Traditional Chinese Medicine (TCM) offers a multitude of treatment options for women with regard to reproductive health, at different stages of life. These include treatments for PMS, PMDD, or othe ‘symptoms’ that occur around the onset of the period; pre-existing or chronic conditions (such as cysts, PCOS, endometriosis, or fibromes); as well offer support before, during, and after childbirth; and later in life with menopause.
TCM view of women’s physiology
In TCM Blood, Qi, Body Fluids, and Essence are considered as ‘Four Vital Substances’. For women, Blood is thought to be of utmost importance, as opposed to men who depend more on Qi and Essence. In women, the lower abdomen houses the Uterus, which stores Blood, and is linked to the Kidneys and the Heart by it’s own internal meridians (胞络，胞脈). ‘Women’s physiology’ in this sense refers to the menstrual cycle.[fn]Maciocia, Giovanni. Obstetrics and Gynecology in Chinese Medicine. New York: Churchill Livingstone, 1998. 7. Print.[/fn]
The menstrual cycle is viewed as 4 phases…1) at the time of the period Liver Blood and Liver Qi ensure smooth flow. 2) After menstruation the Chong Mai and Ren Mai are empty of Blood and Yin. 3)They begin to refill around the time of ovulation, and as the next period approaches, 4) Yang Qi and Liver Qi become more active. Therefore when treating fertility or menstrual irregularity, at each phase of the menstrual cycle there is a different treatment principle according to TCM.[fn]Maciocia, Giovanni. Obstetrics and Gynecology in Chinese Medicine. New York: Churchill Livingstone, 1998. 8. Print.[/fn]
According to the Su Wen, men’s development occurs in 8 year cycles, while womens’ just 7 years. In this sense a women’s physiology develops and changes throughout her lifetime. At about 14, the yin and blood of the Ren and Chong Mai are sufficient for the onset of the menstrual cycle. From 35-42 there is some decline in these energies, which can lead to more difficult conception. At 49 there is a significant decrease, as some women begin to experience menopause. (of course these numbers are guidelines, and as we know, the mentrual cycle is governed by hormone levels which can vary from person to person).
Mentrual Cycle
Cycle length and regularity
The cycle should be regular, meaning the length of the cycle should be consistent from month to month, and approximately 28 days. A short, or long cycle is diagnosed if the periods are more or less than 28 days, +/- 2 days. Some variation is normal, but if the length varies significantly from month to month it is considered to be an irregular cycle.
Period bleeding that is scanty or too abundant is also considered a sign of imbalance that can be restored with TCM.
PMS symptoms. such as fatigue, irritabilité, emotional sensitivity, low-belly or low-back discomfort, or breast-tenderness, that occur in the week or few days prior to period onsent, or during the first few days of the cycle can also be releived quite effectively with acupuncture and chinese herbal medicine.
Fertility/OB-GYN
Fertility
In the case of treatment for fertility, a healthy and regular menstrual cycle is a key indicator. If the cycle is too long, too short, or irregular it indicates an imbalance of yin, yang, blood, and qi. Using acupuncture and herbs can help restore a healthy cycle and improve the chance of conception. From a Western medical perspective, this treatment can regularise estrogen, progesterone, FSH, and LH levels.[fn]Liang, Lifang. Acupuncture & IVF. Boulder, CO: Blue Poppy, 2003. Print.[/fn]
Morning Sickness
During the first 12-15 weeks of pregnancy some women experience nausea, poor appetite, or vomiting. This can be limited to the morning time, but not necessarily. In TCM, this is considered to be due to ‘Stomach Qi rebelling’.
In TCM each of the Organ Systems has a set of specific functions that contribute to the general physiology and homeostasis of the individual. In this case, we can describe the functions of the Spleen and Stomach, which are a pair of organs paired in TCM through their Yin and Yang relationship. While the Spleen performs a lifting and holding function, among others, permitting the organs to retain their position in the thorax and abdomen, preventing prolapse…simultaneously, the Stomach has a descending function. When the Stomach Qi rebels, the food no longer moves downward, and we can experience nausea and/or vomiting.
While some acupuncture points are contraindicated during pregnancy, as they are considered ‘too moving’, the majority of the points are safe. Morning sickness can often be treated in 1-3 sessions using a small number of points.
Breach presentation
As the pregnancy arrives at term, usually 41-42 weeks, there may be complications such as breach presentation. The baby may be resting comfortably, but not in a position that facilitates birthing. Acupuncture, and more specifically moxabustion has been shown to be effective in turning the baby to a suitable position.
This treatment is best started at week 35 which is considered to be not too early, in case a version of the child leads to the onset of labor, and at the same time not too late…as the child will grow to take more place in the uterus, and have less space in which to turn.[fn]”Home – Spinning Babies.” Home – Spinning Babies. Web. 1 Nov. 2014. <http://spinningbabies.com/>.[/fn]
This treatment can be performed relatively easily at home if necessary.
Labor induction
At term, acupuncture can help prepare the mother for delivery of the child. Acupuncture has been shown to be effective in reducing labor duration as well as pain severity. This treatment can be performed around week 41, as the effects can be rather immediate. Points are chosen that stimulate the movement of qi, and in terms of Western medicine, can increase oxytocin levels. As some people say, it is not a ‘due date’, as much as an expectancy.
Post-partum Depression
Following the birth, there may be a disconnect between the mother and child, or an emotional depression for the mother. This is a complex situation that is effected by many factors. Acupuncture has been shown to be as effective as medication in the treatment of this condition.[fn]Manber, Rachel, Rosa Schnyer, Andrea Chambers, Deirdre Lyell, Aaron Caughey, Erin Carlyle, Maurice Druzin, Jenna Gress, Mary Huang, Tasha Kalista, Robin Okada, and John Allen. “34: Acupuncture for Depression during Pregnancy.” American Journal of Obstetrics and Gynecology: S19. Print.[/fn]
Later in Life
Peri-menopausal or Post-menopausal
As the 7 year cycles continue, it is only natural to see a decline in Yin and Blood as we age. Yin being the balancing principle to Yang, the water to the fire…as Yin decreases, one may experience various changes, including most commonly hot-flashes, and night-sweating. Other menopausal symptoms can be due to a decrease in Kidney Yang, including fatigue.