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Expert Advice-Treatment of Ovarian Cysts in Traditional Chinese Medicine(TCM):

Ovarian Cysts and Chinese Medicine

Kelly is a 39-year-old librarian. She had been experiencing lower abdominal discomfort with pain and a sense of fullness for about a year when she came to my clinic. An ultrasound procedure discovered nine cysts in her left ovary and four cysts in her right ovary. Her doctor suggested birth control pills, but the cysts did not respond to this standard therapy. Her next option was surgical removal of the cysts. It was at this point that she looked into alternative medicine and came to my clinic. After three months of acupuncture treatments, Chinese herbal medicine, and dietary changes, all the cysts were gone and her symptoms were under control. She now has follow-up treatments once a month.

Ovarian cysts are an extremely common gynecological problem. It is possible that a majority of women have cysts at some point in their lives and donít know it, because there are usually no clinical symptoms associated with ovarian cysts. Women who do experience symptoms complain of a dull ache in the abdomen, a sense of abdominal pressure or fullness, pain during intercourse, delayed, irregular, or painful menstrual periods, painless swelling of the lower abdomen, or abrupt onset of sharp pain in the lower abdomen.

From a Western point of view, ovarian cysts fall into three categories. Kellyís cysts were functional-type cysts (follicular cysts or corpus luteum cysts) which relate strongly to the menstrual cycle. Follicular cysts occur when the follicle that releases an egg during ovulation does not rupture properly to release the egg. The corpus luteum develops along with the egg, releasing pregnancy hormones if the egg is fertilized, and disappearing if the egg is not fertilized. Corpus luteum cysts occur when the corpus luteum persists abnormally after ovulation. Endometriomas are cysts which form from displaced endometrial tissue. Normally, endometrial tissue lines the walls of the uterus, but in the condition of endometriosis, pieces of tissue migrate to other places in the reproductive system, or even into the abdominal cavity. Wherever endometrial tissue lodges, it continues to respond to the menstrual hormones, enlarging and shrinking and producing blood. In the ovary, the thick, reddish-brown, blood-filled endometriomas are often called "chocolate cysts." The third type of ovarian cyst is a dermoid cyst. Dermoid cysts tend to be firm and self-contained, and are composed of tissue which is usually found in other parts of the body such as skin, hair, or teeth. Functional cysts respond very well to acupuncture and Chinese herbs. Endometrial cysts will generally respond to the Chinese medicine approach to endometriosis. Dermoid cysts need to be surgically removed if they are troublesome.

In traditional Chinese medicine, ovarian cysts are considered to be a product of three main pathological factors: phlegm, dampness, and blood stasis. Each of these factors takes time to develop. Phlegm and dampness are due to an imbalance of the Spleenís energy. The Spleen is responsible for transforming the food that we eat into energy (Chi) and blood. When the Spleenís own energy is deficient, it begins to lose its ability to produce sufficient amounts of Chi and blood. Over time, people with a pattern of Spleen Chi Deficiency do not receive proper nourishment from their food and become fatigued, with digestive problems and a tendency to gain weight and retain water. Excess dampness in the system gradually coalesces into phlegm, which can manifest as lumps and masses of various kinds, including ovarian cysts. Obviously, diet is the key to maintaining good Spleen health. Cold and raw foods and beverages are hard on the Spleen because it has to expend precious energy "cooking" these foods inside the body and bringing them up to body temperature. It is better to drink room-temperature or warm liquids, and to cook vegetables lightly before eating. The habitual over-consumption of greasy, fatty foods, sweets, and alcohol are very damaging to the Spleen and lead to many health problems besides ovarian cysts.

The third major pathological factor in the Chinese medicine interpretation of ovarian cysts is blood stasis. This means that blood is not flowing along its normal pathways easily and smoothly, and has in fact come to a standstill. A condition of blood stasis factors into many gynecological problems such as PMS and infertility, and is also the basis of many coronary problems. When Chi and/or blood slow down and begin to accumulate in an area, it is called Chi stagnation or blood stagnation. Stagnation always produces pain as a side effect. Blood stasis is an extreme form of blood stagnation which generally takes a while to develop, and which always begins with Chi stagnation. As the Spleen is the key organ in the development of dampness and phlegm, the Liver is the key organ in patterns of blood stasis. The Liver is responsible for "storing" blood and regulating menstruation, and it is also responsible for regulating the flow of emotion in our bodies. Anger is the principal emotion associated with the Liver. Unexpressed or inappropriately expressed anger is the primary cause of the Liver Chi Stagnation pattern that can lead ultimately to blood stasis.

Anne Marie is a good example of Liver Chi stagnation and blood stasis. She had a long history of ovarian cysts when I began to treat her. Gradually, we reduced and eliminated the cysts with acupuncture and herbs. Then, she was forced to go back to school and re-train extensively in order to keep her job three years ago. With the stress of this situation her ovarian cysts returned rapidly. I did intensive treatments including acupuncture and Chinese herbs for her. She is good now. She comes in regularly for reducing her stress level and preventing recurring. Although a blood stasis condition is slow to develop initially, once it is entrenched it can recur easily when it is triggered and aggravated by factors leading to Liver Chi Stagnation.