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Women's Health Concerns

Updated: Sep 7, 2019


Women's Health Concerns

Whether it's PMS or some other condition, women have unique health concerns and conditions. Is there a woman in your life who has had their day to day life impacted by problems with their monthly cycle? Know someone with PMS? Infertility? Painful Periods? Menopause? or other menstruation irregularities? Let that person know that there are non-harmful treatments that helps correct the condition and not just mask it. We focus on balancing the entire body instead of only treating symptoms. In Western medicine, doctors often view and treat patients’ conditions by focusing on a specific symptom of disease. These conditions are analyzed with laboratory tests and treated with drugs, supplements, and in severe cases surgery. Traditional Chinese Medicine instead classifies the condition as an overall imbalance in the body, this imbalance can be treated using: acupuncture, Chinese herbs, massage, moxibustion, cupping, gua sha, and lifestyle recommendations.



Balanced Body = Active Lifestyle

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History of OB-GYN in TCM


Did you know that traditional gynecology has a long history in Chinese Medicine? The earliest records of gynecological medical writings date from the Shang dynasty (1500–1000 BC). The text Book of Mountains and Seas from the Warring States period (476–221 BC) describes medicinal plants to treat infertility. Gynecology already existed as a specialty during this time and many famous doctors are recorded in history. The earliest recorded doctors using the name, "gynecologists", were two doctors called Yi Xu and Chun Yu Yan who treated an empress during the Western Han dynasty (206 BC–AD 24). (Maciocia, 2011)



Long History of OB-GYN

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Differences between Eastern and Western Gynecological Medicine


There are more similarities in these Medicines than differences. Traditional Chinese Medicine is a different system of medicine that looks at the body as a whole, like a garden to be nurtured and tended; whereas modern Western Medicine (WM) looks at the body as a machine with parts and specific functions which need to be supplemented, treated, or replaced for optimal performance. The treatment tools are also different, WM is often confined by current scientific knowledge about the problem, offering drugs and supplements which have been newly developed and tested with "acceptable" side effects. Whereas TCM has a longstanding tradition of non-harmful treatments with little to no side effects, that consider the entire body.


TCM uses a variety of diagnostic methods categorizing symptoms to develop a “pattern diagnosis,” with treatments based on the pattern. There is a rich proven history of effective treatment tools and strategies to address the dis-harmonies without identifying it from a biomedical standpoint. TCM menstrual cycle patterns are grouped into overactive and underactive cycles, which then have subsequent subtypes of patterns.


An evaluation of a woman’s overall reproductive health can be gathered with a complete gynecological history. This should include age of menarche, last menstrual period, length of periods (days bleeding), quantity of bleeding (estimate with quantity and type of sanitary napkins used), any clotting, number of days between periods, Premenstrual Symptoms (PMS), recent changes in periods, number of pregnancies (miscarriages, premature births, birth weight, sex, number of weeks at delivery, and type of delivery, or any complications during pregnancy such as hypertension, or a history of depression), history of infertility, first degree family history of diseases, social history (discussion on lifestyle and behaviors within comfort level that may potentially effect health such as: sexual history, use of contraceptives, tobacco, alcohol, drugs, intimate relationship dynamics, health hazards at home or work, nutrition, diet, and exercise), and a Review of Symptoms.


About the Cycle


There are also minor differences in terminology between the two specialties of medicine. In TCM there is an importance emphasized in having a consistent number of days in the cycle but that is not considered as important in WM. The cycle in TCM should not be less than 25 days, where as in Western Medicine every 21 days is considered within normal parameters.


Western Medicine defines the normal duration of an adult cycle, from the beginning of the menses (Day 1) to the beginning of the next (Day 1), averages approximately 28 days (+/- 7 days) and comprises of three distinct phases: follicular, ovulation, and luteal phases. The follicular phase begins with the onset of menses and ends on the day of the luteinizing hormone (LH) surge. Ovulation occurs within 30 to 36 hours of the LH surge. The luteal phase begins on the day of the LH surge and ends with the onset of menses. The follicular and luteal phases each last approximately 14 days. The duration of the luteal phase remains relatively constant, whereas the duration of the follicular phase can vary. (Beckmann, 2014)



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Chinese Medicine treatment options include:


· Acupuncture


· Chinese Herbal Medicine


· Cupping


· Tui Na (Acupressure/Medical Massage)


· Gua Sha (Scraping)


· Moxibustion (Moxa)


· Exercise Therapy + Lifestyle Modification/Coaching



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Cupping Treatment


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Common Menstrual Abnormalities:

Western Medicine Abnormal Menstrual Cycle Definitions (Beckmann, 2014):


Amenorrhea (absence of menstruation) and abnormal uterine bleeding are the most common gynecological disorders of reproductive-age women.


Abnormal uterine bleeding is a difference in frequency, duration, and the amount of menstrual bleeding.


Oligomenorrhea defined as a reduction of the frequency of menses, with cycle lengths of greater than 40 days but less than 6 months.


Hypomenorrhea defined as a reduction in the number of days or the amount of menstrual flow (less than 30 mL).


Polymenorrhea, defined as frequent menstrual bleeding (21 days or less).


Menorrhagia, defined as prolonged or excessive uterine bleeding that occurs at regular intervals (loss of 80 mL or more of blood that lasts for more than 7 days).


Metrorrhagia, defined as irregular menstrual bleeding or bleeding between periods.


Menometrorrgigia, defined as frequent menstrual bleeding that is excessive and irregular in amount and duration.


Dysmenorrhea is defined as painful menstruation.


Premenstrual Syndrome (PMS) is a group of physical, mood-related, and behavioral changes that occur in a regular, cyclic relationship to the luteal phase of the menstrual cycle and that interfere with some aspect of the patient’s life.


Premenstrual Dysphoric Disorder (PMDD) as a specific set of at least 5 of 11 possible symptoms, with at least 1 core symptom – specifically, depressed mood, anxiety or tension, irritability, or decreased interest in activities (DSM-IV, 2010).


Pre-Menstrual Syndrome (PMS) broadly describes emotional and physical symptoms occurring before a period. These may include depression, sadness, irritability, anxiety, lethargy, loss of concentration, aggressiveness, changes in libido, changes in bowel habit, skin eruptions, food cravings, crying, propensity to outbursts of anger, clumsiness, distension of abdomen and breasts, and insomnia. These symptoms can vary in intensity from very mild to extremely serious; a person experiencing PMS may actually injure a member of her family or some other person. The symptoms vary in duration as well as in intensity, ranging from 1 day to 2 weeks before the period. Rarely, these symptoms may be experienced after the period (Maciocia, 2011).



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Monthly Cycles Shouldn't Hold You Back

Chinese Medicine Abnormal Menstrual Cycle Definitions:


Overactive Cycles (Early, Profuse, or Flooding and Leaking):


Early Cycle is defined as lasting less than 25 days in duration (common TCM Patterns: Heat, Blood Stasis, Qi Deficiency).


Profuse Cycle is defined as more than 100 mL or menstruation lasting 7 days or more (common TCM Patterns: Heat, Blood Stasis, Qi Deficiency, Kidney Yang Deficiency, Dampness/Phlegm).


Flooding & Leaking is defined as an abrupt onset of heavy uterine bleeding or gradual uterine bleeding with continuous dribbling of small amounts of blood (common TCM Patterns: Heat, Blood Stasis, Qi Deficiency).


Underactive Cycles (Scanty, Late, Blocked):


Scanty Cycle is defined as menstruation less than 30mL total per cycle , or bleeding only 2-3 days (common TCM Patterns: Heat, Qi-Blood Deficiency, Kidney Yin or Yang Deficiency, Phlegm/Dampness).


Late Cycle is defined as lasting 40-50 days or longer; or bleeding at least 7 days late each month (common TCM Patterns: Heat, Qi-Blood Deficiency, Kidney Yang Deficiency, Phlegm/Dampness).


Blocked Cycle is defined as the absence of menstruation for 3 months or more (common TCM Patterns: Heat, Qi-Blood Deficiency or Stasis, Kidney Yin or Yang Deficiency, Phlegm/Dampness).


One of the key differences between Eastern and Western Medicine in general is that a good TCM practitioner is able to understand and treat both the root (cause) and the branch (manifestation) of the problem, whereas WM practitioners typically can only treat the branch (manifestation) of the problem, which often eventually leads to other problems down the line.


In gynecology this difference is clearly noted in the treatment of PMS. Most PMS symptoms are considered normal in WM, and only worthy of treatment if they are severe enough to justify treatment, and the treatment is generally contraceptives. PMS in TCM is considered an imbalance and the symptoms are easily treated often in conjunction with other conditions.



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Cycle Events and Treatment Goals


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PMS (Treatable) TCM Patterns and Symptoms:


Liver-Qi stagnation: breast and abdominal distension, irritability, depression.


Lung-Qi stagnation: breast distension, sighing, crying.


Liver-Heat: irritability, anxiety, depression, propensity to outbursts of anger.


Heart-Heat: irritability, anxiety, insomnia.


Spleen- and Kidney-Yang deficiency: depression, crying, tiredness.


Phlegm/Dampness: acne, bloating, swelling and discomfort of the breasts.


Qi-Blood Deficiency-Stasis: painful uterine cramping, body pain.


If you are experiencing any of the symptoms contained in this article, contact us for a consultation.


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Western Medicine Guidelines on PMS:


However, the information provided by the U.S. Department of Health and Human Services at http://www.girlshealth.gov/ it gives the following guidelines:


For example, your cycle could be as short as 23 days or as long as 35.


In the days leading up to your period, do you have bloating, moodiness, or some other feelings that you’d rather avoid? If so, you are not alone. Many women have uncomfortable feelings starting a week or two before their period that usually stop when their period starts. These feelings can vary from mild to severe and in how long they last each month. Doctors generally consider such feelings premenstrual syndrome (PMS) if they interfere with some part of your life. You may experience one or more of the symptoms below.


Signs of PMS:

• Acne

• Bloated (swollen) stomach

• Constipation

• Crying spells

• Depression

• Fast heartbeat

• Hunger

• Feeling tense

• Feeling crabby

• Being tired

• Feeling anxious

• Headaches

• Joint pain

• Mood swings

• Tender breasts

• Hard time focusing

• Trouble sleeping

• Swollen hands, feet

• Weight gain

• Hard time handling stress


Western Medicine Guidelines on When to see a Doctor?


You should talk to an adult you trust and/or see a doctor if you experience any of the following:

• You have not gotten your period by the age of 15 or within three years of when you develop breasts

• It has been three months or more since your last period and you had it since

• You are bleeding for more days than usual or more than seven days

• Your bleeding is very heavy

• You suddenly feel sick after using tampons

• You bleed in between periods or with sex (more than just a few drops)

• You have very bad pain during your period



References:

Beckmann, C. (2014). Obstetrics and Gynecology 7th Ed. Philadelphia: Lippincott Williams & Wilkins.

DSM-IV. (2010). Diagnostic and Statistical Manual of Mental Disorders. Arlington, Va: American Psychiatric Association.

Lyttleton, J. (2004). Treatment of Infertility with Chinese Medicine. London: Churchill Livingstone.

Maciocia, G. (2011). Obstetrics and Gynecology in Chinese Medicine 2nd Ed. Edinburgh: Churchill Livingstone.





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