TCM Approach to Dysmenorrhea

Painful menstruation or dysmenorrhea happens prior to, during, and after a woman’s menses. The lower stomach is the part of the body where cramping mainly occurs although it can also be felt in the lower back and even down the legs. The pain varies from woman to woman and it typically manifests as a dull, constant pain or sharp, throbbing pain that often comes and goes. In extreme cases, there is usually nausea and vomiting, and occasionally, some lightheadedness. Approximately 50 percent of women suffer from some of recurring painful menstruation that ranges from mild to really severe symptoms that lasts for one to three days. From the standpoint of Chinese medicine, the symptoms of dysmenorrhea indicate hidden imbalances that can be readily treated. In Western medicine, dysmenorrhea is considered to be just a normal part of a woman’s life.

From the perspective of Western medicine, high prostaglandin levels produced by the uterus cause the menstrual cramping. This triggers abnormal muscle contractions that restrict blood circulation to parts of the uterus. This problem can be divided into two types:

1. Primary dysmenorrhea – This can start from adolescence and endure until early adulthood. It’s associated with hormonal imbalances that lead severe uterine contractions.
2. Secondary dysmenorrhea – This usually develops in women who are in their thirties and forties. Secondary dysmenorrhea is usually experienced along with fibroids, benign tumors (myomas), endometriosis, pelvic inflammatory disease, and other conditions.

The conventional treatments for dysmenorrhea are contraceptive pills to address the hormonal imbalances that accompany the irregular periods. Painkillers are usually recommended if no specific condition causing the dysmenorrhea is diagnosed.

According to Chinese Medicine, gynecological conditions can have two main approaches. One approach is the “organ energetics” approach which is commonly recommended by Traditional Chinese Medicine (TCM). The other is the “channel energetics” approach as espoused by Classical Chinese Medicine (CCM). Despite the fact that TCM was developed relatively recently (during the 1950s, in China), it doesn’t signify a progress but an abbreviated and very simplified variant of Chinese medicine prior to the rise of Mao Tse Tung. After Mao’s rise to power, the healthcare system of China was thrown into disarray due to the lack of practitioners to treat the vast population. To address this problem, the government slashed the length of apprenticeship from the traditional ten years down to three years of class room training with fewer than 50 percent of the energetics of the body being taught.

The body’s energetics is comprised of more than over seventy channels with their own respective energetics and twelve organ energetics. Practitioners of TCM are instructed in just 14 channels and organ energetics; that is, regular channels related to the twelve organs and the twelve organs’ energetics as well as two other channels, Du and Ren. CCM practitioners are taught more than seventy energy channels and organ energetics recognized by Chinese medicine. In TCM, the signs and symptoms of the patient are basically the result of organ energetics imbalances in and rebalancing the organ energetics is the only way to address the imbalances. CCM also recognizes organ energetics imbalances and the imbalances that occur in channel energetics.

What’s the point in bringing up those differences? Well, there are fundamental differences in these approaches that transcend what has been already explained. What’s more, bringing up CCM is one way to make readers aware of just how vast and extensive Chinese medicine is and let them know that TCM is just one component of Chinese medicine. However, this article will only be focusing on dysmenorrhea from the standpoint of TCM.

From this standpoint, adequate flow and volume of blood aided by subtle energy (qi) equals a healthy period. Involved in a woman’s menstruation are the channel energetics of Chong, and Kidney, Spleen, and Liver organs. Liver qi, for example, aids in the healthy circulation of qi and blood. If emotional stress causes stagnation of Liver qi, then blood may be unable to flow well enough, oftentimes leading to pain one or two days prior to menses. Pain will be felt during menses if there is stagnation of Liver-blood.

Chinese acupuncture TCM-style basically works to get qi and blood circulating smoothly via the treatment of the Liver channel because it focuses on the pathway of the Liver channel through the reproductive organs and genitalia. If a TCM practitioner diagnoses blood deficiency in a woman, acupuncture can aid assist in transforming other body resources into new blood. Blood deficiency is a serious condition in a woman because it means she doesn’t have enough blood to circulate evenly and smoothly throughout the body and this can result in sharp or dull pain among many other more serious symptoms.

Dysmenorrhea and other Western medicine conditions are not treated by Chinese medicine. Instead, a practitioner, after performing a thorough intake, uses a naturalistic strategy by classifying the signs and symptoms of the patient into basic patterns of imbalance. There are usually a number of patterns of imbalance that is diagnosed involved in the health of the patient.

Typical TCM Patterns for Dysmenorrhea in TCM-Style of Chinese Medicine

• Blood and Qi Deficiency –scanty menses; dull pain, the pain improves with pressure developing during or after menses

• Blood stasis and Qi Stagnation – pain worsens with pressure, starts during period or prior to or at the first or second day of the period; dark-red menses with blood clotting

• Yang Deficiency Causing Cold in the Uterus – pain during or post period that improves with heat; scanty pale menses

• Kidney-Yin and Liver Deficiency – pain in the lower stomach; scant, thin menses

• Damp heat in the Lower Stomach – pelvic inflammation, occasional burning pain during menses; bright red or yellow and strong-smelling menses

• Damp-Cold in the Uterus – scanty dark menses; pain prior to or during period that improves with heat but worsens with pressure; low back pain

Acupuncture treatments in the tradition of TCM usually involve lifestyle and nutrition changes and Chinese herbs.

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Reading, MA 01867
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