Dysmenorrhea (Menstrual Cramps)

Following is note shared by "YingYang House"

Dysmenorrhea is painful menstruation that arises before, during a/or after menstruation. The pain is mainly in the lower abdomen, however, it can occur in the lower back a/or running down the legs.

Etiology & Pathology:
Etiology:
Emotional Factors - strong emotions (depression, anger) may lead to stagnation of the LV Qi which may lead to a stagnation of Qi & Blood manifesting as painful menstruation.
Cold/Damp Exposure - contact with cold/damp environments (climates, climate controlled buildings, basements) a/or excessive consumption of cold/damp foods (fruit juices, ice cream) may lead to an accumulation of cold/damp in the abdomen which may lead to a stagnation of Qi & Blood manifesting as painful menstruation.
Existing Qi/Blood Deficiencies - symptoms may be exacerbated during menstruation leading to dysmenoorhea.
Existing LV/KD Deficiencies - constitutional weaknesses a/or in women who have had multiple child-births, thus depleting the KD Jing, worsened by the loss of Blood during menstruation.
Differentiation:
When pain is worse prior to a/or during menstruation, this indicates an excess condition:
Qi Stagnation
Blood Stagnation
Accumulation of Cold
When the pain is dull, this indicates a deficient condition:
LV/KD Deficiency
Blood Deficiency
Qi Stagnation - Excess Condition
Signs & Symptoms:
More distention than pain, bloating, breast tenderness is likely, stuffy chest, belching, irritability, short temper.
Tongue: Purplish possible, thin white coat
Pulse: Wiry
Treatment Principle:
Resolve Qi Stagnation
Treatment Points:
LV 2 - move LV Qi, LV 3 may be a better choice
CV 6 - tonify Qi, effect lower abdomen
CV 3 - help to move Qi in the lower abdomen
GB 34 - w/LV 2/LV 3, move LV/GB channel & abdomen w/CV 6
SP 8 - moves Qi and Blood (more for Qi), SP 10 (more for Blood)
SP 6 - direct Blood downwards
If sacral pain - UB 32
Blood Stagnation - Excess Condition
Signs & Symptoms:
Less distention, more pain w/stabbing qualities, no breast tenderness, abdominal pain worse w/pressure, blood clots.
Tongue: Purplish or purple spots which usually appear on the sides, very thin coat
Pulse: Deep, choppy can also be a little wiry
Treatment Principle:
Resolve Blood Stagnation
Treatment Points:
ST 29 - move Blood in the abdomen (also good for starting menstruation in patients who have cessation of menstruation)
CV 6 - move Qi in the abdomen
SP 6 - direct Blood downwards
SP 10 - move Blood and Qi
LV 3 - w/SP 6 move Qi in the lower abdomen
Accumulation of Cold - Excess Condition
Signs & Symptoms:
Pain that is better w/application of heat a/or pressure, scanty menstrual flow, dark blood w/clots that are smaller than the Blood Stagnation clots.
Tongue: White coat
Pulse: Deep, tight
Treatment Principle:
Disperse Cold
Resolve Stagnation
Treatment Points:
CV 4 - w/moxa, tonify Qi, warm & move abdomen
CV 8 - w/moxa, disperse cold
ST 28 - w/moxa, warm abdomen, resolve stagnation
ST 36 - tonify Qi & Blood
LV/KD Deficiency - Deficient Condition
Signs & Symptoms:
Dull a/or intermittent pain of the lower abdomen which arises during a/or after menstruation, pain is better w/pressure, sore back, dizziness, tinnitus (not as prevalent), sallow complexion, lassitude, chronic fatigue, light periods likely w/light red blood.
Tongue: Light red, thin white coat (if extremely deficient tongue may be flabby)
Pulse: Deep, fine or thin
Treatment Principle:
Tonify LV & KD
Move Qi in the Chong Mai and Ren Mai
Treatment Points:
UB 18 - LV Shu
UB 23 - KD Shu
CV 4 - tonify Qi, warm and move abdomen
KD 3 - tonify KD Qi
ST 36 - tonify Qi & Blood
Could add LV 3 or LV 8 - help move Qi in the lower abdomen
Blood Deficiency - Deficient Condition
Signs & Symptoms:
Dull pain after menstruation, better w/pressure, dizziness, palpitations, scanty menstruation.
Tongue: Pale w/thin moss or slightly peeled (peeled section may appear pale as well)
Pulse: Empty, thin
Treatment Principle:
Tonify Blood
Move Qi
Treatment Points:
UB 18 - LV Shu
UB 20 - SP Shu
UB 23 - KD Shu
SP 6 - tonify SP, Blood
SP 10 - tonify & move Blood
LV 8 - nourish LV