Leslie McGee, RN LAc

Can Chinese Medicine help promote menstrual health? The long historical tradition of Chinese Medicine teachings tell us that the answer is yes.

I spent much of my first few decades on this earth suffering with menstrual challenges that I thought were normal. “Oh, every girl or woman has painful periods. Take some ibuprofen and accept it”. That remains the accepted wisdom of Western medicine.

Oh, PMS, just a part of life. Oh, well, 3 weeks out of the month you feel like crap? Just how it is.

Chinese medicine most emphatically disagrees with these statements. The balance, timeliness, and ease of your menstrual cycle are a reflection of the internal status of your yin and yang, and the appropriate flow of your qi (pronounced “chee”) and blood. When you have painful periods, bad PMS, or irregular ovulation a Chinese medicine practitioner will say that it is time to rectify the problem and treat the root of it. What follows is a very abbreviated, but I hope practical, description of how Chinese medicine thinks about the menstrual cycle, and some basic ideas to achieve balance.

When we think about any women’s health issue in Chinese medicine we always come back to the menstrual cycle as the foundation of our understanding. In TCM terms the menses involves the cyclic filling and emptying of the uterus, also called, charmingly, the fetal palace. In order to fill and then empty the uterus, the qi and blood must flow in specific and orderly ways. Various organs play a role in ensuring this orderly flow of things.

The liver is one of the organs with a very important role in the menstrual cycle. We say the liver is in charge of the smooth coursing and flow of all the qi of the body.  Proper liver function is a part of every cycle and every movement the body needs to complete. When the liver cannot ensure the smooth and regular flow of a woman’s blood and qi, menstrual problems result. Premenstrual syndrome, or PMS, is a textbook example of the liver failing to do its job during the cycle.  This is called liver qi constraint or liver qi stagnation.

The cardinal sign of liver qi stagnation is irritability. Other discomforts during the pre-menstrual phase are also linked to the inability of the liver to create smooth flow of our qi. Breast tenderness, acne, insomnia, and headaches can all be blamed, at least in part, on liver qi stagnation. Other patterns can occur in addition, and will manifest in unique ways.  For example, cystic acne is usually due to qi stagnation, heat, and dampness “tangling” and nodulating in the skin.  Dysmenorrhea is often due to liver qi stagnation leading to blood stasis, which creates severe menstrual pain. Many women see their symptoms follow predictable patterns according to their cycles.

How do we ensure that the liver can gently and properly move our qi? Lifestyle remedies are crucial, and the best one is exercise. When we move our body, we move our qi and benefit the liver. That’s why it feels so good to exercise – after a good workout you can feel the relaxation and lift in spirit that signifies an unconstrained liver.

Acupuncture and Chinese herbs are generally very helpful for liver qi stagnation issues.   Simple remedies that are worth trying in advance of getting a professional TCM work-up are evening primrose oil, 2 or 3 caps per day, and a B complex vitamin, 1 a day, with 50 to 100 mg of Vitamin B 6. You may need to get a basic B-complex, then purchase a supplement with just B-6 in it, 50 to 100 mg. I think the entire array of B vitamins are important to women, but the B-6 needs to be in a higher dose than what most B-complex supplements provide.

Evening Primrose Oil and vitamin B-6 have a wonderful ability to help the liver relax and keep the qi flowing. In modern terms it seems that these 2 supplements help prevent estrogen dominance, which is responsible for many menstrual complaints, from bad PMS to sore and congested breast tissue. I believe most women can safely try these supplements on their own, without medical supervision.

Don’t forget exercise!!

Another good safe supplement that anyone can take is high quality fish oil. Fish oil provides essential fatty acids, or EFA’s (as does Evening Primrose Oil, which has another EFA valuable to women).  Fish oil reduces inflammation and seems to gently “quicken the blood”, which means it treats blood stasis, a major cause of painful periods. I recommend 3 capsules per day. Nordic Naturals, Carlsen’s, and the Costco brand Kirkland have all passed inspection from consumer watchdog groups as being well made and pure. Poor quality fish oil can become rancid and is harder to digest.

In summary 3 supplements you can try right away for almost any menstrual issue are:

Evening Primrose Oil, 2 to 3 caps per day

Fish Oil, 3 caps per day

B-complex vitamin, 1 per day, plus 50 to 100 mg of B-6

If these interventions are not enough, consider consulting with a Chinese medicine professional. Chinese medicine can provide customized herbal remedies to treat a whole range of issues, from painful periods, to irregular cycles, to excessive or prolonged bleeding. Acupuncture and Chinese herbal medicine have a long history of providing relief for many women’s health issues.

By the way, after using a Chinese herbal formula for 2 weeks of the month for about 6 months, my painful periods vanished. What a relief to not dread my cycle.

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