Menstrual Cycle Disorders
The menstrual cycle is a reflection of how well your body is functioning, and can give an insight into internal imbalances. An “ideal” menstrual cycle is 28 days (between 26 and 30 days is still considered to be normal) with a regular ovulation occurring mid cycle. Menstrual blood should be a fresh red colour starting with a moderate flow then progressing to heavier for a couple days before tapering off and stopping. There should be no symptoms of mood changes, breast tenderness, headaches, fatigue, bloating, pain/cramping, excessive bleeding, and clots.
A regular healthy menstrual cycle indicates good hormonal balance and ovary function. Regardless of whether you are trying to conceive or not, your menstrual health is important. From a Chinese Medicine perspective we look at this process in terms of the Qi, Blood, Yin, Yang and the internal organs.
Common Menstrual Cycle disorders include:
PMS: A group of symptoms that appear in the lead up to the menstrual period. These include mood changes, anxiety, insomnia, headaches, dizziness, breast tenderness, fatigue, appetite changes, bloating and abdominal cramping.
Dysmenorrhoea: Pain before, during or after the menstrual period. Usually lower abdominal pain, which may radiate to the lower back, sacrum, vulva, and anus or down the thighs. The pain can range from being dull and achey to quite severe and debilitating.
Irregular periods: If the menstrual cycle is unpredictable, arriving 7 days earlier or later than the expected date this is considered irregular.
Shortened Menstrual Cycle: The menstrual period arrives 7 or more days earlier than the expected date.
Delayed Menstrual Cycle: The menstrual cycle is delayed by 7 or more days later than the expected date (can even be 40-50 days).
Menorrhagia: Heavy or excessive menstrual bleeding.
Hypo-Menorrhoea: Very light or scanty menstrual flow often with short duration (<2 days).
Prolonged Menstruation: Menstrual flow continues for an extended period of time (7 – 15 days).
Uterine Bleeding: Bleeding outside of the menstrual cycle, which can be either heavy or scanty.
Amenorrhoea: No periods and no ovulation. Primary Amenorrhoea is when there is no menstrual period by the age of 18. Secondary Amenorrhoea is the absence of a menstrual period for more than 3 months, after having a regular menstruation in the past. This excludes conditions such as pregnancy, lactation and post-menopause.
Morbid Leucorrhoea: Excessive vaginal discharge, which may have an abnormal colour, odour and quality.
From a Chinese Medicine perspective the main organs involved in menstrual cycle disorders are the Liver, Kidney, Spleen and Heart. Patterns of disharmony include: Qi Stagnation, Qi and Blood Stagnation, Blood Stasis, Qi Deficiency, Blood Deficiency, Heat, Cold, Phlegm-Damp, Damp-Heat, Phlegm-Heat, Yang Deficiency and Yin Deficiency.
The menstrual period should come and go with minimal discomfort. You should not have to “live with” or “put up” with severe symptoms, which can impact on your daily life. Your menstrual cycle should be celebrated, not something that is dreaded or avoided!
Uterine fibroids or myomas are benign tumours that grow within the muscle tissue of the uterus. They are quite common, with approximately 50% of women of childbearing age having at least one fibroid. They can range in size from very small to being as large as a melon. They are differentiated according to their location: Sub-serous, Intramural and Sub-mucous.
While many women may not even be aware they have fibroids, as they do not experience any symptoms or problems, symptoms can be quite severe in some cases. The main symptoms experienced are: very heavy and prolonged menstrual periods with clots, pelvic pain, lower back pain, pain down the thighs, pain during intercourse, bleeding between periods, pressure on the bladder (leading to frequent urination or incontinence) and pressure on the bowel (leading to constipation, bloating and fullness).
Fibroids can affect fertility depending on their size and location in the uterus. If they are distorting or obstructing the uterine cavity or fallopian tubes they are a physical impediment to fertilization, implantation and/or development of an embryo. During pregnancy fibroids may grow due to increased oestrogen and blood flow, causing premature delivery. If the fibroid does not affect the lining of the uterus it may be harmless and have little effect on fertility.
The cause of fibroids is unknown, however the growth appears to be dependent on oestrogen. Western medical treatment usually involves surgical removal of the fibroids, however other options include hysterectomy, hormone therapy and uterine artery embolization. It is important to note that often when fibroids are surgically removed they can regrow, so steps need to be taken to minimise their reoccurrence.
From a Chinese Medicine perspective fibroids are a type of “abdominal mass” due to Blood stasis, sometimes in combination with Phlegm. There are a number of underlying internal pathologies, the main ones being Spleen and Kidney Yang deficiency, Liver Qi Stagnation and Cold in the uterus.
Endometriosis is a condition where the cells that line the uterus, the endometrial tissue, grow outside of the uterus in the pelvic cavity. This tissue is actively growing and functioning. Approximately 10% of women of reproductive age are affected by endometriosis. It is diagnosed by a procedure called a laparoscopy, which can determine the location, type of endometrial tissue and extent of spread. The patches of endometrial tissue are commonly located on the uterine wall, uterine ligaments, fallopian tubes, ovaries, bowel and bladder. It can attach either deeply into the membrane or more superficial. The three types of patches of endometrial tissue, each with a different appearance and behaviour are; Brown or pigmented, Chocolate cyst and Pale pink, white or non-pigmented.
The main symptom associated with Endometriosis is painful periods, which can be quite severe and debilitating in many cases. The pain usually starts 1-2 days before the period and lasts throughout it. There may also be lower back pain, possibly radiating pain down the thighs, rectal pressure and pain on bowel movement, pain during intercourse, premenstrual spotting, depression, anxiety and infertility (in some cases). Fertility is affected in a number of ways. Scarring and adhesions can cause damage to the tubes and ovaries or prevent release of the egg and passing through the tube. Substances released from the inflamed areas can have a harmful effect on the embryo, egg or sperm. Local hormones may be altered; uterine lining and implantation of the embryo can also be affected.
The cause of endometriosis is unclear. Theories include:
Retrograde menstruation: Menstrual blood flows backwards and is forced out along the fallopian tubes into the pelvic cavity where the endometrial cells can then implant and grow.
Coelomic Metaplasia: Cells lining the pelvic organs change their structure and function to become endometrial cells.
Immunologic factors: The immune system is unable to recognize the presence of endometrial tissue in abnormal locations and eliminate it.
Women more likely to be affected are those with a family history, delayed childbearing age, early onset of puberty & menarche (before age 11), and those who have undergone elective tubal sterilization surgery.
Western medical treatment includes removal of endometrial tissue during a laparoscopy if possible. Alternatively drugs are used to halt menstruation to prevent bleeding from the endometrial tissue and give it an opportunity to recede. Painkillers and anti-inflammatories are also used.
From a Chinese Medicine perspective Endometriosis is considered Blood Stagnation, in combination with underlying patterns of Kidney Yang deficiency, Phlegm Damp, Liver Qi stagnation, Spleen Qi deficiency, Heat or Cold.
PCOS (Polycystic Ovarian Syndrome) is a common hormonal disorder that can affect up to 25% of women of childbearing age and has become one of the main causes of infertility in women. The ovaries are swollen with denser tissue and contain many small cysts or half matured follicles, and the “dominant follicle” does not develop as easily. Hormonal imbalances of elevated testosterone and LH levels (often with a higher LH to FSH ratio) affect ovulation causing it to occur irregularly or not at all. There may also be insulin resistance and glucose intolerance.
Symptoms include irregular, delayed or no menstrual cycles with late or absent ovulation, periods may or may not be heavy and painful, acne, excess body hair, obesity (although many women may be thin), bloating, tenderness, thinning of head hair and lightheadedness when hungry. In a mild case there may be no symptoms other than a slightly irregular cycle.
Risks associated with PCOS include endometrial hyperplasia and cancer, insulin resistant type 2 diabetes, cardiovascular disease, high blood pressure, strokes, dyslipidaemia, fatty liver disease, autoimmune thyroiditis and miscarriage.
The causes of PCOS are not yet fully understood; however there seems to be a strong genetic component. Current Western medical treatment options include drugs such as the birth control pill, Metformin (insulin sensitizer), Clomid (induce ovulation), hCG and FSH preparations. If these drugs are unsuccessful, IVF is often suggested when trying to conceive.
Correcting hormonal imbalances and managing the symptoms of PCOS is necessary to improve ovarian function and healthy ovulation, reduce the number of follicles and improve egg quality. It is also important for your general health and wellbeing, even more so if you are currently trying to fall pregnant, or hoping to start a family in the future. It will maximize your chances of conception and help to maintain a healthy pregnancy.
Looking at lifestyle, stress, diet and exercise are also important factors to improve overall health.
From a Chinese Medicine perspective PCOS often involves a Kidney Yang deficiency with stagnation and accumulation of Phlegm Damp in the lower abdomen. The Kidney Yin deficient type may involve Qi and Blood deficiency or Qi stagnation.
Menopause is defined as an absence of menstrual periods for 12 months or more. Generally most women reach menopause between the ages of 45 and 55, however it can occur either earlier or later in some cases. The function of the ovaries ceases and pregnancy can no longer occur. The process of menopause is gradual and is termed the perimenopausal transition period. Periods become irregular and symptoms women experience during this time are due to the lowering of oestrogen levels. They can be varied in both quality and severity.
Hot flushes, night sweats and intense sweating are the most common complaints however other symptoms may include mood changes (feelings of anxiety, nervousness, irritability and depression), sleep disturbance, stress, fatigue, headaches, dizziness, tinnitus, poor memory, palpitations, digestive complaints (low appetite, diarrhea, constipation etc.), weight gain, frequent urination or incontinence, vaginal dryness and itchiness, decreased libido and painful sexual intercourse.
Risks associated with menopause are an increase risk of atherosclerosis, osteopenia, osteoporosis, cardiovascular disease and increased blood lipids.
Western medicine treatment involves management of the symptoms with the administration of hormone replacement therapy (HRT). There is a lot of debate about the effectiveness of HRT and the potential adverse effects and associated health risks.
Menopause is not a disease or disorder, it is a natural physiological transition in life. From a Chinese Medicine perspective menopausal symptoms are essentially due to a decline in the Kidney Essence, in the form of Kidney Yin, Kidney Yang or a combination of Kidney Yin and Yang deficiency. In some cases the pattern may be further complicated by Liver Yin deficiency, Liver Yang rising, Heart Empty-Heat, Qi stagnation, Phlegm and Blood stasis.
The severity of menopausal symptoms a woman experiences can be strongly influenced by the lifestyle and dietary habits throughout her life. Stress, overwork, poor diet, smoking, alcohol and coffee can all contribute to weakening the kidney essence over time and causing problems later in life. This highlights the importance of having a balanced lifestyle, as prevention is better than cure!
At Blue Lotus Healing we have a particular interest in working with clients with women’s health issues. A more detailed assessment, Chinese Medicine diagnosis and advice can be given according to your individual constitution.