Dysmenorrhea means painful menstruation.
In Traditional Chinese Medicine, the structures related to the menstruation include not only the uterus and ovaries, but also the vessels and channels that favor the circulation of Qi and Blood in the uterus: Chong Mai, Ren Mai, Du Mai, Kidney channel and Liver channel
The main and common symptoms are pains in the lower abdomen, which can last a while or several days. The pain can radiate to the lumbo-sacral region. When the pain is very violent, there may be pallor, cold sweat, asthenia, weakness, nausea, vomiting, diarrhea, frequent urination, headaches, etc... neurovegetative alterations.
At the diagnostic level, we will begin by distinguishing whether it is dysmenorrhea of the Full type (energy blockage produces pain), or Empty type (lack of energetic nutrition produces pain). Regarding the pain, we are interested in asking about its intensity and quality (stabbing and localized, diffuse, radiates), if it is worse before, during or toward the end of menstruation. We must also ask about the regularity and qualities of the menstrual cycle.
Dysmenorrhea of the Full type is normally due to:
- Liver-Qi stagnation
- Cold in the uterus and Blood stasis
- Heat and Dampness
Dysmenorrhea of the Empty type is due to:
- Qi and Blood deficiency
- Liver and Kidney deficiency
Normally three treatment cycles are needed minimum to resolve the problem. When there is no more pain, the treatment needs to be reinforced with three more cycles. This is for almost all menstrual problems. One session every 7 days, if possible twice a week is more effective.
Dysmenorrhea due to Liver-Qi stagnation
It is of the Full type. The cause is emotional which blocks Qi and stagnates Blood.
Symptoms
- Hurts more before and during the first days. Relieves when expelling stagnated blood.
- The pain is acute, intense, with sensation of swelling.
- There may be pain and swelling of the breasts and in the costal region.
- Menstrual cycle: tends to be delayed, scant quantity, dark, thick blood and clots.
- Irritability, nervousness, sighs. Accentuated Pre-Menstrual Syndrome.
- Tongue with dark, purplish edges.
- Pulse tense and rough
Treatment
- Common points for dysmenorrhea (regardless of cause):
- CV-3, BL-32, SP-6, SP-8, Shi Qi Zhui Xia
- Drain Liver-Qi, eliminate Blood stasis and calm pain
- LR-3, LI-4, SP-10, SP-4, PC-6, moxibustion can be applied locally.
Dysmenorrhea due to Cold in the uterus and Blood stasis
During menstruation, the cervix is open and this favors any cold penetrating the interior. In China they avoid exposure to cold during menstruation. It is of the Full type.
Symptoms
- Hurts more before and during the first days. Relieves when expelling stagnated blood.
- The pain is acute, very intense, stabbing. Relieves with heat. It can be accompanied by sensation of heaviness or distension.
- Menstrual cycle: tends to be delayed, scant quantity but prolonged, lasts more days. The blood is dark, thick and with clots.
- Pulse tense and rough
Treatment
- Common points for dysmenorrhea (regardless of cause):
- CV-3, BL-32, SP-6, SP-8, Shi Qi Zhui Xia
- Eliminate Cold and move the Blood:
- CV-4, CV-6, ST-29. Highly indicated to apply moxibustion.
Dysmenorrhea due to Heat and Dampness
Due to inadequate diet or exposure to external pathogenic energy, Heat and Dampness accumulate in the lower burner. It is of the Full type.
Symptoms
- Hurts more before and during the first days. Also relieves somewhat when bleeding because it eliminates Heat and Dampness.
- Sensation of heaviness, heat-fever, thirst, sweat.
- Itching.
- Menstrual cycle: tends to be advanced, with abundant or normal bleeding. The blood is dark red, thick but without clots.
- Rapid and slippery pulse
Treatment
- Common points for dysmenorrhea (regardless of cause):
- CV-3, BL-32, SP-6, SP-8, Shi Qi Zhui Xia
- Eliminate Heat and Dampness:
- SP-9, LI-11, ST-29, CV-12. In this case do not apply moxa.
Dysmenorrhea due to Qi and Blood deficiency
It is of the Empty type. The cause are chronic disorders that weaken Qi and Blood, or insufficient Earth (Spleen-Qi deficiency and/or [[vacío de Qi de Estómago|Stomach) that do not produce energy and Blood.
Symptoms
- Gentle and moderate pain during the last days of menstruation and after.
- The pain relieves with pressure and heat.
- Menstrual cycle: tends to be delayed, scant quantity, pale, thin blood and without clots.
- Fatigue, pallor, dizziness, palpitations. See Blood deficiency in General Syndromes
- Pale tongue, normal coating.
- Pulse weak and fine
Treatment
- Common points for dysmenorrhea (regardless of cause):
- CV-3, BL-32, SP-6, SP-8, Shi Qi Zhui Xia ( Instead of CV-3 we can use CV-4)
- Tonify Qi and Blood:
- CV-6, SP-10, ST-36, BL-20, BL-17, Chong mai: ST-30, KI-13
Dysmenorrhea due to Liver and Kidney deficiency
It is of the Empty type. The cause is weak constitution or exhaustion due to excessive childbirth, overwork, long-term stress. The pain characteristics are similar to Qi and Blood deficiency. For menstruation to occur, Chong Mai must be full and Ren Mai open. The draining function of Liver facilitates Kidney Jing (which tends to conserve) to regulate this delicate balance. If Kidney Jing is scarce there will not be much loss. The four sacral foramina have multiple vessel connections that receive Liver and Kidney Jing-Blood to nourish the uterus. Therefore they are prohibited during pregnancy, except BL-32, which facilitates dilation. When there is Liver and Kidney deficiency these vessels do not have enough blood to nourish the uterus.
Symptoms
- Gentle and moderate pain during the last days of menstruation and after.
- Pain and weakness in the lumbo-sacral region, which relieves with pressure and heat.
- Menstrual cycle: tends to be delayed, scant quantity, pale, thin blood and without clots.
- General fatigue, weakness of lower back and knees, tinnitus, dizziness, blurred vision. See Kidney Qi Deficiency
- Pale tongue, normal coating.
- Pulse weak and fine
Treatment
- Common points for dysmenorrhea (regardless of cause): CV-3, BL-32, SP-6, SP-8, Shi Qi Zhui Xia
- Tonify Kidney and Liver: BL-18, BL-23, KI-3, LR-8, KI-10, LR-5
- Ren Mai: LU-7, KI-6