Primary Dysmenorrhoea

Primary dysmenorrhoea is caused by uterine contractions which are too strong and occur too frequently. Between the contractions, the uterine muscle does not relax properly, and there is an abnormally high ‘resting tone’. The overall effect is a reduction in the amount of blood flowing through the uterine muscle (ischaemia) which causes the pain known as primary dysmenorrhoea. The most usual cause of primary dysmenorrhoea is an imbalance in the prostaglandins levels. Prostaglandins are complex hormone-like substances found in most body tissues. There are many different types of prostaglandins which control bodily functions by working together as an integrated team. When the different types of prostaglandins are present in normal ratios, menstruation proceeds normally. An imbalance in the ratios in favour of the type of prostaglandins which increase muscle spasm will cause period pain. Their role in menstruation is complex and is discussed in ‘Prostaglandins’. The uterine tonics The uterine tonics, Aletris farinosa, Caulophyllum thalictroides, Angelica sinensis and Rubus idaeus, are used to treat pain because they are believed to regulate the muscular activity of the uterus and help initiate contractions which are Read more [...]

Herbs for functional menorrhagia

Herbs for functional menorrhagia are chosen from the following categories. • Herbs which affect uterine tone and regulate uterine bleeding: the uterine anti-haemorrhagics, uterine tonics and emmenogogues. • Herbs which have diverse ‘systemic’ effects, and which improve the overall vitality or constitutional state of the woman: the female tonic herbs and the Liver herbs which reduce bleeding by clearing Heat and (often) aiding oestrogen clearance. Uterine anti-haemorrhagics Herbalists refer to anti-haemorrhagics as being Drying — in fact one of the ways to tell if a herb has an astringent effect is to see whether it has the typical drying and puckering sensation in the mouth. This ‘astringent’ effect is caused by tannins, but tannins are not responsible for the effects on the uterus because they are not absorbed from the gut. The uterine anti-haemorrhagics usually contain the tannins characteristic of most herbal astringents, in addition to other (non-tannin) constituents, primarily flavonoids and saponins which regulate bleeding. Some of these effects are quite complex, and not all of them are understood. They are discussed in greater detail in the section on uterine anti-haemorrhagics herbs in site. Uterine Read more [...]

White Deadnettle: Modern Use

Modern texts, if the herb appears in them at all, mainly limit themselves to white deadnettle, but vary quite widely in their range of applications. Chevallier cites Gerard on lifting the spirits but restricts his internal uses mainly to women’s complaints. It is, he says, astringent and demulcent, used as a uterine tonic, to stop intermenstrual bleeding and menorrhagia; traditionally for vaginal discharge; sometimes taken to relieve painful periods. It can be taken against diarrhoea and externally used for varicose veins and haemorrhages. Wood cites Hill, Weiss and a 19th century UK herbalist who records the familiar traditional uses of helping the spleen, whites, flooding, nose bleeds, spitting blood, haemorrhages, green wounds, bruises and burns. The source of some of his specific indications ― cough, bronchitis, pleurisy, inflamed prostate, anaemia -is unclear, given his text. Menzies-Trull covers a broad range of uses, although there is no specific discussion of them. Bartram too gives a broad sweep, designating the flowering tops haemostatic, astringent, diuretic, expectorant, anti-inflammatory, vulnerary, antispasmodic and menstrual regulator, with uses including heavy and painful menstrual bleeding, cystitis, Read more [...]

Botanical Treatment Of Chronic Pelvic Pain

Effective botanical treatment of chronic pelvic pain requires a clear understanding of possible etiologies and the appropriate treatment of the underlying cause of the pain. For patients with diagnosed gynecologic conditions associated with pelvic pain, readers are referred to the relevant chapters in this textbook, such as, dysmenorrhea, interstitial cystitis, uterine fibroids, endometriosis, and so forth. Treatments discussed in the following may be used as adjunct palliative therapies for pain, inflammation, and concomitant symptoms in these conditions. In the absence of a clearly identified pathology, the practitioner can approach treatment symptomatically via specific botanical treatments for pain reduction, and attempt to address mechanisms that may be associated with CPP, for example, inflammation. One theory of chronic pelvic pain that was popular among physicians in the early-and mid-twentieth century, and that is still considered a possibility, is that of pelvic congestion syndrome. Women with this syndrome, which is poorly defined, are thought to exhibit many of the symptoms associated with CPP, including aching and dragging sensations in the lower back, lower abdomen, and pelvis, dysmenorrhea, and dyspareunia. Read more [...]

Botanical Treatment Of Chronic Pelvic Pain: Marijuana

One herb, not available widely (or at least, legally available) for clinical use that has clinically demonstrated significant uterine antispasmodic and analgesic effects is Cannabis indica, more commonly referred to as marijuana. This controversial medicinal plant and recrea-tionally used herb has a long history of use for relief of uterine spasms and dysmenorrhea, considered by the Eclectics to be a “soothing uterine tonic.” In fact, its use is ancient, with references and artifacts of its use found widely in Middle Eastern, Ayurvedic, and Semitic writings, continuing through to its medical use in Europe well into the late nineteenth century for the treatment of a variety of gynecologic and obstetric conditions, not limited to but including dysmenorrhea. A pharmaceutical product from the late nineteenth century, Dysmenine Compound, produced by the Keysall Pharmical Company, Kansas City, MO, contained Cannabis, Cypripedium, Scutellaria, Pulsatilla, Viburnum prunifolium, Caulophyllum, Viburnum opulus, and Capsicum. The compound was indicated for dysmenorrhea, menstrual colic, and cramps. Indeed, this formula is not very different from one that might be prescribed by herbalists today (see sample formulae in the following); Read more [...]

Botanical Treatment Of Chronic Pelvic Pain: Anti-inflammatories

Dong Quai Dong quai possesses antispasmodic, analgesic, anti-inflammatory antioxidant, uterine tonic, as well as specific immunomodulatory effects (see Plant Profiles). Immunostimulatory and anti-inflammatory effects have been attributed to isolated ferulic acid. It has been used traditionally in Chinese medicine for the treatment of “blood vacuity” and “blood stasis,” which may be considered related tochronic pelvic pain. Evening Primrose Oil It is thought that the use of evening primrose oil (evening primrose oil), with its high gamma linoleic acid content, may preferentially promote the synthesis of anti-inflammatory prostaglandin series over inflammatory prostaglandins. One critical review of the effects of evening primrose oil for the treatment of PMS concluded that there was no benefit. However, in a study of women (n = 40) who experienced symptoms of irritable bowel syndrome (IBS) just prior to and at the onset of menstruation, 53% reported an improvement in symptoms, whereas no improvement was seen in the placebo group. Improvement generally took 2 to 3 months to become apparent. Blood analysis at the beginning and end of treatment revealed significant improvement in fatty acid imbalances in the evening primrose Read more [...]

Uterine Tonics: Venotonics

Treatment of pelvic congestion syndrome incorporates a combination of therapeutic actions, including anti-inflammatory, uterine tonics, and herbs used as vascular tonics. Uterine tonics, which historically have included herbs such as blue cohosh, goldenseal, lady’s mantle, motherwort, partridge berry, red raspberry leaf, and cramp bark and black haw, are thought to exert their efforts by improving the overall tone of the uterine smooth musculature and vasculature. Goldenseal, for example, typically regarded for its antimicrobial effects, was used extensively by the Eclectics for the treatment of uterine bleeding resulting from a variety of conditions, including endometriosis, fibroids, and changes associated with menopause. Although no clinical studies have been conducted using whole herb, in vitro trials using berberine, one of the primary alkaloids in goldenseal, have demonstrated both uterine smooth muscles stimulant and inhibitory activity. Aqueous extracts of red raspberry leaf also have demonstrated both stimulatory and inhibitory effects on uterine smooth muscle. In fact, this paradoxic effect is seen with several of the herbs commonly used as both uterine tonics and spasmolytics, for example, cramp bark and Read more [...]

Pregnancy Care

Pregnancy Care And Prenatal Wellness The state of a woman’s health is indeed completely tied up with the culture in which she lives and her position in it, as well as in the way she lives her life as an individual. We cannot hope to reclaim our bodily wisdom and inherent ability to create health without first understanding the influence of our society on how we think and care for our bodies. — Dr. Christiane Northrup, obstetrician / gynecologist The past decades have tremendously improved the outcomes of high-risk pregnancies and birth, yet with these improvements have come the ubiquitous presence of technological intervention in nearly all aspects of normal childbearing as well. Yet, the safety and efficacy of the routine use of many interventions is not clear, with a striking lack of an evidence base for many. Nonetheless, the number and frequency of interventions has risen steadily since the 1950s. Since 2003, cesarean section has been the most common hospital surgical procedure performed in the United States, with 1.2 million of these major abdominal surgeries each year, accounting for more than 25% of all US births at a national cost $14.6 billion in total charges. In spite of spending more money and using Read more [...]

Botanical Treatment For Miscarriage

Botanical Treatment For Miscarriage: Threatened And Habitual This section provides botanical strategies for miscarriage prevention in the event of threatened miscarriage (Table Botanical Treatment Strategies for Miscarriage Prevention in the Event of Threatened Miscarriage and Habitual Abortion), and basic support for habitual abortion when resulting from progesterone insufficiency. If fetal demise has been confirmed by ultrasound, readers may follow the protocol in the example in the case history at the end of the chapter. When there is incomplete or missed abortion, special attention needs to be given to the risk of infection and subsequent coagulopathy. Women who miscarry are at some increased risk for post-miscarriage anxiety and depression. Emotional support during and after a miscarriage, as well as during a subsequent pregnancy, is often necessary. Botanical treatments for postpartum depression can be extrapolated for use when needed. Botanical Treatment Strategies for Miscarriage Prevention in the Event of Threatened Miscarriage and Habitual Abortion Therapeutic Goal Therapeutic Activity Botanical Name Common Name Relieve uterine contractions Uterine antispasmodic Viburnum opulus Cramp Read more [...]

Endometriosis

Endometriosis is one of the most common gynecologic problems in the United States and a leading gynecologic cause of both hospitalization and hysterectomy. Women with symptomatic endometriosis face chronic and sometimes debilitating pain; asymptomatic and symptomatic women alike may experience significant fertility problems due to this condition. The least-biased estimate for the overall prevalence of endometriosis in reproductive-age women is about 10%. Endometriosis is defined as the presence and growth of endometrial tissue in locations outside of the uterus. These cells may appear on the ovaries, fallopian tubes, bowel, bladder, peritoneal tissue, ligaments, or other structures in the abdominal cavity, and rarely may occur at other sites, including the nasal and respiratory passages leading to nosebleeds or pink frothy sputum at the time of the menses. Displaced endometrial tissue responds to cyclic hormonal changes, proliferating and shedding outside of the uterus. The bleeding is accompanied by inflammation caused by irritation of local tissue, such as, the peritoneum. Recurrent inflammation can cause scarring and adhesions that can cause pain and dysfunction of other affected sites. Endometriosis is common in Read more [...]