Menstrual pain (dysmenorrhea) is one of the most common gynecological problems that women face. According to TCM theory, women who suffer from dysmenorrhea have some imbalance in the liver energy.

The liver's function is to maintain a free flow of qi or energy through the body. When this energy is disrupted it causes an obstruction which develops into pain in the lower abdomen (uterus) and chest area (breasts) both of which lie in the pathway of the liver meridian.

The liver has another important function too in that it stores the blood. This is important because blood and energy have to fill all the meridians and organs and descend to the uterus for normal menstruation to occur.

The practitioner will look for any of the following syndromes associated with dysmenorrhea which can appear individually or combined: excess, deficiency, hot and cold, and stagnation of qi and blood.

The excess syndrome involves the Yin and Yang theory based on the philosophical construct of two polar complements in the body.

Yin is characterized by cold, water, downward movement; and Yang by lightness, heat, and upward movement. Excess cold (Yin) is characterized by contraction and stagnation which causes extreme pain. It is relieved by heat. Excess heat (Yang) congests by consuming the blood and body fluids thereby obstructing the free flow of qi and blood. This leads to severe pain, menorrhagia (excessive bleeding) and insomnia.

Symptoms are relieved somewhat by cold, but aggravated by pressure. Digestion is often affected showing as constipation or diarrhea and heartburn.

There are numerous Chinese herbs that stimulate and nourish the blood, warm or cool the body and relieve congestion. These are very important for treatment of this disorder.

Deficiency
Deficiency means that there is a deficient amount of qi and blood. It usually affects a woman with a weak constitution, with a chronic disease or after a hemorrhage.

The menstrual flow tends to be delayed and then scanty and pale, lasting only a day or two. The pain is dull and intermittant, often accompanied by soreness of the lower back, dizziness, pale complexion, shortness of breath, fatigue, and depression.

The eyes may feel dry and gritty and there may be spasm in the tendons and muscles. The pain is alleviated a little with pressure. Sluggish digestion and diarrhea are prevalent with this syndrome.

Congestion
Energy congestion manifests itself as less pain but much more distension of the abdomen and breasts. The menstrual flow is scanty and darkish-brown in colour with clots. Stagnation of blood causes a kind of penetrating pain, which is aggravated by pressure. Abdominal and breast tenderness and distension is minimal compared to the pain. The blood flow contains clots that, when passed, alleviate some of the discomfort.

The qi is distributed throughout the body via an intricate system of channels or meridians and the acupuncture points along these channels act as gateways of energy that can clear blocks that lead to pain.

For dismenorrhea, points that regulate the liver energy would be chosen as well as those used to stimulate the blood. Others would be chosen according to the syndrome present. Auricularpoints are especially successful in reducing pain. The needles ar gently manipulated which produces a slight numbness, ripple effect, or heat sensation at the site of the point. This indicates what is called the "arrival of qi." It is a painless procedure which induces deep relaxation.

Moxibustion (so called from the herb that is burned) is a heat treatment that can be used to stimulate the acupuncture points and to remove cold and obstruction from the channels. It's a mild heat that penetrates deep beneath the skin, warming the body and giving a sensation of comfort.

There are numerous Chinese herbs, both patent and those that have to be decocted into a tea, that stimulate and nourish the blood, warm or cool the body and relieve congestion. These are very important for treatment of this disorder.