Chinese Medicine Approach to Uterine Fibroids
Susan's Story
Susan, an attractive 47 year-old hair-dresser, first came to the TCM Health Center in January 1998. She had been diagnosed with uterine fibroids about seven months previously. By the time of her six-month follow-up with her gynecologist, the tumor had grown so big she could not button her pants, or zip up her skirt. She looked like a five- months-pregnant woman. Her gynecologist suggested an immediate hysterectomy. Susan resisted this, because she felt that losing her uterus would be a traumatic experience for her, and she wanted to explore other possibilities. She saw my article, "Endometriosis: A Natural Option," in a newspaper, and came to my clinic. At that point, her hemoglobin was 9.6. She suffered from heavy uterine bleeding, which could be triggered by coughing, squatting, bending over, even walking. She was also exhausted and depressed from loss of blood and constant worry about her condition. After three months of weekly acupuncture treatments and Chinese herbal medicine, she felt her tummy getting smaller and smaller. She could fit into all her favorite clothes again, and the bleeding had totally stopped. I sent her back to her gynecologist to do a follow-up. She did not tell her doctor about the treatment she had from me. She was told the tumor was 50% smaller than it had been three months before. Her doctor was surprised, and asked her what she had done. When Susan told her about her experience with acupuncture, the doctor was very happy to hear about it. The doctor herself had received acupuncture for a sinus problem, and said, "It worked very well for my sinus, but I didn't know it would also be so effective for fibroid tumor." Currently, we are continuing to do treatments in order to shrink the tumor further.
After a few treatments, Susan asked me if her condition could be associated with emotional stress. Before her tumor was diagnosed, there had been a lot of stress at work, and anger with her family. A traditional Chinese medicine diagnosis and treatment can give a clear answer to this question.
Uterine Fibroids in Conventional Medicine
Uterine fibroids are benign tumors composed of smooth uterine muscle and connective tissue. The uterus is the most common site for muscle tumors to occur. Conventional Western medicine believes that estrogen can trigger fibroids and make the fibroids grow more quickly. Estrogen triggers the myometrium (the smooth muscle coat of the uterus) to grow and thicken, which is where the fibroids are located. Depending on the location, fibroids are classified into "intramural fibroids" (located in the innermost layer of the uterus), "subserous fibroids" (protruding into the abdominal cavity), "submucous fibroids" (invading the endometrium) and "parasitic fibroids" (those which have migrated out of the uterus).
Statistics indicate that uterine fibroids develop most commonly in women who are in their 30s and 40s. About 30% of all women will develop fibroids by the time they reach 35. If the fibroids are surgically removed, there is a 10% chance they will grow back. This might be the reason that hysterectomies are so widely favored by doctors to treat uterine fibroids. Actually, uterine fibroids are the most common reason for hysterectomies in the United States. About 30% of all the hysterectomies performed in this country are for uterine fibroids. Some complications of hysterectomy include hemorrhaging, eventual ovarian failure, loss of bladder function, urinary incontinence, depression, and infections. Some studies estimate that up to 70% of all hysterectomies performed in this country are either unnecessary or can be avoided by using alternative approaches. Traditional Chinese medicine therapy for uterine fibroid tumors, using acupuncture and herbal medicine, is the oldest known form of medicine which is still in wide use today.
Patterns of Uterine Fibroids in Chinese Medicine
The traditional Chinese medicine category which includes uterine fibroid tumors is "Zheng Xia." Zheng Xia is defined as "masses in the uterus with a feeling of pain, swelling, or fullness, and with bleeding in severe cases." The Yellow Emperor's Classic of Medicine recorded this disease in the third century BCE. All traditional Chinese medicine gynecology books address this condition in great detail as it has been treated by various schools of medicine over the last two thousand years. Three patterns of uterine fibroids are differentiated in traditional Chinese medicine. Each pattern is differentiated in terms of specific qualities of the menstrual period, abdominal sensations, changes in breast tissue, appearance of the tongue, and qualities of the pulse. The leading herbs and herbal formulas used to treat each pattern are listed.
Chi Stagnation and Blood Stasis. Emotional stress or physical trauma are the most common causes of Chi stagnation. Blood stasis can be caused by abnormally heavy bleeding with menses, blood loss during and after childbirth, or an "improper" sex life (excessive sexual activity, or having sex while menstruating). Symptoms include: regular cycles with heavy bleeding, or scanty but long-lasting bleeding; breast distention; abdominal swelling or pain; a pulling sensation in the anus; a dark-red tongue body with purple dots; and a soggy-thin, deep-wiry, or thin-choppy pulse. The fibroid tumors are felt as masses that are either fixed (not moving), or moveable on palpation. Susan falls into this pattern. Cnidium (Chuan Qiong), angelica (Dang Gui), red peony root (Chi Shao), and corydalis (Yan Hu Suo) are important herbs for this pattern, and BlockagEASE (Shao Fu Zhu Yu Tang) is the leading formula used to address this combined pattern.
Yin Deficiency and Empty-Fire Blazing. Deficiency of Kidney energy or chronic illness is the origin of this pattern. It is an advanced stage of Yin Deficiency. Symptoms include: early periods with heavy or scanty, long-lasting bleeding; a hot sensation in the chest or abdomen; a sensation of itching in the breast, or a feeling of sharp or distending pain in the breast; blood-streaked white discharge or yellow-white vaginal discharge after periods; a red tongue, dry or with a yellow coating; and a wiry-thin or thin-rapid pulse. Anemarrhena (Zhi Mu), and phellodendron (Huang Bai) are the leading herbs used to address this pattern. Water Fire Balance (Zhi Bai Di Huang Wan) is a widely-used herbal formula in China.
Liver Chi Stagnation and Spleen Deficiency. Deficiency of Spleen energy is the origin of this pattern. Symptoms include: regular or late periods with heavy bleeding; a pulling sensation of the lower abdomen; loose bowels; thin vaginal discharge after periods; a pale tongue or thin-white tongue coating; and a soggy-thin or thin-wiry pulse. The fibroid tumor is a soft mass. Buplerum (Chai Hu), and peony (Bai Shao) are widely- used herbs, and Liver Spleen Harmonizer (Xiao Yao San) is a leading formula to address this pattern.
