What are menstrual disorders? Menstrual disorders are conditions that occur around the time of menstruation, although the menstrual cycle and menstrual flow are basically normal. For example, menstrual asthma, menstrual migraine, menstrual skin rash, menstrual pneumothorax, menstrual rhinorrhea, menstrual angina, menstrual arthritis, etc. Possible mechanisms of menstrual disorders 1. increased secretion of endogenous prostaglandins (increased PGF2a); 2. decreased levels of progesterone and estrogen in the body; 3. dysmenorrhea; 4. changes in immune status before and during menstruation. Common menstrual disorders and their mechanisms Menstrual headache Some women feel headache during menstruation and also have more menstrual blood for several reasons: First, under the action of hormones, small blood vessels throughout the body dilate, while intracranial vasodilation can cause headache, while enlarged blood vessels in the reproductive system can also trigger an increase in menstrual blood. Second, the action of hormones may lead to mild intracranial edema, resulting in increased intracranial pressure and the resulting headaches. Oral administration of ergotamine caffeine, glutamate or Yuanhu pain relief tablets, and Jiawei prolotherapy pills can be effective. Others experience periodic migraines, a headache reaction that is due to a decrease in estradiol levels that occurs before menstruation and is also associated with an abnormal vascular response in women. Menstrual arthritis Some women may experience joint pain during menstruation, especially knee pain, which may be accompanied by mild swelling and deep pressure pain in the joints, aggravated by walking (especially going down stairs). Menstrual arthritis is most common in adolescent women. The occurrence of menstrual arthritis is closely related to the imbalance of water and electrolyte metabolism caused by changes in hormone levels in menstruating women, resulting in varying degrees of swelling due to water retention, most noticeable in the face, hands and feet. In the human knee joint, there is a triangular-shaped gap inside the patella, which is filled with fatty tissue called the “infrapatellar fat pad”. When water and sodium retention occurs, the subpatellar fat pad swells, causing pressure on local nerve endings and causing pain. However, as women age, the fat pad becomes thick and fibrotic after middle age and rubs against the surrounding bursa during activity, leading to bursitis. Menstrual rash Some women have small rice-like herpes with burning and itching sensation around the lips or nose, or polymorphic rashes such as papules, erythema, and blisters on the chest and back, or on the extremities, without any other cause around the menstrual cycle. The cause may be due to an allergic reaction caused by increased ovarian secretion of progesterone, so it is an allergic skin disease. Menstrual toothache Some adolescent girls can have toothache around the time of menstruation, but most of them have transient episodes. Some women also have symptoms such as gum congestion, redness and swelling, and spontaneous bleeding. This is mostly due to the increase of estrogen concentration in the body during menstruation, which stimulates the gingival hormone concentration and stimulates the special receptors in the gums, resulting in the expansion and enlargement of the blood vessels in the pulp and periodontal membrane, which in turn compresses the local nerve and triggers it. The swelling of the gums is usually relieved after menstruation and the toothache disappears. Menstrual asthma A small number of young women, due to weakness and menstrual disorders, often cause excessive excitation of the vagus nerve and secretion of acetylcholine when they have their menstrual flow, which leads to spasm of the bronchial smooth muscle, thus causing an asthma attack. Possible mechanisms of menstrual asthma: 1. Menstrual asthma is associated with increased excitability of the vagus nerve in patients. 2. Low levels of progesterone during menstruation lead to contraction of bronchial smooth muscle and progesterone leads to microvascular leakage, etc. 3, Prostaglandin F2α is significantly increased, and bronchial smooth muscle is strongly contracted, which induces asthma attack. 4.The increase of estrogen level in the body makes the balance of the body imbalanced, which induces asthma symptoms to attack or worsen during menstruation. Menstrual pneumothorax A few women can have sudden onset of chest tightness, shortness of breath, or even dyspnea and cyanosis of the lips when they have menstrual flow. It is characterized by the patient’s age between 24-40 years old; the chest lesion is mostly in the right side of the chest cavity; and the onset is often within 72 hours before menstruation to 72 hours after menstruation, and not during the non-menstrual period. Menstrual psychosis occurs mostly in adolescence and is usually preceded by insomnia, dizziness, excessive sweating, dry mouth, cold hands and feet, and poor appetite. Some adolescent girls have sudden onset of the disease, manifesting as disorder, feverish excitement, irritability and talkativeness, followed by crying, panic or dullness, fantasy, refusal to eat and drowsiness, the symptoms of which are similar to those of psychiatric patients and last about a week. The characteristics of menstrual cycle psychosis are: 1. Sudden onset 2 weeks before menstruation (during ovulation or luteal phase). 2. Rapid remission at the onset of menstruation or at the end of menstruation. 3. The condition is not limited to mood swings and can present with psychotic symptoms, especially hallucinations. The symptoms may include markedly uncoordinated motor excitement and, in a few cases, motor inhibition; behavioral disturbances with mild impairment of consciousness; intermittent hallucinations, delusions, and disorganized speech; and markedly elevated or depressed emotions. Menstrual angina Some women have episodes of angina due to changes in their menstrual cycle. A typical case of this type was described in the Journal of the American Medical Association: a middle-aged woman had been suffering from angina for 5 years, but despite various tests, the diagnosis was not clear until she reviewed her medical history after a violent attack and realized that almost every attack of angina occurred 2-3 days before her menstrual cycle, and was followed up by her doctor, resulting in a diagnosis of ” Menstrual-related angina” was diagnosed. Menstrual gastroparesis is a condition that occurs during menstruation, mostly due to endometriosis. The endometriosis is caused by excessive retroflexion of the uterus, vaginal atresia, narrow cervical opening, multiple abortions, and sexual intercourse during menstruation, causing the endometrium to “escape” through the fallopian tubes to the ovaries, stomach mucosa, and nasal mucosa, resulting in stomach pain and nosebleeds. Endometriosis can be treated with medication or surgery. However, prevention is more important. You should minimize abortion, do not have intercourse during menstruation, do not take a tub bath, do not swim, do not do pelvic examinations, and forbid various tubal patency tests before menstruation. Acupuncture therapy for menstrual disorders is used to regulate the nerves that govern the internal genitalia to promote the internal secretion of relevant hormones, thus reducing or even eliminating the symptoms. Therefore, acupuncture points can be considered mainly in the lumbosacral region, and lower abdominal points. This is also well justified from a TCM perspective. According to TCM, menstruation is primarily related to the main reproductive function of the kidneys, and therefore, acupuncture points related to the kidneys should be considered. The lower abdomen is right where the uterus is located, where the qi of yuan yin and yuan yang occurs; therefore, lower abdominal acupuncture points, vocation Guan Yuan, Qi Hai, and Qi points – the uterus are considered. Secondly, the lumbosacral region is innervated by the sacral plexus, from which the innervation of the genitourinary system mainly originates, and the sacral medulla is one of the centers of the parasympathetic nerves; therefore, the lumbar bone points are also important, such as Kidney Yu, Life Gate, Guan Yuan Yu, and Qi Hai Yu, all of which are very important. Secondly, the relevant acupuncture points can be combined appropriately according to the specific symptoms. It is best to treat with electroacupuncture or use acupuncture point buried thread.