Chinese Medicine and Menstrual Cramps

Every month many women experience uncomfortable menstrual cramps. This pain is caused by contractions of the uterine lining. For some, menstrual cramps are barely noticeable, and for others they are debilitating. Dysmenorrhea is the medical term for painful menstrual periods.

Many people reach for Advil or other NSAID to aid their menstrual cramps. These drugs act upon the inflammatory response in the body. Besides common over the counter drugs, Traditional Chinese Medicine can naturally improve menstrual cramps and menstrual related inflammation.

Individual experiencing menstrual cramps

Moxibustion to Relieve Menstrual Cramps

A review published in January 2022 analyzed the use of moxibustion as an adjuvant therapy for primary dysmenorrhea. Moxibustion therapy involves the burning of Mugwort leaves to enhance the effects of acupuncture.

In this review, the mechanism of moxibustion for primary dysmenorrhea focuses on regulating endocrine hormones, immune function, neuro-related factors, and uterine microcirculation. For example, dysmenorrhea in 60% of patients with primary dysmenorrhea is associated with prostaglandins.

Previous studies have found moxibustion to help regulate PGE2 and PGF2-alpha levels. PGF2-alpha is responsible for contracting and tensing the uterine smooth muscle. An increase in the PGF2-alpha/PGE2 ratio leads to excessive contraction of uterine smooth muscle, ischemia, and hypoxia. Therefore, increasing the pain sensitivity of the nearby nerves causing dysmenorrhea.

The review found moxibustion to be a promising therapy for primary dysmenorrhea. However, more clinical research is necessary to further support the mechanisms of moxibustion and dysmenorrhea.

Moxibustion for menstrual cramp relief

Removing Stagnation with Cyperi Rhizoma (Xianfu)

The herb Cyperi Rhizoma (Xianfu) promotes the flow of Qi in the liver and sanjiao channels. These channels are thought to be disrupted in mensural pain.

A review in 2022 found Cyperi Rhizoma to clinically improve Qi stagnation disorders. The herb contains antioxidant, anti-inflammatory, and neuroprotective properties, leading to relief in Qi stagnation present in dysmenorrhea.

Xiao Yao San and Menstruation

The Xiao Yao San formula commonly includes eight herbs: Bupleurum root, Chinese angelica root, white peony root, poria, bighead atractylodes rhizome, roasted ginger, prepared licorice root, menthol, and peppermint. Significant research has explored this herbal formula for depression. However, during these studies the researchers also noted the potential for the formula to restore normal menstruation.

A systemic review of randomized controlled trials in 2012 noted that since the herbal formula was found to invigorate the spleen and nourish the blood, research should explore Xiao Yao San as a therapy for dysmenorrhea.

How to Approach Dysmenorrhea Caused by Endometriosis

Endometriosis is a gynecological disorder where uterine tissue improperly grows outside of the uterus. Understandably, when tissue is growing where it is not supposed to be, pain occurs. In this case, the dysmenorrhea is referred to as secondary dysmenorrhea.

Researchers have explored a significant amount of complementary and alternative medical therapies for secondary dysmenorrhea relief. These therapies include traditional Chinese medicine herbs and acupuncture.

Traditional Chinese medicine can help relieve pain, reduce the recurrence rate, and overall improve quality of life. Just an hour less of painful menstrual cramps is beneficial!

Red blood cells

A review in 2021 explored the complementary and alternative medicine for dysmenorrhea caused by endometriosis.  The herbs were found to help reduce pain through four main mechanisms:

• 1) Reducing the viscosity of whole blood, improving local circulation
• 2) Reducing the expression of inflammatory factors, including interleukin-1 and interleukin-6
• 3) Reducing the expression of PGE2 and PGF2-alpha
• 4) Relieving uterine muscle spasm by inhibiting smooth muscle activity

The authors explored four main herbal formulas: Shao fu Zhu yu decoction (SZD), Weng jing decoction (WJD), Xue fu Zhu yu decoction (XZD), and Dang gui Si ni decoction (DSD).

A randomized controlled trial in 2019 showed SZD to relieve dysmenorrhea more effectively than ibuprofen. After three months of each of the therapies, 90% of those taking the herbal formula found relief while 70% of the ibuprofen group found relief.

How did SZD provide relief? Researchers in 2018 found that in rat models, the formula reduced cell proliferation, thus reducing the abnormal tissue growth (ectopic endometrium).

Researchers found similar responses in comparison to ibuprofen for WJD. A randomized clinical study in 2015 randomly divided 60 patients with secondary dysmenorrhea to either a treatment group with WJD or a control group with ibuprofen. After three months, 90% of the WJD group found relief while 76.7% of the ibuprofen group found relief.

The patients’ ratings of the visual analogue scale were also significantly lower in the WJD group than the ibuprofen group. This scale rated the severity of the symptoms of dysmenorrhea.

In 2015 researchers explored DSD for endometriosis dysmenorrhea. DSD contains angelica, which promotes hematopoietic progenitor cells related to antiplatelet and antithrombotic aggregation, and cinnamon, which contains compounds such as coumarins with analgesic properties. These herbs help promote blood flow during menstruation to relieve pain. The researchers found DSD to be 89.19% effective as a therapy for dysmenorrhea.

Tampons

The Therapeutic Actions of Acupuncture

A systemic review and meta-analysis in 2017 analyzed 10 studies that explored acupuncture for endometriosis related pain. The outcomes assessed included pain level and peripheral blood CA-125 level for both the acupuncture and control groups.

A CA-125 level can be positively correlated with the severity of endometriosis. The review found acupuncture to both reduce pain and serum CA-125 levels, suggesting that acupuncture as a sufficient therapy for secondary dysmenorrhea pain.

Take Aways

This article introduces only some of what traditional Chinese medicine therapies can do to help menstrual cramps and dysmenorrhea caused by endometriosis. I would encourage you to work with your health practitioners to find which one is appropriate for your individual needs!