How Does TCM Diagnose and Treat Dysmenorrhea

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There are different strategies a traditional Chinese medicine (TCM) practitioner can take when it comes to dysmenorrhea. Dysmenorrhea or painful menstruation treatment primarily focuses on the main complaint of the patient: pain during menstruation. This condition is considered acute and needs to be immediately addressed over any other symptoms. Not only do TCM practitioners address the pain and other overlying symptoms of dysmenorrhea, they also treat the root of the reason that has led to the condition in the first place. This guarantees that there is no recurrence of the condition during the patient’s succeeding periods. To attain these objectives, the practitioner needs to determine the cause of the problem and select specific herbs as well as acupuncture points to address the symptoms and the cause.

Diagnosing the root cause of the problem, which acupuncturists call differentiation, is an extremely important part of the treatment process. The practitioner or acupuncturist first interviews the patient. The interview gives the acupuncturist an insight into the cause of the condition of the patient. Skill and care needs to be applied here. When treating dysmenorrheal, special attention to its symptoms and signs that can include the kind of pain, what eases the pain, the size of blood clots, the number of clots, the quality of the flow (whether it’s light or heavy), the color of the blood, and other factors need to be taken into consideration.

The herbs that are prescribed are typically taken three days prior to the start of the period and maintained for six menstrual cycles in order to obtain the best results. Without treatment, the dysmenorrheal pain will only worsen leading to added stress; eventually the condition will result in another disorder known as premenstrual syndrome or PMS. This is the reason why treatment needs to begin two to three days prior to the onset of menses.
What is Chinese Medicine Diagnosis (Differentiations) All About?

The diagnostic terminologies used in Traditional Chinese medicine is very different from those utilized by Western Medicine. Acupuncturists and other traditional Chinese medicine practitioners use terms that are never heard of in Western medicine. The practitioner may use diagnostic terminologies such as wind heat, abundance of cold, blood stasis, heart fire, or spleen deficiency to address the underlying factors of a condition. They may sound odd to Western doctors but these terms have actually been used for thousands of years to resolve dozens of illnesses. When an acupuncturist tells his patient that he/she is suffering from spleen qi (pronounced chee), the acupuncturist is referring to an energy deficiency in a channel (meridian) where qi travels related to the spleen. Spleen qi deficiency then means that the energy flowing to the spleen is weak which is causing the spleen to malfunction. Terms like these were and are still used because thousands of years ago, they were terms found in nature and were the best ways to explain to the patient the things happening within his/her body.

One of the factors a traditional Chinese medicine physician needs to determine in a patient is the patient’s Yin and Yang balance. Yin and Yang is famously symbolized by the symbol of the Tai Ji which is half black and half white, with a dot of the opposite color in each half. Passivity, nourishment and rest are representations of Yin while activity, energy, and, motion represent Yang. Yin and Yang, like electricity, represent the duality of the universe and in order to be balanced and healthy, each of us must have a proper balance of these two energy polarities internally.

When it comes to dysmenorrhea, one can encounter two types of diagnostic terminologies:
1. Blood and Qi Stagnation
Stagnation of Qi means that there exists an obstruction of energy in one or more of the energy vessels where Qi travels. Blood stagnation, on the other hand, simply means that blood is not freely circulating in a certain part of the body. There is usually pain on the body part where blood is blocked, according to traditional Chinese medicine. Signs and symptoms of this diagnostic pattern include:
__Delayed menstruation – When menses arrive blood clots occur (clots usually indicate stagnation); the blood is typically dark red in color.
__Hypochondriac pain, the breasts are tender to the touch.
__Pain in the lower stomach during the first day of menstruation or one to two days before; the pain may linger throughout the entire term of the period.

Treatment
TCM practitioners are known to use the herbal formula Tao Hong Si Wu Tang to treat Blood and Qi stagnation. This herbal formula is readily available at your local Chinese drug store.

The aim of the treatment involves the restoration of blood and qi flow to alleviate the pain. Stress can cause this problem and if this is the case, acupuncturists may diagnose the condition as liver qi stagnation, which is one of the most common conditions experienced by individuals in traditional Chinese medicine

Cause
Stagnation of Qi usually develops when a person experiences a strong emotion such as stress, anger, or depression.
The pain associated with blood and qi stagnation typically vanishes two or three days after the start of menstruation. This is because blood starts to flow then.

Blood stagnation is similar to Western medicine’s diagnosis of blood supply inadequacy in the lining of the uterus.

2. Blood Stasis Caused by Overabundance of Cold
The term Blood stasis is defined as the inability of blood to flow freely. Overabundance of Cold means the there is too much YIn than Yang in the body.

Blood stasis signs and symptoms may include:
__Dark red menstrual blood that clots; The clots and blood may look like black bean juice
__Pain experienced one to two days prior to or during menses
__Scanty and delayed menses
__Lower stomach pain that gets better with warmth
__The person may have cold limbs or has an aversion to cold

Causes
Overabundance of Cold can occur from overexposure to cold. One can develop this condition by too much eating of smoothies or ice cream, staying in an air conditioned long for too long, cold water swimming, staying outdoors on a chilly climate for several hours.

Treatment
The aim of treatment is obviously to warm the body through acupuncture needles inserted at specific meridians in order to restore normal menstrual flow and to alleviate pain.

Complementing acupuncture are herbal formulas such as Warm Cycle Tea pill and Wen Jing Tang to help treat blood stasis caused by cold. They have the ability to nourish and move blood as well as warm the meridians.

 Key words:  Dysmenorrhea

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