Painful periods – Dysmennorhoea

Woman of all ages regularly come to see me at the acupuncture clinic for help with pain around menstruation. A small amount of cramping and aching is normal on the first day, but for many the pain is unbearable and disrupts everyday life. Painful periods with no serious underlying causes is known as ‘primary dysmennorhoea’ – there is no obvious medical reason why this happens. Pain that is related to conditions such as endometriosis and fibroids is called ‘secondary dysmennorhoea’. This too responds well, though these conditions deserve a separate article to themselves.

In Chinese medicine, pain is seen as ‘stagnation’, and usually with severe period pain we call it ‘blood stagnation’. The underlying cause of this stagnation can be a combination of many things and the job of your acupuncturist is to work out what these may be. Acupuncture visualizes everything in the body in constant motion, slowly and gently. The pain results when the blood and Qi of the pelvis can’t move in the direction it needs to, instead it sits and creates a blockage like a dam, and as the pressure builds up you feel more and more discomfort.

I really see very good results using acupuncture, diet and lifestyle changes. My top tips for managing primary dysmennorhea are the following;

1. Acupuncture regularly – in the second half of the cycle. I usually ask to see my clients twice before their expected period starts. I needle directly on the lower abdomen and the legs using lots of heat to relax the muscles. Sometimes we also work on the lower back and sacrum too. It really doesn’t hurt. The needles just sit under the skin and once in place, the body responds to them by releasing a whole load of various substances which will aid in general pelvic circulation. You can’t usually feel this happening ( some women will be aware of tingling and warmth or muscles relaxing), but it takes around 20-30 mins which is why you will just be lying there listening to music and daydreaming.

2. Discourage ‘bad prostaglandins’ by reducing all meat and dairy produce –  small amounts can be taken (they must be organic). Prostaglandins are present in all cells of the body and most have a beneficial effect. There are a few that are related to constriction and inflammation and too much of these types will cause an imbalance. Women suffering with severe dysmennorhea are found to have higher levels of two particular types of prostaglandins known as PGF2 and PGE2. The fuel the body needs to make these ‘negative prostaglandins comes from arachidonic acid which is abundant in meat and dairy. So cutting these out will make it harder for the body to produce PGE2.

3. Encourage ‘Good Prostaglandins’ – To tip everything in our favour we need to add certain things into our diet. Lots of the ‘good prostaglandins’ will help the uterus contract beautifully and with ease. Adding in lots of oily fish, nuts, seeds and leafy greens will do this. You also need to have adequate amounts of certain vitamins and minerals in your diet so that your body can create these good prostaglandins. Everything should be present in a varied healthy wholefood diet, but if your diet is compromised you may need to take these as supplements short term to boost your levels.

4.  Pelvic stretches – absolutely essential for getting good circulation going. I have a set of yoga stretches I show to each woman that really get deep into the groin. There are plenty of short videos on You Tube for inspiration too. You want to be doing 10-15 mins every 2 days initially. The 5 days before your period you must do every day. Everyone can find time to do 10 mins – once you are familiar with the stretches you can do them in front of the TV in the evenings. After a few months you will probably not need to do them so often as the overall circulation has improved. The one exercise to avoid if you suffer from painful periods is of course sit-ups.

As with many things in natural and complementary medicine – it is the combination of a few small changes here and there which give dramatic results. In acupuncture we don’t accept that severe pain at menstruation is ‘normal’ and something to be put up with. Working with your body requires time and patience and a genuine desire to get to know yourself. Using the 4 interventions above, I see huge reductions in the monthly pain within 6-10 weeks. If you or someone you know suffers with debilitating cramps – please get in touch with the clinic to see how we can help you.

 

Links I like – healthy recommendations in Norwich

I always encourage my patients to make healthier lifestyle changes that will support their constitution and undo the effects of a stressful / sedentary routine. Below are the links to local individuals and groups who provide a honest healthy option in Norwich.

Yoga – yes from stress to insomnia to infertility, I’m always recommending yoga as a cheap and accessible way to improve circulation, calm the mind and get you functioning optimally. Lou Kitchener, Joss GuinJessica McKenna and Michelle Busettil all run excellent regular classes.

Healthy eating – Norwich Farmshare is a great option for locally grown organic veg in which you help support local trade. Norwich Market has an excellent organic fruit and veg shop and of course Rainbow Health Foods in the city centre provides a plethora of food free from GM and pesticides. Harveys are an organic butchers with a brilliant reputation.

Vitamins / supplements / body care - The Natural Food Shop opposite Jarrolds is my first choice. Not only is the stock of high quality but the staff all have additional training in what is and isn’t safe for you to take. Great for body lotions and creams that are free from parabens and sulphates. Simply Soaps are a local skincare company that I have used for years – again beautifully scented with essential oils and not much else!

Herbalist – I often advise people to try herbs – especially for skin and menopausal complaints. Andrew Chevallier is a first rate medical herbalist and has helped many of my patients and family members. Naji Malak uses Chinese herbs and again is absolutely superb and highly recommended.

Massage – Both San Jaspal and Jessica Carey come highly recommended and work in Norwich city centre. San switches between full body, reflexology and head massage which undoes weeks of stress every time.

Meditation –  Norwich Buddhist Centre runs regular drop in sessions for beginners and advanced, there are even short classes at lunchtime. There are also hundreds of short meditation videos on You Tube which can get you in the habit of switching off for 10 mins of the day.

Getting moving in nature – turning your mobile phone off and spending a little time out in the elements can have a wonderfully nourishing affect on the body. Try Strumpshaw Fen, Earlham Park, Marriots Way and Whittingham park for nearby nature.

Getting fit – there are plenty of running groups such as parkrun which do 5km every week. For cardio combined with FUN try zumba queen – seriously the most fun I have had in a long time. The UEA has a great swimming pool – another non time consuming way to keep fit at all levels.

Whether you’re a full time mum or full time office workaholic it”s important to take at least 10 mins of the day consciously doing something for yourself. It can be your short walk in the park at lunchtime – or a 5 min You Tube relaxation video when the kids are in bed. It all adds up. Your body wants to be healthy – it wants to be energised in the day and to sleep soundly at night. And if you’re not feeling that? Well then you definitely need to start making those tiny changes now!

 

A typical fertility session with acupuncture

 

Prior to booking an initial consultation for fertility, many women ring in first just to find out a little bit more about how I work.

Usually I will have agreed with my client beforehand to book her appointment at key points in her cycle – around day 7, 14 and 21, though this can vary hugely depending on the length of each woman’s cycle. We start off with a general chat about how she felt after the last acupuncture session and how her week has been mentally, emotionally and physically. If she has been charting (checking her daily temperatures), keeping a food diary or has brought in a recent set of blood results she hands over everything to me. Depending on what arises in our conversation combined with her Chinese tongue and pulse diagnosis I decide whether to start needling on her back or front. It can be a very different experience lying face up or down – and some women have a clear preference about which makes them feel better afterwards! I tap all the needles in very gently at first, then revisit each needle and work with my client to achieve the ‘De-Qi’ sensation on as many points as possible rechecking the pulses as I go. Heat lamps and electro-acupuncture are added now if needed.  Once I am satisfied that my client is comfortable and warm, I turn the lights down, gather up her notes and leave the room.

While she is relaxing I sit in a  nearby room, writing up her notes and examining any new information she may have brought in. This is the time when I review her progress and make a decision about what I will ask her to do out of the clinic until her next appointment. The acupuncture needles stay in for 25-35 mins and occasionally longer if needed. When I return, I check the pulses again before removing the needles, leaving the room while my client dresses. We then have several minutes at the end of each session to discuss lifestyle or dietary changes for that week and make a ‘contract’ about what realistically can implement.

With each woman we quite early on decide on a key marker (or several markers), that would indicate to both of us that progress is being made. An example could be a change in the menstrual flow – in Chinese medicine we aim for a period that starts with bright fresh looking blood with minimal clotting that is at it’s heaviest in the first two days before tailing off to a scanty bleed for the rest of the period. So if one of my clients has an extremely scanty and brownish coloured menstrual bleed throughout, a key marker would be a increase in flow and redness of her bleed. In Chinese medicine this is equated to improved Yin and Qi in the pelvic region, but you could also relate it to a thicker endometrial lining from a conventional perspective.

I constantly refer back to these key markers in each case – sometimes acupuncture alone is not strong or quick enough to change the environment in a woman’s body and that’s when I will ask her to implement a change in her life that week. Very often I ask my clients to commit to one yoga and meditation class per week. In my opinion it is one of the most effective ways of managing stress, improving circulation to the pelvic region – undoing the effects of sedentary desk jobs and heavy workloads. And it’s a fraction of the price of acupuncture! It is simply my ‘wonder tool’ for bringing anyone back into balance physically and mentally and most importantly the only thing my clients have told me that has stopped the internal stress caused by not getting pregnant! There are many fantastic yoga teachers in Norwich, I recommend Louise Kitchener and Michelle Busuttil for yoga that truly transforms you from inside out!

Often I will ask my clients to alter their diets. I may be encouraging them to gain or lose weight and most often making sure they eat warm well cooked meals. Yes strange as it may seem cold salads and refrigerated sandwiches are not on the menu with fertility acupuncture! All meals should be warm and easy to digest – so cinnamon porridge instead of cornflakes for breakfast and soups instead of sandwiches at lunch.

The combined effects of acupuncture and lifestyle changes should yield noticeable results within 2-3 menstrual cycles. The initial focus is on these key markers – welcoming each new improved menstruation as a sign the body is becoming more fertile rather than the common pattern of sadness and frustration if the period arrives. It is difficult to shift the attention away from a positive pregnancy test – but that is often the key with fertility acupuncture – enjoying the journey, observing the changes in oneself and knowing everything is happening just as it should.