This is my final post in this series on dysmenorrhea though I reserve the right to write more about it later!
In this post I want to share a concept that has been important to me in my clinical practice.
The MOST important idea I want to convey to practitioners is to forget that your patient has dysmenorrhea! Yes, I mean it. Ignore the dysmenorrhea especially if it is the main complaint! The biggest block to effective treatment is our desire to treat diseases. How do we treat gout, hypertension, infertility, dysmenorrhea….etc. We don’t!
The most important key to successful treatment is to treat people that suffer from illness as opposed to treating illness.
When we try to treat dysmenorrhea, we risk becoming myopic, looking for herbs and formulas for dysmenorrhea. It is vital to ask, “how would I treat this person if I didn’t know they had dysmenorrhea”? This will help us see what type of person this is that has dysmenorrhea. It will also help us see the dysmenorrhea in the context of the whole Qi dynamic. For example: Are they also constipated or do they have diarrhea? Do they have respiratory issues? A woman who suffers from chronic constipation will not respond to a stopping pain formula for her womb as long as the large intestine stays stagnant. The descending and disseminating function of the Lungs is very much related to the easy descending function of the womb. Recently I successfully treated a woman for dysmenorrhea/infertility with modified Ban Xia Xie Xin Tang because the root of the stasis in her body in general stemmed from a block in the epigastric area that prevented the normal ascending and descending Qi mechanism function in her body. This kind of block also prevents the normal absorption of nutrients and diminishes the production of healthy blood.
Another way of saying this is to look at what is going on in the patient both constitutionally, energetically and symptomatically and to then ask how what is going on helps explain the dysmenorrhea. This is a bit different than what most of us were taught – which is to focus on the dysmenorrhea and try to differentiate the syndrome. So, my advice and my practice is to start with the whole patient and explain the dysmenorrhea from there. So we forget the dysmenorrhea or the hypertension or the diabetes or the insomnia to start with and then, after we have a clear view of the whole person and the dynamic of disharmony, we add it back in to the mix. I treat the whole dynamic with the main complaint of dysmenorrhea taken into account.
Of course, what I am suggesting here takes a bit more work than simply looking up dysmenorrhea formulas and seeing which one matches the best. This involves understanding body types and integrating all the information from an intake. It also involves a deep understanding of physiology and the nature of the entire Qi mechanism. When we work this way, we can take information like that in the previous posts and integrate it into a more comprehensive approach. Without this your results will always remain mediocre.
This approach is also what is taught in the White Pine Institute Graduate Mentorship Program. Most of us were not taught how to take the information we gather from patients and process it into a clear diagnosis that integrates the whole picture. In this program we learn to do this step by step. We then go on to apply our diagnostic skill to the problems our patients bring into our clinics and to an understanding of classic and experiential formulas and herbs.