• Menstrual Disorders
• Menopause
• Infertility
• Pelvic Inflammatory Disease (PID)
• Endometriosis
• Uterine Fibroids
• Ovarian Cysts
• Yeast Infections
• Problemsi with Pregnancy
• Polycystic Ovarian Syndrome
• Headaches around menstruation
• Acne around menstruation

What is a regular period?
Before we can talk about irregular periods, we should define exactly what a regular period is. It usually occurs every 28 or 30 days and lasts anywhere from 3 to 7 days. Every woman's cycle is a bit different. You may get your period every 21 days or every 35 days, but as long as they occur with roughly the same number of days between each cycle, they are regular.

How do irregular periods happen?
Irregular Periods occur when hormone levels are thrown out of sync. The glands affected with the process of menstruation include the hypothalamus, pituitary gland, and the ovaries. This is often referred to as the HPO Axis.

Irregular menstruation is generally related to disruptions in the balance of hormones. Delayed periods may be signals that ovulation has not occurred and, consequently, that the endometrial lining has grown thicker. Delayed periods usually involve heavier bleeding due to this increased thickness. Lighter periods or bleeding between periods may arise when hormone levels are not sufficient to nourish the endometrial lining.

Some causes of irregular periods:

• Stress
• Poor diet
• Intense exercise
• Weight gain or Weight loss
• Pelvic infection
• Menopause
• Uterine polyps
• Fibroids
• Uterine cancer / Uterine abnormalities
• Dysfunctional bleeding

About Contraceptive Pills
Most doctors will put a woman with irregular periods on the contraceptive pill. This will regulate menstrual cycles but unfortunately does not treat the root cause of the irregularity. Consequently, when a woman discontinues the pill, the irregularity will most likely return. What happens is that the pill tricks the body into thinking that it is pregnant and does not allow for ovulation. No egg is released from the ovary and pregnancy cannot occur. Essentially, the hormones override the body's natural hormone balance.

Irregular Periods according to TCM:
An irregular cycle is always due to an imbalance of the liver and kidneys according to Traditional Chinese Medicine (TCM). "It is the rhythmic ebb and flow of blood and essence that give rise to periods".

Emotional stress causes the liver Qi (or energy) to stagnate causing blockages in the body. The liver is referred to as the "woman's organ" as it stores the blood and is the main organ responsible for the menstruation. Anger, frustration, tension, and anxiety all will have an effect on the liver organ as it is also in charge of the emotions. As one of the functions of the liver is to promote Qi flow through the body, emotional stress leads to blockages in the meridian system resulting in organ imbalance.

Overwork can lead to a deficiency in the kidney system. The kidney system is involved in reproduction and development. As far as the meridian system goes, the kidneys and uterus are directly connected. If there is a deficiency in the kidney system, this causes the uterus to become depleted leading to irregular periods.

Lifestyle
Take time for yourself. A tired and stressed out body will definitely have an effect on the menstrual cycle. Also, try to exercise daily. Anything that gets your heart rate up.

Acupuncture and Herbal Medicine
In our practice, when dealing with irregular menstruation, We find that the combination of herbal medicine and acupuncture treatments are most effective. Acupuncture sessions are commonly on a weekly basis at the beginning and last about 30-45 minutes.

The pain mainly occurs in the lower abdomen, lower back. In severe cases, there may be nausea and vomiting or even fainting. Some women describe cramps as being sharp throbbing pains that come and go while others describe them to be dull and constant. Some people may think that having cramps is just simply part of the unfortunate things that women go through; however, according to Traditional Chinese Medicine, it reveals that there is an imbalance occurring in the body which can be resolved.

What causes menstrual pain?
The pains are caused by contractions in the musculature of the uterus. The contractions are caused by the release of the body's prostaglandins, which are hormones produced by the lining of the uterus.

Chinese Medical point of view:
For a normal period to occur, blood must be abundant and move adequately. Proper movement of blood relies on the free flow of liver Qi (energy). If liver Qi is stagnant, it causes pain especially before the period. If liver-blood is stagnant, it causes pain during the period. Stagnation is the most important thing to treat when dealing with painful menstruation.

In acupuncture, there are 14 meridian systems in the body. These meridians are pathways of communication. Each meridian corresponds with a particular organ. In painful menstruation, the liver meridian is the primary meridian that is focused on. The liver in TCM stores the blood and is considered the "woman's organ". The liver also promotes the smooth flow of Qi and blood throughout the body. When the liver is not working properly, or is "stagnant", the Qi and blood will not flow through the body properly and pain will result. The liver meridian also runs to the pelvic region. The other organs which can be involved in painful menstruation are the spleen and kidneys.

Etiology according to TCM:
• Excess exposure to cold and dampness especially during puberty
• heat or damp-heat invades the body during period or after childbirth
• prolonged severe illness
• excessive sexual activity
• too many childbirths or insufficient rest after giving birth
• constitutional spleen, stomach, liver, and/or kidney deficiency

Patterns in TCM:

Qi Stagnation & Blood Stasis
Symptoms include distending pain in lower abdomen before period or during first or second day of period; dislike pressure on abdomen; menstrual flow comes and stops with clots; menstrual flow is dark-red; pain is totally relieved after period

Cold in the Uterus due to Yang Deficiency
Symptoms include cold pain appearing during or after period; pain is relieved with warmth; menstrual flow is dull light color; periods are quite scanty

Cold-Dampness in Uterus
Symptoms include cold pain before or during period; pain is relieved with warmth but not with pressure; small amount of menstrual blood; dark-red color of blood; pain in lower back

Damp-Heat in Lower Abdomen
Symptoms include distending or burning pain in lower abdomen before or during period; burning sensation extends to sacrum; may always have lower abdominal pain but worse during period; bright-red colored blood; blood is thick with clots; profuse yellow smelly vaginal discharge This pattern is usually in patients with chronic pelvic inflammation

Qi and Blood Deficiency
Symptoms include dull pain in lower abdomen during or after period; like pressure on abdomen; scanty, light, and thin menstrual flow

Liver and Kidney-Yin Deficiency
Symptoms include dull pain in lower abdomen during or after period; scanty and thin menstrual flow

The TCM Doctor does a thorough consultation with the patient and then concludes as to the specific TCM pattern. Very often, the patient will not only exhibit one pattern but rather many patterns complicated into each other. Treatments will consist of acupuncture and/or herbal medicine. Nutrition and lifestyle changes will be addressed as well. With treatments for painful menstruation, the patient should expect significant improvements within three months of treatment.

• abdominal bloating
• cramps
• breast tenderness & swelling
• mood changes (irritability, frustration, depression)
• acne
• back pain
• fatigue
• food cravings
• headaches
• insomnia
• joint pain
• water retention
• anxiety
• dizziness

What can you expect?

Typically, I advise the patient suffering from PMS to come into the clinic twice per week for acupuncture and I will combine a Chinese herbal for them to take as well. To effectively treat the root cause of the PMS, it takes approximately three menstrual cycles at least. Some women will see a reduction in their symptoms right away while others it may take a longer period of time. Stress levels, lifestyle, and general health are important factors involved in response time.

How does Acupuncture help?

According to Traditional Chinese Medicine, PMS is very often due to blocked Qi (energy) and blood in the body. This blockage can manifest as emotional blockage (frustration, irritability, anxiety, tension, impatience) and/or physical blockage (pain, breast tenderness, water retention etc.). Acupuncture stimulates the circulation of blood and Qi throughout the body by inserting tiny thin needles into specified acupuncture points.

• Eat plenty of fresh fruits and vegetables, whole-grain cereals and breads, beans, peas, lentils, nuts and seeds, broiled chicken, turkey, and fish.
• Have high-protein snacks between meals to balance blood sugar levels
• Include foods that are high in complex carbohydrates and rich in fiber. These help rid the body of excess estrogen (if high estrogen levels are your problem)
• Drink plenty of water
• Avoid red meat, salt, processed foods, and junk food. Eliminating salt is especially important to prevent bloating and water retention around the menstrual period.
• Limit consumption of dairy products and refined sugars
• Avoid caffeine – caffeine can cause breast tenderness and anxiety as it is a central nervous system stimulant. It also depletes many nutrients out of the system as it acts as a diuretic.
• Do not consume alcohol especially during the week before the period – it causes valuable nutrients like magnesium to be excreted out of the body through the urine
• Regular exercise is very important as it increases oxygen levels in the blood which helps in nutrient absorption and efficient elimination of toxins from the body. It also helps keep hormone levels more stable.

What is Menopause?

Menopause is defined as the permanent stoppage of menstruation, marking the end of a woman's ability to conceive. It is a normal process of ageing which occurs when the ovaries stop making hormones called estrogens. This usually happens between the ages of 45 to 60, but it can happen earlier. Menopause can also occur when the ovaries are surgically removed or stop functioning for any other reason. Once a woman has not menstruated for a full year, menopause is considered complete (she is post-menopausal). A diagnostic test can confirm menopause. The FSH test measures the body's level of follicle stimulating hormone. As estrogen levels decline, the pituitary gland secretes FSH; therefore, a high level may indicate menopause. Blood and urine tests can also determine if a woman is still ovulating.

What are the common symptoms?

As most women approach menopause, their menstrual periods become irregular - they happen closer together and/or farther apart. Other common symptoms include:

Achy joints, Tension & anxiety, Lack of concentration, Hot flashes, Depression, Difficulties with memory, Night sweats, Extreme sweating, Frequent urination, Vaginal dryness, Headaches, Bone loss, Loss of sexual desire, Dizziness Insomnia, Rapid mood changes

Keep in mind that a woman may have one, some, or none of these symptoms.

What is HRT?

Hormone Replacement Therapy (HRT) is a combination of estrogen and progestin prescribed to women who have not had a hysterectomy. Progestin is added because, given alone, estrogen can increase the risk of endometrial cancer. Estrogen Replacement Therapy is given to a woman who has had a hysterectomy, since there is no risk of endometrial cancer to worry about. While there are numerous forms, Premarin (conjugated estrogen) and Provera (medroxyprogesterone) remain the most popular. Infact, Premarin is the most frequently prescribed medication in the United States.

Possible Risks of HRT

Unfortunately, despite the possible benefits, HRT has many potential conflicts & controversies. Increased risk of breast cancer, uterine cancer, ovarian cancer, endometrial carcinoma, malignant neoplasm, gallbladder disease, thromboembolitic disease, & photosensitivity are some possible adverse effects. Progesterone minimizes the risk of endometrial cancer but can cause side effects such as an increase in cholesterol, water retention, weight gain, and bleeding.

Unfortunately there is no consensus on how menopause should be treated with western medicine. Despite all the clinical & laboratory research, medical doctors can't agree on when and under what circumstances to start the treatment of menopause. Some propose to begin treatment during the perimenopausal years, while others prefer to initiate treatment only after menopausal symptoms have begun. Some doctors discourage the use of HRT completely since the risks outweigh the benefits.

How can TCM treat Menopause?

TCM involves a number of practices including acupuncture & acupressure, Chinese herbal medicine, and nutritional advice. It especially emphasizes lifestyle changes. TCM has been used as the sole source of medicine in China for over 3,000 years and is still being used today throughout the world.

Gynecology is an area in which TCM shines. It can be used instead of or in conjunction with western medicine for the successful treatment of menopausal symptoms. Evidence that acupuncture and herbal medicine have been used for women's health can be found in early medical literature dating back to 3 A.D. TCM doesn't recognize menopause as one particular syndrome. Instead, it aims in treating the particular symptoms that are unique to each individual. For example, if ten women are treated with TCM for hot flashes and night sweats, each of these ten women will likely receive a unique, customized treatment with different acupuncture points, different herbs, and different lifestyle & diet recommendations. This gives a very effective result.

According to TCM, menopause is mainly due to a deficiency of the kidneys. The kidneys are responsible for growth, maturation, and aging. They are the foundation and need to be nurtured throughout our whole life. Excessive stress, overwork, poor diet, too many children or births too close together are some things that can deplete the kidneys and make menopause more difficult. A deficiency of kidney-yin is directly related to symptoms and complications of menopause. Other common conditions that are complicated with kidney yin deficiency are kidney yang deficiency, kidney essence deficiency, liver Qi stagnation, blood deficiency, and uprising heat from deficiency.

Chinese herbs have been used for centuries for menopausal symptoms and to protect the bones. The formulas have many subtle but yet powerfully strengthening effects upon the whole endocrine system. The herbs act by stimulating the production of hormones, altering the condition of hormone receptors or changing the rate of catabolism of hormones rather than providing the hormones or hormone analogs that function the same as hormones. The herbs have little or no hormonal effects but the effect of the whole formula will substantially increase hormone levels. They work by improving the function of aging organs and glands.

How does Acupuncture help?

Acupuncture is the stimulation of specific points on the body that have the ability to alter various biochemical and physiological conditions in order to balance the body and eliminate menopausal symptoms. Acupuncture is usually recommended once per week in combination with herbal medicine and dietary and lifestyle recommendations.

Diet Therapy

Diet is extremely important in having a healthy menopause. It is important to avoid cigarettes, avoid losing too much body fat, and reduce alcohol intake, caffeine, red meat, soft drinks and refined sugars. Eat a diet rich in leafy green vegetables, low fat yogurt, whole grains, vegetables, fruit, and legumes. The list of foods and herbs that contain hormone precursors is quite long. These will reduce the impact on the body of lowered estrogen and progesterone production by the ovaries. When we process our food and eat animal protein and fat, it reduces our body's supply of sex hormones. Some supplements that may be incorporated into your daily regimen are calcium & magnesium, evening primrose oil, flax seed oil or fish oils, and a good multi-vitamin.

Some Research for Menopause

The Chinese Journal of Traditional and Western Medicine, 1991, reported a study of 2 months administration of Rehmannia 6 Formula (a very common Chinese herbal formula for menopausal patients) to relieve menopause in early post-menopausal patients. The study showed an increase of 20% in estrogen, a 50% decrease in FSH, and a decrease in LH to pre-menopausal levels; the number of estrogen receptors in leukocytes more than doubled.
For the treatment of menopause, western medicine offers few options and comes with risks and cautions. TCM is an effective method of treatment for menopause and has a long history of successful treatment for gynecological disorders. Many of the newest western medical treatments for a given ailment have yet to be tried for over one generation allowing measurement of any long-term side effects. TCM extends back over 200 generations of doctors and patients and has over 30,000 volumes of medical literature.