In TCM, This syndrome is usually caused by decline of kidney qi, near exhaustion of reproductive substance (tiangui), deficiency of the thoroughfare and conception vessels and insufficiency of essence and blood before and after menopause; or by asthenia of kidney yang and malnutrition of meridians and vessels; or by frequent asthenia of blood; ot by multiparity and excessive sexual life, or serious disease and prolonged illness and severe asthenia of kidney yin that lead to failure of yang to keep in latency as well as asthenia of yin and hyperactivity of yang; or by deficiency of kidney yin that fails to nourish the heart and liver, leading to hyperactivity of heart and liver fire; or by frequent asthenia of yang and excessive intake of cold foods consuming kidney yang. This syndrome is marked by kidney asthenia, disturbance of the heart, liver and spleen as well as disorder of yin, yang, qi and blood. There is no such a term of perimenopausal period in TCM literature. But the symptoms are included in recurrence of menstruation in old women, hysteria and lily disease, collectively known as symptoms before and after menopause.