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Case Histories - Painful Periods (1)

A 32-year-old woman had been suffering from painful periods for 2 years. The pain occurred during the period in the hypogastrium, lateral abdomen and sacrum. It was dull in character and associated with a bearing-down sensation. Her periods were regular and the menstrual blood was slightly dark with a few clots. She also suffered from pre-menstrual tension with a pronounced distension of breasts and abdomen and irritability. She had been on the contraceptive pill for 10 years and the periods became painful when she stopped taking it. She had been given a progesterone pill but this had not helped the dysmenorrhoea at all. Apart from the menstrual problems she also suffered from the so-called irritable bowel syndrome causing her a spastic pain in the abdomen and alternation of constipation and diarrhoea: she had had this problem for 10 years. On interrogation, it transpired that her vision was sometimes blurred, she was occasionally dizzy and experienced tingling of the limbs. Her tongue was slightly orangey on the sides, and her pulse was Fine on the right side and Fine but also slightly Wiry on the left.

This is a very clear example of stagnation of Liver-Qi associated with (or caused by) Liver-Blood deficiency. The symptoms of Liver-Qi stagnation are very obvious: pre-menstrual tension with distension and irritability, painful periods, Wiry pulse on the left, abdominal pain with constipation and diarrhoea. The symptoms of Liver-Blood deficiency are also equally clear: the dull character of the menstrual pain, the blurred vision, the tingling and dizziness, the orangey colour of the sides of the tongue and the Fine pulse. I am inclined to think that, in this case, stagnation of Liver-Qi derived from Liver-Blood deficiency and this was, in turn, probably caused by the contraceptive pill.

Treatment

This patient was treated with acupuncture and patent remedies. The acupuncture points used were selected from the following:-

LU-7 Lieque (on the right) and KI-6 Zhaohai (on the left) to regulate the Directing Vessel and strengthen the Uterus.-
L.I.-4 Hegu, in combination with LIV-3 Taichong, to regulate the ascending and descending of Qi and calm the Mind.-
LIV-3 Taichong to pacify the Liver, move Qi, eliminate stagnation, calm the Mind and settle the Ethereal Soul.-
ST-36 Zusanli and SP-6 Sanyinjiao with warm needle to tonify Qi and Blood. -
Ren-4 Guanyuan to nourish Blood and strengthen the Uterus.-
ST-29 Guilai to move Qi and Blood and stop pain.

An example of a point combination in one treatment would be: LU-7 (on the right) and KI-6 (on the left), L.I.-4 on the left, LIV-3 on the right, Ren-4, ST-36 and SP-6 bilaterally; the last three points with reinforcing method, the others with even method.

The patent remedies used were the Three Treasures's (or East West Treasures) Brighten the Eyes to nourish Liver-Blood and Freeing the Moon to pacify the Liver and eliminate stagnation. The latter remedy (a variation of Xiao Yao San Free and Easy Wanderer Powder) also nourishes Liver-Blood, and, in addition, pacifies Liver-Qi and tonifies Spleen-Qi. The patient took Brighten the Eyes for 2 weeks after the period and Freeing the Moon from then until the beginning of the next period.

This patient reacted exceedingly well to the treatment, improving even after the first session. After only three acupuncture sessions (over a period of 1 month) and use of the remedies, she reported experiencing no menstrual pain with her last period and no abdominal bowel pain, and feeling very much better in herself. Such a quick reaction is rather unusual as it normally takes at least three monthly cycles to affect a menstrual irregularity.