In this article, we look a little closer at some of the more common problems that can occur around period time and how an acupuncturist might think about these. Typical symptoms that indicate there is a problem with menstruation include pain, bloating, dark and clotted menstrual blood. An interesting way to think about menstruation is to think in terms of the movement of energy in the body.

The primary goal from the point of view of acupuncture is to encourage complete discharge of menses, i.e. we want to make sure the cervix opens properly, the old endometrium detaches fully from its basal layer and then is expelled fully downwards from the body.

In terms of movements of energy, we might say that we want to encourage opening, dispersing and lowering. If any of these movements are impaired, it will be experienced as the typical symptoms around period time.

In traditional Chinese Medicine, the Liver qi is responsible for storing blood and the smooth movement of qi around the body so this could easily affect this desired downwards flow of qi. Liver qi is by nature rising and expansive, so there is a natural bias in the movement of Liver qi in an upward direction. Other imbalances (e.g. excess heat) will tend to exacerbate this.

If there is excessive upward movement of the qi (which an acupuncturist might describe as the pattern Liver yang rising) leading to an excess of qi in the upper part of the body, then we want to know if there is a corresponding excess or deficiency in the lower half, as this will determine exactly how we should rebalance (or regulate) the qi. For instance, if the periods are heavy with bright-red blood and the patient suffers from constipation and hot, swollen hands and feet, it would make no sense to try and lower the qi from above as this would simply lead to a larger build up of excess below. In this case one would want to directly disperse the excess heat before attempting to create a downward movement of qi. Conversely, if there are signs of Liver yang rising but the patient suffers from cold feet, loose stools and a light, congested menstrual flow, it would be inappropriate to disperse the excess qi from above as it would leave the patient with an overall deficiency. In this case the correct approach would be to lower the qi that is too raised in order to balance out the channel before doing any further work.

So one can see that if the Liver yang is in excess, the correct treatment depends on a secondary differentiation into yang-yang and yang-yin states. This is why your acupuncturist will maybe talk to you in terms of patterns and movements of energy as opposed to a ‘point for this’ or a ‘point for that’. The goal of acupuncture treatment is to create an intervention that re-establishes the correct dynamic flows of energy in the body, appropriate at a particular time (of the month, or in the year). In the early stages of pregnancy, one wants to create a closing, holding and raising energy in the body. By contrast in the later stages of pregnancy when the baby wants to come out, an opening and lowering energy is once again appropriate.

The period problems described above are primarily yang in nature, but there is another class of period problems that are primarily yin. In the next article in this series, we will explore a little more the nature of the movements of qi for these very common pathologies.

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