Endometriosis Case 1

 

A forty year old female with severe lower abdominal pain was referred to my clinic by her previous acupuncture physician. This pain had been consistently associated with her menstruation for the last twenty years.

 

 

She was diagnosed with endometriosis twenty years ago. She had a history of unbearable lower abdominal cramping pain during the first hour of menstruation, that radiated to her lower back and vaginal area. Oral painkillers proved generally ineffective. It was common for her to need to be seen in the ER to receive injections of pain medications in order to relieve the abdominal pain during menstruation. Usually, by the second day of menstruation, her severe abdominal pain would gradually subside. She often had abdominal pain and lower back pain without menstruation. She had consulted several outpatient treatments but they failed to relieve her symptoms. She had also tried treatment with acupuncture and Chinese herbal formulas. These formulas and treatments had been designed to clear heat and dry dampness, and tonify her liver and kidney, but ultimately these failed to control her pain. Weekly massage and other forms of therapy have been able at times to help reduce her pain.

At her first visit, she had pain in her lower abdomen and lower back without menstruation, that radiated to pelvic and vaginal area. Sexual intercourse caused unbearable vaginal pain, and at times she had a burning sensation in her vaginal area with abnormal vaginal discharge or odor. She suffered from headaches, but did not have pain in her neck or upper back. Her first menstruation appeared at 11 years of age, and came regularly once a month with dark blood. There was often water without blood clots in the beginning of her menstruation, a moderate volume of the blood for 5 to 6 days and each cycle lasted 27 days. She suffered from occasional poor sleep, stress and nervousness that was worse during, and improved after, her monthly menstruation. Her appetite was normal. She had no acid reflux but experienced occasional gas and belching. She had one bowel movement a day, but which sometimes contained undigested food. Her urination was also normal. She often felt lassitude. From time to time she experienced alternating hot and cold in her body, with her hands and feet slightly cold to the touch. Her face looked slim and ruddy.

Examination showed tenderness and painful sensation with a slight touch or pressure as detailed below. There was obvious pain on both sides of her lower abdomen – she qualified the pain as 6-7/10 in her right lower abdomen, and 4-5 /10 in her left lower abdomen. There were painful sensations in her lower back at the L3 to S1, with a slight touch, which she placed at 4-5/10. The Ears Pressure Test showed that there was significant painful sensation to touch in the corresponding parts of her endocrine, brain, neck, chest, waist, leg, shenmen, stomach and rectum – she described her level of pain with these areas as 8-9/10. Her tongue body presented medium sized, pale with red color. There was a slightly dark color on the tip of her tongue, and a white coating. Her pulse was thin, weak and wiry.

Based on Traditional Chinese Medicine, her conditions were due to yang deficiency in spleen and kidney, with cold in the meridian of liver, and stagnation of qi and blood. The treatment principle was to warm yang and tonify spleen and kidney, to warm and disperse cold from the liver meridian, and to enable the free movement of qi while invigorating blood. Acupuncture included electric acupuncture of points in DU20, Yintang, LI4 and GB20; the manual acupuncture points included SP6, ST36, ST27 and 25, RN3,4,6, UB23, KI3 and LV3. These were applied 15 minutes once a week. Auricular (ear) points included brain, waist, leg and Shenmen, among others.

The Chinese herbs included two formulas for her conditions. The first formula (1) included the following herbs: Huang Qi, Dang Shen, Gan Jiang, Bai Zhu, Rou Gui, Wu Zhu Yu, Xian Mao, Xian Ling Pi, Dang Gui, Chuan Xiong and Wu Yao. It was 50g power of an herb Rx for one week, to be taken orally 3 times a day, 2g per dose, and mixed with about 2 oz warm water within half hour before and after meals. This formula (1) was usually taken orally before and after menstruation. The second formula (2) included Wu Yao, Wu Zhu Yu, Gui Zhi, Zhi Shi, Xiang Fu, Sheng Jiang, Mu Xiang, Yan Hu Suo, Bai Shao Yao and Gan Cao. It was 50g power of an herb Rx for one week, to be taken orally 3 times a day, 2g per dose, and mixed with about 2 oz warm water within half hour before and after meals. It was taken orally at 3 days before menstruation until the end of each menstruation cycle.

The treatment during follow up visits modified some points of the acupuncture protocol, and herbs in the herbal formula, according to patient’s progression.

Result: After several weeks of treatment, the patient reported that her menstruation had come the previous week with significant improvement in abdominal pain, and it had not been necessary for her to go to the ER for an injection of pain medication. Examination showed that tenderness in her lower abdomen and lower back had subsided to pain levels of 3-4/10 and 2-3/10. Given the effectiveness, the treatment plan was to continue with the same methodology as before. During her following visit, she had no obvious pain in her lower abdomen or lower back during menstruation, but examination showed tenderness in her lower abdomen and lower back, pain she described as 2-4/10. The Ears Pressure Test showed that there was significant painful sensation to the touch in points, near 4-5/10. She changed the frequency of her visits to our clinic to once every 2-3 weeks, due to the inconveniences of her two hour drive. A periods of time later, she reports she had slight abdominal bloating and gas, occasional slight pain in her left lower abdomen during menstruation, with pain in the range of 3-4/10. To her previous herbal formulas, the herbs San Leng, E Zhu, Chuan Lian Zi and Xue Jie were added to strengthen the functions of moving qi and invigorating blood to reduce pain. After couple months of treatment, her pain disappeared on the lower abdomen and lower back during menstruation. There was no pain to the touch upon examination. The Ear Pressure Test showed her painful sensations in points had disappeared completely. However, her feet were still not warm, she had a slight bloating in her abdomen and reported undigested food in her stool. The plan of acupuncture treatment same as before, and her previous herbal formula was modified to strengthen her spleen and help her digestion. After  a few years of treatment, she reported there was no pain in her lower abdomen and back, no visible undigested food stool. Sexual intercourse had again become feasible with only a slight discomfort.

 

*Treatment result may vary on individual basis, such as age, condition, and ethnicity. We are not responsible for the claim by the patient, but we are pleasure to help you.