regulating cycle while on 3 month birth control

Hey Erin,
I think this is a time where you should just treat the patterns presenting. This will help balance the imbalances that the BCP can cause. The week before she comes off the pill you could quicken blood and course Qi, then when she bleeds use the phase theory to strongly quicken the blood, especially if there is Stasis.

We are not allowed to tell someone to stop western medications, but you could tell her what you would do if it were happening to you. If she stops the BCP, then treat however you feel.

Hey

I have been treating a similar type of patient. She is on the Birth Control Pill and only has several periods a year because of this. I have treated her for a variety of problems and though we have had success with her main complaints (digestive, sleep) I do not believe this has been an adequate treatment for her period pain. I would love for her to stop the pill for atleast 3-4 months to see what results we could get with herbs. Alas she has not so I continue to treat to her presenting pattern!

I attended a class given by Giovanni Maciocia last year and he believes that the BCP will override the herbs when it comes to the 4 phases. His sentiment was that if the patient is taking BCP everything changes and you cannot use the 4 phases. I agree with webdoktor with the treatment strategy of coursing Qi and invigorating the Blood premenstrually and during the period if her presentation lends itself to that. I would add that they she may benefit from herbs to nourish Blood and Yin after the period, again depending on her presentation. Outside of that I would treat according to her presenting patterns. She may have Phlegm accumulation in addition to Blood stasis.

Hello, Erin. Great to hear you’re out there!

Regarding your patient diagnosed with endometriosis, if you can treat her without her taking the BCP, that would be ideal. But if she must continue to take the pill because of the severity of the case, or because of her comfort level, you need to take into account how it affects the hormonal cascade in relation to the 4 phases. The pill overrides the body’s hormonal processes so ovulation cannot occur. Because the 4 phases are a reflection of these hormonal comings and goings, it would be safe to say that the pill overrides the 4 phases. So herbal treatments would need to be focused on her current state/pattern, and the factors created under the influence of the hormones, as she is taking them. At the end of the three months your treatment can focus on helping her have a comfortable breakthrough bleed.

I have found it interesting and illuminating to monitor a woman’s cycle using their basal body temperature when they are on the pill. In my experience the body temperature remains elevated, just like during the last two phases, for the whole cycle, except of course when she is menstruating in the first phase—while she is taking a placebo, or no pill at all. So, when the body is in a suspended phase 3 and 4, what is going on? In those phases normally the uterine lining is building and being maintained so as to house a fertilized egg if perchance conception were to occur. In TCM we know that yang qi is built up during phases 3 and 4. Qi, blood and body fluid are accumulating in the lower burner. Because of this, I would treat her pattern without the 4 phases in mind while she takes her BCP.

When treating a woman who is already on the pill, consider its effect on the body in your treatment protocol. The pill makes blood stasis by directly affecting the blood-clotting cascade. It consumes qi, blood and essence overriding the reproductive hormonal processes. The pill can lead to phlegm damp accumulation. Woman should be made appropriately aware of these side effects. You might want to ask her to take her basal body temp for her three-month cycle. This may give you greater insight into what is going on and how to support it.

I agree with Spence’s caution regarding advising a patient about her allopathic prescription medication. But in the case of the BCP, it is my opinion to avoid the pill and treat the condition for which the pill was prescribed. (I understand that some cases are very severe; sensitivity to each individual case is necessary). I view the BCP as a potentially dangerous medication with side effects users are rarely adequately informed about, and it should be used with caution in any case.

It is the beauty of websites like this that if you run into roadblocks or difficulties in your treatment (like we all do) there are a number of practitioners out here waiting to help and support you. I know some cases of endometriosis are very stubborn.

Good luck. Keep us updated.
Andrea

While this case is centred around the pill, it is a piece of a much bigger problem - one we all face a lot, perhaps my biggest ongoing challenge after 10 years of practice - the whole issue of treating a patient for a problem they are also medicating for at the same time. While we cannot ethically advise them to discontinue medication, I have become increasingly provocative with patients as I practice more and gain more experience. I do throw the question back at them and ask, 'well, what do you want me to do for you then?' It starts an interesting discussion. Because then they often ask, 'what can you do?'

Daniel Schulman
Charlottetown, PEI, Canada

Thanks for the feedback!

He asked for it. LOL And this is a long post but I hope that everyone will find it helpful and inspires more discussion.

Someone said that we cannot advise our patient to go off the Pill. This is true. However, we can advise/educate women about each treatment and how they differ. We can tell them about the side-effects and long term effects of each treatment. We can urge them to research the Rx they are on and even give them referals to journals, dependable websites etc as well as provide them with research about our treatments. Tell them to read all of it and make a well informed decision. I am sure it is more then just my own experience that the treatment of endometrial pain takes time and the patient may have to endure it for at least few cycles while we regulate. This should be something we advise them. Perhaps they can talk to thier MD about a medication they can take to help the cramps during the period, while we work with them off the Pill.

If the patient is using the Pill for Birth Control as well as pain management then it becomes our responsibilty to advise them about other birth control options and the effectiveness of such options as compared to the Pill. The last thing this world needs is more unwanted children or any more women feeling the only option they have is abortion, which is an emotionally painful and often traumatic experience. Perhaps the patient could be counseled to use a cycle based pregnancy avoidance method as taught in (http://www.amazon.com/Taking-Charge-Your-Fertility-Anniversary/dp/0060881909/ref=pd_bbs_sr_1?ie=UTF8&s=books&qid=1196972293&sr=8-1) , along with a barrier method during every act of penetration.

Although many doctors and even practitioners of TCM know that extremly painful periods are not natural, certinely menstrual suppression is even more unnatural. I am a menstrual awareness advocate with membership in The Red Web Foundation (http://www.redwebfoundation.org/12.html?&clear=1&PHPSESSID=6500efe7472cbfaaf80b432916c23123). I'd like to tell you who we are and why we are here. You can become a member or just sign up for our newsletters. You can meet us, e-mail us etc when you have questions or want to refer a patient to our books, websites, classes etc. After the intro I will list several interesting articles about the topic of menstrual suppression. Hopefully these articles will help you counsel your patients about the side-effects of such a treatment.

Who We Are: We are a non-profit 501(c)3 organization dedicated to supporting a positive societal view of girls' and women's bodies and menstrual cycles from first menstruation (called menarche) through menopause. Members of The Red Web Foundation form a network of women committed to promoting menstrual health in their personal and professional lives. These “menstrual health advocates” offer a diverse range of products, workshops, and educational materials and include artists, mental health professionals, businesswomen, moms, students, teachers, and health care providers. The Foundation is committed to including a diversity of cultural views and experiences of the menstrual life-cycle. We honor individual and cultural practices of the present day and the past which promote a healthy outlook for women and society.

Why We Are Our members, and many others worldwide, devote countless resources toward the work of menstrual health advocacy. Yet, because menstruation is still a taboo subject in mainstream culture, quite often they do this in isolation with little societal or financial support. At the same time, many more women and girls are seeking information and guidance about their bodies and their place in this world as women and are unable to access the help they need. The Red Web Foundation was created to address these needs.
What We Are Doing About It- The Goals of the Red Web Foundation are:
To sponsor educational days, every two years, on the subject of positive menstruation for greater public education and awareness. (CLICK HERE To View In The Flow Embracing the Cycles of Womanhood.)
To provide a comprehensive online resource for public education including books, articles and a listing of members, menstrual health advocates, available for consultation.

To continue expanding our web by supporting an ever-growing collaboration of members who network and share ideas and resources.

To support each member’s work by providing the platform and support for them to promote and sell their products and services.

Document the impact a positive menstrual view has on girl’s and women’s physical, emotional and spiritual well being.

To support our members and our organization in being financially literate, transparent and conscious in all aspects of our business.

Our very long term goal is to become a generously funded Foundation which will support widespread free educational programs for women and girls of all economic and cultural backgrounds.

Here are some articles about menstrual suppression.

http://www.mum.org/bothamen.htm
http://www.nwhn.org/news/fact_sheets?story=25
http://www.athenainstitute.com/sciencelinks/Hsuppress.html
http://www.arhp.org/files/menstruationsurvey2003.pdf (this last "research study" was written to support menstrual suppression, however, majority of the women polled think that menstruation is natural function of nature and that the absence of periods usually shows disease or lack of health. Frankly, I think most of the info defeats the authors purpose and supports the opposing view.)

Be Well,
Juliette Aiyana, L.Ac. Chinese Herbalist, Menstrual Health Advocate
http://www.amazinghealing.com

Thank you Juliette for your posting. I share your feelings and beliefs surrounding menstruation and its profoundly important and meaningful place in women's lives.

You have said much of what I wanted to say. To paint a futher picture of the commoness of the side effects related to the pill, and the fact that many of these BCP side effects go unreported, leading to the illusion that the pill is a relatively safe medicine, I'll outline four of the cases I have seen. For the sake of concision, I'll restrict myself to cases that have occurred among close friends and relations, not my general practice:

Case one : female age 30
I was treating a friend for knee pain. She had had a Deep Vein Thrombosis in the same knee two years prior. She had been on the pill as a contraceptive and developed a blood clot. (No trauma at the time)

Case two: female age 19
Went on the pill as contraceptive. Two months later, developed severe headaches and vertigo which led to the discovery of transient ischemic attacks. Was immediately taken off of the pill, which was seen as the probable cause.

Case Three: female age 21
On the pill as a medication for her acne. Three months later developed blood clot in her brain stem, which presented as three grand mals seizures. Cause attributed to the BCP.

Case Four: Me
I am the last example. At age 16 I developed a Deep Vein Thrombosis in my ankle after having been on the BCP for four months. I have been left with chronic veinous insufficiency.

In each of these cases, the BCP was regarded as the probably correlative factor in the blood clots. Many tests were run in each woman's case history to try and diagnose a genetic blood clotting condition. None were found. Yet ultimately, the cause was perceived to be too ambiguous by the attending physician (and, no doubt, too much bother and paperwork) to be reported as an explicit side effect of the BCP. Consequently, the statistics related to side effects of the BCP do not include these cases, nor many, many other similar cases.

My message here is not to rant about the pill and how horrible it is, but to make a greater sense of awareness about the potentially very dangerous side effects of the pill and to advocate for appropriate reporting of BCP related traumas--as well as to promote an appreciation for the delicate interplay of hormones and the awesome and beautiful process of menstruation. The miracle of human physiology should be valued and respected.

I agree that helping women find safe and effective forms of contraception is very important. The Natural Fertility Awareness method is an approach I too advocate.

Andrea