beans, sesame seeds, soybeans, walnuts, goji berries, mulberries, yams, licorice, lotus seeds, and chrysanthemum flowers. Avoid stress, tension, and all stimulants.

Lifestyle: Avoid stress, tension, and anxiety as much as possible. Avoid cigarette smoking and second-hand smoke — they dry yin and body fluids. Natural progesterone cream can be applied every 15 minutes to help relieve hot flashes. Eliminate potentially toxic substances: alcohol, coffee, cigarettes, refined sugars, saturated fats, and chemical-based household cleaners and personal hygiene products.

CASE STUDIES

— 49-year-old female (J.J.): Constipation, abdominal bloating, night sweats on sugar pill days of birth control pills; yin deficiency and stagnation. Gentle Lax (Deficient) 3 capsules 3x/day + Balance (Heat) 3–5 capsules at night. Result: regular daily bowel movements, bloating resolved, night sweats resolved.

— 54-year-old female (J.M.): Hot flashes especially bad at night, waking constantly; deep thin pulse, dusky pink tongue with center crack; Kidney yin deficiency. Nourish + Balance (Heat) up to 5 capsules 3x/day. Result after 4 weeks: shorter hot flash duration, sleeping through the night.

— 55-year-old female (S.S.): Hot flashes 10x/day, irritability, difficulty staying asleep, reliance on sleeping aids causing grogginess; arthritis in thumbs, acid reflux; yin deficiency and Liver qi stagnation. Balance (Heat) 3 capsules 3x/day + Calm 3 capsules 3x/day. Result: less irritable, no more hot flashes, sleep improved, sleeping aids only occasionally needed, acid reflux improved.

— 56-year-old female (J.N.): Hot flashes, night sweats, inability to stay asleep, moodiness; Kidney yin deficiency. Balance (Heat). Result: hot flashes and night sweats reduced; sleep and moodiness gradually improved; symptoms returned when herbs stopped.

— 56-year-old female (F.R.): Night sweats, irritability, difficulty staying asleep; Liver yin deficiency. Balance (Heat) 4 capsules 3x/day for 3 months. Result: no more night sweats; only occasional sleeplessness and irritability.

— 56-year-old female (C.R.): Hot flashes, difficulty sleeping, dry mouth, anxiety, depression, constant palpitations and sweating; Kidney yin-deficient heat. Nourish (Fluids) + Kidney Tonic (Yin) + Balance (Heat). Result: less heat sensation, decreased anxiety and sleep difficulty with Kidney Tonic (Yin) + Balance (Heat); dry mouth and thirst resolved with Kidney Tonic (Yin) + Nourish (Fluids).

— 50-year-old female (M.K.): Hot flushed face, mild sweating one week before menses; unable to wear nylon or silk due to sweating; thready weak Kidney yin pulse; Kidney yin deficiency with deficiency heat. Balance (Heat) 8 capsules 2x/day. Result: symptoms resolved quickly; reduced to 4 capsules 2x/day for maintenance.

— 62-year-old saleslady: Night sweats, dry skin, frustration, weight gain; hypothyroid on levothyroxine 100 mcg/day; 1.5 packs cigarettes/day; Liver qi stagnation, Kidney yin and yang deficiency, qi and blood stagnation. Balance (Heat) 2 weeks. Result: "I feel much better overall and I definitely sleep better and am less irritable."

— 44-year-old female nurse: Irritability, 60 hot flashes/day; red tongue no coating, slippery rapid pulse; Kidney and Liver yin deficiency. Modified Balance (Heat) 6 capsules 3x/day + Gui Ban 15g + Qing Hao 9g. Result: hot flashes reduced from 60/day to 2–3/week.

— 49-year-old female social worker: Stress, anxiety, dizziness, irregular menses, irritability, hot flashes, night sweats, painful menses, dry eyes, muscle cramps; Kidney and Liver yin deficiency with Liver qi stagnation. Balance (Heat) + Calm (ES). Result: reduced hot flashes, less irritability, stress, anxiety, and dizziness; better sleep; less painful menses.

— 41-year-old female (M.M.): "Adrenaline-rush" heat flushes to face, mood swings, anxiety; red and purple tongue, red face; Liver stagnation and yin deficiency. Calm 2 capsules 3x/day + Balance (Heat) 2 capsules 3x/day. Result: calmer affect and personality, "feeling good," increased energy, sound sleep.

— 48-year-old post-menopausal female (J.D.): Severe hot flashes requiring constant battery-operated fan at face; no insomnia, mood swings, or palpitations; had tried HRT and OTC supplements with no success. Balance (Heat) 3 capsules 3x/day. Result after 2 weeks: hot flashes completely resolved.

— 51-year-old female nuclear medicine technician: Hot flashes, night sweats, insomnia; irregular periods 1.5 years; Kidney yin and Heart yin deficiency with deficiency heat. Previously: Liu Wei Di Huang Wan (minimal results); Zhi Bai Di Huang Wan (reduced hot flashes from 10–12 to 4/day). Balance (Heat) 6 capsules 2x/day. Result within 1 week: hot flashes and night sweats gone; supplemented with Tian Wang Bu Xin Dan for improved sleep.

— 50-year-old female interior designer: Peri-menopausal hot flashes, night sweats, insomnia, emotional fragility; residual hot flashes despite correct HRT dosing; yin deficiency with deficiency heat. Balance (Heat) 3 capsules afternoon + 3 capsules before bedtime. Result within 1 day: all residual heat symptoms resolved; "excellent addition to hormone replacement therapy."

Related Reading

Also see: Nourish – for Kidney yin deficiency, dryness, and genitourinary atrophy | Kidney Tonic (Yin) – to tonify Kidney yin and jing | Calm – for irritability and mood swings | Calm (ES) – for severe shen disturbance and insomnia | Calm ZZZ – for stress, insomnia, and fatigue | Osteo 8 – for menopause-related osteoporosis | Balance Spring – for vaginal dryness | Shine – for depression and crying spells | Polygonum 14 – for hair loss | Vitality – for lack of libido and Kidney yang deficiency | Nourish (Fluids) – for thirst and dryness | Gastrodia Complex – for menopause with hypertension | Women's Health & Hormonal Support Collection.