A very active, and otherwise healthy 17 year-old student reported that she had not had a period for 5 ½ years. She stopped menstruating just 6 months after her first period at 12 years old. Reluctant to go on birth control pills simply to regulate her cycle, she decided to try acupuncture and herbs.
Evaluation, clinical reasoning & treatment strategizing
The patient was a high school senior who earned top grades and had recently been offered an athletic scholarship to a top college. It was clear she had been under a lot of academic pressure for a prolonged period of time. Although she ate a healthy diet, she did complain of fatigue, frequent abdominal distention and a tendency towards loose stools.
Her symptoms were consistent with qi stagnation and blood deficiency, so the treatment plan was to use acupuncture to move the qi and herbal medicine to build blood.
The Traditional Chinese Medicine (TCM) concept of “blood”, especially menstrual blood, is that of a fluid which is built from combination of food qi, constitutional essence (what you were born with), plus Heart & Kidney qi. Females undergo a complex process of making, storing and moving the blood in order to get their period every month.
The core problem for this case was that the patient was not putting enough food in her body to make blood. Although she ate healthy food, she was burning nutrients off too fast with her physical activity (also the reason why a lot of marathon runners stop menstruating). The prolonged academic stress then impeded her ability to store and move any menstrual blood she could have made.
Weekly acupuncture treatments focused on ‘Tonifying the Middle’ (TCM language for stabilizing the digestive processes), as well as moving blood. Nutritional counseling focused on adding blood-building foods to her diet like beets, black beans, eggs, red meat, and green leafy vegetables. Food is considered the first line of defense in Chinese herbal medicine. Its energetic and thermal properties are used as folk remedies to treat many conditions ranging from digestive issues to hypertension. The patient was prescribed Chinese herbs twice a day.
Outcomes and follow-up
The almost immediate response to acupuncture and TCM was improved digestion. After three treatments, she got her first period after 5½ years. She kept up weekly acupuncture and Chinese herbs for three months. She continued to get her period every month and her digestive symptoms fully resolved. Six months later, she no longer needs to take these herbs, and she comes in for maintenance & wellness acupuncture once a month. Her menstrual cycle remains regular and consistent.