CHAPTER 13 Gynecological problems
Tui na treatment of gynecological problems has two main areas of focus:
1. Treating the presenting disharmony such as stagnation or Cold in the Uterus
2. Releasing and clearing congestion, accumulation and knotted or hyper-tense fascia
There are several key factors involved in creating a woman’s fertility and healthy menstrual cycle:
• The smooth and harmonious movement of Qi and Blood through the Chong Mai, Ren Mai and Uterus
• The strength and balance of Kidney-Yin and Kidney-Yang
Abdominal release work
Applying the abdominal release work described on pages 151–152 is, in my experience, of great benefit in the treatment of gynecological problems. In addition to this, I have found the following methods to be effective for clearing stagnation in the Uterus, helping to balance the ebb and flow of Yin and Yang throughout the monthly cycle, for aiding ovulation and encouraging the correct alignment of the fallopian tubes and ovaries:
• Kneading–grasping compound technique applied to the lower abdomen using both hands, with your fingers to one side of the uterus and your thumbs at the other. Work deeply into tight and congested areas.
• With your patient lying with her knees up, apply An fa in a rocking, wave-like motion similar to the cat’s paw technique, using the ulnar edge of your hand horizontally across Ren2 and ST30. Rock from one side to the other about 100 times.
• With your patient lying supine again, apply palm Rou fa to Ren4 for a minimum of 5 minutes.
• Apply warming palm to the abdomen with your attention at the level of the Uterus. Work with Sun Qi if there is Yang Xu or Cold, and Moon Qi if there is Blood or Yin Deficiency.
General tips for treating gynecological problems
• In the second half of the cycle, work more dynamically, focusing on moving and invigorating Qi and Blood, dispersing stasis, and clearing and dredging pathogenic factors.
• In the first half of the cycle, work more gently with a Yin approach, focusing on nourishing and tonifying Deficiency.
• In the case of menorrhagia, local abdominal work and release work should only be performed in the postmenstrual week.
• Work on the patient’s back, hips and sacrum first, stimulating relevant points, areas and channels according to your diagnosis. Stimulation of the 8 liao points from BL31 to BL34, and generally the area of the sacrum, ilium, iliopsoas and gluteus, with Rou fa, Gun fa and Ya fa is very effective for moving stagnation and warming the Uterus.
• Work distally on appropriate channels and points.
• Work on the chest and ribs if the patient has signs of Qi stagnating in the chest or has emotional symptoms such as depression and irritability or insomnia.
• Apply local abdominal work after you have worked on the back, distally and on the chest.
• Use the abdominal release work if there are areas of knotting, congestion and adhesion or stagnation and accumulation of pathogenic factors.
• Work on the face and head to finish if the patient has emotional symptoms, headaches or insomnia.
To help you plan a Tui na treatment for gynecological problems, see Table 13.1 for some suggestions of techniques to consider including in the treatment of common patterns of disharmony. In all cases the foundation area routine for the abdomen can be used as an outline for the local work, with the addition of any abdominal release work and techniques and methods relevant to the presenting disharmony.
Table 13.1 Suggestions for the treatment of gynecological problems
