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Intra-uterine adhesions & TCM

Erin Flynn
Erin Flynn's picture
Posts: 1
 Joined: 2008-08-12

Hello CMTers,

I have a patient who has just been told that the results of her HSG reveal some intra-uterine adhesions. Unfortunately, the results did not indicate severity or quantity (she is requesting these results directly from her doctor).

Does anyone have any experience or advice about what TCM can do for her? She is very hesitant to undergo the general anaesthetic necessary for the hysteroscopy, the wait list for the procedure (in Canada) is 3 monthes (which of course she'd rather not wait), and she wants a more natural approach anyways. However, I am wondering whether acupuncture and/or chinese medicinals would be able to rectify this condition enough to enable her to conceive a baby.

Thanks,
Erin Flynn

--

erin@acubalance.ca


Submitted by Erin Flynn on Mon, 2008-09-22 17:54.
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rayrubio
rayrubio's picture
Posts: 84
 Joined: 2007-05-29
Intra-Uterine Adhesions and TCM

Hi Erin -

You are correct that it's difficult to predict how successful you would be in treating this patient with TCM, without knowing the extent of the adhesions. For example, if a patient presented with uterine adhesions and a diagnosis of Asherman's Syndrome (complete closure of the uterus due to adhesions) - it would require surgery to correct, and TCM would be most helpful post-surgically to heal and scar tissue and inflammation from the surgery.

Uterine adhesions would obviously be diagnosed as blood stasis/stagnant blood in TCM, and the treatment would involve softening hardness, eliminating stasis, dispersing stagnation, and invigorating blood. Of course we know that moving blood too vigorously can prevent ovulation, or prevent implantation, or lead to early miscarriage, so you may need to either: 1. stage your treatments and only treat the adhesions (i.e. follow the treatment principles above) just before and during the period after pregnancy has been ruled out, or
2. Ask the patient to refrain from trying to conceive for the first two months and really go after the adhesions during the entire cycle.

Knowing the strength of the patients qi/xue reserves, and their personal situation would guide your decision-making process here.

Appropriate Guiding Formulas for this purpose might be either:

A. Gui Zhi Fu Ling Tang + additions
B. Ge Xia Zhu Yu Tang + additions

Key added herbs in either case would be Di Long, Ru Xiang, Mo Yao, San Leng, E Zhu, Chuan Shan Jia.

Acupuncture: Rice Grain Direct Moxa on Liver 8. This is one of Kiiko's recommended treatments for any Endometrial, Ovarian, Uterine stasis or inflammation. Ba Liao with E-Stim. Sp 6/8/10. Maybe also Fu Ke/Huan Jiao (Master Tong points for Uterine/Ovarian problems).

Just some thoughts & suggestions. Hope they help.

Ray Rubio, D.A.O.M., L. Ac. FABORM
President ABORM
www.westlakecomplementarymedicine.com


Thu, 2008-09-25 11:16
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Atisha
Atisha's picture
Posts: 101
 Joined: 2007-01-30
Ashermans

Nice post Ray!

I have seen cases of this Asherman's/ uterine adhesions as a consequence of a D&C. I have tried working via the traditional herbal/ acupuncture routes you suggested without much success. The best success I have seen has been through surgery with CM support afterwards. We just recently helped a 42 year old women through this route, for a which she was happily rewarded with a healthy live birth.

The main issue is that many OB's do not know how to diagnose or treat this condition very well. There seems to be only a handful of skilled Asherman experts in the world. One of the best specialists that I know of practices out of the Santa Monica, California, area. His name is Dr. Charles March. The above mentioned case used his services and was very pleased with his skill and care.

From my understanding, Asherman's does not have to be a complete closure of the uterus, which would be its most severe presentation. Asherman's just refers to the presence scar tissue in the uterus, which ultimately fails to respond to estrogen and other hormones. http://en.wikipedia.org/wiki/Asherman's_syndrome

Trevor Erikson, R.TCMP
www.skin.health-info.org
www.acubalance.ca


Thu, 2008-09-25 14:46
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rayrubio
rayrubio's picture
Posts: 84
 Joined: 2007-05-29
Asherman's...

Hey Trevor -

I knew that one of you clever Acubalance doc's would catch my loose description of Asherman's. The definition you list is the technically correct one, but I was between patients when I posted....

I know Doctor March actually. Competent Doc. Well respected. Congrats on your patient.

Love the photo with your posts by-the-way. My family and I took a vacation up to Vancouver Island this last summer and had the chance to go kayaking on some the lakes, and off of Telegraph Cove. Heaven.

Ray Rubio, D.A.O.M., L. Ac. FABORM
President ABORM
www.westlakecomplementarymedicine.com


Thu, 2008-09-25 15:48
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Atisha
Atisha's picture
Posts: 101
 Joined: 2007-01-30
Kayak adventures

Hey Ray!

Glad to hear you share a love of adventure up here on our wild coast :-)

My profile pic is from a journey my wife and I did this summer up in Desolation sound. Nothing beats camping on different islands while watching sunsets from the beach. Paradise indeed!

Feel free to see more pics from that trip on my Flickr feed. http://www.flickr.com/photos/28473868@N04/sets/72157607090356632/

Best
Trevor Erikson, R. TCMP
www.skin.health-info.org
www.acubalance.ca


Thu, 2008-09-25 16:46
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