Acupuncture for Dysmenorrhea (Menstrual Cramps) - Treatment Protocols

General Approaches

Acupuncture For Dysmenorrhea (Menstrual Cramps) - Treatment Protocols

Acupuncture treatment protocols are generally directed towards the deeper root of a persons set of health issues, not at each individual issue. In Traditional Chinese Medicine, treatment is generally directed towards the individuals diagnostic pattern(s) and their primary issue is only a part of the information required to approach the correct patterns to treat (see "treating the cause vs. the symptoms" for an introduction to this process.).

In designing an acupuncture protocol for dysmenorrhea (menstrual pain - cramps), one might find one or a combination of the following patterns: blood stagnation, kidney yang deficiency, kidney yin deficiency, liver qi stagnation, liver yin deficiency among many other possibilities and possible combinations.

Below you will find some of the more common tcm diagnoses and acupuncture treatment protocols for premenstrual syndrome (PMS). There are many ways to approach the treatment of this condition within TCM. Our presentation describes foundational approaches that would need to be further tailored in most cases to be effective for a given individual.

Dysmenorrhea is painful menstruation that arises before, during a/or after menstruation. The pain is mainly in the lower abdomen, however, it can occur in the lower back a/or running down the legs.

  • Etiology & Pathology:
    • Etiology:
      • Emotional Factors - strong emotions (depression, anger) may lead to stagnation of the LV Qi which may lead to a stagnation of Qi & Blood manifesting as painful menstruation.
      • Cold/Damp Exposure - contact with cold/damp environments (climates, climate controlled buildings, basements) a/or excessive consumption of cold/damp foods (fruit juices, ice cream) may lead to an accumulation of cold/damp in the abdomen which may lead to a stagnation of Qi & Blood manifesting as painful menstruation.
      • Existing Qi/Blood Deficiencies - symptoms may be exacerbated during menstruation leading to dysmenoorhea.
      • Existing LV/KD Deficiencies - constitutional weaknesses a/or in women who have had multiple child-births, thus depleting the KD Jing, worsened by the loss of Blood during menstruation.
    • Differentiation:
    • Qi Stagnation - Excess Condition
      • Signs & Symptoms:
        • More distention than pain, bloating, breast tenderness is likely, stuffy chest, belching, irritability, short temper.
        • Tongue: Purplish possible, thin white coat
        • Pulse: Wiry
      • Treatment Principle:
        • Resolve Qi Stagnation
      • Treatment Points:
        • LV 2 - move LV Qi, LV 3 may be a better choice
        • CV 6 - tonify Qi, effect lower abdomen
        • CV 3 - help to move Qi in the lower abdomen
        • GB 34 - w/LV 2/LV 3, move LV/GB channel & abdomen w/CV 6
        • SP 8 - moves Qi and Blood (more for Qi), SP 10 (more for Blood)
        • SP 6 - direct Blood downwards
        • If sacral pain - UB 32
    • Blood Stagnation - Excess Condition
      • Signs & Symptoms:
        • Less distention, more pain w/stabbing qualities, no breast tenderness, abdominal pain worse w/pressure, blood clots.
        • Tongue: Purplish or purple spots which usually appear on the sides, very thin coat
        • Pulse: Deep, choppy can also be a little wiry
      • Treatment Principle:
        • Resolve Blood Stagnation
      • Treatment Points:
        • ST 29 - move Blood in the abdomen (also good for starting menstruation in patients who have cessation of menstruation)
        • CV 6 - move Qi in the abdomen
        • SP 6 - direct Blood downwards
        • SP 10 - move Blood and Qi
        • LV 3 - w/SP 6 move Qi in the lower abdomen
    • Accumulation of Cold - Excess Condition
      • Signs & Symptoms:
        • Pain that is better w/application of heat a/or pressure, scanty menstrual flow, dark blood w/clots that are smaller than the Blood Stagnation clots.
        • Tongue: White coat
        • Pulse: Deep, tight
      • Treatment Principle:
        • Disperse Cold
        • Resolve Stagnation
      • Treatment Points:
        • CV 4 - w/moxa, tonify Qi, warm & move abdomen
        • CV 8 - w/moxa, disperse cold
        • ST 28 - w/moxa, warm abdomen, resolve stagnation
        • ST 36 - tonify Qi & Blood
    • LV/KD Deficiency - Deficient Condition
      • Signs & Symptoms:
        • Dull a/or intermittent pain of the lower abdomen which arises during a/or after menstruation, pain is better w/pressure, sore back, dizziness, tinnitus (not as prevalent), sallow complexion, lassitude, chronic fatigue, light periods likely w/light red blood.
        • Tongue: Light red, thin white coat (if extremely deficient tongue may be flabby)
        • Pulse: Deep, fine or thin
      • Treatment Principle:
        • Tonify LV & KD
        • Move Qi in the Chong Mai and Ren Mai
      • Treatment Points:
    • Blood Deficiency - Deficient Condition
      • Signs & Symptoms:
        • Dull pain after menstruation, better w/pressure, dizziness, palpitations, scanty menstruation.
        • Tongue: Pale w/thin moss or slightly peeled (peeled section may appear pale as well)
        • Pulse: Empty, thin
      • Treatment Principle:
        • Tonify Blood
        • Move Qi
      • Treatment Points:

The information on our site is drawn from our own lecture notes and clinical experience. The following lecture notes were consulted within this section:

  • St. John, Meredith: New England School of Acupuncture, Etiology and Pathology Lecture Notes
  • Valaskatgis, Peter: New England School of Acupuncture, Etiology and Pathology Lecture Notes

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