Monday, February 01, 2010
Traditional Chinese Medicine (TCM) has a long and vital history. This includes the treatment of women’s health issues, including fertility, painful periods, pre-menstrual syndrome, and many other disorders. Inscriptions on bones and tortoise shells dating from the Shang dynasty (1500-1000 BCE) tell ways to treat problems of childbirth. Medicinal plants to treat infertility can be found in a textbook written during the Warring States period (476-221 BCE). Over the next two thousand plus years, treatment has been refined in what we use today. In recent history traditional medicine and western medicine have been combined to enhance the effectiveness of both types of therapy. Modern research shows that acupuncture and herbal medicine are effective ways to treat many different types of modern gynecological disorders. As evidence for the efficacy of chinese medicine grows, more and more women are discovering for themselves just how much chinese medicine can benefit their health.
TCM Terminology Used in this Article
- Channel/Meridian - routes through which qi flows
- Qi - Power that unifies and animates the body. Movement of energy through the meridian network.
- Blood - Transports nourishment throughout the body.
- Jing/Essence - Formed at conception. Nourishes fetus during pregnancy. Important in functions of growth, reproduction, and development. Includes ovaries and pituitary gland.
- Yin/Yang - Opposing relationships and qualities in the body.
- Yin Qualities - Cool, nourish and moisten body, build and accumulate, contraction, inward movement
- Yang Qualities - Warm, dry and activate the body, expansion, dynamic and outward movement
The Reproductive System in Chinese Medicine
The Uterus (includes the ovaries and fallopian tubes): The uterus is one of the six extra organs in chinese medicine. Unlike the twelve main organs, which are seen as either yin or yang, the uterus exhibits a dual nature. The uterus has the yang quality of menstruation and labor, and the yin qualities of storing blood and nourishing the fetus. The uterus does not have a specific energetic channel, but is effected by the 14 main channels of the body. The organ influences are the kidneys, liver, heart, and spleen. It’s function also depends on the Chong Mai (penetrating vessel), Ren Mai (directing channel) and Du Mai (governing vessel).
Kidneys (KI’s): In TCM the KI’s are often called Ming Men or “Gate of LIfe”. The KI’s are the root of pre-natal jing (reproductive essence). The amount and quality of jing influences fertility and contributes to longevity. The jing is considered part of the material basis for the menstrual blood. Another important aspect of the KI’s is that they are the source of fire that warms the uterus and balances the yin influences of the body. The yang functions of the KI’s include conception and sexual desire.
Liver (LV): The LV is important to the reproductive system because it stores blood that is used in the monthly menstrual cycles. The LV is also responsible for the free flow of qi throughout the entire body. This is especially important in the pre-menstrual phase, where the blood needs to move correctly to prepare for the period.
Spleen (SP): The spleen makes blood from digesting the food and drink we take into our bodies. This blood is stored in the LV and used during the menstrual cycle.
Heart (HT): The heart governs blood and houses the shen (mind). It also connects to the uterus by the Bao Mai (uterus vessel). This connection explains why emotional stress can influence the menstrual cycle.
Chong Mai (Penetrating Vessel): This channel is also called the Sea of Blood. It supplies blood to the uterus and is responsible for the proper movement of blood throughout the menstruation.
Ren Mai (Directing Vessel): Also called the conception vessel, this channel encompasses the entire reproductive system, including the cervix, vagina, and vulva. It provides to the substances of essence and body fluids during the monthly menstrual cycle.
Du Mai (Governing Vessel): The Du Mai is not as important as the two channels above, but its pathway begins near and passes through the reproductive organs. It can effect the genitalia and balance the Ren Mai.
The Menstrual Cycle: Western View
In western medicine a woman’s menstrual cycle is broken into 2 main phases, the follicular phase, when the egg grows and develops, and the luteal phase, the time after ovulation. The follicular phase (about 14 days total) is broken into 2 parts, the menstrual (~5-7 days)and the post-menstrual (~7days). Day one begins on the first day of bleeding. This is when the endometrial tissue that has been building throughout the month begins to slough off – menstrual bleeding .
During the follicular phase the ovum (egg) grows and develops. The hypothalamus releases gonadotrophin releasing hormone (GnRH). This in turn stimulates the pituitary gland to release follicular stimulation hormone (FSH). This hormone stimulates the egg to grow and develop. As the egg grows estrogen is released. As the level of estrogen rises, it tells the pituitary to decrease production of FSH, so there is only enough left for one egg to mature. The increase of estrogen also stimulates the endometrium, which was just reduced during menstruation, to begin growing again. At around day 14 the estrogen reaches a high enough level to trigger a surge of luteinizing hormone (LH) from the pituitary, which stimulates ovulation.
The luteal phase begins with ovulation. Like the follicular phase, it is broken into two parts, ovulatory and pre-menstrual. During this time the ovarian follicle produces progesterone that will build and thicken the endometrium, switch off the production of LH and FSH, raise the basal body temperature, and close the cervix with the corpus luteum. If fertilization occurs it will be within 24 hours of ovulation.
When the egg arrives in the uterus, the body produces human chorionic gonadotrophin (HCG). This prevents menstruation. Progesterone will be produced as well to sustain the pregnancy until the placenta develops.
If fertilization does not occur, the egg will be reabsorbed and the corpus luteum will go away. The levels of estrogen and progesterone fall, which triggers the hypothalamus to release GnRH and FSH. This begins the cycle again with the follicular phase and menstruation.
The Menstrual Cycle: Chinese Medical View
The cycle begins with the yin phase (follicular phase). During the first week (menstrual flow), the “Sea of Blood” or Chong meridian is emptying. The qi and blood need to be flowing freely to prevent problems during this part of the cycle. After menstruation, the Chong needs to refilled. This functions to rebuild the uterine lining which was sloughed off during menstruation and help the follicle grow and mature. The body produces blood and yin hormones to complete this function. When the body reaches a maximum amount of yin, ovulation will occur, and the cycle begins its yang phase.
The second half of the cycle is the yang phase (luteal phase). This is the active phase when the egg is released from the follicle and travels down the fallopian tube. It is important that that the womb is warm during this time, and the body has an abundance of yang energy. If implantation of an embryo does not occur, the yang phase will transform back into yin. Menstruation will occur and the cycle will begin again.
How Traditional Chinese Medicine Can Help You
Chinese Medicine is a holistic way to look at the body. We use a variety of diagnostic techniques, including irregularities in the menstrual cycle, to find imbalances in the channels and organs. By using certain acupuncture points and herbal medicines, we can treat the underlying constitutional imbalances. We can combine this with therapy to harmonize the menstrual cycle, and very effectively treat a number of women’s health disorders.
Written by Sarah Shupe, L.Ac.
Information for this article from these sources:
Obstetrics & Gynecology in Chinese Medicine by Giovanni Maciocia
The Treatment of Infertility with Chinese Medicine by Jane Lyttleton
Fertility and Conception: A Complete Guide to Getting Pregnant by Geoffrey Sher and Zita West