Have you ever been to the doctor’s office and only spent five or ten minutes with your clinician? You go in to see the doctor with an array of concerns but they only ask a few questions, make a few suggestions, maybe prescribe medication, and then it’s over? You might leave feeling like it was a waste of time or not much was accomplished. Let’s be honest, you wouldn’t be the first person to experience this, and you won’t be the last.

This isn’t meant to discredit modern medical physicians. The system is built on insurance companies, and insurance companies don’t often cover long or in-depth appointments. It’s one of the many reasons Balanced Thistle doesn’t accept insurance. We work for you and we want to help you without anyone telling us how to do our jobs.

This brings us to the topic of today’s blog: Health intakes for a female patient. We work heavily in the field of women’s health at Balanced Thistle. What does that mean? Some of the most common concerns we deal with are those that present in the female population: painful menstruation (dysmenorrhea), missing cycles (amenorrhea), Polycystic Ovarian Syndrome (PCOS), endometriosis, fertility enhancement, and infertility, IVF or IUI support, prenatal and postpartum care, and menopause.

There are a couple of unusual aspects to seeing an acupuncturist for concerns such as this. One, we will still ask you about overall health. Meaning we’ll ask about stress, sleep, digestion, bowel movements, etc. In our medicine, all of these concerns are interconnected. The menstrual cycle (or lack thereof) is not an independent factor of health. In fact, the function of our hormones has a whole lot to do with the function of everything else!

But perhaps the more unnerving thing is the type of questions we ask. To be honest, we go very in-depth and a new patient is sometimes a bit surprised and often times can’t even answer our questions. They’ve never thought about if they sweat at night before or after their cycle. They’ve never noticed if they cramp before the bleed starts or after it has begun. No one has ever asked if they drink their beverages with ice or how many tampons they fill in a day. The idea that the color of the blood could indicate something isn’t common knowledge!

So we thought we’d touch on a few details of the menstrual cycle from a Chinese Medicine standpoint. It might help you understand why we ask the questions we ask.

Let’s start with painful periods because this is something MANY women experience and tend to be under the impression that it’s totally normal.

Pain during menstruation, from a Chinese medicine point of view, can be caused by a stagnation of qi, stasis of blood, damp-heat, cold, deficiency of qi or blood, and a few others. These are not phrases you’ll hear at a typical doctor’s office! But let’s look a little deeper.

Say for example a patient is experiencing a cold in the uterus. Think about how water flows and if it’s cold, it freezes. Now if you apply that to the menses, a healthy period would flow, but if there is too much ice, it might not. The blood gets “stuck” if you will and the result can be discomfort. Your body trying to push out the ice = pain. This is why we ask questions like do you drink icy beverages? Warm beverages would melt that ice and soothe the pain. This is why we ask questions like do you run warm or cold? If you tend towards chilliness, you might have cold stagnating your menstruation.

Qi and blood are a little more complex to grasp because qi isn’t a term many of us know well. Qi can be described as the energy or communication within the body. Blood is a more literal translation. In our theory, qi, or energy, carries blood throughout the body. Therefore if it gets stuck, blood doesn’t flow. If it doesn’t flow, we might get pain.

Below are a handful of intake questions your acupuncturist might ask! Yes, they aren’t typical of western medicine OB/Gyns.

Pain BEFORE or AFTER your cycle? This tells us if we have an excess condition (before) or deficiency (after).

Is pain relieved with warmth or cold? This tells us if your uterus is too cold or too hot.

What color is the menstrual flow? Purple, red, bright red, pink, even orange? This tells us how things are, or are not, flowing.

Do you pass any clots? How large are they? This tells us how stuck energy and blood are.

Do you experience cramps in the lower abdomen and/or lower back? This tells us excess or deficiency.

Do you sweat at night? Before, during, or after blood flow? This tells us excess or deficiency.

Do you have any unusual discharge or smell? This tells us if there is some kind of infection.

Any burning sensation? This tells us LOTS.

How much do you bleed? We might actually ask how many pads or tampons you use per day. This tells us if you have heat or cold.

How many days do you bleed? We will likely track your full cycle from period to period. So much hormone information can be gathered from this.

Is the pain better or worse with pressure applied? This tells us excess or deficiency.

How is your libido? This tells us excess or deficiency.

What is your stool like while on your cycle? How is your energy level? Excess or deficiency?

We could go on. But in summary, we ask a lot of questions, and there is in fact a reason behind it. Sometimes it takes a few cycles to get used to the questions and to be fully prepared to pay a little closer attention.

For more details about painful menstruation check out Samantha’s blog post: Painful Menstruation

And if you want to see a boatload of studies on acupuncture and menstruation, check out Google Scholar (it’s free!)

If you choose to try acupuncture and Chinese Medicine to help with female health issues, don’t be put off by the depth of our questions and the length of our intake. Every little detail is a clue and we are some serious detectives!

Blog is written by Dr. Meghan Gray, DACM, MSHNFM, L.Ac.