Millions of women suffer from painful periods. Often the pain occurs the day before the period starts. Some women experience menstrual cramps during the period. And some feel exhausted and achy when the period is over. Chinese Medicine explains menstrual period cramps in terms of the proper flow and quantity of Qi (energy) and Blood. By asking very detailed and specific questions about the menstrual cycle a practitioner can determine the underlying cause of menstrual cramping. Both acupuncture and Chinese herbal formulas are very effective to resolve the vast majority of painful period cramps.
To determine the pattern of imbalance in the body that is causing the painful period symptoms, questions must be answered as to the timing of the pain, the location of the pain, the character of the pain and whether or not it is aggravated or relieved by cold, heat or pressure. The regularity and length of the cycle, the quality of the pulse and the color of the tongue may also be significant in coming to a correct diagnosis.
Menstrual period cramps can be due to the stagnation of Qi or Blood. Pain can be due to a deficiency of Qi or Blood. Pain can be due to the presence of internal Heat or Cold. In many cases, a combination of the above will explain a painful period.
In Chinese Medicine, the energy of the Liver, or Liver Qi, is responsible for the free flow of energy in the whole body. When the Liver Qi is stuck, or stagnant, Blood will stagnate in the uterus leading to painful periods. Anger, frustration and resentment are the most common factors leading to Liver Qi stagnation. When pain is due to Liver Qi stagnation, women will have abdominal and breast distention for a few days before the period starts. The menstrual blood will be dark and may start and stop hesitantly. Irritability is common. Acupuncture is very effective to move the Liver Qi. A very famous Chinese herbal formula, Xiao Yao Wan, addresses all of the symptoms of Liver Qi stagnation.
Stagnant Liver Qi can “turn to fire”. When stagnant qi generates heat in the body, the menstrual flow will be heavier, irritability will become pronounced with actual outbursts of anger. The woman will be thirsty and actually feel warm. Constipation may become a problem. The tongue will show heat signs. It will be red, especially the sides of the tongue, and have a yellow coating. The pulse will be rapid and wiry. A modified version of Xiao Yao Wan, Dan Zhi Xiao Yao Wan is more appropriate because of the addition of heat clearing herbs.
Chronic Liver Qi stagnation often leads to stagnation of Blood. When the Blood becomes stagnant, the pain is more intense or stabbing in nature with severe menstrual cramps. The menstrual blood is dark with blood clots. The tongue may take on a purplish color and the pulse may have a wiry or choppy quality. There are several Chinese herbal formulas to address Blood stagnation in the lower abdomen. Tao Hong Si Wu Tang is one of the most commonly used and contains many herbs to nourish and invigorate Blood.
Chinese Medicine believes that excessive exposure to cold and damp weather can cause Cold to invade the uterus. This is especially true during puberty when the body is vulnerable, or in women during or shortly after the period or childbirth. Cold causes contraction and stagnation of Blood which in turn causes pain. This pain is relieved by the application of heat. The menstrual blood is scanty, bright red with small blood clots. Women with this pattern feel cold and have a sore back. The tongue has a pale blue or bluish purple cast to it. The pulse feels choppy or tight. To treat Cold stagnation, the Chinese herb moxa is used on acupuncture points to expel cold and warm the uterus. A famous Herbal formula to treat Cold obstructing the uterus is Wen Jing Tang (Warm the Menses decoction).
When pain is due to deficiency conditions, it is usually a dull pain and occurs towards the end or after the period. If there is a Qi and Blood deficiency, there will be a dragging sensation in the lower abdomen that is relieved by pressure and massage. There will be scanty bleeding. The woman may feel tired and dizzy after the period. The complexion and tongue will look pale. A famous Chinese herbal formula to nourish the Qi and Blood is Ba Zhen Tang. Ba Zhen Tang may be modified to add a few herbs to move qi and stop pain, but this basic formula will address the root of the problem by tonifying Qi and Blood.
If a woman is Yang and Blood deficient, her abdominal pain will be relieved by heat and pressure. The menstrual blood will be scanty and pale. She will feel cold and fatigued in general and may have frequent urination. The tongue will be pale and swollen. Moxa should be used in these cases to warm the Yang. A good formula to treat the root of the problem is Dang Gui Jian Zhong Tang.
The last deficiency pattern is one of Kidney and Liver Yin deficiency. A woman with this pattern will experience dull back pain towards the end of the period. She may have hot flashes or night sweats, blurry vision and ringing of the ears. The tongue will be red with cracks and no coating. A good Chinese herbal formula for this pattern is Gui Shao Di Huang Tang. This is a variation of the famous Liu Wei Di Huang Tang with the addition of two herbs that nourish Blood – Dang Gui and Bai Shao.
If there is a mixture of deficiency and excess patterns, the excess, or stagnation, may be treated for two weeks prior to the menses and the deficiency in the two weeks after the period. It usually takes a minimum of three months to fully resolve menstrual irregularities, though many women experience an improvement in symptoms soon after acupuncture and or herbal treatment starts.
About the Author:
Joyce Marley is a licensed acupuncturist serving New Hartford-Whitesboro-Clinton-Utica-Rome, NY. She writes Acupuncture and Traditional Chinese Medicine (TCM) articles for alternative health solutions.