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Menstrual Problems
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Many women regard their periods as normal even though they may experience pain, excessive bleeding, an irregular cycle or pre-menstrual tension. The term ‘menstrual problems’ covers a wide range of conditions, such as painful periods, heavy or scanty periods, flooding or trickling periods, irregular periods, early or late periods and bleeding between periods.
In orthodox medicine, women are often prescribed the contraceptive pill or coil for heavy periods. Whilst these may help the immediate symptoms in some cases, they act as a suppressant on the overall system and there is some evidence that they are linked to serious diseases such as cancer. If these suppressants are discontinued, symptoms may return, and can do so even more strongly than before.
Menstrual Problems and TCM
In TCM, diagnosis and treatment of menstrual problems and related conditions is based upon an in-depth consultation which involves identifying the causative factors of the condition. Treatment is based upon a number of factors including physical and emotional signs and symptoms. During a treatment, the practitioner will work with the patient to balance their body and mind. For example, much attention is given to the detail of the patient’s lifestyle, diet, exercise and previous history. Other practices, such as Chi Kung and T’ai Chi, flowing forms of exercise that are designed to strengthen and regulate the circulation of Qi throughout the body by harmonising the body, mind and breath, may also be recommended to enable the patient to relieve their pain and enable them to manage their health in a constructive way.
Menstrual problems may be caused by overwork, emotional stress, excessive physical work, exposure to cold, too many children too close together, surgery etc. When diagnosing the cause of menstruation problems, the practitioner will discuss a wide variety of symptoms with the patient, including how regular the cycle is, the amount of bleeding, the colour of the blood and so on. Factors such as the use of contraception (contraceptive pill or coil) will also be taken into account as they can significantly alter how the period manifests itself.
Is Acupuncture Helpful in the treatment of Menstrual Problems?
1Witt et al (2008) demonstrated that acupuncture could alleviate pain in patients with painful periods (dysmenorrhea); the patients also experienced a better quality of life. In an earlier study, 2Cai et al found a 97% improvement in women treated for dysmenorrhea with acupuncture plus auricular (ear) acupuncture.
The use of Chinese herbs in treatment is also successful.
References:
1Witt, C, Reinhold, T, Brinkhaus, B., Roll, S., Jena, S, Willich, S (2008) Acupuncture in patients with dysmenorrhea: a randomized study on clinical effectiveness and cost-effectiveness in usual care American Journal of Obstetrics and Gynecology, Vol 198, No 2, pp166.e1-168 e8
2 Cai, Z, Li, F, Lu, M (2004) Treatment of dysmenorrhea with acupuncture plus auricular acupuncture Journal of Acupuncture and Tuina Science, Vol 2, No 6, pp 45-46
The Menopause
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The menopause is the medical term for the time, usually between the ages of 45 and 55, when a woman’s periods end. This happens as a result of a decrease in frequency, and eventual ceasing, of ovulation, and a consequent drop in oestrogen levels. The menopause is therefore characterized by hormonal changes which can trigger some of the following symptoms:
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Hot flushes
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Vaginal symptoms e.g. dryness
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Palpitations
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Joint pain
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Headaches
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Insomnia
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Anxiety
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Irritability
The majority of women in the developed world will experience some of these symptoms, and for one in five they will be marked, with a significant impact on health and well-being.
Another consequence of the hormonal changes can be osteoporosis: the lower levels of oestrogen can lead to bone loss and a consequent risk of fractures.
Menopause and TCM
In TCM, the reproductive system and the bones are both associated with a concentrated form of Qi which is known as Jing or ‘vital essence’. Jing is partly inherited from our parents, and is gradually used up over our life. If we live a healthy and balanced life, we do not consume our Jing too quickly; if, on the other hand, we live a life in which we fail to nourish ourselves properly and push ourselves to work (and play) beyond our natural limits, we use up our Jing too quickly. This may explain why women in the developed world seem to suffer much more from menopausal syndrome than their sisters in the undeveloped world—they are using up their Jing too quickly in the pressured and unbalanced lifestyles which are considered normal in consumer societies.
Chinese Medicine cannot, of course, stop the ageing process, but it can support a woman to go through the transition which is the menopause in a natural and harmonious way. As Jing declines, a woman’s systems temporarily become out of balance. Treatments such as acupuncture, herbal remedies and Chi Kung can help to restore that balance, making the transition smoother and less disruptive.
Beyond this, Chinese Medicine is a holistic treatment which works on the level of the Spirit as well as of the body; it is particularly effective in supporting us through periods of transition in our life when, for example, our role in our family and in society is changing as our body changes.
Is Acupuncture Helpful in the treatment of Menopause?
Significant evidence has been accumulated in China over the years which suggests that appropriate acupuncture treatment during the menopause increases oestrogen levels, which may account for its success in treating menopausal symptoms. Similarly, Chinese trials suggest such treatment promotes bone function and decreases the loss of bone mass, thus combating osteoporosis.
Several smaller scale trials in the West, for example 1Cohen et al (2003) also suggest the effectiveness of acupuncture in treating menopause.
References:
1 Cohen et al (2003) Can acupuncture ease the symptoms of menopause Holist Nurs Pract. 2003 Nov-Dec;17(6):295-9.
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Tamoxifen and Hot Flushes
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Tamoxifen is primarily used as an additional therapy in the treatment of breast cancer, together with surgery, chemotherapy and radiation. Its purpose is to provide treatment when no tumour is detectable but there is a risk of tumour development or recurrence. It prevents oestrogen from binding to receptor sites in breast cells.
Because it is an anti-oestrogenic hormonal treatment, it causes menopausal symptoms such as flushing, night sweats, insomnia, vaginal dryness, digestive upsets and mood changes. Side effects such as hot flushes may be due to certain physiological changes occurring in the hypothalamus (brain) because it is not correctly regulated by naturally occurring opiods. Tamoxifen is not suitable for all patients e.g. those with clotting disorders or coronary heart disease.
Tamoxifen and Hot Flushes and TCM
Whilst Western medicine aims to kill tumours, Traditional Chinese Medicine (TCM) seeks to regulate yin and yang, bringing the body back into harmonious balance. TCM can be used to strengthen the body and relieve the side effects of treatment. The combination of Western and Chinese measures to complement each other can achieve a far better effect than relying solely upon one form of treatment.
Hot flushes are one of the main symptoms of menopause, and are often extremely distressing to the sufferer, especially if they are also accompanied by night sweats. In TCM hot flushes are regarded as an imbalance between yin and yang, where yin is not strong enough to control the upward yang movement which then floats upwards, bringing heat to the upper part of the body.
In conjunction with the appropriate TCM treatment, which may include acupuncture and herbs, the patient can also help themselves by eating suitable foods, taking exercise and reducing stress through relaxation techniques. Wolfe (1998) explains how such self help can be applied.
Is Acupuncture Helpful in the treatment of Hot Flushes?
There is a wealth of research into the effectiveness of TCM on hot flushes, specifically those experienced as a side effect of Tamoxifen.
1Lahans (2007) cites case studies, whilst 2Wolfe (1998) reports on several trials undertaken in China. A more recent trial in Norway was reported in April 2008 at the 6th European Breast Cancer Conference in Berlin, available on the ECCO website. Hervik reported a 50% decrease in the incidence of hot flushes in women receiving acupuncture after taking Tamoxifen. 3Filshie et al (2005) also report good treatment outcomes using acupuncture .
References:
1Lahans, T (2007) Integrating Conventional and Chinese Medicine in Cancer Care: A Clinical Guide, Edinburgh, Churchill Livingstone
2Wolfe, H L (1998) Managing Menopause Naturally, Boulder, Blue Poppy Press
3Filshie, J., Bolton, T., Browne, D., Ashley, S (2005) ‘Acupuncture and self acupuncture for long term treatment of vasomotor symptoms in cancer patients - audit and treatment algorithm’ Acupuncture in Medicine Vol 23, no 4 pp 171-180