Menstruation and pregnancy
-Dysmenorrhea
Menstruation, or period, is normal vaginal bleeding that occurs as part of a woman's monthly cycle and usually lasts three to seven days. Its color is dark red most of time, and a little lighter at the beginning and at the end. Its texture is not either thin or thick, and it should be clot less and odorless. The total quantity is about 50-80 milliliters each period. Besides bleeding, some can experience abdominal or pelvic cramping pain, lower back pain, bloating and sore breasts, and mood swings and irritability. They should be mild, without interfering with her daily activities and disappear with the ending of the period.
The menstrual cycle is counted from the first day of one period to the first day of the next. It varies between 21 and 35 days and is 28 days for most woman. But for a woman, it should be regular and her cycles tend to shorten and become more irregular as she ages. A missed period can be an early sign of pregnancy. Breast-feeding typically delays the return of menstruation after pregnancy.
According to Chinese Medical theory, menstruation and its cycles are a complicated natural process. They rely on vigorous Kidney and sufficient Blood and Qi in Chong and Ren Vessels strongly. Besides, they require other internal organs to function well and work together harmoniously, and Qi and Blood to flow freely in unobstructed Meridians and collaterals. The same requirements should be met for a successful pregnancy.
Kidney, the most important organ was talked about in my other blogs and is skipped here. There are some details about Liver, Spleen (Stomach), Heart, Lungs and Uterus.
Liver is situated in the right hypochondriac area and stores the Blood formed from our diets. Though the nature of the Blood is still and passive, it should circulate in the vessels throughout the body. Its circulation deeply depends on Qi because the latter is dynamic and active. It is Liver that maintains the free flow of Qi. Menses come from the Blood in Chong Vessel and cannot run easily without the free flow Qi in Ren Vessel.
What we eat and drink is received in Stomach and transformed in the Spleen into Qi as well as Blood. Stomach and Spleen are in upper abdomen. The Blood should stay in the blood vessels all the time and it is Spleen that keeps it remain inside.
Air breathed into Lungs in the chest contributes to the formation of Qi. Lungs governs Qi, which means the function of the Lungs greatly influences the functional activities of the whole body such as heart beating, respiration and digestion.
Heart, located in the chest, provides the motive force for Blood circulation and sustain the normal blood vessel structures. Besides it compasses mental activities including thinking and emotions, which have impacts on menstruation, its cycle and pregnancy.
Through Meridians and Collaterals, the internal organs connect the rest of the body, working as a whole organic system. Uterus in lower abdomen is where menstruation is from and also where a fetus stays. It connects Kidney through Uterus Collateral and Heart through Uterus Vessel, and is also where Chong and Ren Vessels originate.
The menstruation is a key element for a woman. Its quality, quantity, color, and cycle are the most clearly observable external signs of the functions of internal organs and Meridians. In other words, its problems are the sign of the dysfunction or imbalance of the latter and can affect the fertility, and must be resolved.
Dysmenorrhea or menstrual pain is one of them. Even though it is not cause or even direct contributing factor to female infertility, it can be useful diagnostic components in a clinical picture which includes infertility.
To demonstrate it, there is a case. Christine, 33 years old, came in July 2020 and said to me, “I am preparing for my first pregnancy in this coming September and would love to know if you could help me.” “How long have you had the infertility problem?” I asked her, assuming she had it since most of pregnancy problems I saw was infertility. “I did not know if I have that since my husband and I did not try yet.” She answered. She looked healthy. With more detailed conversation, I learnt that she was a Ph.D. Student and just moved to Charlottesville from the other state not very long after the worldwide Pandemic and a national health emergency were announced in March 2020. Being stressful as everyone else was. She knew that she was just beyond the best reproductive age and eagerly hoped she would be pregnant as they planned. Her cycles had been regular (every 27 days), and each menstruation lasted for 5 days. But she had dysmenorrhea and it had been with her for many years. The pain in her abdomen was so bad that she had to take pain killers every single day to relieve it. This information caught my great attention.
For her, the treatment goal was to make her organs function well and meridians unblocked and get rid of the mensural pain first. I suggested the number of her sessions be enough to cover at least three menstrual cycles. After two acupuncture sessions, she had her period. She told me surprisingly and happily that her pain was much less and that she took pain killers just one day. Her menstruation in August and afterwards was reported normal. The last time I saw her was in November 2020. In February 2021, I got an email from her, saying, “Hi Dr. Chang, I am now 12 weeks. It is very exciting! I have had some nausea and headaches, but they are getting better now. I will contact you if any other issues come up throughout the pregnancy. Best, Christine.” Later, she sent me another email, saying that her healthy son was born in September 2021.