Acupuncture Premenstrual

8/9/2019 Acupuncture Premenstrual

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acceptable# >hy are women's moods seen as such a problem? %enha)e moods too, after all(9# ( double standard e.ists# @)eryone isaware that men's moods change, but a man does not need to e.plainhis temper tantrums, and male )iolence is an accepted part of theirnature ### P%& is now cited as the cause, and female frustration cancontinue to be ignored or in)alidatedA drugs are gi)en to soothe thewomen and ensure they are not disrupti)e(10# ( oth the negati)ee)aluation and the medicalisation of premenstrual and menstrualchange function to preser)e the asymmetrical roles of men andwomen in the family and society(11# (%ight we $i#e# women not di)edeeper into menstrual pain and irritability to see what it is and use itin some positi)e way? /n presenting this possibility, there is no intentto belittle menstrual pain or suggest it would all go away with abetter attitude# Bet, some of us can benefit by loo!ing at the upsets,rage and sense of 'worthlessness' that often accompany P% >e can

as! oursel)es what these worthless feelings ha)e to say aboutwomen's position in society# /f we are more sensiti)e and responsiblein the premenstrual phase, then perhaps we realise, e)enunconsciously, that what bothers us is )ery important to us# >e can't

8ust brush it off as we usually do the rest of the monthA it erupts inthe classic P%& symptoms because, premenstrually, feelings we')erepressed all month characteristically surface1"(# /n fact, accordingto a 19 * study around 1"6 of women feel better beforemenstruation, reporting increased energy, sensiti)ity and creati)ity,heightened arousal and desire for se. and general well being13# /thas been pointed out that most =uestionnaires produced to e)aluateP%& do not include a section to report positi)e e.periences#/n considering cultural factors, it should be noted that incidence ofP%& appears to be similar throughout a range of races andnationalities, including pache /ndian, Cree!, Tur!ish, apanese,;igerian and merican women# @)en the animal !ingdom is notimmune, with baboons demonstrating premenstrual beha)iouralchanges#

Treatment

Treatment is 'largely empirical and is fre=uently no better than thea)erage placebo response rate of *06'1*# s with the proposedaetiology of P%&, a considerable number of treatments are ad)ocatedby different authorities, including hormonal $progestagens,progesterone, oral contraception, testosterone, danaEol etc# , nonhormonal $tran=uillisers, antidepressants, lithium, diuretics, )itamins,aldosterone antagonists, essential fatty acids etc# , and other


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$psychotherapy, diet, hypnosis, yoga, acupuncture, masturbation,hysterectomy, low salt4high protein diet, reduction in alcohol, caffeineand tobacco etc# #


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order to mo)e the blood# The intimate relationship between theidney and Gi)er in respect of gynaecology is reflected in the saying

(The idney and Gi)er ha)e the same source(, the statement by BeTian &hi (the Gi)er is the pre hea)en =i of woman( and the importantconcept that ministerial $i#e# mingmen fire is entrusted by the

idneys to the Gi)er#/t is the growth of yang prior to menstruation, and especially thegrowth of Gi)er =i, that most commonly causes pre menstrualsymptoms# >hen the Gi)er is harmonious it is characterised bysoftness, openness and free flow# /f there is o)ert or hiddenstagnation, howe)er, this will become more pronounced as the Gi)er=i grows prior to menstruation# Gi)er =i stagnation is thus theprimary pattern seen in P%*# %enstruationDuring menstruation the emphasis is on harmony and free flow of

blood# P%& is fre=uently accompanied by menstrual disturbance sincestagnation of Gi)er =i may easily result in blood stasis, whilst heatdue to transformation of Gi)er =i may easily enter the blood and gi)erise to rec!less bleeding#

5)er)iew of P%& patterns

Gi)er =i stagnation

Gi)er =i stagnation is the primary pattern seen in P% The &piritual.is stated (The Gi)er stores blood, the blood is the residence of the

hunA when Gi)er =i is .u there is fear, when shi there is anger(1+,and (with anger the =i rebels upwards and accumulates in thechest(1 # >hen Gi)er =i is bound and constrained, there will bedepression and weepiness $tears are the fluid of the Gi)er , outburstsof irritation and anger, distention and pain in the chest and breastsand sighing#(The Gi)er go)erns uprising(19, and Gi)er =i stagnation may rise tothe nec!, bac! and shoulders causing tension, !notting and pain#(The Gi)er dominates physical mo)ement("0 and stagnation of Gi)er=i may bind up the a)ailable energy leading to feelings of lethargy, or

burst out from constraint into hyperacti)ity# t the same time)igorous mo)ement $physical e.ercise will help to unbloc! thedammed up =i# inding Gi)er =i stagnation may e.tend to theintestines and gi)e rise to sluggishness of the stools or constipation#&uch is the importance of Gi)er =i stagnation in P%& that it is aperfect e.ample of Ihu Dan.i's statement (>hen the =i and bloodcourse harmoniously, the myriad diseases will not arise# 5nce there is


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constraint, all diseases may come into being# Disease in humanstherefore usually arises from constraint("1#hen the Gi)er =i is flowing freelyand harmoniously, we are li!ely to be aware of $i#e# feel , as well ase.press, our constantly changing emotions# t the same time thisemotional spontaneity is a precondition for a freeflowing Gi)erfunction# ei o Jiong said ( oy, anger, melancholy, an.iety, grief,fear and terror are common to e)eryone# Ci)ing )ent to 8oy, angerand melancholy as occasion re=uires is what is meant by )entingemotions properly(# ailure to )ent emotions, especially anger, resultsin Gi)er =i stagnation and subse=uent depression, resentment,weepiness, irritability etc# %any people are afraid of their own andothers' anger, whether through childhood e.perience of anger as)iolence, or because their original family frowned on its e.pression,

especially by girls# De)eloping asserti)eness can help us learn torecognise and e.press our feelings at an early stage and is animportant middle way between e.cessi)e passi)ity and itstransformation into aggressi)eness, but in real life some anger isprobably una)oidable# /t is said that at puberty, the Gi)er is entrustedwith ministerial $ idney fireA in other words mingmen fire passes tothe Gi)er to facilitate the decisi)eness and asserti)eness re=uired toestablish our adult identity# s this Gi)er fire struggles to find itsproper e.pression there can be periods of great emotional lability andunpredictable moods, especially rage""# /t is possible that acti)esuppression of such emotional e.pression within the family at thistime especially, teaches a lifelong pattern of potentially harmfulrestraint#


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unlimited supply of fuel, and gi)ing )ent to rage and anger will notonly fail to dispel the fire but will continually sto!e and encourage it#

t the same time, the anger itself will in8ure the body, and at thisstage assistance is needed to help a person moderate e.cessi)eemotion#5ne other important aspect of the premenstrual wa.ing of Gi)er =ineeds to be mentioned# or some women, in whom there is relati)elylittle constraint, the days preceding menstruation occasion a welcomefeeling of greater asserti)eness, decisi)eness, clarity and creati)ity#@)en when there is stagnation that bursts out premenstrually, it maymean that what needs to be said is said, and what needs to be doneis done#

Gi)er blood and yin .u(The Gi)er is yin in its substance and yang in its function"*(# >hilst

this statement may be said to apply to all the Eangfu, it is especiallyimportant in relation to the Gi)er# The Gi)er is !nown as the'indomitable Eang' and corresponds to the energies of &pring, growthand forcefulness# lthough the Gi)er's free going function assists theascent and descent of the =i of all the Eangfu, its own =i direction isupwards, hence the saying (The Gi)er go)erns uprising(# &ince itsgrowing, spreading and rising yang acti)ity is by nature e.uberant,fierce and strong, the Gi)er yin and blood must be e=ually strong torestrain and lubricate the potential harshness of the Gi)er =i# loodand yin deficiency can therefore lead both to a failure of thefreegoing function of the Gi)er and to e.cessi)e uprising of Gi)eryang# ecause of menstruation, women are prone to blood deficiency,and P%& as well as many other gynaecological disorders, is oftencharacterised by the combination of Gi)er =i stagnation and blood .u#/n 8ust the same way, the decline of idney yin as women approachmenopauseK, may result in malnourishment of Gi)er yin and agreater tendency to Gi)er stagnation# s far as treatment isconcerned we can almost generalise to the e.tent of saying that incases of Gi)er =i stagnation in women, the Gi)er blood or yin mustalways be nourished#

&pleen disharmonyThe nature of the Gi)er is to spread and e.tend, and this asserti)eand outgoing =uality can easily become aggressi)e when the Gi)er isshi# t the same time, the &pleen, ceaselessly e.pending its =i intransportation and transformation, easily becomes wea!ened ande.hausted and thus unable to resist encroachment by the Gi)er# Thepattern !nown as Gi)er &pleen disharmony which is almost in)ariably


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present to some e.tent in P%&, may spring primarily from anaggressi)e Gi)er which suppresses the &pleen, or from a deficient&pleen which is unable to withstand e)en the normal spreading ande.tending of the Gi)er# This important clinical relationship isrecognised in the statement by Ihang Ihong ing (>henencountering Gi)er disharmony, it should be remembered that theGi)er often in)ades the &pleen, therefore strengthen the &pleenfirst(#

ccording to the &u >en (>hen the spleen is diseased, damp isgenerated("-, and (Damp, swelling and fullness all pertain to the&pleen(" # >hen Gi)er wood o)eracts on &pleen earth in this way,therefore, the &pleen is unable to transform li=uid and solid foodresulting in such symptoms as hea)iness, swelling, oppressi)esensations, loose stools, nausea and oedema"+# >hen &pleendeficiency is further complicated by idney yang deficiencyK, the

swelling and oedema will be e)en more pronounced# &ince (>hen =iflows water also flows(" , Gi)er =i stagnation can also play a part inthis oedema#>hen the body is hea)y with dampness, the mind clouded and bodymo)ement weighted and lethargic, the conse=uent uncoordinatedmo)ements may result in clumsiness# s far as the stools areconcerned, when Gi)er and &pleen suffer dual disharmony, thesymptom of alternating constipation and loose stools is fre=uentlyseen, with constipation for se)eral days as Gi)er stagnation builds,and diarrhoea or loose stools usually one or two days before theperiod when &pleen deficiency predominates#&pleen deficiency is traditionally associated with diminished appetitein


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emotions# :epression of any of the emotions will cause the Gi)er =i tostagnate, and after time to transform to fire# The pattern of Gi)er fireis characterised by outbursts of anger and fury as well as many signsof the =i stagnation from which it transforms# /f fire rises from theGi)er to the Heart there will be restlessness and insomnia, often with)i)id dreams, in which feelings of internal aggression are pro8ectedinto )iolent characters or e)ents# >hen the fire rushes upwards tothe head, there may be diEEiness, tinnitus, headaches, nec! pain etc#/f heat consumes yin fluid, there will be thirst, and if it enters thestored blood of the Gi)er there will be signs of rec!less bleeding suchas early, hea)y or prolonged menstruation#

Phlegm/n a small percentage of cases of P%&, the emotional disturbancemay e.tend beyond the more normal range of depression, weepiness

and outbursts of anger# /n these cases there may be more se)erelydisturbed emotional beha)iour including )iolence to the self andothers, e.tremely se)ere depression, disturbance of consciousness,e.acerbation of psychiatric disorders etc# These symptoms reflectstagnant fire of the Gi)er and Heart with phlegm heat obscuring theHeart orifices# &tagnant fire $transformed from Gi)er =i stagnationboth affects the Gi)er and rises to the Heart# Phlegm is produced bythe combination of =i stagnation and heat# The relationship of =istagnation to phlegm is an important one# Gi Bong hen the circulation of the =i is smoothand ordered, this will lead the body fluids in a smooth and orderedcirculation as well(3"# s far as Gi)er and Heart fire is concerned, theheat will distil and condense body fluids into phlegm# inally, thedisturbance of &pleen function which commonly accompanies Gi)er =istagnation, will contribute to the formation of phlegm#

reast pain, distention and lumpsccording to Ihu Dan.i (The breasts are where the yangming passes,

and the nipples are ascribed to the 8ueyin#( reast disorders,

therefore, are mainly ascribed to disharmony of the Gi)er and&tomach, although as far as acupuncture treatment is concerned it isimportant to remember that the Pericardium primary channel and theCall ladder muscle channel tra)erse the breast# Pre menstrualbreast distention, swelling, pain and lumpiness in)ol)es three mainpatterns, in order of increasing se)erity2 i# Gi)er =i stagnation $breastdistention, hypersensiti)ity, pain and lumpiness , ii# Gi)er stagnant


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fire which further transmits to the &tomach channel $more se)erepain, hypersensiti)ity and heat sensation , and iii# Gi)er =i stagnationcomplicated by phlegm and4or phlegm fire $more pronouncedlumps #

DiarrhoeaPre menstrual diarrhoea is commonly encountered in clinical practice#The most fre=uently seen pattern is &pleen deficiency, which may becomplicated by dampness# /f Gi)er =i stagnation transforms to heat,howe)er, the heat and dampness may combine to form damp heatwhich sin!s to the lower 8iao causing diarrhoea, often accompaniedby leucorrhoea# The =i stagnation that results from obstruction bydamp heat may also gi)e rise to pain, especially e.acerbation ofe.isting pain, in the lower bac! and hips#

HeadachePre menstrual headache is commonly encountered clinically# 5nceagain the most li!ely pattern is some form of Gi)er disharmony,whether =i stagnation, =i stagnation transforming to heat, or Gi)eryang rising# This last pattern is due to the gathering of yin blood inthe :en and


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cne/f Gi)er fire transmits to the &tomach and4or Gung it can manifest asoutbrea!s of premenstrual facial acne# The !ey symptom thatdistinguishes between the two is the presence of constipation$&tomach # Two other pathological mechanisms may be in)ol)ed#5ne is the tendency of heat to separate off and rise $to the facewhen yin accumulates below, and the second is the resonancebetween blood stasis in the lower 8iao and the acne lesionsthemsel)es, indicated by their purple coloration#

;on Gi)er patternslthough Gi)er =i stagnation is the primary pattern seen in P%&,

there is another important mechanism for disharmony at this time#s menstruation approaches, blood gathers in the :en and


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and lumps, the more li!ely Gi)er =i stagnation is to be accompaniedby phlegm due to poor fluid circulation� &uffocated, oppressi)e feeling in the chest with difficulty in ta!inga satisfactory breath, undue consciousness of breathing, sighing� Headache, nec!ache, tightness and pain in the region of ian8ingC "1� Desire to stretch the body or yawn e.cessi)ely� Gower abdominal distention or pain prior to menstruation, which isrelie)ed at onset of bleeding� /rregular menstruation $either early or late� Dream disturbed sleep� @rratic energy lethargy or hyperacti)ity�


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� Poor appetite, loose stools4diarrhoea, nausea�


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� atigue, breathlessness, poor appetite� Pale puffy face� Profuse or scanty menstruation without clots $depending onwhether =i or blood .u is more predominantTongue2 pale $with thin white coatingPulse2 thready, wea! or sodden, small

here there is disorder of menstruation itself, treatment should becontinued throughout the bleeding phase#&ignificant &pleen deficiency can be treated throughout the month#/t is widely accepted that treatment needs to be gi)en o)er at leastthree menstrual cycles to stand a chance of long term effect#

Point selection

The points listed below are only suggestions# There are many otheracupuncture points that can be used effecti)ely#

1# Gi)er =i stagnation


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� Taichong G/M 32 The name of this point, 'Creat Thoroughfare'refers to its function as the great passageway for the flow of =i in thechannel# /t is a primary point for promoting the free flow of Gi)er =i,and can resol)e Gi)er =i stagnation gi)ing rise to pain and distentionin any part of the body, whether the head, eyes, throat, chest, Heart,breasts, epigastrium, abdomen, flan!s, hypochondrium, uterus orgenitals# /n modern clinical practice, Taichong G/M 3 is also muchused for emotional and psychological manifestations of =i stagnationsuch as depression, frustration, pent up feelings, irritability etc# /t isstri!ing howe)er, that these indications are almost entirely absentfrom classical sources#� ;eiguan P 2 &ince this point belongs to the hand 8ueyin channelwhich meets with its paired foot 8ueyin Gi)er channel at Fimen G/M1*, it is especially suited to regulate and unbind stagnation of =i ofthe upper 8iao, manifesting as oppression and tightness of the chest#

Due to the pathway of the Pericardium channel through the three 8iao, it is also effecti)e in the treatment of disorders of the middleand lower 8iao, and was classically indicated for deficiency and cold of the &pleen and &tomach, nausea and )omiting, abdominal pain anddiarrhoea# The Pericardium is the 'wrapping' of the Heart whichstores the shen, and the Pericardium longditudinal luo connectingchannel lin!s ;eiguan P directly with the Heart# ;eiguan P istherefore able to regulate the Heart Eang and calm the shen and isindicated for insomnia, mania, poor memory, sadness, fear, panic andapprehension#� Canshu G 1 2 as the bac! shu point of the Gi)er Eang, Canshu

G 1 is able to regulate most Gi)er functions# /n the conte.t of P%&,it is able to spread and deobstruct the Gi)er =i, calm anger and manicfeelings, nourish Gi)er blood and yin, and nourish and rela. thetendons in the nec!, shoulders and whole body#� &anyin8iao &P 2 this point is able to harmonise the &pleen $bothtonifying its =i deficiency and resol)ing dampness , soften the Gi)er$both spreading the Gi)er =i and nourishing Gi)er blood , benefit the

idneys, and treat insomnia# /t is of course additionally one of theforemost acupuncture points to regulate menstruation itself#� Iulin=i C *12 Iulin=i C *1 is one of the main acupuncture

points to spread the Gi)er =i, especially when =i stagnation manifestsalong the course of the Call ladder channel gi)ing rise to distention,pressure and pain in the chest, head, eyes, breast and flan!s# /t isspecifically indicated for such symptoms as fullness of the chest,inability to ta!e a satisfactory breath, headache, diEEiness,distention, menstrual irregularity, and pain, lumps and phlegmnodules in the breast#


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ccording to symptoms� Depression and weeping2 Tongli H@ -, &henmen H@ +, Jinshu G1-, Tianfu GL 3� /rritability2 FuEe P 3� reast pain2 &hanEhong :@; 1+, :ugen &T 1 , Fimen G/M 1*,Giang=iu &T 3*, ian8ing C "1� Headache2 according to location, probably shaoyang channelhence Taiyang [email protected] , &huaigu C , >aiguan & -, Bangfu C 3� &tiff nec!2 engchi C "0, ian8ing C "1, JuanEhong C 39� Gower abdominal distention2 Fihai :@;� /rregular menstruation2 Daimai C " , Juehai &P 10, Gigou G/M -Dream disturbed sleep, insomnia2 &henmen H@ +, Gidui &T *-, Binbai&P 1, Jinshu G 1-, >angu C 1"�


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constipation#

3# Gi)er =i stagnation complicated by idney yin .u

/n addition to the points listed for Gi)er =i stagnation2� Tai.i /D 3 and &henshu G "32 as the shu stream4yuan sourceand bac! shu points of the idneys respecti)ely, these are the twoprincipal points to tonify all deficiency patterns of the idneys#� /n case of hot flushes and night sweats, add :angu /D ", uliu

/D + and Bin.i H@ #*# Gi)er and &tomach stagnant fire/n addition to the general points listed for Gi)er =i stagnation, thepoints gi)en abo)e for breast distention and pain should be used#@specially important are2� Giang=iu &T 3*2 as the .i cleft point of the &tomach channel which

go)erns the breast, this point is indicated for all acute and se)erebreast disorders#� Daling P +2 as stated abo)e, the Pericardium 8ueyin channel has aclose relationship with the Gi)er 8ueyin channel, as well as with the&tomach channel $the Pericardium primary channel passes throughthe middle 8iao # /n addition to treating breast pain and abscess, thisheat clearing point is indicated for insomnia, restlessness, an.ietywith a hungry sensation, weeping, fullness of the chest, chest andflan! pain, sighing and foul breath#

-# Gi)er =i stagnation accompanied by blood .u

/n addition to the points listed for Gi)er =i stagnation2� Ceshu G 1+2 as the hui meeting point for blood, this is animportant point to treat all blood disharmony, including blooddeficiency#� Iusanli &T 3 2 (The &tomach is the sea of =i and blood (3 # s thehe sea point of the &tomach channel, this is the most important pointon the channel to tonify both blood and =i#� Pishu G "02 s the bac! shu point of the &pleen Eang, where the=i of the &pleen emanates from the interior to the body surface, this

point has a strong action on regulating and tonifying the &pleen, andthus promoting blood formation#

# Heart and Gi)er fire stagnation, phlegm obscures the clear orifices

/n addition to the points listed for Gi)er =i stagnation and Gi)er fire2� englong &T *02 (The &pleen is the origin of phlegm(3+# ccording


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to the theory of the luo connecting points, englong &T *0 is able totreat disorders of the &pleen and is the primary acupuncture point totreat phlegm disorders# /t is indicated for copious phlegm, fullness,oppression and pain of the chest, plumstone throat, wind phlegmheadache, mania depression disorder, mad laughter, li!es to ascendto high places and sing, li!es to undress and wal! around,restlessness, sees ghosts, indolence and epilepsy#� ianshi P -2 along with englong &T *0, this is the most importantpoint to treat phlegm disorders and is indicated for such symptomsas sudden palpitations, oppression of the chest, apprehension,susceptibility to fright, epilepsy, sudden mania, manic ra)ing,agitation and restlessness, absent mindedness, poor memory andplumstone throat#� Gaogong P 2 see abo)e#� :enEhong DL " 2 the Du %ai both enters the brain and connects

$)ia its anterior pathway with the Heart# :enEhong DL " is animportant point in the treatment of mania depression disorder, and isindicated in classical te.ts for une.pected laughter and crying# Theimportance of :enEhong DL " in the treatment of mania disorder isreflected in its categorisation as one of the thirteen 'ghost' or 'de)il'points of &un &i %iao for the treatment of mania disorder andepilepsy# ccording to The 5de to Jihong (the ability of :enEhongDL " to treat mania disorder is supremeA the thirteen de)il pointsmust not be o)erloo!ed(#

+# &pleen dampness due to &pleen .u and Gi)er suppression

/n addition to the points listed for Gi)er =i stagnation2� Ihangmen G/M 132 as the front mu point of the &pleen, located onthe Gi)er channel, this is an essential point to harmonise Gi)er &pleendisharmony, especially when it affects the middle and lower 8iao#� Binling=uan &P 92 (Binling=uan &P 9 opens and mo)es the waterpassages(3 # Binling=uan &P 9 is the foremost point on the &pleenchannel for transforming and draining shi dampness#� Iusanli &T 3 2 see abo)e#� Pishu G "02 see abo)e#

� englong &T *02 see abo)e#/n case of complication by idney yang .u2� uliu /D +2 this is an important point in the treatment of any !indof oedema, especially when due to idney deficiency#� ingmen C "-2 the front mu point of the idneys and indicatedfor both chronic oedema and diarrhoea due to deficiency of both&pleen and idneys#


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# Gi)er channel damp heat/n addition to points for Gi)er =i stagnation and Gi)er fire2� Fu=uan G/M 2 as the he sea and water point of the Gi)er channel,Fu=uan G/M has a strong action on draining damp heat from thelower 8iao#� Ihong8i :@; 32 as the front mu point of the ladder and ameeting point of the :en %ai with the &pleen, Gi)er and idneychannels, Ihong8i :@; 3 is able to drain damp heat from the wholelower 8iao, especially in the treatment of leucorrhoea and urinarydisorders#� Tianshu &T "-2 the front mu point of the Garge /ntestine bothtreats diarrhoea due to dampness or damp heat and regulates theuterus#� Daimai C " 2 this point , located on the Dai %ai girdle channelwhich binds the :en, eiEhong G *02 these are two of the fewacupuncture points traditionally indicated for s!in disorders#� Bu8i GL 102 the ying spring and fire point of the Gung channel, toclear heat from both the Gung Eang and channel#10# lood .u $Heart and &pleen� &anyin8iao &P 2 see abo)e#� Iusanli &T 3 2 see abo)e#� ;eiguan P 2 see abo)e#� &henmen H@ +2 as the shu stream and yuan source point of theHeart channel, this is the ma8or Heart channel point to nourish Heartblood and stabilise the shen#� Jinshu G 1-2 the bac! shu point of the Heart Eang, to nourish the

Heart and shen#� Pishu G "02 see abo)e#

%anagement of P%&

full discussion of the management of P%& is beyond the scope ofthis article# There are many P%& self help groups which ad)ocate


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dietary changes, nutritional supplements, e.ercise etc#, and these allha)e their committed supporters# brief discussion of e.ercise anddiet is, howe)er, follows2

@.ercisePhysical mo)ement and e.ercise is one of the most effecti)e ways tocounter stagnation of Gi)er =i since it )igorously promotes =icirculation throughout the whole body# >hen stagnant =i isuna)ailable for use, there may be sub8ecti)e sensations that mimic =ideficiency, and the resultant lethargy may mean that there is a greatreluctance to e.ercise# /f e.ercise is ta!en, howe)er, and the =ibegins to flow, there will be much greater energy afterwards, agreater feeling of well being, and an impro)ement in many of theP%& symptoms39# Cenerally spea!ing, aerobic e.ercise is moreeffecti)e than e.ercise such as =igong, and


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&ources

1# The most thorough source on


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Gi!e many con8ectures about P%& this is not uni)ersally accepted#&ome argue that P%& in young women may be ascribed to difficultadolescent beha)iour, P%& in women o)er *0 may be ascribed to themenopause, and that many women in their "0's use thecontracepti)e pill which diminishes the symptoms of P%

+ 5' rien, Premenstrual &yndrome, $19 + , lac!well &cientificPublications#

&cambler, # and &cambler, C# $19 - (%enstrual symptoms,attitudes, and consulting beha)iour', &ocial &cience and %edicine "0210 - #

9 Gaws, $19 -a '%ale power and menstrual eti=uette', in H#

Thomas $ed# The &e.ual Politics of :eproduction, Gondon2 Cower#

10 Taylor, D# $19 :ed low2 :ethin!ing %enstruation, reedom,


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"1 Fuoted in ormulas and &trategies, by ens!y and arolet,@astland Press, p# "91#

"" /t sometimes seems that the ministerial fire entrusted to the Gi)erat puberty e.presses itself primarily through emotions in youngfemales, and through the genitals $which belong to the Gi)er inboys#

"3 Fuoted in Health Preser)ation and :ehabilitation, PublishingHouse of &hanghai


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characterised by a )ariety of possible symptoms such as agitation,restlessness, oppression of the chest, disturbed sleep, irritability, rashand impetuous beha)iour, abnormal speech, fre=uent yawning andstretching, disorientation, worry, grief, weeping, sighing and e)encon)ulsions without complete loss of consciousness# Cenerallyconsidered to be due to emotional frustration which impairs thesmooth flow of Gi)er =i or worry which in8ures Heart yin,accompanied by blood deficiency# Historically this condition was alsoassociated specifically with blood deficiency of the uterus, drawingparallels with the original >estern concept of hysteria which is howEang Eao is sometimes translated#

3- &piritual .is

Acupuncture Premenstrual

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