Dysmenorrhea and

AcupressureEDUARD DRANNIKOV, MD

INTEGRATIVE FAMILY MEDICINE FELLOW

UNIVERSITY OF MICHIGAN

Disclosures

No financial sponsorship

Affiliated with University of Michigan, Integrative Family Medicine Department

Fellowship focus in acupuncture, certified and credentialed

Objectives

Introduction of Dysmenorrhea

Primary vs Secondary

Introduction of Traditional Chinese Medicine (TCM)

Specific recommended acupressure points for Dysmenorrhea

References

Practice!

DYSMENORRHOEA

Dysmenorrhea

is defined as severe, cramping pain in the lower abdomen that

occurs just before or during menses.

(primary or secondary)

Primary dysmenorrhea occurs in the absence of significant

pelvic pathology. Usually develops within the first 2 years of

the menarche

Characteristics of primary dysmenorrhea

The pain is often intense, cramping, crippling and severely incapacitating so that it causes a major disruption of social activities.

It is usually associated with the onset of menstrual blood loss but may begin on the day preceding menstruation.

The pain only occurs in ovulatory cycles, is lower abdominal in nature but sometime radiates down the anterior aspect of the thighs and back

The pain often disappears or improves after the birth of the first child.

Dysmenorrhea is often associated with vomiting and diarrhea

Pelvic examination reveals no abnormality of the pelvic organs.

Secondary dysmenorrhea

Secondary dysmenorrhea is caused by organic pelvic pathology and it usually has its onset many years after the menarche.

Any woman who develops secondary dysmenorrhea should be considered to have organic pathology in the pelvis until proved otherwise.

Pelvic examination is particularly important in this situation and, if the findings are negative, laparoscopy is indicated.

Common associated pathologies include endometriosis, adenomyosis, pelvic infections and intra-uterine lesions such as submucous, and fibroids.

Acupressure

What is Acupressure?

Acupressure is an ancient healing art developed in Asia over

5,000 years ago that uses the fingers to press key points

on the surface of the skin to stimulate the body's natural

self-curative abilities. When these points are pressed,

they release muscular tension and promote the

circulation of blood and the body's life force energy (Qi)

to aid healing. Acupuncture and acupressure use the

same points, but acupuncture employs needles, while

acupressure uses gentle but firm pressure.

The Advantages of using acupressure

relieving pain

balancing the body

maintaining good health.

the healing touch of acupressure reduces tension, increases circulation, and enables the body to relax deeply.

by relieving stress, acupressure strengthens resistance to disease and promotes wellness.

Channels or Meridians—The

invisible pathways of Qi

Chinese use the term “Jing Luo” (筋絡) which means: channels, conduit, meridian, etc.

These are the invisible channels through which Qi circulates throughout the body.

The acupressure points (or holes as the Chinese term “xue” (穴位) is more aptly translated means) are the locations where the Qi of the Channels rises close to the surface of the body.

There are 12 main meridians—

6 Yin are: Heart, Lung, Spleen, Liver, Kidney, and Pericardium.

6 Yang: Small intestine, Large intestine, Stomach, Gall Bladder, Urinary Bladder, Triple Burnner.

And numerous minor ones, which form a network of energy channels.

Each meridian is related to, and named after, an organ or function.

There are more than 400 acupoints and there may be as many as 2000 points in use for different treatment.

How to Find The Points

Of the hundreds of acupressure points on the body, most either lie under-neath major muscle groups or follow the bone structure, residing in the joints or in the hollows of bone.

In order to find an acupressure point with your hands, concentrate on feeling for a muscular cord or a hollow in the bone structure.

Feel for a slight indentation or depression between the tendons and muscles at each point.

Once you have found a muscular cord, press directly on it; or if you feel a bony hollow, slowly press directly into it.

How to Press The Points

Often the point is indicated by some degree of soreness upon pressure. If there is extreme (or increasing) sensitivity or pain, gradually decrease the pressure until a balance is achieved between pain and pleasure.

You should find that the initial pain you feel from the finger pressure is simultaneously relieving the other pain. When you hold the point long enough, the pain will diminish, indicating that the acupressure is working.

After repeated sessions with different depths of pressure, you will begin to feel a pulse at the arthritic pain sites; this is a good sign—it means increased circulation. Try to pay attention to the type of pulse you feel.

If it’s very light and faint, hold the point even longer until you feel the pulse grow fuller and deeper.

If the pulse is throbbing, continue to hold the point until you feel the pulse become more regular.

How to Use Acupressure to Relieve Pain

Try to find a comfortable sitting or position, hold the painful joints and nearby acupressure points for at least three minutes, breathing deeply into your abdomen; the breathing helps the points release and enables healing energy to circulate into your arthritic joints and throughout your whole body.

Relaxation and feeling of well-being will emerge the more you practice self-acupressure as a daily routine.

Meridians Involved in Uterine Health

Liver (LIV or LV)

Spleen (SP)

Spleen Meridian

Dysmenorrhea Point Liver 3

Point Localization: On the dorsum of the foot in a depression distal to the junctions of the 1st and 2nd metatarsal bones.

TCM Actions: Controls Liver Yang. Extinguishes Inner Wind. Smooths the flow of Liver Qi. Resolves Dampness. Invigorates Xue. Regulates menstruation. Calms the Mind (Shen). Resolves spasms.

Indications: Headache. Dizziness. Blurred vision. Numbness of the head. Opisthotonos. Epilepsy. Facial paralysis. Irritability. Anger. Insomnia. Concern. Thoracic and abdominal distention. Nausea. Constipation. Borborygmos. Swelling, redness and genital pain. Urinary difficulty. Jaundice. Irregular and painful menstruation. Prolapse of Uterus. Cramp. Stiffness in the back.

Target area: Head. Uterus.

Point Name and Meaning: Taichong – Bigger Rushing

Dysmenorrhea Point Liver 4

Point Localization: Anterior to the medial malleolus,

midway between SP5 and ST41, in a depression on

the medial side of the tendon of tibialis anterior.

TCM Actions: Smooths the flow of Liver Qi in the lower

burner. Resolves Dampness in the lower burner.

Indications: Abdominal distension. Belly button pain.

Pain, swelling and redness of the genitals. Urinary

difficulty. Painful urination. Cloudy urine.

Target area: Uterus. Genitals.

Point Name and Meaning: Zhongfeng – Middle Seal

Dysmenorrhea Point Spleen 6 Point Localization: 3 cun directly above the tip of the

medial malleolus on the posterior border of the tibia.

TCM Actions: Strengthens the Spleen. Resolve dampness. Stimulates the function of the liver. Smooths the flow of Liver Qi. Tonifies Kidney. Nourishes the Blood (Xue) and Yin. Benefits urination. Regulates uterus and menstruation. Moves the Blood (Xue) and eliminates stasis. Cools the blood. Stops pain. Analgesia. Calms the Mind (Shen).

Indications: Deficient Spleen and Stomach. Heaviness. Edema. Fullness and abdominal distension. Cold abdomen. Belly button pain. Dizziness. Blurred vision. Tinnitus. Irregular menstruation. Infertility. Excessive and painful menstruation. Retention of lochia and dead fetus. Abdominal masses. Difficult urination. Enuresis. Cloudy urine. Palpitation. Insomnia. Gallbladder deficiency. Shyness. Irritability. Softened feces. Bleeding in the intestines and uterus. Vaginal secretion. Humidity in the lower burner. Night sweating. Sensation of heat. Dry mouth.

Point Name and Meaning: Sanyinjiao – Three Yin Meeting

References

A randomized controlled clinical trial evaluating quality of life when using a simple acupressure protocol in women with primary dysmenorrhea. Bazarganipour F, Taghavi SA, Allan H, Hosseini N, Khosravi A, Asadi R, Salari S, Dehghani R, Jamshidi Z, Rezaei M, et al. Complement Ther Med. 2017 Oct; 34:10-15. Epub 2017 Jul 14.

The effect of applying pressure to the LIV3 and LI4 on the symptoms of premenstrual syndrome: A randomized clinical trial. Bazarganipour F, Taghavi SA, Allan H, Beheshti F, Khalili A, Miri F, RezaeiM, Mojgori M, Imaninasab F, Irani F, et al. Complement Ther Med. 2017 Apr; 31:65-70. Epub 2017 Feb 21.

Effects of SP6 acupressure on pain and menstrual distress in young women with dysmenorrhea. Wong CL, Lai KY, Tse HM. Complement Ther Clin Pract. 2010 May; 16(2):64-9. Epub 2009 Nov 14.

Acupuncture or Acupressure at the Sanyinjiao (SP6) Acupoint for the Treatment of Primary Dysmenorrhea: A Meta-Analysis. Chen MN, Chien LW, Liu CF. Evid Based Complement AlternatMed. 2013; 2013:493038. Epub 2013 Feb 28.

Effectiveness of SP6 (Sanyinjiao) acupressure for relief of primary dysmenorrhea symptoms: A systematic review with meta- and sensitivity analyses. Abaraogu UO, Igwe SE, Tabansi-OchioguCS. Complement Ther Clin Pract. 2016 Nov; 25:92-105. Epub 2016 Sep 9

Chinese Acupuncture and Moxibustion, Foreign Language Press, Beijing 1987, Cheng Xinnong

Practice

LIV 3 LIV4 SP6

Thank you!!!