Last time we discussed why smooth menstruation is so important in women’s health. So what is considered a smooth menstruation in TCM’s perspective? In western society, menstrual pain and discomfort are quite “normal” and accepted. Your family doctor would simply recommend off-the-counter pain medications. In many countries, women are allowed menstrual leaves from work.
Many women don’t know that a healthy menstruation should simply be the inconvenience of bleeding for 5 to 7 days of every 26 to 30 days. There is spotting on the 1st day, heavy flow on the 2nd and 3rd days, and then slowly decreasing each day until finish. Menstrual blood should be bright red, the same color when you accidentally cut yourself. Quality shouldn’t be too watery or too thick. And there shouldn’t be any clots. There also should not be any acne outbreak, mood swing, diarrhea, Edema (swelling), cramps, or pain.
Now we know that during menstruation, the nutrient from food will be sent up to become breast milk, and descend to uterus with Heart’s power. If anything that goes wrong, a good TCM practitioner can diagnose which link(s) of the process went wrong.
Here are top 3 menstrual discomforts, their causes, and treatments:
1. Acne outbreak:
Acne is generally a result of internal heat in TCM. And Heart is symbolized as fire because Heart is the main source of heat generation. And Small intestine has a special connection to Heart just like your palm and the back of your hand. Heat generated by Heart is shared by Small Intestine, which warms the uterus in front. When the passage between Heart and Small Intestine is blocked, the heat will revert up to the face and becomes acne. Not until after the period is finished, will the acne slowly disappear.
To treat the menstrual acnes, first is to unblock the passage between Heart and Small Intestine whether it's blocked by Qi, Blood, Cold, or Phlegm. Second is to strengthen Heart Qi (Heart's function). This will also help to break the blockage. Last is to clear heat. This should be done carefully not to hinder Heart's function to pump blood and generate heat.
2. Emotionally unstable (PMS):
In TCM, this is usually caused by stagnation of Qi. What this means is that when blood isn’t flowing smoothly, the Qi is backed up like a traffic jam. When people are stuck in a traffic jam for a long time, they can get angry! It’s the same thing in the body.
To treat PMS, first is to spread the stagnated Qi. Second is to move blood. Because in TCM Qi is supposed to lead the flow of blood. Blood circulation will require the pulling of Qi. If there is anger or irritability, clearing heat will also help.
3. Abdominal cramps and pain:
In modern medicine, we were told the pain and cramps come from the contraction of uterus. And the contractions inhibit blood flow to the lining of the uterus (the endometrium). In addition, substances known as leukotrienes are also elevated during menstruation, and they may be the cause of menstrual cramps. But it doesn’t tell us why there is a contraction or why leukotriene is elevated.
In TCM, we care about the “why.” TCM theory says blockage causes pain. Blockage will cause unsmooth blood flow of uterus. Cold is the number one reason that there is a blockage. Cold contracts muscles and blood vessels, making blood flow difficult. That’s why applying a heat pad to the area or drinking a bowl of hot soup usually relieves the cramps. Many women lack of the knowledge to take care of their bodies around the menstrual period. They are still eating ice cream and drinking iced beverages. It’s very important NOT to do this before or during menstruation period.
To treat menstrual cramps and pain, first is to determine what the cause of blockage is. If the blockage is caused by cold, then warming of the uterus is the first priority. The blood clots will melt as the uterine temperature returns to normal. If there isn't any cold signs, that means it is simply just blood stasis. Treatment to invigorate blood flow will usually yield good result.
TCM treatment is based on the etiology (cause) of the disease. A simple menstrual pain can have many different causes. It's very important to syndrome differentiate and plan the treatment accordingly.