Dysmenorrhea or painful menstruation occurs before, during, and after a woman's menstruation. The cramping can occurs mainly in the lower abdomen, but can also be experienced in the lower back and even down the legs. Pain symptoms vary from woman to woman but normally present as throbbing, sharp pain that often come and go or a constant, dull pain. Often, in severe cases, there is nausea and vomiting, sometimes lightheadedness. Roughly half of women have some form of recurring dysmenorrhea, ranging from mild to debilitating symptoms usually for one-to-three days. Although Western doctors and their patients often take dysmenorrhea to be just a normal part of being a woman, from a Chinese medicine perspective the symptoms point to underlying imbalances that can be easily corrected.
From a Western medicine perspective, the menstrual cramping is caused by high levels of prostaglandin hormones produced by the uterus triggering abnormal muscle contractions that cut off blood flow in areas of the uterus. The condition is categorized into the following two types:
- Primary dysmenorrhea: begins from adolescence, can last through early adulthood, and is related to hormonal imbalances that cause excessive uterine contractions.
- Secondary dysmenorrhea: commonly occurs in women who are in their thirties and forties and is often accompanied by conditions such as pelvic inflammatory disease, endometriosis, myomas (benign tumors), and fibroids.
Contraceptive pills are the standard treatment for hormonal imbalances that are accompanied by irregular periods. If no specific condition is diagnosed as the cause of the dysmenorrhea, then analgesics are usually prescribed.
In Chinese Medicine, there are two main approaches to gynecological conditions. There is the more common "organ energetics" approach espoused by the more recent development in Chinese medicine called TCM or "Traditional Chinese Medicine." And there is the "channel energetics" approach emphasized by CCM or Classical Chinese Medicine. Although developed more recently (that is, in China during the 1950s), TCM does not represent an advancement but a very simplified, abbreviated version of what Chinese medicine was before Mao came into power. After their assent to power the China faced a healthcare crisis with not enough practitioners to treat the vast population. So what was traditionally ten years of apprenticeship training was truncated down to three years of class room instruction with less than half of the energetics of the body being taught.
As suggested above, the energetics of the body is made up of the twelve organ energetics and over seventy channels that have their own unique energetics. TCM practitioners have learned organ energetics and just fourteen channels; that is, the twelve organs' energetics and regular channels associated with those twelve organs plus two other channels, Ren and Du. CCM practitioners have learned organ energetics and the over-seventy energy channels recognized by Chinese medicine. Basically, TCM says that patient signs and symptoms are caused by imbalances in organ energetics and need to be corrected by rebalancing organ energetics. CCM recognizes imbalances in organ energetics and those imbalances that arise in channel energetics as well.
So what? Why bring up these differences? First, there are very important differences in these approaches beyond what has been already stated. And, although I will be approaching dysmenorrhea from a TCM perspective (because it is much more likely to be encountered by readers) for the remainder of this article, I bring up CCM in order to just hint at the breadth of Chinese medicine so that the reader does not come to the conclusion that TCM is Chinese medicine.
From a TCM perspective, a healthy period requires adequate blood volume and flow, assisted by qi or subtle energy. Liver, Spleen, Kidney organ and Chong channel energetics are involved in a woman's period. For instance, Liver qi assists in the normal flow of blood and qi. If Liver qi stagnates from emotional stress, then blood cannot move adequately enough, usually causing pain a day or two before the period. If Liver-blood stagnates, then there will be pain during the period.
Basically, TCM-style of Chinese acupuncture works to get blood and qi moving smoothly with the treatment of the Liver channel as its main focus as the Liver channel's pathway passes through the genitalia and reproductive organs. If a woman is what Chinese medicine calls "blood deficient," acupuncture can assist in the conversion of other body resources to form new blood. This is important because blood deficiency means that there is not enough blood for the blood to flow smoothly and evenly, causing dull or sharp pain.
Chinese medicine does not treat Western medicine conditions--including "dysmenorrhea." Instead the Chinese medicine practitioner takes a naturalistic approach by organizing patient signs and symptoms into basic patterns of imbalance, after conducting an extensive intake. Usually there are multiple patterns of imbalance involved in a patient's health presentation.
Common Patterns in TCM-Style of Chinese Medicine for Dysmenorrrhea
- Qi Stagnation and Blood Stasis: dark-red menses with clots, pain worse with pressure, beginning before or at the first day or two of the period and during period.
- Qi and Blood Deficiency: scanty menses, dull pain better with pressure occurring during or after the period.
- Liver and Kidney-Yin Deficiency: thin, scanty menses, lower abdominal pain.
- Cold in the Uterus from Yang Deficiency: pale, scanty menses, pain during or after period and better with heat.
- Low Abdominal Damp-Heat: strong-smelling, yellow or bright-red menses, pelvic inflammation, possibly burning pain during period.
- Uterine Damp-Cold: dark, scanty menses, low back pain, pain before or during period, relieved with heat but worse with pressure.
TCM-style acupuncture treatments usually include nutrition, other lifestyle modifications, and, perhaps, Chinese herbs.
About the author: Andrew Lagomarsino LAc is a graduate of the Swedish Institute's Acupuncture Program in NYC where he studied under the world-renowned Chinese medicine practitioner and Taoist master, Jeffrey C. Yuen. He specializes in the treatment of reproductive and gynecological conditions using classical Chinese acupuncture. For more information about Manhattan, NY acupuncture for dysmenorrhea, gynecological, or fertility health issues please visit his website.