The Digestive System
Acupuncture for Irritable Bowel Syndrome/ IBS
This condition refers to a disharmony between the Liver (Gan) and Spleen (Pi). Symptoms commonly associated with this condition include:-
Worse for Stress
Worse after eating particular things
Alternating diarrhoea and constipation
Worse for emotional turmoil
Loose stools or hard pebble-like stools
Acupuncture is a good treatment choice since irritable bowel syndrome is a functional problem rather than a structural problem.
IBS is known as ‘Liver invading the Spleen ‘ in Chinese medicine. The function of the Liver is to ensure the smooth circulation of Qi around the body and by doing this it aids all the other vital organs. When the Liver is out of balance it can upset other organs, and in this case the Spleen, (i.e. the digestive system). The Liver is particularly affected by stress, anger, bitterness, frustration, resentment, and lack of exercise.
Why are some people affected and not others?
If the digestive system (Spleen in Chinese medicine) is strong then is it still able to function adequately even though the Liver maybe out of balance. In other words, for IBS to occur there needs to be an imbalance in both the Liver and the Spleen (digestive system). Thus, to treat IBS it is important to smooth the flow of the Liver’s energy and to strengthen the digestive process. Along with acupuncture, this will involve eating food that is easier for the body to digest.
IBS is often successfully treated with a combination of acupuncture, dietary changes, and lifestyle advice.
Follow this link to read about the acupuncture treatment of 913 infants with colic.
Acupuncture for Nausea and Vomiting
This is termed ‘Rebellious Stomach Qi’ in Chinese medicine. Normally stomach energy descends and food & fluids pass through to the duodenum and small intestines. Nausea and vomiting occur when the stomach energy goes up instead of down! Chinese medicine looks at causes for this disruption in stomach energy.
Causes of nausea and vomiting
This is not an exhaustive list, however I will highlight some conditions that I see in the clinic.
The Liver organ ensures the smooth circulation of energy throughout the body. When the Liver is affected by stress, this can upset the movement of qi in the stomach.
Food poisioning will upset the stomach’s qi. This often passes after 24 hours.
Food stagnation in the stomach is a common cause of vomiting and nausea. This is especially the case with babies and toddlers as their digestive system is working flat out and can easily become overtaxed.
Pregnancy often causes morning sickness (please refer to the discussion on morning sickness in ‘conditions treated’. In this case, the growing foetus disrupts the normal movement of stomach qi.
Excessive heat in the stomach can lead to vomiting & nausea. This may be caused by eating too much hot & spicy food, drinking excessive alcohol, medications, or long-term stress. Normally there is a burning sensation in the stomach and bad breath.
Acupuncture for Constipation
It is not often that people come to the clinic with the main problem of constipation. This is probably because it is not widely known that acupuncture can help. At the initial consultation it is common practice to ask about bowel habits as this forms an important part of diagnosis.
There are varying views about what defines constipation. It is not infrequent to hear doctors saying, quite wrongly, that it does not matter if one has a bowel movement only twice a week. On the other hand, some naturopaths believe that it is normal and desirable to have up to four bowel movements a day.
I would suggest one bowel movement per day to be acceptable, anything less is a form of constipation.
The causes of constipation
Excessive heat in the body is the main cause of constipation. Heat in the Large Intestine dries up the fluids and so dries up the stools so that they cannot move properly. This heat can come from many sources such as diet (to much hot, spicy food), heat generated from emotional stress, or a febrile illness.
Constipation can also be caused by a lack of Qi (energy). Literally, there is not enough energy to move the stool properly. In this case if laxatives are used on a frequent basis then the Large Intestine becomes progressively more weakened and the situation becomes more chronic and more difficult to treat.
Internal Cold can also cause constipation since cold obstructs the movement of energy. Patients may often feel cold, and their limbs may be unusually cold to touch.
An obstruction in the Large Intestine’s energy can result in poor bowel movement. This may be structural, or functional. Acupuncture can help in the latter case.
Acupuncture and appropriate lifestyle and dietary changes will remedy most cases of constipation. Colonoscopies and other internal examinations will rule out any structural cause for constipation.
Acupuncture for Heartburn
Heartburn or acid regurgitation refers to the abrupt bringing up of undigested materials into the back of the mouth & throat.
Normally our Stomach energy (qi) goes down and food passes from the Stomach into the Small Intestine. When our Stomach Qi goes up, then nausea, vomiting, or acid regurgitation can occur. This is termed ‘Rebellious Stomach Qi’.
Causes of Heartburn
(a) Food stagnating in the Stomach
This is a common cause of heartburn and may be the result of weak stomach acids. Food stays in the stomach too long and disrupts the flow of stomach qi, causing it to ascend rather than descend. Food ferments in the stomach and becomes acidic. Often anti-acid medication is taken symptomatically for this condition. This helps with the immediate symptoms, but long-term usage can be very damaging for the stomach’s qi.
(b) Excessive cold and raw food
Our digestive systems require warmth in order to digest and metabolise food. This is referred to as ‘Spleen Yang ’ in Chinese medicine, or the ‘digestive fire ’. This digestive food becomes damaged by the over consumption of cold & raw food which can then lead to food stagnating in the stomach and the disruption of the stomach’s qi.
(c) Long-term emotional strain
Unmanaged stress can lead to digestive problems. Stress prevents the stomach’s qi moving correctly. This is a condition called ‘Liver invading the stomach ’ in Chinese medicine. Stuck stomach qi can develop into heat. This is analogous to a car ticking over on a motorway, stuck in a traffic jam, and gradually getting hotter & hotter. This stomach heat frequently causes acid regurgitation since the excessive heat is generated in the stomach and the Stomach’s energy is not flowing freely.
Acupuncture is effective treatment for these conditions. Changes in lifestyle and/or dietary habits may also be recommended.
I would also recommend visiting your GP since some conditions can be very serious (e.g. stomach ulcers).
Related Articles from the NEWS Section
Acupuncture for Globus Hystericus
Within the Chinese medical texts, this condition is generally regarded as an imbalance in the Liver organ. There maybe other associated symptoms such as moods swings, irritability, pain or tenderness (on palpation) in the hypochondrium region (just below the rib cage), headaches, frequent sighing, digestive imbalances, etc.
It is treated with acupuncture and maybe with some Chinese herbs.
Classically, the sensation of globus hystericus is described as ‘having swallowed a fruit pit or fishbone that has become lodged in the oesophagus’. This benign yet frustrating and uncomfortable sensation is generally diagnosed as globus hystericus by Western medicine after repeated radiographic and endoscopic studies of the oesophagus show no foreign object.
Traditional Chinese acupuncture is a good treatment choice for this condition.
Aside from dental caries, this normally indicates a problem in the stomach. There is a condition in Chinese medicine called ‘Stomach Fire’ which refers to excessive heat in the stomach caused by food stagnating and fermenting. You may wish to read the article on heartburn for more information about this.
Bad breath can be caused by excessive heat in the Stomach, and the fermentation of the stomach contents. Often the tongue has a thick yellow coating. There may be accompanying burning pain around the stomach region, especially if there is acid regurgitation.
Haemorrhoids may not cause any problems, but they can cause bleeding, protrusion and pain. Since bleeding is involved, it is important to rule out any more serious conditions. If the blood is fresh-coloured then it is most likely going to be caused by the haemorrhoids, if it is darker in colour then this may indicate bleeding further up the digestive tract. It is worth getting things checked out with your G.P.
According to the theory of Chinese medicine, energy is required to hold things in place. We have gravity acting downwards all the time and so we need an upwards force to counteract this and prevent our organs from sinking downwards. When this upward force is weak then prolapses can occur and conditions such as haemorrhoids.
Haemorrhoids can also develop when there is a lot of ‘stagnation’. I have treated a patient who was suffering from painful periods that were caused by stagnation of energy and blood. After several months of treatment her periods became more comfortable and she told me (incidentally!), that she used to suffer from haemorrhoids and now they have disappeared! Since people do not normally think of acupuncture in the treatment of haemorrhoids, it is usually a secondary issue however it does form part of a larger picture of imbalance within the body.
Haemorrhoids can also occur during pregnancy and there is an empirical point on the leg that is very good at treating this.
Chinese Dietary Therapy
In the West we tend to categorize food according to calorific content, mineral and vitamin content. The Chinese medical system categorises food according to the effect that it has on our bodies. For example, salads are cooling and red meat is warming. This is to say, when we ingest salads our body temperature drops, and conversely eating red meat warms our bodies. This classification of food using the scale ‘hot-warm-neutral-cool-cold’, is not based on the temperature of the food, it is based on the energetic qualities of food. To illustrate, if a red chilli and a cucumber are at room temperature, one will have a warming effect and the other a cooling effect when eaten.
This way of classifying food is very useful when we look at medical imbalances in our bodies and ways of restoring good health. I will illustrate with a case study.
Case Study – Vegan – Female 26 (1999 –Leeds, West Yorkshire)
A patient came to see me who was diagnosed as suffering from R.S.I. (repetitive strain injury). She had been working hard using computers and developed a problem in her right wrist after long hours of using the mouse. When I felt her hand and wrist it was remarkably cold and it felt cold half way up her arm. In contrast, her other hand and wrist felt fine. This patient had a diet consisting of a lot of raw, cold food and lived in a cold, damp climate (Yorkshire). As a consequence there was a lot of cold in her body.
Long hours using a mouse and keyboard had weakened her hand and wrist. Since there was a lot of cold inside her body she was vulnerable to external Cold (from the climate) invading her joints. I treated her successfully by using a combination of acupuncture and ‘moxibustion’. This warmed the acupuncture channels flowing in her wrist & hand and her RSI symptoms disappeared.
This example illustrates the problems of eating a diet that is not suitable to the climate we live in. Can you imagine a native Eskimo living on salads!
Our climate is cold and damp and so we need food that is warming and helps disperse Damp within our bodies.
Chinese dietary therapy is based on each individual’s ‘pattern of disharmony’. This is to say, a diet that is suitable for one person, may not be suitable for another. It is based on the general constitution of the individual and their presenting symptoms when they come to the clinic.
Acupuncture for Fertility / IVF
Growing Interest in Traditional Chinese Acupuncture & Fertility
‘Integrated Acupuncture for Fertility’ was the title of a six day international seminar at the Royal College of Physicians in London. This event was supported by The Prince’s Foundation for Integrated Health with Mr. Michael Dooley as the Patron (Dec 2006). Mr Dooley is the Medical Director of the Winterbourne IVF unit and totally endorses the benefits of combining complementary medicine with orthodox medicine. I mention this to show just how far acupuncture is actively involved with the treatment of fertility problems.
A Little Background
Traditional Chinese acupuncture is a holistic therapy based on traditional Chinese medicine. It is a completely different system of medicine compared to western medicine and has an enormous amount to offer in the treatment of fertility. There are areas of fertility that Western medicine is best suited, and there are other areas of fertility where traditional Chinese acupuncture is best suited. There is also a growing research base to show that combining acupuncture with Western medicine gives even better results.
The use of Chinese acupuncture to improve reproductive health is very well documented. Historically, acupuncture has been used for over 2000 years to improve reproductive health. In the West, the benefits of acupuncture to help with fertility are only recently being properly acknowledged.
Acupuncture as part of a Fertility Plan
Acupuncture can be used at different stages of fertility treatment, and may form part of a ‘fertility plan’. Acupuncture can be used to assist with natural conception. It helps regulate the menstrual cycle and it helps correct any imbalances in the uterus that may be preventing successful implantation of the embryo. Although it is not unusual to see a successful pregnancy when there are still signs of imbalance, it is true to say that; the better the reproductive health and well-being of the woman, the better the chances of conceiving and maintaining a healthy pregnancy.
When considering acupuncture as a means of assisting natural conception, you need a good ‘window’ of time for acupuncture to begin to correct any imbalances. This is especially the case for long standing problems, for example, an uneven blood flow within the uterus. ‘Uneven’ referring to possible symptoms of period pain, blood clots, very dark blood, premenstrual headaches and moodiness. In this case the uterine environment is not so inviting for implantation of an embryo. In fact, these symptoms are important to address for natural conception or IVF treatment because if the uterine lining is not in good condition then miscarriage can occur.
All acupuncture treatment is based on trying to maximize pregnancy success rates, whether it happens naturally or via IVF.
How much influence can acupuncture have during IVF treatment?
This is an interesting question. There is a general consensus and acceptance that acupuncture helps before and after embryo transfer (see ‘Paulus Protcol’).
Acupuncture is often perceived by infertile women to have a positive impact on their health (see ‘Australian Study’).
The 2012 study (link – Acupunct Med) demonstrates that acupuncture can be beneficial at the first and seventh day of ovulation induction.
Certain drugs (for example ‘Clomid’) can enhance fertility, but also have undesirable side effects that can diminish fertility (ref : Jane Lyttleton, lecturer in fertility & Chinese medicine). Acupuncture may have a role in helping to offset some of these side effects.
Going through IVF can be a very stressful time and acupuncture is well known for helping stress.
In summary, there is evidence to suggest that acupuncture during IVF treatment is beneficial. In addition, the psychological benefits of regular acupuncture treatment must not be understated. Underlying imbalances can be treated, but it is best to start this before IVF treatment
What does it mean to have high FSH levels?
The level of Follicle Stimulating Hormone is often used as an indicator of fertility, however there are mixed views about this. For more information please follow the link, exploring the relationship of FSH and fertility.
Some very interesting research has been published in the States by Diane Criennda and Dr. Magarelli . Diane graduated in Traditional Chinese medicine in 1995, and subsequently studied a Masters in Oriental medicine. For over ten years she has been working with reproductive endocrinologists using a combination of Eastern and Western medicine therapies for the treatment of infertility.
She was the first researcher to discover that acupuncture could compensate for ‘poor prognosis patients’ undergoing IVF (i.e. patients who are statistically less likely to be successful with IVF). She found that when this group was treated with acupuncture, the success rates were equal to the pregnancy rates in the ‘normal prognosis patients’. You can see the results of this study here.
Diane has conducted a three-year research project adding acupuncture to IVF treatments. The results showed that there was a higher percentage of pregnancy, and more importantly, more babies were born to those who have acupuncture.
Another study (link – Acupunct Med 2012) looked at a group of patients who had a minimum of two failed IVF attempts. The group that had acupuncture during IVF treatment had a better outcome than the control groups.
Many research articles can be found at the bottom of this section on fertility. I have summarized and put into more readable English a lot of research papers. References to the original papers are also included.
General advice following embryo implantation
First and foremost… take plenty of rest. In addition :
AVOID caffeine, smoking, alcohol and drugs.
AVOID heavy lifting.
AVOID strenuous exercising and housework (including vacuuming).
AVOID bouncing activities (horseback riding, aerobics, etc).
AVOID sunbathing, saunas, hot tubs and jacuzzis
AVOID swimming and baths.
Links to Fertility & Acupuncture Articles in News Section
There are many causes of male infertility. Within the theory of Chinese medicine, male infertility is most often associated with dysfunction within the Kidney, Liver and Spleen organs. The Kidneys have prime importance since they govern birth, growth, reproduction and development. They are also regarded as the root of all ‘Yin and Yang energies’, and so their importance cannot be overstated. Decreased sperm mobility is often associated with a decline in Kidney Yang function, although this is not the only cause of decreased sperm mobility.
Impotence or loss of libido is other cause of infertility. This can affect men who are stressed by overwork or facing the emotional conflicts of a mid life crisis. It is also seen in younger men overwrought with sexual anxiety or frustration. Within Chinese medicine the Liver is concerned with ensuring the smooth circulation of Qi throughout the body and it is always affected by any kind of emotional strain. The Liver channel runs through the genital region as shown in the diagram. Thus, Liver disharmony can cause infertility.
Decreased sperm count or abnormal sperm are other causes of infertility. The movement of sperm is primarily governed by Kidney Yang. The number and form of the sperm is primarily governed by Kidney Yin. In clinical practice Yin and Yang are interdependent upon one another and so it is not unusual to see a decline of both Kidney Yin and yang that manifests as a low sperm count (reduced Kidney Yin), and reduced sperm mobility (decline in Kidney Yang).
Acupuncture for Morning Sickness
Morning sickness ranges from ‘unpleasant’ to life threatening due to severe dehydration. It is very common during the first trimester of pregnancy and often settles down. For some women morning sickness can be a real problem and make pregnancy a right ordeal.
What causes morning sickness?
The presence of a baby in the uterus obstructs the movement of energy in the acupuncture channels. Instead of stomach energy descending, as it ought to, it ascends leading to nausea and vomiting. This is termed Rebellious Stomach Qi (energy), as the Qi isn’t moving in the direction that is should be. For most women, the body adjusts itself and the symptoms go away. For others, morning sickness persists and treatment is necessary to regulate the acupuncture channels and stop sickness.
Results can be dramatic after one to three sessions, for others it takes longer, depending if there are any other underlying causes that are contributing to the morning sickness. For example, I recently treated a lady for morning sickness who had a history of irritable bowel syndrome. In this case the energetic in her abdomen were out of balance before she became pregnant, and so she needed more treatment.
Acupuncture is a good treatment choice for morning sickness as the results are often very successful and quick, and it does not involve taking any medication.
Acupuncture for Backache During Pregnancy
During pregnancy ligaments become softer and stretch to prepare you for labour. This can put a strain on the joints of your lower back and pelvis, which can lead to backache. As the baby grows, the hollow in your lower back may increase and this may also cause backache.
During this period it is best to avoid heavy lifting and to always bend the knees and keep the back straight when lifting or picking something up from the floor. If it is necessary to carry something heavy, then hold it close to the body. Avoid twisting and lifting at the same time. Balance weight between two baskets if carrying shopping.
Acupuncture is very effective treatment for backache. During pregnancy it is always advisable to only take essential medication as prescribed by your GP. Acupuncture offers a natural alternative to taking painkillers and anti-inflammatories.
Constipation During Pregnancy
In terms of Western medicine, constipation can occur very early in pregnancy because of the hormonal changes going on in the body. Progesterone has a relaxant effect on the smooth muscles of the gut.
It is always helpful to: -
Include plenty of fibre in your diet. Try not to eat too much hot spicy food, since these dry up the fluids in the intestines. Equally, it is important not to consume too many cold foods since the nature of cold is that it contracts the muscles of the intestines, and prevents the correct movement of qi (energy). Cold food includes; fruit juices from the fridge, bananas, and salads.
Exercise regularly to keep muscles toned up. Exercise stimulates the movements of the Large Intestine.
Drink adequate water (at room temperature, or warm).
Avoid iron pills if they cause constipation – ask your GP about this. There are liquid herbal formulas that contain iron in a more easily digestible form.
From a Chinese point of view, constipation during pregnancy can be due to the mother’s blood & Kidney energy being diverted to nourish the growing foetus and leaving herself depleted. It is important to rest if this is the cause of constipation.
It can also be caused by ‘stagnation’ i.e., there is not the smooth movement of qi (energy) in the bowel, which in turns leads to constipation and difficult bowel movements. In this latter case the stool is often pebble-like, or like rabbit droppings. If constipation is left untreated there may be the added complication of haemorrhoids after childbirth. Stagnation in the intestines can be caused by emotional stress, anger, resentment or frustration. Worrying and brooding will also slow down the transportation of food in the Intestines.
Generally acupuncture is very effective at treating this condition, along with some dietary or lifestyle advice if appropriate.
Acupuncture for Induction of Childbirth
Occasionally full-term pregnant women come into the clinic to see if there is anything we can do, to help start labour.
Provided that the woman is full-time, acupuncture is used to induce labour. There is a combination of acupuncture points which have a strong action on ‘down bearing’ or ‘descending qi’ i.e. they provide a stimulus to start a strong downward movement which is required for labour. One of the acupuncture points is known to dilate the cervix. For these reasons, these acupuncture points are forbidden during pregnancy in case they induce premature labour.
Treatment is on a daily basis, or perhaps even twice daily. I recently treated a woman who was 10 days overdue, and she give birth later on that day, after one acupuncture session.
If your body is ready to give birth then acupuncture can provide the stimulus to get things moving.
Pain Relief During Labour
There are various ways of giving pain relief during labour including epidural injections, gas and air, TENS machine, massage and acupuncture.
Until the 1970s, acupuncture was very rarely used for the relief of pain in labour and delivery because, in accordance with Chinese culture and oriental tradition, women were expected to experience the pain of childbirth.
Acupuncture has rapidly become more popular for women in childbirth today, mainly because it is a natural pain-reliever with no harmful side effects for mother or baby. Moreover, women like to feel in control during their labour and delivery, a feeling of which they may be deprived, if more potent conventional analgesics are. For example, drugs can be used to start or increase labour, which means the artificial forcing of a process which has not yet occurred within the woman’s body according to her own natural ‘biological rhythm’ This may involve rupturing the amniotic membranes artificially and then giving the mother an intravenous infusion of Syntocinon (oxytocin) to stimulate uterine contractions. It is then necessary to have an epidural because of the increased pain that is frequently experienced in an induced labour.
Until 1853, anaesthesia for childbirth in England was unheard of. It was regarded by many to be ‘contrary to religion and the express command of the scriptures’.
Today, women do not want to undergo the pain of childbirth but they do want to be ‘in control’ to be allowed to choose; to be encouraged to trust one’s own body to overcome the pain barrier through its own natural rhythm. There are a number of ways of achieving the desired balance: Yoga, massage, TENS, Alexander technique, meditation, acupressure, and of course, acupuncture.
Although Western doctors today are much more open to alternative ways, it remains very important for the medical profession to shake off its doubts and overcome is scepticism towards complementary medicine, so that women may be offered choice from the outset.
Using Acupuncture during Labour and Childbirth
Ear points are used for analgesia in labour, as they do not restrict the woman’s movements (unlike the use of body points). One ear is used, although the needles can be changed to the opposite ear if it becomes sore, or the women wishes to lie on the side with the needles. The needles are taped in place and attached to electrodes. The electro-acupuncture apparatus provides stimulation to the needles and the woman can control it herself, increasing the intensity when a contraction takes place. This type of acupuncture can be started at any stage of labour, according to individual needs.
Difficult labour may result from abnormality of uterine contractions, an imbalance between the size of the maternal pelvis and the foetal head, or a bad position of the baby. Acupuncture can be of help in the first of these, but not for the others. Acupuncture may be the treatment of choice if contractions have weakened in strength, rhythm or regularity or if they are totally absent.
Acupressure for Childbirth
This small downloadable booklet describes which acupuncture points to use and when they are best to use, to promote a natural labour. It is designed to promote natural pain relief techniques during labour and with partner involvement. Although they are easy to use and the booklet provides clear instructions to point location, I would advise one visit to see an acupuncturist to confirm location & pressures, etc. The author of the booklet, Debra Betts, has personally experienced the benefits of acupressure during two of her own labours.
Article about acupuncture for childbirth in NEWS section :
Acupuncture for Labour Pain Management – a systematic review of trials
Acupuncture for Breech Babies
This is something commonly treated with acupuncture, and the good news is that it doesn’t involve needles! Ideally treatment starts around 34-36 weeks, although treatment can be later provided there is space for the baby to turn.
Treatment is very straightforward and only involves one visit to my clinic. Further treatments can be done in your home after I have taught you the technique.
The procedure is non-invasive and pain free. Studies show that at 34 weeks gestation, 48% of babies will move spontaneously. However, with this technique 75% of babies will move from the breech position. When the baby moves following treatment, a midwife needs to check the positioning of the baby.
Considering that this is a very simple and inexpensive procedure, I would recommend it to all expectant mothers as there is nothing to lose with trying, and a lot to be gained!
Related articles form the NEWS section :-
Should Acupuncture and Moxibustion Be Routinely Recommended for the Treatment of Breech Presentation?
Acupuncture for Period Pain
A few years ago I spoke to an acupuncture colleague from the Northern College of Acupuncture who had done a PhD on the treatment of period pain with acupuncture. I remember saying to her that I was surprised I didn’t see more women in the clinic who wanted help with period pain. She replied, ‘that’s because a lot of women have been told by their GP that it is normal’.
In recent years there has been a lot of interest in fertility treatment & acupuncture, and as a result of this I have seen a lot more women with period pain. Acupuncture helps regulate the menstrual cycle to optimise successful conception and implantation of the embryo. Typical symptoms associated with period pain… cramps, stabbing pains, blood clots with period, etc., all point to an imbalance in the reproductive system that could be compromising fertility.
Whether you are trying to conceive or not, acupuncture has a lot to offer for women suffering from painful periods. There are a number of energetic imbalances that create period pain and the initial acupuncture consultation will identify which is present – or often there are several imbalances that are interconnected.
Articles you may be interested in from the News Section
Acupuncture for Heavy Menstrual Bleeding
A menstrual bleed that is sudden, profuse and often early is termed “flooding” in Chinese medicine.
It can be caused by any of the following: -
Long-term emotional strain
Overwork & excessive sexual activity
Excessive physical work (or exercise) combined with chronic illness
Excessive loss of blood at childbirth
Different characteristics of the menstrual bleed & Chinese medical diagnosis
The nature of the bleed gives important information about what is causing this problem. For example, if the blood is bright red with profuse bleeding then this would indicate heat in the Blood. Heat is said to “move the blood recklessly in the channels”. This implies that the blood is agitated by the heat, and it leaves the blood channels which results in excessive bleeding.
Long-term emotional strain can cause this. For example, long-term stress causes the qi (energy) to stagnate. Over time, this stagnation generates heat. This is analogous to a car ticking over in a traffic jam; the car gets hotter and hotter unless the traffic starts to move again.
There is also something termed ‘Empty Heat’ in Chinese medicine and this can occur due to overwork & excessive sexual activity. This also causes the blood to move recklessly.
If the blood is particularly dark with some blood clots then it is clear that the blood is not moving smoothly and this can cause excessive menstrual bleeding. It is similar to a rock in a water pipe; the water cannot flow smoothly and there is a danger that the pipe will burst (which causes the bleeding). This can also be caused by long-term emotional strain. Energy (qi) moves the Blood, therefore if the energy stagnates over a long period of time then Blood will eventually stagnate and result in excessive bleeding.
Energy is also required to ‘contain the blood within the blood vessels’. This may sound somewhat peculiar, however in Chinese medicine it relates to a condition called ‘Spleen Qi Not Containing’. Spleen energy can become depleted by physical overwork (including too much sport), and chronic illness. This lack of energy can cause the blood to leave the vessels and cause excessive bleeding.
Correct acupuncture treatment depends on differentiation of syndromes according to Traditional Chinese medicine.
I would also recommend visiting your GP for this condition, to make sure that the bleeding isn’t caused by more serious conditions such as cervical cancer, cancer of the uterus, endometriosis, fibroids or endometrial polyps. This is not to say that acupuncture would not be helpful… quite the contrary!
Continous Menstrual Bleeding
This refers to a menstrual bleed that continues beyond the normal length of time for a period. Within Traditional Chinese medicine, there is a lot of overlap between this condition and heavy menstrual bleeding.
Excessive or prolonged menstrual bleeding needs treatment as it can lead to more complicated & difficult to treat conditions later on in life. Treatment is based on differentiation of syndromes according to the theory of Traditional Chinese Medicine.
Irregular periods may not be a concern for most women unless they are accompanied by period pain or perhaps the woman is trying for a baby. Irregular periods do indicate that the menstrual cycle is out of balance and it may be a cause of infertility.
Within Chinese medicine there are three main reasons for irregular periods.
The first is stagnation of energy & blood in the uterus. Other signs of stagnation of Qi (energy) and blood are; period pains, lower abdominal bloating leading up to the period, irritability & mood swings, and blood clots in the menstrual bleed. You may be interested in reading the section on dysmenorrhoea if this sounds familiar. When there is stagnation within the uterus, the menstrual cycle can become irregular as the smooth cyclic monthly flow is disrupted.
Irregular periods can also be caused by a condition called cold in the uterus. This is treated using a Chinese herb called moxa and you may like to read the section on moxibustion for more information about this. When cold lodges in the uterus it prevents the smooth movement of energy & blood and disrupts the menstrual cycle. With this condition the abdomen may feel cold leading up to the period, the woman may feel cold generally, and there may be intense period pain which is relieved by placing a hot water bottle on the lower abdomen. A hot water bottle may also bring relief for woman who suffer from Qi and Blood stagnation since the warmth will move the energy and reduce pain. Since Cold causes the energy and Blood of the uterus to stagnate there is often an overlap between this condition and the previous one.
Another common cause of irregular periods is due to a condition termed Liver Blood deficiency. In this case the Blood that goes to the uterus is reduced in quantity. Please bear in mind that when I refer to blood in Chinese medicine it does not have the same meaning in Western medicine. In this condition the woman may miss periods all together, or the periods may be irregular but the blood flow is very small. It can also occur that the woman may miss one, two or more periods and then there is a heavy bleed. This category of irregular bleeds is very different from the pervious two since it is not based on stagnation but rather on a deficiency i.e. a lack of menstrual blood. There may be associated symptoms such as dizziness and tiredness that are notably worse after the menstrual bleed.
Although I have separated irregular periods into three separate categories, there is a lot of overlap between these categories. In clinical practice woman will often have with a mixture of these different conditions. The beauty of Traditional Chinese Acupuncture is that treatment is individualised for each patient according to the presenting symptoms.
Acupuncture has a lot to offer for all gynaecological problems and irregular periods are no exception.
Scanty periods are technically known as ‘amenorrhoea’. The menstrual flow may either be very light, or it will be irregular, sometimes missing months all together.
There are several reasons why this may occur. Within Chinese medicine, Liver blood fills the uterus each month and it is the movement of this blood that causes the menstrual flow. If the Liver blood is ‘deficient’ then the period will be light or non-existent. This blood deficiency may be a result of poor diet over many months, excessive physical exercise, emotional upset, or long-term illness. There may be other associated symptoms such as tiredness, pale complexion, dizziness or visual disturbances.
Scanty periods can also be caused by stagnation of Liver blood. In other words, something is preventing the smooth monthly flow of the menstrual cycle. If the Liver blood is obstructed then the menstrual blood is dark red and contains blood clots. There may be accompanying abdominal pain that gets better as the period progresses, i.e. when the blood is flowing. The longer the pain continues for (once the period starts), the more severe the stagnation.
What causes this stagnation?
In Chinese medicine energy moves our blood. If our energy becomes stuck for a long period of time then the blood can no longer move freely, and pain is often the result. Stress, anger, resentment, frustration, and bitterness will upset the movement of energy, particularly Liver energy. In fact, any long-term emotional strain can affect the Liver and lead to scanty periods with accompanying abdominal pain.
Cold can invade the uterus and obstruct the movement of Liver Blood. You may be interested in looking at the section on moxibustion for some more information about this condition. Cold has a contracting nature and it inhibits the movement of qi.
Please click on painful periods for more information.
Treatment of scanty periods depends on the underlying cause. If there is a deficiency of Liver blood then acupuncture points are selected which help to tonify the blood, and appropriate dietary and lifestyle advice will be given. If the cause is more to do with stagnation then acupuncture points are selected which move stagnation of qi and blood in the uterus.
As a general rule, all menstrual imbalances need to be weekly for at least three months. It takes three menstrual cycles to start to see a change in the pattern, although you may (and quite frequently do), see a change after the first menstrual cycle.
PMS is very common in this country and the symptoms can be very distressing. A lot of women have to endure these discomforts while carrying on with a busy work schedule or caring for their children, or just general everyday activities! Some relief may be gained from painkillers, anti-inflammatories, etc., but this can become a regular monthly occurrence. Is there an alternative?
Fortunately acupuncture and the theory of Chinese medicine has a lot to offer for women suffering from PMS. Most of the symptoms of PMS are due to stagnation of qi (energy) and blood. Leading up to the period there is an increase in Yang energy that moves the blood in the uterus and starts the period. If this energy gets ‘stuck’ then the period cannot flow easily and pain results. Pain leading up to the period and at the beginning of the period is caused by stagnation. Over a few menstrual periods acupuncture will regulate the flow of Qi and pain will disappear.
Period pain can also be caused by a condition called ‘Cold in the Uterus’. This often affects young women who stand and wait in long queues for nightclubs wearing very little clothes. Cold can invade the uterus and prevent qi (energy) from moving, and this causes pain. Cold is contracting in nature and stops the movement of Qi. When we are outside in cold weather we often tense our shoulders to try and keep warm. Over time, this tension impedes the circulation of Qi and blood within the muscles.
Symptoms of stagnate qi include; breast pain, irritability, mood swings, and cravings for sweet things leading up to the period. When qi (energy) stagnates then this will eventually cause the blood to stagnate and/ or body fluids. It can then lead to more serious gynaecological problems.
Breast tenderness is a common symptom in women leading up to their period. There may also be accompanying abdominal pain, mood swings, and other symptoms of PMS. The menstrual bleed may be dark and have blood clots although this isn’t always the case.
The breast area is governed by the Liver channel in Chinese medicine and many symptoms associated with PMS are caused by an imbalance in the Liver channel. Within Chinese medicine, pain is caused by stagnation of energy. When the Liver channel is obstructed then the breasts can be affected. If breast tenderness continues over many years it can lead to breast lumps that may be benign or malignant. This is because energy moves the blood and body fluids. If energy stagnates over a long period of time, then other body fluids can stagnate and develop into masses.
Acupuncture for The Menopause
The menopause is a time of transition and marks the end of a woman’s reproductive years. Some women are fortunate and do not suffer unduly during this period. For others the menopause can be a very unpleasant experience and cause a lot of stress and worry. The medical literature reveals an inconsistent and varied list of symptoms related to the menopause. Some of the symptoms that a woman may experience include the following: -
Palpitations (awareness of the heart beating)
Pain in the joints
Anxiety, irritability, nervousness, moodiness
All of these symptoms can occur in women without the menopause. However it is the clustering or combination of these symptoms that forms the ‘menopausal syndrome’.
There are also cultural differences in the manifestation of menopausal symptoms. For example, in the Rajput caste in India the women report virtually no symptoms related to the menopause. Interestingly, in this culture the woman’s status increases after the menopause and she is given certain privileges.
In addition to all the biological changes with menopause, women have to confront and deal with many changes in their lives. Big adjustments have to be made such as ‘empty nest syndrome’ – as sons and daughters leave to set up their own homes.
The treatment of menopausal symptoms in Western medicine involves HRT – Hormone Replacement Therapy. Thus, the menopause is regarded as a deficiency of oestrogen that needs to be supplemented. HRT is a controversial treatment programme and since it is relatively new, physicians are only now beginning to understand what the long-term implications of this drug may be. Please click on the text HRT for more information about this.
How can Acupuncture and the theory of Traditional Chinese medicine help with the symptoms of menopause?
The Chinese medical model is very different to what we are used to in the West. Instead of talking about the ovaries, pituitary gland and the role of oestrogen, they talk about the Directing (Chong) vessel, Conception (Ren) vessel and the Kidney channels. Acupuncture does affect the hormonal system even though the Chinese do not have a concept of the hormonal system as viewed in the West.
Acupuncture and Chinese herbs function by regulating the channels & organs and restoring balance within the body. By doing this the menopausal symptoms will disappear over a period of months. There will be a gradual improvement. Furthermore, treatment is tailored to each individual and priority is given to the symptoms that are most dominant.
Link to Articles in News Section related to The Menopause
Acupuncture for Polycystic Ovary Syndrome
Polycystic Ovary Syndrome (PCOS) is a complex endocrine and metabolic disorder.
Interesting article from the NEWS section
Can Acupuncture be used to treat Polycystic Ovary Syndrome?
Urinary/ Kidney Disorders
This is known as ‘Painful Urination Syndrome’ in Chinese medicine and is common within the UK, especially with women. It is characterised by burning pain on urination, frequent urination and tenderness in the lower abdomen. The urine is darker than normal and can have a strong odour.
The symptoms of cystitis correspond to ‘heat ‘ and ‘damp’ within the Bladder. The heat causes the burning pain on urination, strong odour and dark urine. ‘Damp’ obstructs the flow of urine and so the bladder may not be emptied fully each time, resulting in a more frequent need to go to the toilet. If the urine is cloudy then this is another clear sign of ‘Damp’ in the Bladder.
This ‘Damp Heat’ may just be isolated to the bladder, or it may be more systemic. At the initial consultation I will look at the tongue, feel the pulse, and ask questions to see if there are any other signs and symptoms of ‘Damp Heat’ in the body. If the cystitis is recurrent then it is likely that there is an imbalance in the body that makes the bladder more vulnerable to this condition. Acupuncture will correct this imbalance along with appropriate dietary or lifestyle advice.
Pain on Urination
Under this heading it is possible to include conditions such as cystitis, urethritis, bladder stones, kidney stones, etc. In Chinese medicine these conditions all fall under the category of ‘Lin syndrome’, with pain on urination being the main characteristic. Urination is often short, painful, frequent and with a sense of urgency.
Although pain on urination is the primary symptom, additional symptoms give a more detailed diagnosis. The Chinese category of ‘Lin Syndromes’ can be further broken down into five categories.
If the urine is usually dark yellow or even reddish, this would usually indicate heat. Sometimes the urine is also cloudy and in Chinese medicine this points to ‘Damp in the Bladder’. Damp is like a turbidity which develops when the ‘clear’ fluids and the ‘dirty’ fluids are not separated properly. Thus, this condition is termed ‘Damp Heat in the Bladder’. There may be other accompanying symptoms such as burning on urination, lower back pain, feeling hot, etc.
Urinary stones are termed ‘Stone Lin Syndrome’ in Chinese medicine. These result in very painful, difficult urination that often stops and starts. There may also be excruciating pain in the lower abdomen and the urine is typically dark yellow, or bloody.
Sometimes urination is interrupted, or slow and painful but the urine is normal colour. There may also be some bloated feeling in the lower abdomen. In this case the energy in the lower part of the body is not moving smoothly and acupuncture aims to restore this. This condition is the easiest to treat.
Sometimes the energy is very depleted in the lower abdominal area (and elsewhere). In this case urination is more painful and difficult when feeling particularly tired, fatigued, and after overexertion. There may be accompanying lower back pain, or a bearing down sensation in the lower abdomen.
All these conditions can be treated with acupuncture, although there are times when Chinese herbs may also be needed, in which case I will be able to refer you to a good herbalist if this is necessary.
I would also recommend visiting your GP and he/ she may decide to do some further tests or scans.
Hesitant Urine Flow
There are often accompanying signs & symptoms alongside a hesitant urine flow and these may include; pain on urination, burning sensation, lower back pain, lower abdominal bloating, dark concentrated urine, cloudy urine, etc.
Sometimes the flow of urine stops and starts, other times it is very difficult to go at all, this latter case is termed ‘urinary retention’.
An interrupted urine flow can be due to stagnation of energy in the lower abdomen. Acupuncture will help regulate the flow of energy and usually good results are achieved. If the urine is cloudy then this indicates ‘Damp’ in the bladder. Damp is a Chinese medical term and refers to a turbidity that collects in the body when the ‘clear’ and ‘unclear’ are not separated correctly, i.e. there is a problem with fluid separation. Acupuncture is also effective at eliminating ‘Damp’ from the bladder, although it will need a course of treatment, rather than just one or two sessions. Damp obstructs the movement of energy in the Bladder and makes urination difficult, with a stop-start flow.
Difficult urine flow can also be the result of insufficient energy in the lower abdomen.
This symptom also needs investigations from a GP since there may be problems with the prostate gland. Mild cases of prostatic hypertrophy (enlargement of the prostate gland) are treatable by acupuncture, or a combination of Chinese herbs and acupuncture. More severe cases may respond best to a combination of surgical treatment backed up by acupuncture.
Kidney stones can be extremely painful depending on their location and size, or they may cause no symptoms at all. They can cause pain, bleeding, obstruction and secondary infection. Renal colic is typically excruciating and intermittent, usually originating in the flank or kidney area and radiating across the abdomen, frequently into the groin region and inner thigh. There may also be nausea & vomiting and chills & fever.
Within Western medicine an X-ray scan will show up the majority of kidney stones and then most treatment involves the destruction of the stones by the application of shock waves (known as SWL – shock wave lithotripsy), provided that the stone is less than 2 cm in diameter and in a location to carry out this procedure. If the stones are small enough they may eventually travel along the urinary tract and pass out through the urethra during urination.
Generally, acupuncture is a suitable form of treatment for small stones (less than 5 mm diameter) and gravel. Larger stones will require shock wave treatment or surgery. Acupuncture can be performed during bouts of pain and during the symptom-free periods.
When the pain is intense, acupuncture is applied to general points that influence the urinary tract, and to points located according to the position of the pain. Treatment may be daily or even twice daily depending on the severity of the pain.
When the patient is pain-free, acupuncture may be applied to strengthen the Kidneys, improve urinary function and promote urination, treatment will normally be once weekly.
Kidney stones are often caused by stagnate qi (energy) and heat. The heat is said to ‘boil’ the body fluids, thus condensing them to form stones. Stagnation develops when the flow of energy is poor. It is important to maintain a good intake of fluids – warm water is better than cold.
Oedema is characterised by over-retention of water in different parts of the body. Water is essential for life and for all the physiological processes in the body, however if it accumulates then it becomes ‘pathogenic ‘ or ‘disease causing ‘. So, we can differentiate between water that is good for us, ‘physiological water’, and water that is bad for us, ‘pathogenic water’. It is all water, but depending on the amount and location of the water, it is either good or bad.
Oedema may be generalised or localised. It may for example affect the face, or the abdomen, or the legs. It may be hot or cold to touch. It may have started very suddenly, or it may have a gradual onset over many years. When pressure is applied on the oedematous area then it may leave a ‘pitting’ behind where the finger was. There may be ulcers or boils, or pimples present. All these aspects are important in forming a diagnosis in Chinese medicine.
Taking a detailed history of the illness is important in order to form a diagnosis, look for a possible cause, and to formulate a treatment plan. Depending on the type and severity of the oedema, treatment maybe over many months or it may respond quickly.