Feeling hot and cold at the same time can feel perplexing, but modern medicine explains that this happens when the body's regulatory systems lose their balance. Translating upper heat and lower cold from Donguibogam into modern terms points directly to hormonal imbalance and autonomic nervous system disruption.
The central factor in the climacteric is a sharp decline in estrogen levels. Estrogen supports not only reproductive function but also overall health, especially thermoregulation. The hypothalamus in the brain houses the body's thermoregulation center. When estrogen drops, the function of the hypothalamus becomes unstable. Like an erratic thermostat, it overreacts to minor shifts in body temperature. As a result, even when the body is not actually overheated, sudden vasomotor symptoms appear, such as facial flushing and profuse sweating.
The autonomic nervous system also plays a central role here. It is divided into the sympathetic nerve and the parasympathetic nerve, unconsciously regulating heartbeat, digestion, blood pressure, and thermoregulation. During the climacteric, declining estrogen and chronic stress tend to trigger sympathetic hyperactivity. When the sympathetic nerve becomes overly active, blood vessels constrict, reducing blood flow to peripheral areas such as the hands, feet, and lower abdomen, which creates cold qi. The cold-dampness of the lower abdomen described in Donguibogam can be understood as this reduced circulation and localized cold sensation caused by sympathetic hyperactivity, along with resulting mild inflammation or edema.
When these constricted, cold blood vessels suddenly dilate, trapped heat is rapidly released, producing facial flushing and sweating, much like suppressed pressure releasing at once. In addition, estrogen influences intestinal motility and fluid metabolism. Its decline can weaken bowel function and fluid metabolism, worsening lower abdominal discomfort or cold sensations. Chronic stress, irregular routines, and sleep deprivation deepen this autonomic nervous system imbalance and impair temperature regulation, aggravating climacteric symptoms. Modern neurology and endocrinology continue to reflect the Donguibogam view that the body's internal systems are organically interconnected. Keeping the lower abdomen warm is therefore an effective way to support core bodily functions.
