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Acupuncture Today
May, 2008, Vol. 09, Issue 05
 
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Treatment to Regulate Menstruation and Promote Fertility, Part 1

By John Chen, PhD, PharmD, OMD, LAc

Infertility is defined as failure to become pregnant after several years of regular sexual activity during ovulation. Infertility afflicts more than 6 million American couples, of which approximately 40 percent is attributed to male and 60 percent to female partners.

For females, there are many reasons that contribute to infertility, including but not limited to: ovulatory failure or defect, blocked fallopian tubes, endometriosis, uterine fibroids, polyps, pelvic adhesions, pelvic inflammatory diseases, chlamydia, hormonal imbalance, age (especially those older than 34) and psychological issues. Often, more than one cause contributes to infertility.

According to traditional Chinese medicine, treatment of female infertility must focus on regulating menses. Essential keys in becoming pregnant include a healthy menstrual cycle along with strong kidney qi , an abundance of blood in the chong (thoroughfare) channel and an unblocked ren (conception) channel.

Menstrual Phase

In this phase, it's important to regulate the menses and ensure proper shedding of the uterine lining. Qi and blood-moving herbs are utilized to clear and prevent any stagnation in the lower jiao .

Herbal treatment

bai shao (Radix paeoniae alba)
chi shao (Radix paeoniae rubrae)
chong wei zi (Semen leonuri)
chuan xiong (Rhizoma ligustici chuanxiong)
dang gui (Radicis angelicae sinensis)
fu ling (Poria)
xiang fu (Rhizoma cyperi)
ze lan (Herba lycopi)

These herbs are mild so as to regulate the menstrual flow and promote healthy shedding of endometrial tissue. Dang gui (Radicis angelicae sinensis) tonifies and moves blood. Chong wei zi (Semen leonuri) promotes blood circulation and regulates menstruation. When combined with dang gui (Radicis angelicae sinensis), they treat various types of gynecological disorders ranging from irregular menstruation, dysmenorrheal and amenorrhea, to postpartum abdominal pain. Ze lan (Herba lycopi) moves blood to dispel clots. It also works with fu ling (Poria) to reduce water retention and edema associated with menstruation. Chi shao (Radix paeoniae rubrae) and chuan xiong (Rhizoma ligustici chuanxiong) treat a wide variety of gynecological disorders by relieving pain. Xiang fu (Rhizoma cyperi) enters the liver and regulates qi to relieve bloating and emotional imbalances during the menstrual period. Bai shao (Radix paeoniae alba) nourishes blood, softens the liver and has an anti-spasmodic effect to relax the uterus and relieve pain.

From the Western medicine perspective, these herbs have marked influence to regulate menstruation. According to several studies, dang gui (Radicis angelicae sinensis) has both stimulating and inhibiting effects on the uterus, thereby exhibiting an overall regulatory effect on menstruation.1 Furthermore, dang gui (Radicis angelicae sinensis) in essential oil form was effective in relieving menstrual pain, with a 76.79 percent rate of effectiveness among 112 patients.2 The mechanism of this action is attributed in part to the analgesic and the anti-inflammatory effect of the herb, which has been cited to be similar or stronger than acetylsalicylic acid.3 Many other herbs are used in this formula to treat menstruation-related symptoms. For example, xiang fu (Rhizoma cyperi) has an inhibitory effect on the uterus to relax the muscles and relieve pain.4 Bai shao (Radix paeoniae alba) and chi shao (Radix paeoniae rubrae) have an anti-spasmodic effect to alleviate spasms and cramps.5,6 Xiang fu (Rhizoma cyperi) and bai shao (Radix paeoniae alba) have analgesic effects.7,8 Chi shao (Radix paeoniae rubrae) and chuan xiong (Rhizoma ligustici chuanxiong) have anti-platelet effects to reduce clotting and pain.9,10 Chuan xiong (Rhizoma ligustici chuanxiong ) and xiang fu (Rhizoma cyperi) have sedative effects to relieve stress, anxiety and general discomfort.11,12 Lastly, fu ling (Poria) has diuretic effects, reducing water accumulation and treating edema.13,14

Follicular Phase (The week following the last day of menstruation)

During this phase, the key strategy is to tonify the kidney yin , jing (essence) and blood, which are depleted. This stage is essential in fortifying the body to ensure healthy conception.

Herbal treatment

bai zhu (Rhizoma atractylodis macrocephalae)
chong wei zi (Semen leonuri)
chuan xiong (Rhizoma ligustici chuanxiong)
dang gui (Radicis angelicae sinensis)
E jiao (Colla corii asini)
fu ling (Poria)
gou qi zi (Fructus lycii)
huai niu xi (Radix achyranthis bidentatae)
lu jiao shuang (Cornu cervi degelatinatium)
mu dan pi (Cortex moutan)
nu zhen zi (Fructus ligustri lucidi)
shan yao (Rhizoma dioscoreae)
shan zhu yu (Fructus corni)
shu di huang (Radix rehmanniae preparata)
tu si zi (Semen cuscutae)
wu wei zi (Fructus schisandrae chinensis)
ze xie (Rhizoma alismatis)

These herbs tonify blood, nourish yin and replenish jing. Mild qi - and blood-moving herbs also are used to prevent stagnation as a result of the rich tonics. In this formula, dang gui (Radicis angelicae sinensis), shu di huang (Radix rehmanniae preparata) and E jiao (Colla corii asini) are among the most effective blood-tonifying herbs to replenish what was lost through menstruation. Bai zhu (Rhizoma atractylodis macrocephalae), fu ling (Poria) and shan yao (Rhizoma dioscoreae) strengthen the spleen. A healthy spleen is essential in the production of blood and extraction of postnatal qi from food. Shan zhu yu (Fructus corni), nu zhen zi (Fructus ligustri lucidi) and gou qi zi (Fructus lycii) nourish the kidney yin and jing. Tu si zi (Semen cuscutae) and lu jiao shuang (Cornu cervi degelatinatium) are two mild yang-tonic herbs to support the kidney yang.

Without yang tonics, yin tonics cannot achieve their maximum effect. Wu wei zi (Fructus schisandrae chinensis) is an astringent herb added to consolidate, bind and prevent the leakage of jing. Ze xie (Rhizoma alismatis) is used to offset the stagnating nature of shu di huang (Radix rehmanniae preparata). Chuan xiong (Rhizoma ligustici chuanxiong), mu dan pi (Cortex moutan) and chong wei zi (Semen leonuri) are mild blood-moving herbs used to ensure that the tonics do not become stagnant. Huai niu xi (Radix achyranthis bidentatae) guides the effect of the herbs to the lower jiao, namely the kidney. In summary, this formula successfully tonifies the body to ensure healthy conception by using herbs that supplement the kidney yin, jing and blood.

From the Western medicine perspective, these herbs facilitate and restore normal health and well-being after menstruation. This formula contains herbs with regulatory effects to promote normal menstruation, hematological effects to promote production of white and red blood cells and adaptogenic effects to address mental and physical stresses associated with menstruation. According to several studies, administration of dang gui (Radicis angelicae sinensis) is associated with both stimulating and inhibiting effects on the uterus, thereby exhibiting an overall regulatory effect.15 Because of this regulatory effect, dang gui (Radicis angelicae sinensis) is beneficial and can be used before, during and after menstruation. Since most women have pronounced weakness and deficiencies after their menstruation, many herbs in this formula promote the production of various types of blood cells. According to one study, gou qi zi (Fructus lycii) has a marked hematopoietic effect to increase the production of red blood cells and white blood cells.16 According to another study, administration of E jiao (Colla corii asini) has a marked hematopoietic effect to increase the production of red blood cells and white blood cells,17 and its use has been shown to effectively treat leukopenia and anemia.18

Furthermore, bai zhu (Rhizoma atractylodis macrocephalae) has an immunostimulant effect by increasing the activity of macrophages and the reticuloendothelial system. It also increases the number of white blood cells, lymphocytes and IgG.19,20 Wu wei zi (Fructus schisandrae chinensis) has an immunostimulant effect to heighten non-specific immunity.21 Lastly, gou qi zi (Fructus lycii) has an immunostimulant effect to increase non-specific immunity and the phagocytic activity of macrophages and the total number of T cells.22 As stated above, this formula contains herbs with an adaptogenic effect to help the body cope with mental and physical stress during and after menstruation. Examples of these herbs include bai zhu (Rhizoma atractylodis macrocephalae) and tu si zi (Semen cuscutae).23,24 In addition, shan yao (Rhizoma dioscoreae) has a stimulating effect on the gastrointestinal tract to promote normal digestion and absorption of nutrients.25 Chuan xiong (Rhizoma ligustici chuanxiong) and mu dan pi (Cortex moutan) stimulate blood circulation and promote delivery of oxygen and essential nutrients to various parts of the body.26,27 Wu wei zi (Fructus schisandrae chinensis) stimulates the central nervous system and increases mental alertness, improves work efficiency and quickens reflexes.28 Fu ling (Poria) and ze xie (Rhizoma alismatis) have diuretic effects, drain water and treat edema frequently associated with menstruation.29,30

References

  1. Zhong Yao Xue (Chinese Herbology), 1998; 815:823.
  2. Lan Zhou Yi Xue Yuan Xue Bao (Journal of Lanzhou University of Medicine), 1988; 1:36.
  3. Yao Xue Za Zhi (Journal of Medicinals), 1971; (91):1098.
  4. Zhong Hua Yi Xue Za Zhi (Chinese Journal of Medicine), 1935; 12:1351.
  5. Zhong Cheng Yao Yan Jiu (Research of Chinese Patent Medicine), 1980; 1:32.
  6. Zhong Yi Za Zhi (Journal of Chinese Medicine), 1985; 6:50.
  7. Gui Yang Yi Xue Yuan Xue Bao (Journal of Guiyang Medical University), 1959;113.
  8. Shang Hai Zhong Yi Yao Za Zhi (Shanghai Journal of Chinese Medicine and Herbology), 1983; 4:14.
  9. Zhong Xi Yi Jie He Za Zhi (Journal of Integrated Chinese and Western Medicine), 1984; 4(12):745.
  10. Hua Xi Yi Xue Za Zhi (Huaxi Medical Journal), 1993; 8(3):170.
  11. Zhong Yao Yao Li Yu Ying Yong (Pharmacology and Applications of Chinese Herbs), 1983:123.
  12. Zhong Guo Yao Ke Da Xue Xue Bao (Journal of University of Chinese Herbology), 1989; 20(1):48.
  13. Chang Yong Zhong Yao Cheng Fen Yu Yao Li Shou Ce (A Handbook of the Composition and Pharmacology of Common Chinese Drugs), 1994; 1383:1391.
  14. Shang Hai Zhong Yi Yao Za Zhi (Shanghai Journal of Chinese Medicine and Herbology), 1986; 8:25.
  15. Zhong Yao Xue (Chinese Herbology), 1998: 815-230.
  16. Zhong Yao Xue (Chinese Herbology), 1998: 860-2.
  17. Zhong Cheng Yao Yan Jiu (Research of Chinese Patent Medicine), 1981; (5):31.
  18. Shan Dong Yi Yao Gong Ye (Shandong Pharmaceutical Industry), 1986; 3:21.
  19. Jun Shi Yi Xue Jian Xun ( Military Medicine Notes ), 1977; 2:5
  20. Xin Yi Yao Xue Za Zhi (New Journal of Medicine and Herbology), 1979; 6:60.
  21. Zhong Yao Xue (Chinese Herbology), 1998: 878-881.
  22. Zhong Cao Yao (Chinese Herbal Medicine), 19(7):25.
  23. Xin Yi Yao Xue Za Zhi (New Journal of Medicine and Herbology), 1974; 8:13.
  24. Chang Yong Zhong Yao Cheng Fen Yu Yao Li Shou Ce (A Handbook of the Composition and Pharmacology of Common Chinese Drugs), 1994: 1563-4.
  25. Zhi Wu Zi Yuan Yu Huan Jing (Source and Environment of Plants), 1992; 1(2):10.
  26. Zhong Yao Xue (Chinese Herbology) , 1989; 535:539.
  27. Guo Wai Yi Xue Zhong Yi Zhong Yao Fen Ce (Monograph of Chinese Herbology from Foreign Medicine), 1983; (3):5,1984;(5):54.
  28. Zhong Yao Xue (Chinese Herbology), 1998; 878:881.
  29. Sheng Yao Xue Za Zhi (Journal of Raw Herbology), 1982; 36(2):150.
  30. Chang Yong Zhong Yao Cheng Fen Yu Yao Li Shou Ce (A Handbook of the Composition and Pharmacology of Common Chinese Drugs), 1994; 1383:1391.

Click here for more information about John Chen, PhD, PharmD, OMD, LAc.

 

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