Menstrual Disorders

As each woman’s body prepares for pregnancy each 28 days, the menstrual cycle begins on the first day of her period till the first day of the next menstrual period. Every woman is unique in how her menstrual period manifests referring to length of cycle (a short cycle of 21 days to a lengthened cycle of 35 days). Some irregularities that are not within normal range are these conditions: Amenhorrhea (cessation of menstruation or not starting to menstruate by 16 y.o.), Dysmenorrhea (painful periods), Menorrhagia (heavy menstrual bleeding), PMS and PMDD (more intense symptoms of PMS that are debilitating)

Acupuncture and traditional Chinese medicine has a long history of dealing with gynecological problems, and can successfully treat these issues without the use of hormones.

Elyse Josephs, L.Ac., Dipl. OM

Acupuncture Treatment of Dysmenorrhea Resistant to Conventional Medical Treatment

V. Iorno; R. Burani; B. Bianchini; E. Minelli; F. Martinelli; S. Ciatto
Authors and Disclosures
Published: 12/11/2008Other Health Care Provider Rating:

Abstract and Introduction

We evaluated the effect of acupuncture on NSAID resistant dysmenorrhea related pain [measured according to Visual Analogue Scale (VAS)] in 15 consecutive patients. Pain was measured at baseline (T1), mid treatment (T2), end of treatment (T3) and 3 (T4) and 6 months (T5) after the end of treatment. Substantial reduction of pain and NSAID assumption was observed in 13 of 15 patients (87%). Pain intensity was significantly reduced with respect to baseline (average VAS = 8.5), by 64, 72, 60 or 53% at T2, T3, T4 or T5. Greater reduction of pain was observed for primary as compared with secondary dysmenorrhea. Average pain duration at baseline (2.6 days) was significantly reduced by 62, 69, 54 or 54% at T2, T3, T4 or T5. Average NSAID use was significantly reduced by 63, 74, 58 or 58% at T2, T3, T4 or T5, respectively, and ceased totally in 7 patients, still asymptomatic 6 months after treatment. Our findings suggest that acupuncture may be indicated to treat dysmenorrhea related pain, in particular in those subjects in whom NSAID or oral contraceptives are contraindicated or refused.

Introduction

Dysmenorrhea is a common symptom, reported by ∼25% of women, and by up to 90% of adolescents.[1–4] It has been reported to impair current working activity[5,6] in 10% of cases, as well as quality of life[7] and is the main cause of non-attendance at school for adolescents,[2,3,5,8] and the first cause for adolescents seeking medical advice.[9] Dysmenorrhea is commonly categorized as ‘primary´, i.e. in absence of proven pelvic pathology, or ‘secondary´, i.e. in presence of pelvic pathology: the distinction has mainly a therapeutic purpose, as for cases of secondary dysmenorrhea (e.g. endometriosis or pelvic inflammatory disease) a specific treatment may be offered.[10] Pain is the dominating symptom, not controlled by NSAID assumption in 20–25% of cases,[11] and several other symptoms, contributing to the pre-menstrual syndrome, may be associated, reaching severe intensity in 3.5–5% of cases.[12]

Non-conventional medicine has become very popular in western countries in recent years.[13,14] Acupuncture, a traditional Chinese medicine procedure, is well tolerated and free of relevant side effects[15] and has been approved by FDA.[16] Acupuncture is commonly used to treat chronic pelvic pain,[17] and its use has been recently recommended by the National Institute of Health for the treatment of several diseases, including dysmenorrhea.

The aim of the present study was to assess the efficacy of acupuncture in a consecutive series of women affected by primary or secondary dysmenorrhea (painful menstrual cramps without or with evident pathology to account for them), not controlled by NSAID. Efficacy was measured in terms of pain control, impact on NSAID consumption, and cost-effectiveness.

Medscape Today from Web MD

From Evidence-based Complementary and Alternative Medicine: eCAM

University of Maryland Medical Center

Description
An in-depth report on the causes, treatment, and prevention of menstrual cramps.

Alternative Names
Dysmenorrhea; Menorrhagia; Amenorrhea; Cramps; Heavy menstrual bleeding

Treatment
Making dietary adjustments starting about 14 days before a period may help some women with certain mild menstrual disorders, such as cramping. The general guidelines for a healthy diet apply to everyone; they include eating plenty of whole grains, fresh fruits and vegetables, and avoiding saturated fats and commercial junk foods.

Salt Restriction. Limiting salt may help bloating.

Reducing Caffeine, Sugar, and Alcohol. Reducing caffeine, sugar, and alcohol intake may be beneficial. The effects of alcohol are mixed. One study found that women who drank less wine had less menstrual pain than those who drank more wine. Another reported that regular consumption of alcohol lowered the risk for developing cramps, but it actually increased the length of cramping time in certain women. In any case, alcohol is certainly not recommended for relieving menstrual disorders.

Maintaining Healthy Iron Stores and Preventing Anemia

Forms of Iron. Women who have heavy menstrual bleeding can sometimes become anemic. Eating iron-rich foods can help prevent anemia. Iron found in foods is either in the form of heme or non-heme iron. Heme iron is better absorbed than non-heme iron.

  • Foods containing heme iron are the best for increasing or maintaining healthy iron levels. Such foods include (in order of iron-richness) clams, oysters, organ meats, beef, pork, poultry, and fish.
  • Non-heme iron is less well absorbed. About 60% of iron in meat in non-heme (although meat itself helps absorb non-heme iron). Eggs, dairy products, and iron-containing vegetables have only the non-heme form. Such vegetable products include dried beans and peas, iron-fortified cereals, bread, and pasta products, dark green leafy vegetables (chard, spinach, mustard greens, kale), dried fruits, nuts, and seeds.

The absorption of non-heme iron often depends on the food balances in meals. The following are foods that enhance absorption of non-heme iron:

  • Meat and fish not only contain heme iron, the best form for maintaining stores, but they also help absorb non-heme iron.
  • Increasing intake of vitamin C rich foods can enhance absorption of non-heme iron during a single meal. In any case, vitamin C rich foods are healthful and include broccoli, cabbage, citrus fruits, melon, tomatoes, and strawberries. One orange or six ounces of orange juice can double the amount of iron the body absorbs from plant foods. (Taking vitamin C supplements does not appear to have any significant effect on iron stores.)

Exercise

Exercise may help reduce menstrual pain. It is not clear, however, how intense the exercise should be to reduce dysmenorrhea. For example young female athletes in one study were only half as likely to suffer from dysmenorrhea as their non-active peers. However, they were also three times more likely to experience an absence of periods. Exercise may be very helpful for women with menstrual pain due to endometriosis. It relieves stress and tension and may reduce hormonal levels that could contribute to endometrial growth.

Other Lifestyle Measures

Sexual Activity. There have been reports that orgasm reduces the severity of menstrual cramps.

Applying Heat. Applying a heating pad to the abdominal area, or soaking in a hot bath, can help relieve the pain of menstrual cramps.

Menstrual Hygiene. Change tampons every 4 – 6 hours. Avoid scented pads and tampons; feminine deodorants can irritate the genital area. Women should not douche during or between periods. Women who douche on a weekly basis are more likely to contract cervical cancer than those who do not. Douching may destroy the natural bacteria normally present in the vagina. Bathing regularly is sufficient.

Alternative Remedies

Acupuncture and Acupressure. Some studies, including a small well-conducted trial, have reported relief from pelvic pain after acupuncture or acupressure, a technique that applies small pins or pressure to specific points on the body.

Yoga and Meditative Techniques. Yoga and meditative techniques that promote relaxation may help relieve menstrual cramps.

Chiropractic. Some women with primary dysmenorrhea have sought help from chiropractors trained in spinal manipulation. One study compared a high-force spinal manipulation technique with a low-force maneuver used as a placebo technique. Both showed lower scores on tests that measure pain, perhaps indicating that a simple back rub by a sympathetic partner or friend may be helpful.

Herbs and Supplements. Generally, manufacturers of herbal remedies and dietary supplements do not need approval from the Food and Drug Administration to sell their products. Just like with drugs, herbs and supplements can affect the body’s chemistry, and therefore have the potential to produce side effects that may be harmful. There have been a number of reported cases of serious and even lethal side effects from herbal products. Patients should check with their doctor before using any herbal remedies or dietary supplements.

Studies have not generally found herbal or natural remedies to be any more effective than placebos for reducing menstrual disorders. Natural remedies for menstrual symptoms include:

  • Black cohosh (also known as Cimicifuga racemosa or squawroot) contains a plant estrogen and is the most studied herbal remedy for treating menopausal symptoms, although a 2006 study indicated it is ineffective. Some women also use it for dysmenorrhea. Black cohosh has been used for decades in Germany and appears to be safe, but because its actions resemble estrogen more clinical studies are needed to confirm both long-term safety and effectiveness. Headaches and gastrointestinal problems are common side effects. At this time, experts do not recommend taking it for more than 6 months.
  • Ginger tea or capsules may help to relieve nausea and bloating.
  • Aromatherapy with topically-applied lavender, sage, and rose oils may help ease menstrual cramps, according to a small 2006 study.
  • Pycnogenol, an extract from the bark of the French maritime pine tree, may help reduce menstrual pain and discomfort, according to some small studies.

Resources

References

American Academy of Pediatrics Committee on Adolescence; American College of Obstetricians and Gynecologists Committee on Adolescent Health Care; Diaz A, Laufer MR, Breech LL. Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Pediatrics. 2006 Nov;118(5):2245-50.

Apgar BS, Kaufman AH, George-Nwogu U, Kittendorf A. Treatment of menorrhagia. Am Fam Physician. 2007 Jun 15;75(12):1813-9.

Beaumont H, Augood C, Duckitt K, Lethaby A. Danazol for heavy menstrual bleeding. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD001017.

Casablanca Y. Management of dysfunctional uterine bleeding. Obstet Gynecol Clin North Am. 2008 Jun;35(2):219-34.

For more information on Menstrual Disorders in online encyclopedia:

http://en.wikipedia.org/wiki/Menstrual_disorder