Chinese Medicine Treating Leucorrhea- Part two Acupuncture

By Keren Zelicha

Excessive vaginal discharges or leucorrhea is a frequent seen symptom in women’s clinics.

As mentioned in the first part of the article: Chinese medicine treating leucorrhea – part one herbs, vaginal discharges are necessary to maintain the health of the vagina’s mucous membrane lining. Tracking cervical mucus is a good indicator for understanding hormonal changes and the events that occur during the menstrual cycle. Few days before ovulation the cervix produces more fluids due to an estradiol rise. At that stage, vaginal discharge will be slippery odorless like an egg white. The presence of fertile cervical fluid is a good indication for ovulation to come (ovulation tests and basal body temperature tracking is more reliable for confirming ovulation). When the amount color, texture or odor of the vaginal discharge change, it can cause irritation and discomfort of the vulva and vagina.

What are the causes for excessive vaginal discharge?

Yeast, also called Candida that is part of the normal flora of human skin but can also cause infections.
Gardnerella, a type of bacteria found normally in the female genital tract that is the cause of bacterial vaginosis.
Trichomonas, an organism made up of one cell.
Sexually transmitted diseases such as gonorrhea or chlamydia also can cause vaginal discharge.
Low estrogen levels as in menopause (atrophic vaginitis).

Acupuncture for Vaginal discharge:

The Chinese medicine pathology of excessive vaginal discharge (leucorrhea/ leukorrhea) is related to:

Chong- Ren not binding: This can include signs and symptoms of spleen qi deficiency, liver blood deficiency, kidney yang deficiency, cold in the uterus, kidney yin deficiency with heart fire (Bao mai disorder).
Dai mai failure of regulating fluids in the lower Jiao: This can include signs and symptoms of lung- spleen and kidney qi deficiency, liver qi stagnation.
Accumulation of water- damp: This can include signs and symptoms of spleen- kidney qi deficiency damaging water passages, damp heat in the lower Jiao, toxic heat in the lower Jiao.

As constitution may vary, different signs can be seen, excess or deficiency can be mixed and should be addressed simultaneously.

Acupuncture points for vaginal discharge:

1. Chong- Ren not binding:

Excessive vaginal discharge can be a manifestation of spleen and kidney deficiency. In Su wen chapter 60 it is written:

《素问，骨空论》任脉为病，女子带下瘕聚 “Disease in the Ren mai, leucorrhea will gather”. It can also be understood that a Ren mai disease will cause an accumulation below the belt meridian.

Ren mai and Chong mai both originate inside the uterus. The uterus is part of the 6 extraordinary organs. In Su wen Chapter 11 it is written:

脑髓骨脈胆女子胞，此六者地氣之所生也 “The brain, Marrow, blood vessels, gall bladder, bones and the uterus, these six are all generated from earthly qi”.

The extraordinary organs stores essence and qi, similar to the nature of earth that stores things. The uterus as part of the extraordinary organs is depended on the generation of spleen qi and has a close connection with kidney qi and essence. When spleen and kidney qi are depleted, Chong (representing blood) and Ren mai (representing yin) can not bind, therefore excessive leucorrhea can appear. Cervical mucus is a reflection of the Tai yin system. If the Tai yin system is imbalanced fluids will not be transported and finally will be accumulated. When Tai Yin system is involved and affects the genital area or women physiology we might think of using master Tung’s Fu ke acupuncture point.

11.24 Fu ke (妇科) master Tung’s acupuncture point:

One of the major points in Tung’s acupuncture for many gynecology symptoms is 11.24 Fu ke (妇科). Fu ke is indicated for uterus cancers, tumors and fibroids, inflammation, infertility, menstrual disorders, dysmenorrhea, genital region swelling or pain, vaginal discharge (red or white leucorrhea/ leukorrhea), postpartum syndromes.

The point‘s reaction area is the uterus and the six bowel. It is located in the thumb, where lung and large intestine meridian flow representing metal. Metal has a downward movement, therefore Fu ke is relates to the lower jiao were the uterus and bowls are.

11.24 Fu ke acupuncture point is located on the lung channel, on the dorsum proximal phalanx of the thumb, on the ulnar border of the phalangeal bone. It is a two set of points found when dividing the phalanx into thirds. I use this point in many women conditions including vaginal discharges and vaginal itching.

11.27 fu ke tung acupuncture

Lower three emperors master Tung’s Tian Huang (77.17)+ Di Huang (77.19)+ Ren Huang (77.21)

When vaginal discharges occur due to kidney- spleen qi deficiency we can combine Fu ke point with 77-12 lower three emperors (下三皇).

Lower three emperor acupuncture points combination are on the spleen meridian, these points acts as post heaven supporting pre- heaven kidney. They can regulate menstruation and water metabolism. For kidney qi not binding causing premature ejaculation, nocturnal emission, vaginal discharges, lin syndrome, nephritis and urine protein, diabetes, limbs edema, lower back pain.

Lower three emperors 77-12

Chinese Medicine Treating Leucorrhea- Part One Herbs

2. Dai mai failure of regulating fluids in the lower Jiao:

The Dai mai is regarded as a belt that can be tight or loose. It controls the area bellow the umbilicus, the pelvic, uterus, ovaries, genital organs, lumbar fascia and ligaments. It wraps all the meridians and determines the shape of the human body. The Dai mai has a regulative function of mobilizing fluids, stools, regulating lumbar region, lower jiao organs and lower limbs. The Dai mai is able to hold and connect between different parts of the body. It is also in charge of regulating the free flow of qi towards the upper parts of the body. Therefore Dai mai is indicative for headaches, eye, shoulder, arm, chest and flank complaints. Order, flexibility and free movement is important for maintaining the area and the functionality of the Dai mai.

The spiritual and physiological functions of the Dai mai:

The spiritual aspect of the Dai mai:

Ling shu chapter 11 mentions that kidney meridian goes behind the knee (Kd 10) upward to meet with the bladder meridian. It then rises up and links with the kidneys and enters the Dai mai. The connection of the kidney with the Dai mai is important spiritually. The Zhi (志 will power) can be achieved by the flexibility and the free movement of the Dai mai. If the Dai is flexible then the gall bladder will give us the courage to walk through our “Dao” or our life mission. We can say that the Dai mai gather us and directs us through life, it strengthens our role in the universe along the cosmic orders and laws.

The physiological aspect of the Dai mai:

From a physiological point of view, the Dai mai has a mobilizing function since it is related to the Shao yang. If the Dai mai is open and not congested, then from the ministerial fire, yang qi will be spread out through the body. Yang is essential for the spleen to transform and transport body fluids, otherwise damp will accumulate in the lower jiao.

Both aspects can cause vaginal discharges, or vaginal itching.

Yun Bai 云白 (44.11) and Li bai 李白 (44.12) Tung’s acupuncture points:

When we treat vaginal discharges (leucorrhea) and the situation involves congestion in the Dai mai area with liver qi stagnation, we can choose two useful master tung’s acupuncture points that are located on the large intestine meridian: Yun Bai point 云白 (44.11) and Li bai point 李白 (44.12). These points are on the shoulder area, from a large Tai ji holographic correspondence the shoulder area is mirroring the genital/ tailbone/ lower back/ abdomen area. Therefore, using the deltoid muscle area can reflect and treat lower back pain, hip or inguinal pain, abdominal pain, genital disorders. These points are on the large intestine Yang ming hand meridian. According to Zang Fu Be Tong theory (extraordinary connection of Zang Fu) large intestine can regulate liver Jue yin leg meridian. therefore Yun bai and Li bai can treat leucorrhea, genital itching or pain. I usually choose these two points with Tian zong 44.10 which is also indicative for genital itching and discharge.

Acupuncture shoulder mirroring

Tung's Yun bai Li bai points

Yun bai 云白 (44.11):

Location: 2 cun anterior to Jian Zhong 肩中 ( Shoulder Center 44.06), needle 1-2 cun in depth.

Reaction area: Lung, six Fu.

The point reacts on the liver and kidney channels. Its can attune the menstrual cycle, rectify Dai mai, diffuse the lower Jiao.

Functions: mainly used in gynecology symptoms such vaginitis, uterus or ovary inflammation, vaginal itching, vulvodynia, white or red vaginal discharge, polio or lower leg pain, ankle sprain.

Li bai 李白 (44.12):

Location: 2 cun posterior to Jian Zhong 建中 (Establish Center). needle 0.5- 1.5 cun.

Reaction area: The point acts on the liver meridian, it soothes the sinews, quicken the Luo meridians.

Functions: for body odor, excessive sweat, leg/ foot sprain or pain, polio paralysis. For women genital itching or leucorrhea use Li bai (44.12) with Yun Bai (44.11) and Tian zong 天总 (44.10).

3. Accumulation of water and dampness in the lower Jiao:

Vaginal discharges are necessary for lubricating the vagina, clearing old cells for refreshing the area and helps the vagina retaining a healthy acidity PH, which is important to fight infections. Abnormal vaginal discharge can indicate a debility of the spleen and stomach, poor transformation and transportation leading to damp- phlegm – fluids accumulating in the lower Jiao.

The outline of female medicine (Nu ke cuo Yao) written by Xue Ji (1487- 1559), mentions vaginal discharge:

或因六淫七情，或因醉饱房劳，或因膏粱浓味，或服燥剂所致，脾胃亏损，阳气下陷；或湿痰下注，蕴积而成，故言带也.

” This may be due to the six excesses and seven emotions; or due to drunkenness, overeating, or bedroom taxation; or due to rich food with concentrated flavors; or caused by taking drying prescriptions. These lead to debility of the spleen and stomach with yang qi sinking downward or lead to dampness and phlegm pouring downward. They accumulate and become this, so it is said to be discharge.” [1]

Leucorrhea is manifests the middle Jiao condition and function, physically and mentally. If the spleen and stomach are depleted blood and body fluids will not be generated and transported through out the body. Fluids will accumulate and sink bellow the Dai mai region. If the woman was emotionally hurt and the ground that she stands on was shaken, her feelings would weaken spleen and stomach functionality. To address this we should invigorate the spleen and stomach, supporting yang qi. Some women according their constitution will develop damp heat, others will have more liver qi stagnation or heat symptoms. Each women will need a specific treatment to address her disharmony.

Qi Men (33.01)+ Qi Jiao (33.02)+ Qi Zheng (33.03) Tung’s 33-10 Dao ma:

For cases of vaginal discharges with liver qi stagnation and damp heat signs I prefer to use master Tung’s (Hold three this) 33-10 Dao ma.

Location:

33.01– Qi Men- on the lateral border of the radius, 2 Cun proximal to the wrist on the line between L.I 5 & Li 11.

33.02– Qi Jiao- 2 Cun proximal to 33.01.

33.03– Qi Zheng- 2 Cun proximal to 33.02.

Reaction area: Large intestine, Bladder. Use this combination to open the qi flow, move stagnation, clear and drain the lower Jiaos.

Indications: Leucorrhea, hemorrhoids, anal prolapse, irregular menstruation.

Needle technique: 15 degrees from radial to ulnar side (large intestine to triple warmer channels) especially if Shao yang symptoms are involved. If I see more Yang Ming symptoms I needle the points 15 degrees along the large intestine channel from proximal to distal and not transversely towards the triple warmer channel.

Master Tung Acupuncture 33-10 Transverse- Left Hand

Chinese medicine has wonderful solutions to treat vaginal discharge. Chinese herbs, formulas, external wash or sauna and acupuncture are all indicative to address leucorrhea. I don’t think that the causes for vaginal discharges are linear. In the clinic I frequently see several pathological manifestations involving different organs. Emotional aspect is one of the common causes for vaginal itching or excessive leucorrhea. Don’t forget to ask about the emotional state of the patient, her relationship with her partner or family. If we can not quiet the mind/ spirit the symptoms will be chronic. Acupuncture points such Fu ke, and 33-10 Dao ma are frequently used in my clinic for vaginal discharges especially if the Tai yin system and liver heat are involved. Yun bai Li bai are chosen when I palpate the Dai mai area and feel congestion.