Menstrual pain (dysmenorrhea) is one of the most common gynecological problems that women face. According to Traditional Chinese Medicine (TCM) theory, women who suffer from dysmenorrhea have a blockage in the flow of liver energy.
The liver’s function is to maintain a free flow of qi or energy through the body. When this energy is disrupted it causes an obstruction which develops into pain in the lower abdomen (uterus), and chest area (breasts), both of which lie in the pathway of the liver meridian.
The liver has another key function which is to store the blood. This is important because blood and energy have to fill all the meridians and organs and descend to the uterus for normal menstruation to occur.
When assessing a patient with complaints of menstrual pain, a TCM practitioner will look for any of the following syndromes which can appear individually or combined: excess, deficiency, hot and cold, and/or stagnation of qi and blood.
The excess syndrome involves the Yin and Yang theory based on the philosophical construct of two polar complements in the body.
Yin is characterized by cold, water, downward movement; and Yang by lightness, heat, and upward movement. Excess cold (Yin) is characterized by contraction and stagnation which causes extreme pain. It is relieved by heat. Excess heat (Yang) congests by consuming the blood and body fluids thereby obstructing the free flow of qi and blood. This leads to severe pain, menorrhagia (excessive bleeding), and insomnia.
Symptoms are relieved somewhat by cold, but aggravated by pressure. Digestion is often affected showing as constipation or diarrhea and heartburn. There are numerous Chinese herbs that stimulate and nourish the blood, warm or cool the body and relieve congestion. These are very important for treatment of this disorder.
Deficiency means that there is a deficient amount of qi and blood. It usually affects a woman with a weak constitution, with a chronic disease, or after a hemorrhage. The menstrual flow tends to be delayed and then scanty and pale, lasting only a day or two. The pain is dull and intermittent, often accompanied by soreness of the lower back, dizziness, pale complexion, shortness of breath, fatigue, and depression.
The eyes may feel dry and gritty and there may be spasm in the tendons and muscles. The pain is alleviated a little with pressure. Sluggish digestion and diarrhea are prevalent with this syndrome.
Energy congestion manifests itself as less pain but much more distension of the abdomen and breasts. The menstrual flow is scanty and darkish-brown in colour with clots. Stagnation of blood causes a kind of penetrating pain, which is aggravated by pressure. Abdominal and breast tenderness and distension is minimal compared to the pain. The blood flow contains clots that, when passed, alleviate some of the discomfort.
The qi is distributed throughout the body via an intricate system of channels or meridians. Acupuncture points along these channels act as gateways of energy that can clear blockages which are causing pain.
For dismenorrhea, acupuncture points that regulate the liver energy would be chosen, as well as those used to stimulate the blood. Others would be chosen according to the syndrome present. Auricular points (in the ear) are especially helpful for reducing pain. The needles are gently manipulated which produces a slight numbness, ripple effect, or heat sensation at the site of the point. This indicates what is called the “arrival of qi.” It is a painless procedure which induces deep relaxation.
Moxibustion (so called because the herb that’s burned is called “moxa”) is a heat treatment that can be used to stimulate the acupuncture points and to remove cold and obstruction from the channels. It’s a mild type of heat that penetrates deep beneath the skin, warming the body and giving a sensation of comfort.
There are numerous Chinese herbs available for clearing menstrual difficulties – both patent formulas and raw herbs that have to be decocted into a tea. These can be used to stimulate and nourish the blood, warm or cool the body, and relieve congestion. These are very important for treatment of menstrual pain.
Diet plays a big role because any food that causes congestion is only going to increase the discomfort of menstrual problems. Greasy, fatty, oily, spicy, hot, and pungent foods should be avoided, along with alcohol, coffee, excessive red meat, and raw foods (because they can cause congestion for those who lack adequate digestive strength to metabolize raw foods). Over-eating is obviously very damaging as well. Generally, whole grains, seeds, nuts, fresh fish, steamed vegetables, and fresh fruit are adequate for most people. In addition, keep in mind that dairy products can cause mucous to build up in the body if you have an intolerance or lack the proper digestive enzymes. This mucous build-up can further add to blockage in the liver meridian.
Exercise, as we all know, is essential for health. With menstrual problems it becomes ultra-essential to exercise because it also helps to steady the emotions, and emotional upheaval immediately affects the free flow of liver energy.
Deep breathing and meditation done on a regular basis are recommended, and don’t forget muscle relaxation. By making a concerted effort to relax, everyday pain – whether from headache or menstruation – will be greatly relieved. Lie on the floor and spend some time being aware of the rhythm of your breathing. Concentrate first on the muscles of your feet, working up the legs, thighs, buttocks, right on up to the head, relaxing all the muscles as you go. Pay special attention to unpleasant feelings in the stomach area, and let them go as well. Do this as often as you need to and feel the benefits almost immediately.
After a while pain tends to become part of life, something that we believe has to be endured. But take heart, it is not necessary. You can be in control. With careful diagnosis and treatment, Traditional Chinese Medicine can ease or eliminate the pain and facilitate a normal menstrual period.
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