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womens_health

Dysmenorrhea

A healthy, well-balanced woman will menstruate about every 25-31 days for 5-7 days. There need not be any discomforts – physical or emotional – before, during, or after the period. However, there are many imbalances that manifest themselves as painful or uncomfortable. Chinese medicine therapy can help to remedy this condition. Menstrual pain is estimated to affect up to 50 percent of women of reproductive age, and anywhere from 60 to 85 percent of teenagers.

Research Studies

Researchers conducted an analysis of data from 39 different randomized, controlled trials that involved a total of 3,475 women. Women in these trials were given traditional Chinese herbs including cinnamon bark (rougui), Chinese angelica root (danggui), fennel fruit (huixiang), licorice root (gancao), Szechuan lovage root (chuanxiong), Chinese motherwort (yimucao), nut- grass rhizome (xiangfu), red peony root (chishao) and white peony root (baishao). The treatments were carried out in a traditional way to regulate energy (qi) and blood, warm the body and improve liver and kidney functions.

The researchers found that Chinese herbal treatments led to a significant reduction in the symptoms of menstrual cramps, and that the degree of pain reduction was higher than that from other treatments. In one study, 53 percent of women receiving Chinese herbal treatment reported decreased pain, in comparison with only 26 percent of the women receiving a placebo treatment.

Menstrual Pain (Dysmenorrhea)

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, diarrhoea or constipation. This is a common health problem for women worldwide.

Sign and Symptoms

Symptoms and degree of pain vary, but may include the following:

  • Abdominal cramping or dull ache that moves to lower back and legs
  • Heavy menstrual flow
  • Headache
  • Nausea
  • Constipation or diarrhoea
  • Frequent urination
  • Vomiting (uncommon)

What Caused It

Primary dysmenorrhea is caused by:

  • Strong contractions of the uterus triggered by prostaglandins, chemicals in the body that are involved in inflammation and that stimulate pain receptors.
  • Higher levels of prostaglandins are associated with more menstrual pain.

Secondary dysmenorrhea can be caused by:

  • Endometriosis (inflammation of the lining of the uterus)
  • Blood and tissue being discharged through a narrow cervix
  • Uterine fibroid or ovarian cyst
  • Infections of the uterus
  • Pelvic inflammatory disease (PID)
  • Intrauterine device (IUD)

Treatment Options

Treatment of Dysmenorrhea with herbal medicine

Chinese herbal medicine appears to be more effective at relieving menstrual cramps and pain than pharmaceutical drugs, according to a new study conducted by Australian researchers and published in the journal Cochrane Library.

Dysmenorrhea can be 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.

Following are the most typical patterns of dysmenorrhea with the herbs most commonly prescribed to treat them:

Qi Stagnation and Blood Stasis Pattern: Abdominal pain before and during menstruation; menses of a purple or dark color, with small volume and blood clots; decreased pain after passing blood clots; purplish spots on the tongue; and a wiry-choppy-strong pulse. Herbs used: aurantium fruit (Zhi Ke), lindera root (Wu Yao), and cyperus tuber (Xiang Fu) are used to regulate the Qi. Cnidium (Chuan Qiong), persica seed (Tao Ren), and safflower (Hong Hua) are used to invigorate the Blood. One of the popular herbal formulas is BlockageEASE (Ge Xia Zhu Yu Tang).

Deficiency Cold Pattern: Abdominal pain during or after menstruation; feeling better when pressure and/or warmth are applied to the abdomen; pale, watery menses with small volume; soreness of the lower back and legs; long-drawn-out urination with a thin stream; a white tongue coating, and a deep pulse. Herbs used: Cinnamon bark (Rou Gui) and evodia bark (Wu Zhu Yu) are two herbs that warm the pelvic area (uterus). One of the widely used herbal formulas is “Warming Menses Formula” (Wen Jing Tang).

Cold Dampness Pattern: Abdominal pain before or during periods; application of warmth reduces pain; dark-colored menses with blood clots; aversion to cold; cold limbs; white or white-sticky tongue coating; and a wiry-tight or wiry-slippery pulse. Herbs used: Cinnamon bark (Rou Gui), fennel seed (Xiao Hui Xiang), and dry ginger (Gan Jiang) are three major “warm property” herbs that can remove Dampness from the system. StagnationEASE (Shao Fu Zhu Yu Tang) is a popular formula for this pattern.

Damp Heat Pattern: Abdominal pain before menstruation; aversion to heat; soreness and distention of the lower back; a feeling of heat in the abdomen or a low grade fever; menses that are sticky, with a dark red color and blood clots; a burning sensation when the menses flow out; yellow and sticky vaginal discharge; scant urine; a red tongue body, with a yellow-sticky tongue coating; and a wiry-rapid or slippery-rapid pulse. Herbs used: Coptis (Huang Lian),and peony bark (Mu Dan Pi) are two leading herbs for clearing Damp Heat. “Heat-Clearing Blood- Regulating Decoction” (Qing Re Tiao Xue Tang) is a very standard formula for this pattern of dysmenorrhea.

Qi Blood Deficiency Pattern: Abdominal pain after menstruation; dull abdominal pain; menses that are thin, with a pale color and small volume; tiredness; loose stools; pale complexion; pale tongue body; and a thin-weak pulse. Herbs used: Ginseng (Ren Shen), astragalus (Huang Qi), angelica (Dang Gui), and rehmannia (Di Huang) are the leading Qi and Blood tonic herbs. “Chi Blood Tonic” (Ba Zhen Tang) is a time-tested formula for the Qi Blood Deficiency pattern of disease.

Kidney Liver Deficiency Pattern: Dull abdominal pain after menstruation; sore back; menses that are pale, with small volume; dizziness; ringing in the ears (tinnitus); poor memory; insomnia; a flushed face; hot flashes; a dark-red tongue body; and a deep-thin pulse. Herbs used: Angelica (Dang Gui) and white peony root (Bai Shao) nourish the Blood and Liver. Cornus fruit (Shan Zhu Yu) is a Kidney and Liver tonic. “Liver Tonic” (Tiao Gan Tang) is recommended.

Treatment of Dysmenorrhea with Acupuncture

Besides using herbal formulas to treat dysmenorrhea, acupuncture is another viable way to treat menstrual pain.

A recent German study published in the February, 2008 issue of the American Journal of Obstetrics & Gynaecology also confirms this; that acupuncture can relieve a woman of her 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 the transmission of pain signals, and increases adrenocorticotropic hormone. In order to test these historical and modern claims about the effectiveness of acupuncture in treating dysmenorrhea, a clinical trial was organized at the Gynaecology Clinic of the Kaiser-Permanente Medical Centre in Oakland, California. Forty-three women with primary dysmenorrhea were followed for one year. Patients were randomly assigned into one of four different groups: the Real Acupuncture Group; the Placebo Acupuncture Group (i.e. random points); the Standard Control Group (no acupuncture or medicine); and the Visitation Control Group (physician visits only).

The following results demonstrated that 90.9% showed improvement in the Real Acupuncture Group compared with 36.4% showing improvement in the Placebo Acupuncture Group; 18.2% showed improvement in the Standard Control Group; and only 10% showed improvement in the Visitation Control Group. There was reduction of analgesic medication used by the women in Real Acupuncture Group, but no change or increased use of medication in the other groups.