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TCM Gynecological Issues Treatment Theory

Chinese Medicine Theory is used to understand and treat a broad range of gynecological issues. Below you
will find a brief outline of the theories which relate to gynecological issues and their contributing factors.
TCM Physiology of Menstruation: 26-32 days between periods is noral so long as it reains consistent.!-
6 days of bleeding is considered noral.

Phases of enstruation: Menstrual Phase - " days - Blood should be o#ing during this phase$ health
depends on the sooth flow of %& 'i and Blood.

(econd Phase - appro). * days - Blood and +in are relati#ely epty and the ,& and C& are relati#ely
depleted.
Mid-cycle -o#ulation. - Blood and +in are stronger and the ,& and C& are filling up.

Preenstrual Phase - appro). * days - +ang 'i rises and %& 'i o#es in preparation for the period.
,enerally$ you can tonify during the first period and o#e during the second period.

Menopause a#erages around age "/ - later than "" is delayed and earlier than 3" is early. 0terus and
1elated 2rgans: The 0terus is a curious organ in TCM.

Many aspects ha#e an effect on the 0terus and ,ynecology:

3idney 4ing 5ssence$ root of 'i$ root of yin 6 yang -fire.$ ateral essense for the foration of %&
Blood.7nfluences the * year cycle. 7nfluences the horones associated with the 0terus. Controls the Bone
arrow -western - responsible for foration of Blood..

%i#er (tores Blood$ nourishes the 0terus.

Blood 7ssues: Blood 8eficiency - aenorrhea$ scanty a9or late periods. :ot Blood - dysenorrhea$ hea#y
bleeding$ s;in eruptions. (trongly effects sooth flow of 'i and Blood.

(tagnant %& 'i ay lead to painful periods$ PM( a9or irregular periods - which ay lead to Blood
(tagnation and clotting.

(pleen 2rigin of the Blood. :olds organs 6 Blood in place and ascends 'i - prolapses$ rec;less bleeding.
Controls the +i -intellect..

:eart Connects directly to the 0terus #ia the Bao Mai. ,o#erns the Blood. :as an ental9eotional effect
on the 0terus.

%ung <ot a #ery strong influence but significant in that it go#erns the 'i of the body. 5ffected by sadness
6 grief which in e)cess can lead to 'i a9or Blood stagnation - enstrual issues a9or breast lups.

(toach Connects to the 0terus #ia the Chong Mai (T 3/.7nfluences breast feeding and breast il;.
5)traordinary &essels C&$ ,& and Chong Mai all arise fro Ming Men and connect with C& = as well as
the 0terus.

Conception &essel relates closely with +in$ essence and fluids as well as the 0terus and the whole feale
reproducti#e syste. 1esponsible for conception$ fertility$ enarche$ pregnancy 6 enopause.,o#erning
&essel connects with C& =$ the 0terus and also with the Brain. 1elates closely with the +ang of the body.
Chong Mai is the >(ea of Blood> and has an iportant influence on the supply and o#eent of Blood in
the 0terus.
5tiology 6 Pathogenic ?actors 3 Ma@or Pathogenic ?actors Cold 8irect stri;e of Cold to the 0terus - easy
during enstruation or after labor$ can lead to painful periods.

Accuulation of Cold in the lower warer - strongly effects enstrual functions$ dysenorrhea. 8ap
5ffects lower body$ can cause discharges a9or pain during o#ulation. Boen are ore #ulnerable during
enstruation or after labor.
8ap-:eat - can lead to abdoinal asses a9or o#arian cysts. :eat Bind-:eat or (uer-:eat can enter
into the Blood and cause hea#y bleeding.
TCM Understanding of Women's Physiology
TCM understands the gender #ariation in physiology and disease de#elopent. Therefore$ during
consultation it is necessary to consider these differences and to pay attention to the characteristics
of woenCs diseases.
,enerally$ en and woenCs organs$ meridians$ blood and qi (vital energy ha#e siilar
acti#ities but woen ha#e special physiological structures li;e the uterus that affect enstruation$
pregnancy$ childbirth and lactation. These organs especially need blood and Di -#ital energy. to
function with the eridians acting as counicating channels. As a result$ the physiological
functions are dependent upon the prootional effects of the organs$ eridians$ blood and Di -#ital
energy. wor;ing together.
The !"tra !ight Meridians
<oral physiological functioning also depends on the proper regulation of the standard
noenclatures of the eight eridians. Because the a@ority of uterine Di and blood tra#els within
these eridians$ the relationship of the uterus and the e)tra eridian networ; is e)treely close.
The e)tra eight eridians include the Governor #essel$ Conce%tion #essel$ Thoroughfare
#essel$ Girdling #essel$ &in 'in( #essel$ &ang 'in( #essel$ &in )eel #essel and &ang )eel
#essel. 0nli;e the t*elve regular meridians$ these eight #essels are not distributed regularly but
are situated in a rather cople) pattern aong the regular eridians. Their ain function is to
strengthen the lin;s between the twel#e regular eridians and to regulate Di and blood circulation.
They ha#e special relationships with the liver$ (idney$ uterus$ brain and arrow and thus influence
these structures physiologically and pathologically. These #essels do not possess direct connections
or interior-e)terior relationships with the zang organs and fu organs.
The +emale ,e%roductive -ystem
7n TCM anatoy$ the feale reproducti#e syste consists of the uterus$ cer#i)$ birth canal$
#aginal orifice and the surrounding eridians. The uterus$ also called the >childCs palace$> lies in
the lower abdoen$ in the center of pel#ic ca#ity$ behind the urinary bladder and in front of the
rectu. 7ts lower opening connects with the birth canal. The priary function of the uterus is to
produce enses and to culti#ate the fetus.
Additionally$ physiological functions of the uterus are associated with the heart$ liver$ s%leen and
The Governor #essel (du mai originates fro the perineu @ust before the anus$
runs in the idline up along the spinal colun and reaches the head finally. This
eridian eets all the +ang eridians$ thus is called the >sea of the yang eridians.>
7t is responsible for go#erning the Di for all the yang eridians of the body. This
#essel has close relationships with the brain$ spinal cord and ;idney respecti#ely.
(ince it counicates with the brain$ it can be regarded as a lin; siilar to the
pituitary-adrenal a)is in Bestern edicine. 7n woen$ this #essel a;es blood e)it
the body during enstruation.
The Conce%tion #essel (ren mai originates fro the perineu$ runs along the
anterior idline of the abdoen$ passes through the chee; and enters into the eye
soc;et finally. 7t eets all the yin eridians$ and thus is called the >sea of the yin
eridians.> 7t is responsible for recei#ing and bearing the Di of the yin eridians. 7n
woen$ this eridian is thought to originate in the uterus where the fetus is nourished$
thus there is a saying that >the Conception &essel doinates the uterus and
pregnancy.> 7t pro#ides yin substances for all woenCs physiological acti#ities.
The Thoroughfare #essel (chong mai originates in the pel#ic ca#ity and runs
alongside the ;idney eridian up to the thora). 7t is regarded as the Esea of blood$>
which is the place for the twel#e regular eridians to con#erge and where it helps
regulate the Di and blood inside the. This #essel influences the supply and proper
o#eent of blood in the uterus$ and is closely related to the enses. The ain
difference between the Thoroughfare &essel and Conception &essel in relation to
enstruation is that the Conception &essel controls Di and can be used to tonify and
nourish$ where as the Thoroughfare &essel controls blood$ and is used to o#e Di and
blood and to reo#e obstructions.
The Girdling #essel (dai mai originates below the rib side$ runs down along the
lateral side of loin and encircles the waist. 7t passes through the uterus li;e a girdle.
The ,irdling &essel retains the eridians of the entire body$ prooting their
interconnected relationships. 7n woen$ it also ta;es charge of nourishing and
lubricating the uterus and controls #aginal discharge.
./
Producing menses0
Menstruation is fored in the uterus. Bhen a woan reaches puberty$ her uterus
atures and her ;idney essence is enriched to a certain e)tent. The ;idneys then will
produce a type of substance for prooting se)ual functions$ which is called tian1gui.
0nder the action of this substance$ the Conception &essel and Thoroughfare &essel
are e)uberant and flushed with abundant Di and blood. The e)cessi#e Di and blood will
epty into the uterus and produce regular enses. 7n old age$ the ;idney essence is
e)hausted and tian-gui declines. The Conception &essel and Thoroughfare &essel
gradually close and becoe obstructed. A woan then begins to ha#e enstrual
irregularities until enopause occurs.
2/ Cultivating the fetus0
2nce a woanCs uterus is fully de#eloped$ and her enses are regular. (he has the
ability to becoe pregnant and gi#e birth. Bhen an egg fro her o#ary is fertiliFed
with a sper$ pregnancy will result. ?ro a TCM understanding$ this process in#ol#es
the cobination of congenital essences fro both se)es$ which are transitted into
the ebryo in the uterus. Thereafter$ the uterus supplies the nutrients for the growth
and de#elopent of the fetus until childbirth.
(idneys as well as the Conception and Thoroughfare &essels. This is because producing enses
and culti#ating a fetus rely on the nourishent of blood and prootion of the ;idney essence.
These nourishing substances are regulated and supplied by the following TCM concepts:
The heart rules the blood.
The li#er stores the blood.
The spleen go#erns the blood.
The ;idneys store essence.
The Conception and Thoroughfare &essels control Di and blood in the uterus.
Therefore$ only when the organs and eridians function well can the uterus wor; norally.
Pathologically$ disorders in the abo#e organs and eridians will affect the uterus resulting in
enstrual disorders and possibly sterility. 7n the treatent of woen disorders$ TCM often focuses
on nourishing these organs$ and tends to particularly replenish blood.
<ote: ?ro the foregoing physiology and pathology of the uterus$ it can be seen that the uterus in
TCM encopasses not only to the wob but also the whole internal genital syste.

Uterus
This is considered the ost iportant of the e)traordinary organs. 7t regulates enstruation$
conception and pregnancy. 7t is #ery closely related to the 3idneys$ 1en and Chong Mai. Both
Mai originate fro the 3idneys and ha#e a@or functions of regulating enstruation$
conception and pregnancy$ they also both flow through the 0terus. 7f 3idney 5ssence is strong$
1en and Chong flourish$ hence the 0terus is nourished with 'i and blood. (ince the :eart
go#erns blood$ the %i#er stores the blood$ and the (pleen controls the blood$ the 0terus has
#ery close relations with the. 8isorders of blood associated with any of these organs directly
effects the health and functioning of the 0terus$ in particular the enstruation. ?or e)aple$ if
the blood is deficient there can be aenorrhea. 7f the blood is hot there can be etrorrhagis or
enorrhegia. 7f %i#er 'i is stagnated there will be clotted enstrual blood and painful periods.
The relationship between %i#er blood and the 0terus is #ery iportant in practice. 8isorders of
reproduction on the other hand are often fro wea; 3idneys -iscarriage$ infertility.. The
0terus is also related to the (toach #ia the connection fro the Chong Mai. Morning
sic;ness is usually due to changes in the 0terus e)plained through this connection.

&. The 0terus
The uterus is located in the lower abdoen. 7ts lower opening is connected to the
#agina$being a feale reproducti#e organ. 7ts ain physiological functions are as
fol=ows :
1. Producing Menses
The enses is one of the physiological characteristics of the feale. ,enerally $during
the period of =! to !G years of age$feales ha#e the physiological changes of
enstruation e#ery onth$i$ e. $ >the enses coe on schedule. >Menstruation belongs to
the physiological function of the uterus. This de#elopent of the feale body possesses
the regular changes$ along with the prosperity or decline of ;idney-Di Bhen the essential
Di of ;idney is enriched to a certain e)tent $the substance tiangui is produced. Bhen
tiangui reaches a certain le#el$its prooting action influences the uterus to de#elop to
aturity$ ensuring proper enstruation and adeDuate conditions for conception and
childbearing. 7n old age$ the changes of physiological function ha#e ta;en place$ along
with a decrease of the ;idney essential Di$which causes enstruation to gradually
cease$and the reproducti#e function to be lost.
7n addition$ enstruation is also closely related to the Chong Meridian and 1en
Meridian -Conception &essel. . Both belong to the e)tra eridians and start fro the
uterus$ and are in close relation with the occurrence of enstruationH hence$ they are also
affected and regulated by tiangui. The Conception &essel @oins with the three yin
eridians of the foot in the abdoen$ and regulates all the yin eridians of the body.
Thus$ the Conception &essel is referred to as >the sea of the yin eridians. > Bhen the
tiangui arri#es$ the Di and blood of the Chong Meridian and Conception &essel freely
flow an becoe abundant$ and epty into the uterus to produce enstruation. Thus$ there
are sayings that$ >The Conception &essel doinates the nourishent of the fetus$> and
>The Chong Meridian is the sea of blood. > 7n aged people$ tiangui decreases$ and the Di
and blood of the Chong Meridian and Conception &essel becoe insufficient$ causing
enstrual irregularity and e#entual enopause. 7n clinical practice$ dysfunction of the
Chong Meridian and Conception &essel ay lead to pathological changes of
enstruation$ leading to disorders of the enstrual cycle$ aenorrhea$ and so on.
2. Cultivating the Fetus
2nce a woanCs uterus de#elops to aturity$ and her enses are regular$ she has the
ability to be pregnant and to gi#e birth. Cobination of the essences of ale and feale
ay be transitted to the ebryo in the uterus$ which supplies the nutrients for the
growth and de#elopent of the fetus until the childbirth.
TCM belie#es that the physiological function of the uterus also is related to the heart$
li#er$ and spleen$ apart fro the Chong Meridian and Conception #essel. The reason is
that the production of the enses and breeding of the ebryo rely on nourishent of the
blood. The blood is doinated by the heart$ stored by the li#er$ and coanded by the
spleen$ while the essence is stored by the ;idney. Therefore$ only when these four organs
function well can the uterus ;eep its noral physiological functions. Pathologically$
dysfunction of these organs and eridians due to #arious causes will affect function of
the uterus$ leading to enstrual disorders or sterility. 7n treatent of these
conditions$TCM usually begins by ad@usting and replenishing the abo#e organs and
eridians.

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