Period pain and discomfort are just the tip of the iceberg when it comes to symptoms that women have become accustomed to dealing with every month - and they shouldn't have to.
According to a recent study on dysmenorrhea (painful periods), it was found that up to 91% of women within reproductive age have experienced some level of pain during their cycle, with up to 29% reporting severe pain. This pain may occur before, during, or after menstruation and could be located in the lower abdomen, sacral region or even extend down the legs.
Beautiful Uterus, Marissa Falk-Varco
Little known fact: periods actually shouldn’t be painful.
Dysmenorrhea can be differentiated into several causal mechanisms of disease, including
high levels of inflammation
hormonal imbalance
impaired blood production and circulation
structural dysfunction
impairment in central metabolism and energy production.
In Traditional Chinese Medicine terms, these translate into
heat or damp/phlegm retention (inflammation)
yin/yang imbalance (hormone imbalance)
blood deficiency or stasis (impairment in blood production/circulation)
injury, blockage, or qi stagnation of the channels (structural dysfunction)
Qi deficiency (central metabolism & energy production lacking)
The good news? Acupuncture and herbal supplementation can actually target many of these factors simultaneously and are powerfully effective at mitigating painful periods. The reason they are such effective treatment strategies? Because, like all TCM approaches, the root cause is the target for treatment. As opposed to prescriptions or protocols that are used to mask the pain, our approach finds and corrects the underlying cause of the discomfort in order to resolve the manifesting symptoms.
At a biological level, Acupuncture works via several different mechanisms that contribute to the lessening of pain and other cycle associated symptoms.
(I apologize in advance for the depth of these descriptions. If science isn't your jam, just stick to the title
1. Modulates Prostaglandin Levels.
Prostaglandins are compounds that are made in the body in response to stress, injury or inflammation. They have hormone-like effects, meaning they influence a cascade of reactions in the body beyond just where they are secreted - such as contraction or relaxation of smooth muscle, dilation and constriction of blood vessels, and control of blood pressure. In the uterus, prostaglandins cause the muscular walls to contract, which in turn causes the shedding of the uterine lining (aka the endometrium). Studies have shown that too high of levels of prostaglandins can lead to worsening of period pain while too low of levels of prostaglandins can lead to a weakened immune system. Acupuncture has been shown to impact prostaglandin levels, both through lowering and raising levels in different instances in relation to the presenting imbalance.
2. Impacts HPO Axis
The Hypothalamic-Pituitary-Ovarian Axis is a system that includes the hypothalamus, pituitary gland, and gonadal glands (ovaries) and their interactions with each other. These interactions are critical in regulating the hormonal mechanisms that control the menstrual cycle. Any interruption in the communication between these entities can lead to abnormal cycles and associated symptoms such as cramping. Acupuncture and Herbal Medicine stimulate the transmission of signals to areas of the brain such as the hypothalamus and pituitary in order to maintain proper functioning of the HPO axis and appropriate production of period-associated hormones.
Hypothalamic - Pituitary - Ovarian Axis
3. Regulates Sympathetic and Parasympathetic Nervous Systems
Changes in the sympathetic nervous system (SNS) associated with pain have been described for well over a century, and it has been shown that "blocking" the sympathetic nervous system is effective in the treatment of pain conditions (1). Our nervous systems, especially the (SNS) or “fight-or-flight” response, has been shown to be very responsive to stress (whether that be mental, emotional, physical or chemical). This explains why during the times that you are undergoing stress, you may find that any pain you may be experiencing becomes worse than normal. There is a very interdependent relationship at play here. Activation of the SNS leads to higher than normal levels of circulating adrenaline, which in turn increases our sensitivity to pain (ie menstrual pain from uterine contraction). In this ‘wound-up’ state painful sensations can become increasingly painful, and sensations that are not normally painful can become very sore. The emotional component of stress may generate feelings such as worry, which in turn winds the nervous system up more. This is the start of a vicious cycle: nervous system winds up resulting in more pain, which may result in more worry, stress & poor sleep causing more wind-up and then further pain, and on and on. Acupuncture and TCM lifestyle modifications can wind down the sympathetic nervous system in order to reduce this pain and sensitivity. They conversely signal activation of the parasympathetic nervous system (PNS), which induces a state of calm and well-being; the perfect landscape for healing to occur. In PNS activation, there are less stress hormones perpetuating the pain signal as well as lowered sensitivity to pain.
4. Balances Hormone Production
Excess or deficiency in either of the primary menstrual hormones - estrogen and progesterone - can lead to a myriad of undesirable symptoms. Too little progesterone with high estrogen is incredibly common - it’s called estrogen dominance and often presents as heavy, painful, frequent or irregular cycles, PMS, spotting, mood swings, and breast tenderness Usually this is not due to over production of estrogen, but instead that progesterone levels have become depleted. Progesterone can be depleted by a number of causes, including the birth control pill, lifestyle stress, alcohol consumption, and too low fat or fibre diets. Two other important hormones, Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) can also become disrupted in a downstream effect of estrogen imbalance (thanks to that thing we discussed earlier, the HPO Axis). Imbalances in FSH and LH are present in conditions like PCOS, early menopause, and Luteinized Unruptured Follicle Syndrome.
The effect of Acupuncture is transmitted into the brain from distance sensory receptors around the acu-points, via peripheral nerves and body fluid. A study done by Fu, H. et al. demonstrated that Acupuncture significantly lowered serum levels of E2 (estrogen) compared to a control group receiving Clomiphene Citrate - a common drug used in cases of infertility and PCOS (2). Another study focused on a 39 year old woman with a history of infertility and high Follicle Stimulating Hormone (FSH) levels. It was shown that Acupuncture and Chinese herbal treatments decreased serum FSH levels; at onset of treatments it was 23.64 mIU/ml and after three months of treatments the level had dropped to 7.65 mIU/m (3). There was also some improvement in cycle length of patient which was a little irregular at the beginning (24-35 days) and at the end of treatments (27- 29 days). It is clearly established that Acupuncture and Herbal Medicine, in combination with other TCM modalities, exert strong effects on modulating hormone levels.
5. Improves Follicular and Ovarian Health
A theory on the mechanism of acupuncture by P. Magarelli (3) suggested that acupuncture may increase the blood flow and neuro-vascularization to the cortex of the ovaries, thereby improving their quality and health.
Disruptions to ovarian structures such as cysts and endometriosis have been implicated in period pain. Encouraging blood circulation promotes nourishment and proper growth of the follicles and ovaries, and counters these structural disorders leading to easier and more pleasant cycles.
So, what's the take away from all this? Just because it seems like the norm, doesn't mean it's the way things were meant to be. Thanks to this thousand year old medicine, we have all the tools we need enjoy pain free periods.
Interested in learning more? Book a free 15-minute consultation to see if TCM is the right treatment approach for you. If you’re ready to start your treatment plan, book an initial consultation here.
(1) https://www.sciencedirect.com/science/article/abs/pii/S1472029910002778
(2)https://www.hindawi.com/journals/ecam/2011/606514/
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