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Dysmenorrhea and pain control
Dysmenorrhea refers to cyclical abdominal pain which is experienced during or before menstruation. It occurs most typically in young women two to three years after the onset of menstruation. Menstrual pain will take the form of cramping, lower abdominal pain, lower back pain or a pulling sensation in the inner thighs. Pain is often accompanied by headaches, dizziness, vomiting, nausea, diarrhea or constipation. This is a common health problem for women all over the world.
Rose is a nurse who works in a conventional medicine hospital. She has been affected by menstrual pain most of her adult life, and has had to skip five days of work every month for the last ten years. Over the years she has tried all kinds of prescription pain killers and over-the counter pain relievers. Finally, a friend recommended that she see an acupuncturist. She was skeptical at the beginning, but she came to see us on one of her "miserable" days, and experienced relief from the very first acupuncture treatment. We recommended that she have two treatments
every month before her menstruation. Three month’s acupuncture and herbal
medicine treatments, turned her from a skeptic to a firm believer.
Conventional medicine uses the term "primary dysmenorrhea" for pelvic pain that is the normal result of having a period, and the term "secondary dysmenorrhea" for pain during menstruation which is caused by an abnormal condition such as endometriosis, fibroids, or pelvic inflammatory disease. Ibuprofen or Naproxen is two of the over-the-counter pain relievers for menstrual pain which are commonly recommended by doctors. Birth-control pills and some stronger prescription medications also reduce menstrual pain, but with these there can be unwanted side effects. The way conventional medicine manages menstrual pain is to block the formation of prostaglandins, a substance that is produced abundantly by the body during menstruation.
In Chinese medicine, menstrual pain, like other forms of pain, is caused by one or more of the following diagnostic patterns: blockage of Qi and Blood; deficiency of Qi and Blood; retention of Heat, Dampness or Wind; or imbalance of Kidney and Liver. The goal of treatment (both herbal and acupuncture) is to tonify the deficiencies, open the blockage, remove the excesses and regulate the internal organs.
Dysmenorrhea and Pain Management in Chinese Medicine In Chinese medicine, pain is the symptom 0f a deeper problem. The root cause of pain can be either an Excess (Shi) pattern or a Deficiency (Xu) pattern. The blockage of Qi and Blood, or the retention of Heat, Dampness
or Wind, are Excess patterns. Deficiency of Qi and Blood, or imbalance of Kidney and Liver are Deficiency patterns. Blockage of Qi and Blood causes pain; imbalances of the internal organs cause pain; blockage of the meridians causes pain. Figuring out the source of the pain is the key to diagnosis and treatment. Non-fixed pain is attributed to a Wind pattern. "Chilly" pain is associated with a Cold pattern. Heavy and swollen pain is associated with a Dampness pattern. Sharp pain is associated with a Blood Stasis pattern. Stomach pain and back pain are attributed to retention of Cold in the Middle. Dull pain is associated with a Blood Deficiency pattern. Pain with redness, swelling and heat is associated with a Heat pattern. Joint pain with leg soreness is attributed to Kidney Deficiency. Chinese medicine practitioners use acupuncture and herbal medicine to relieve pain through one or a few of the following strategies: expelling Wind; dissipating Cold; eliminating Dampness; moving Qi; invigorating Blood; nourishing the Blood; clearing the Heat; tonifying the Kidneys.
Differentiating the patterns of menstrual pain depends on analyzing the timing, nature, location, intensity, color, volume and quality of the menstrual cycle and discharge, and "reading" the tongue, pulse, and associated symptoms. Generally speaking, menstrual pain before the period indicates an Excess pattern, whereas menstrual pain after the period indicates a Deficiency pattern. Aversion to pressure on the abdomen indicates an Excess pattern, and feeling relief when pressure is applied to the abdomen indicates a Deficiency pattern. Sticky menses with dark-red color indicates an Excess pattern. Feeling relief after passing menstrual blood clots indicates a Blood Stasis pattern. Abdominal pain with hypochondriac distention indicates a Qi Stagnation pattern. Thin menses of a pale-red color, and experiencing pain after the period indicates a Qi and Blood Deficiency pattern. Experiencing "cold" abdominal pain, and passing small, dark blood clots indicates a Cold pattern. Thin menses of a pale-red color, and experiencing back soreness indicates a Kidney-Liver Deficiency pattern.
Treatment of Dysmenorrhea with Herbal Medicine Dysmenorrhea is effectively treated with Chinese herbal medicine and acupuncture. The most important of the herbal menstrual pain relievers, angelica (Dang Gui) and corydalis tuber (Yan Hu Suo), are either used in a single herb form or in combination with other herbs in a formula. Treatment of Dysmenorrhea with Acupuncture Besides using herbal medicine to treat dysmenorrhea, acupuncture is another viable way to treat menstrual pain. Acupuncture can open the blockage of Qi and Blood, balance the internal organs, and clear the blockage of meridians. Scientific studies find the following mechanisms
for pain relief: acupuncture stimulates the production of endorphins, blocks
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