GYNECOLOGY

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MENSTRUAL CRAMPS

Why Menstrual Cramp?
Physician Goh Xin Yi

Have you ever been bothered by painful cramps before or during your periods? Unfortunately for many women, they have come to accept the monthly pain as part of their life. Sometimes cramps can be so severe that they have to miss school or work. In this issue, we look at the modern and Chinese Medicine views of menstrual cramp and how Chinese Medicine can help.

What is Menstrual Cramp?

Menstrual cramps, also known as dysmenorrhea in medical term, are painful sensation felt in the lower abdomen and pelvis that can occur prior, during or after a women’s menstrual period. The pain can range from dull to severe, and can extend to the hips, lower back and inner thighs or even lead to fainting. Menstrual cramps may also be accompanied by a headache, nausea, constipation or diarrhea.

Causes of Menstrual Cramp
Menstrual cramps are categorized into 2 groups: Primary or Secondary dysmenorrhea.

1. Primary dysmenorrhea
Usually occurs within six months to a year following the beginning of menstruation in young women. There is no underlying organic problem causing the pain.

2. Secondary dysmenorrhea
Usually develops later in women who have had normal periods and is often related to problems in the woman’s reproductive system such as:
• Endometriosis-A condition in which the tissue lining the uterus is found outside the uterus.
• Fibroids-Growths on the inner wall of the uterus
• Adenomyosis-A condition where the lining of the uterus grows into the uterus wall.
• Pelvic inflammatory disease-An infection in the uterus and can spread to other reproductive organs
• Cervical stenosis-Narrowing of the opening to the uterus

TCM Perspective
In Chinese medicine, menstrual cramp may be due to the obstruction or insufficient flow of Qi and Blood flow to the uterus. The most common cause of obstruction of Qi and Blood to the uterus is stress and over-consumption of cold food and drinks. On the other hand, those with a weaker body constitution (i.e. more prone to getting sick), or who had a major illness or loss of blood may suffer from a deficiency of Qi, Blood or Kidney essence, which are essential in providing nutrients to the uterus.

Chinese Medicine believes that adjusting the emotions, diet, lifestyle factors and moderate exercise are important factors to help alleviate the pain.

a) Regular exercise such as walking, jogging, aerobics can help to soothe menstrual cramps.
b) Adjust your emotions and mood. Do deep breathing to relax or activities to reduce stress and frustration.
c) Avoid consumption of icy drinks, cold and raw food such as ice-cream, sashimi, especially prior, after and during your period.
d) Be careful not to catch a cold, especially during your period. Keep yourself warm, especially your lower abdomen and legs in an air-conditioned room prior or during your period.
e) Have sufficient rest. Do not overwork.

For those with severe pain, based on TCM differential diagnosis, a physician can prescribe herbal medicine or perform acupuncture to reduce the pain. Visit your physician to get your personalized treatment.

Some suggested drinks that you can drink prior or during your period:

a) Rose or Jasmine Tea:
Suitable for those who experience stress, frustration and bloated-ness at lower abdomen prior to the period.

b) Ginger Tea:
Suitable for those who felt cold especially during the period and those who felt better after applying a warm patch over the lower abdomen.

c) Motherwort tea:
Suitable for those who suffer from sharp menstrual cramp pain and has menstrual flow with blood clots.

d) Longan Red dates tea:
Suitable for those who felt tiredness and dizziness especially during the period.

This massage can be done 1 week prior to your period, once to twice a day.

a) Rub your abdomen, with your belly button as the centre, in circular clockwise motion for 100 times.
abdomen massage final

b) Rub your lower abdomen with both your hands in an upwards downwards motion until you feel that it is warm.
abdomen massage 2

c) Rub your lower back in an upwards and downwards motion for 50 times
lowerback masssage

d) Rub your ribs in a forward and backward motion for 50 times.
ribs massage

e) Use a deep and firm pressure to massage and stimulate the following acupoints for 1 minute:

i) He Gu (合谷):
Location: At the highest spot of the muscle when the thumb and index fingers are brought close together
heguxue

ii)San Yin Jiao (三阴交):
Location: Four fingers space above the inner ankle, at the inside of your leg.
sanyinjiao

**Note that this acupoint should not be used in pregnancy as it may induce labour.

iii)Xue Hai (血海):
Location: About Three fingers space above the inner kneecap.
xuehai

e) Rub and massage the inner portion of both legs.
calf massage