Monday, December 8, 2014

It's That Time of the Month Again


                                                                                            

            It has become a cultural norm here in America that accompanied with a monthly menstrual cycle is pain. Women load up on Midol and Motrin every month to alleviate symptoms of abdominal and lower back cramping, breast tenderness, ovulation pains, ovarian cysts and every other type of pain associated with a period. Patients are placed on birth control to reduce said symptoms and regulate their periods, and sometimes the treatment is to completely stop their cycles all together. The link that many doctors and patients don’t recognize is that abnormal cycles can actually be a precursor to a more serious problem, such as infertility.

                One of the most common western diagnoses for painful periods is Endometriosis. This is when viable endometrial tissue is present outside of the uterine cavity. In Chinese Medicine this will present with symptom of blood stasis leading to the accumulation of damp heat and fire in the lower jiao. When there is blood stasis in the lower jiao, there will be a lack of blood flow to important reproductive organs. This will lead to a lack of nourishment causing infertility. Damp heat in the lower jiao will present as inflammation and cause blockages that must be resolved for fertility to be possible (2).
                Western medicine classifies dysmenorrhea as pain or cramping in the lower abdomen accompanied by other symptoms: sweating, headaches, vomit, nausea, diarrhea and tremors occurring just before or during menstruation. There are two types of dysmenorrhea: primary and secondary. Primary dysmenorrhea occurs in women under the age of twenty with no pathological pelvic disease present. Secondary dysmenorrhea occurs in women over the age of twenty and is usually linked to some pelvic pathology. Risk factors for dysmenorrhea include age, smoking, high BMI, early menarche, null parity, long and heavy menstrual flow and a family history of dysmenorrhea (1).
                Common patterns associated with dysmenorrhea include Spleen Qi and Kidney Yang Xu with a Chong and Ren Disharmony; Kidney Qi Xu with Blood Stagnation; Kidney Yin Xu with LQS and Blood Heat; Spleen Qi and Blood Xu (3); and Excessive Heat or Cold (1). The first pattern is typically associated with luteal phase defect or polycystic ovarian syndrome which can both cause infertility or miscarriage early on in pregnancy. Kidney Qi Xu with Blood Stagnation is common in women with autoimmune disorders or anti-phospholipid syndrome and can cause miscarriage at any time during pregnancy. Kidney Yin Xu with LQS and Blood Heat is commonly seen with anti-sperm antibodies or hyperthyroidism. Spleen Qi and Blood Xu are connected to hypothyroidism, luteal phase defect or incompetent cervix (3). Excessive heat will produce early and heavy periods, whereas excessive cold will produce scanty or delayed periods (1).
                Chinese Medicine views the regulation of blood to be the main treatment of any menstrual disorder. The three main herbs used in any formula for menstrual irregularities are Dang Gui, Bai (Chi) Shao, and Sheng Di Huang. Dang Gui is known as the “female ginseng” for its abilities to regulate menstruation, tonify the reproductive system, relieve pain, reduce PMS and reduce symptoms of menopause (2). Acupuncture points will focus on the Spleen, Kidney and Liver meridians since these are the three meridians most closely associated with menstrual disorders. SP 8, 10 and LV 5 are primary points to move blood and stop pain. SP 6, LV 3, ST 36, KD 6, BL 18, 20 and 23 are good points to nourish the menstrual reservoir. Zi Gong and Ti Tuo are local points that can be used to move stagnation and relieve pain, as well as points on which to use needle Moxa to warm the UT.
                For many reasons, dysmenorrhea and infertility are best treated with the use of both Western and Eastern Medicine. Western medicine has mounds of technology that can visually show where dysfunction is happening in the body and show levels of hormones associated with menstruation and fertility. Many western medicines are very fast and effective for treating the primary concern, but they produce harsh side effects that can be moderated by Chinese herbs to ensure a quick and effective treatment. In the treatment of women’s health, one is good, but two is better.
Works Cited:
                1. Hong, Ju, Mark Jones and Gita Mishra. “The Prevalence and Risk Factors of Dysmenorrhea.” Oxford Journals, Medicine and Health, Epidemiologic Reviews 10.1093 (2013): Web. 27 Dec. 2013.
                2. Zhou, J., and F. Qu. "Treating Gynecological Disorders with Traditional Chinese Medicine: A Review." African Journal of Traditional, Complementary and Alternative Medicines 6.4 (2010): 494-517. NCBI. Web. 8 Dec. 2014. 
                3. Zhao, Liqin. "The Treatment of Recurrent Spontaneous Miscarriage." Journal of Chinese Medicine 101 (2013): 13-18. Print.                                                                               

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