When we talk about pain here in clinic we are usually talking about menstrual pain. Given that it is National Pain Week from Monday 23rd July, we are devoting this blog to the total pain in the you-know-where that is dysmenorrhea, more commonly known as painful periods. For some women this is just a mild occasional discomfort but for many it is a ball-and-chain holding them back in life. The nature, duration, location and timing of the pain can differ greatly between women, as can the level of intrusion into ones everyday life.
You may have heard of a famous Chinese saying ‘Where there is free flow there is no pain and where there is pain there is no free flow’. To us practitioners of Chinese medicine, this saying acts as a guiding tool for our thinking. There is pain, so where is the flow obstructed? What is causing this disruption to the normal functioning of our reproductive anatomy? Why is blood not moving smoothly? The treatment we choose is based on the answers to these questions.
You may realise already from talking to other women just how different period pain can be. It doesn’t even always occur during the period. Period pain can be experienced before, during or after the period. Pain at the onset of the period is differentiated from pain toward the end. There is also ovulatory pain, where the normal functioning of the ovary is obstructed and pain is felt at ovulation time.
Period pain may be experienced centrally, on both sides of the abdomen, down the inner thigh, and/or travelling around to the back. It may be dull, sharp, twisting, pulling, burning, throbbing, cramping, distending or an empty, dragging like sensation. For some it is better for warmth, for other it is resistant to pressure. For some, their period means a headache.
For many women the pain is mild, it is accepted as a bit of monthly mild discomfort that soon passes, they may not need to take medication or a hot pack may suffice. Though for many unfortunate women, period pain is far more serious, sometimes so severe it ends with confusion, dizziness or fainting or a visit to hospital. Many women with Endometriosis fall into this latter group and it can be a debilitating disease, which disrupts ones life, slows career progression and dramatically effects wellbeing. Many women spend years being ignored by medical advisors and misunderstood by peers and colleagues.
In clinic, we use acupuncture and Chinese herbal medicine for period pain, depending on the pattern. Period pain can be categorised as Qi constraint, Blood stasis, various patterns of cold, dampness, deficiency of vital nutrients or deficiency in related organ function. This may not mean much to the non-practitioner but it is a window into how pattern discrimination informs our choice of treatment and highlights how individual each patient presentation can be.
To finish, here are some recent peer-reviewed findings from research into acupuncture and Chinese herbal medicine supporting what we have long known, that acupuncture and Chinese herbal medicine is an effective and safe choice for pain reduction or elimination in women with period pain:
A recent (Nov 2017) systematic review of randomized controlled trials on the efficacy of acupuncture as a treatment for primary dysmenhorrea found that acupuncture was significantly more effective than sham acupuncture or no treatment (1. )
Another recent study found it to be more effective than non-steroidal anti inflammatory drugs (NSAIDS) for pain relief in dysmenhorrea, a reduction of 69% in mean pain scores for acupuncture compared to 52.2% for NSAID’s (2.)
An interesting study where two randomised groups of women with endometriosis were given either acupuncture specifically for endometriosis pain (group 1) or were given non-specific acupuncture (group 2). Later, the treatment groups were swapped to receive the opposite. It was found the first group found a significant reduction in pain intensity after the first course of treatments, whereas group 2 showed significant pain reduction only after the cross-over (3.)
So if you have period pain and are interested in discussing what we can do to help you, please feel free to give us a call at clinic so we can talk over your options. Have pain of a different nature? I’ve added a few study links below, or give us a call to see if we can help you.
Written by Kim Riley who has just joined our team at Angea! Kim is a registered doctor of Chinese Herbal Medicine and Acupuncture and has been practicing for over six years. Kim brings a wealth of knowledge and experience in women’s health, fertility, ivf, postnatal, pregnancy, teenage hormonal issues, gut health, the 4th trimester, Endometriosis, menopause, PCOS, nutrition and Chinese herbal medicine.
Kim is also a happy gardener, musician, cook and spends a lot of time in the great outdoors. She has a background in working in the health foods industry and initially studied naturopathy before changing paths to Chinese Medicine. This background serves her well in her work as she integrates her knowledge of whole foods, nutrition and supplements with her Chinese Medicine understanding.
- Acupuncture for Primary Dysmenorrhea: A Meta-analysis of Randomized Controlled Trials. Altern Ther Health Med. 2017 Nov 7. pii: AT5435
- A randomized pilot study of acupuncture treatment for primary dysmenorrhea. Eur J Obstet Gynecol Reprod Biol. 2013 Jul;169(2):292-5
- Is acupuncture in addition to conventional medicine effective as pain treatment for endometriosis? A randomised controlled cross-over trial. Eur J Obstet Gynecol Reprod Biol. 2010 Nov;153(1):90-3
Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. J Pain. 2017 Nov 30. pii: S1526-5900(17)30780-0.
Acupuncture for Myofascial Pain Syndrome: A Network Meta-Analysis of 33 Randomized Controlled Trials. Pain Physician. 2017 Sep;20(6):E883-E902.
Acceptability, Adaptation, and Clinical Outcomes of Acupuncture Provided in the Emergency Department: A Retrospective Pilot Study. Pain Med. 2016 Feb 25. pii: pnv114. [Epub ahead of print].