I’m getting ready to teach part of the Chinese Medicine Gynecology class at NUNM this Spring. This class covers the treatment of all things related to our reproductive system - periods, fertility, pregnancy, postpartum and menopause. I also said that I wanted to do a class about sex (yay!) so I am going to teach about sex in Chinese Medicine too. I will be discussing painful sex too (boo!), which is a super important topic.

Sometimes I take for granted how amazing Chinese Medicine is for gynecological issues, because it was a big part of my introduction to acupuncture while working in women’s health and fertility clinics. I saw that many of these patients were also benefiting from acupuncture and realized that was the type of care I wanted to offer these patients. Most people associate acupuncture with treating pain and may not know about how comprehensive acupuncture can be for internal medicine issues. I figured painful periods is a great place to start this discussion.

Painful menstruation is called dysmenorrhea, and refers the pain that occurs around the menstrual, or bleeding, phase of the cycle. There may be other associated symptoms like nausea, fatigue or diarrhea. While many people experience some cramping with their period, some have pain severe enough that it keeps them from doing their regular activities. They may rely on pain relievers and heating pads, but sometimes that is not enough. There are many possible causes for dysmenorrhea that can be explored with a gynecologist - endometriosis, adenomyosis, fibroids, cysts, hormone imbalance, heavy periods, low back injury, past or present infection, pelvic nerve compression, pelvic inflammatory disease.

From a Chinese Medicine perspective, most dysmenorrhea is related to Blood Stasis. Blood stasis is diagnosed through questioning, observation and palpation. Here are some of the signs that would indicate blood stasis:

sharp, stabbing or paroxysmal pain
dark colored blood, possibly with clots
firmness in the abdomen, particularly at the location called “oketsu”
a slippery or wiry pulse
a purple or dusky tongue, possibly with distended sublingual veins
cold hands and feet

There may be other factors that contribute to the blood stasis - heat (inflammation), cold (constricted blood vessels and hypo-function), Qi stagnation (stress and emotions), dampness (fluid retention) and so on.

Acupuncture and Chinese Herbs are amazing for treating blood stasis and therefore painful periods. Acupuncture increases blood circulation, as shown in many research studies that document things like uterine blood flow. (Do you like reading research studies?) We use points like Spleen 6 on the lower leg as well as points on the abdomen or around the sacrum. Typically for menstrual issues, patients come in weekly for about 3 months for significant relief. Then returning in the week before the period for another few months. Though treatment plans are always individualized. Herbs can help significantly, because this brings the treatment home and works on underlying imbalances and inflammation.

Abdominal massage is also amazing for treating dysmenorrhea. While I offer abdominal massage sessions called Chi Nei Tsang - translates to internal organ massage - I also recommend having a self massage routine. A few drops of frankincense (invigorates blood and promotes healing) in some almond oil can make this rather enjoyable. Make sure to work in a clockwise direction and put a pillow under your knees to help relax your abdomen. You can view a quick instructional video here.

I have so much more to say about this topic, but it starts getting more and more individualized. I will save it for my class next month and for the treatment room. Hope to see you there!

By Amber Hincks LAc FABORM