Menstrual Pain: Why Avoid Si Wu Decoction?

During menstrual cramps, there may be a desire to have a bowel movement?

Dr.
Huang: Hello, this is a forwarded message.
I would like to know if the content is true, thank you.
> You should not consume Si Wu Tang (Four Substance Decoction)! (Extremely important! A must-read for women!) >> For many years, I have been experiencing dysmenorrhea.
About two years ago, I heard that drinking Si Wu could help improve it, so I bought Si Wu tea bags from Watsons and Cosmed and started brewing it myself.
> After drinking it for a while, my menstrual pain not only did not improve, but it became increasingly severe.
> I went to National Taiwan University Hospital for an examination, and the doctor told me I have endometriosis and a chocolate cyst, and recommended surgery.
However, I was very afraid of surgery, so I chose to see a traditional Chinese medicine doctor.
>> I consulted many doctors and noticed one thing: every doctor (even the Western medicine doctor I visited asked me this) would ask me, "Do you feel like having diarrhea during menstrual pain?" > Moreover, every doctor told me, "You should not consume Si Wu Tang." > After asking them, I discovered that although not every patient with endometriosis experiences dysmenorrhea, most do have a tendency to feel like having diarrhea, and since you have endometriosis, it is best to avoid tonics (like Si Wu, ginseng, etc.), as they do not nourish your uterus but rather the endometrium, leading to increased congestion and more pain! >> As a victim, I hope that those who experience dysmenorrhea can pay attention and not worsen their condition like I did! > I still experience pain, but my doctor advised me to maintain a positive mood.
Now, when my period comes, I drink Shenghua Tang (Postpartum Recovery Soup) or longan and red date soup to help with elimination, and I exercise more.
The doctor also suggested that after my period, I should start drinking "Si Wu Tang" (specially formulated by a TCM practitioner), and I have seen gradual improvement.
However, if I want to have children in the future, I will still need to rely on Western medicine to clean out the endometrium to facilitate conception! >> I hope all women will share this with other women, and men who receive this can also forward it to women!

Si Wu Tang, 20~29 year old female. Ask Date: 2004/01/30

Dr. Huang Yicheng reply Pharmacology

This formula is primarily for nourishing blood and regulating menstruation.
Among its ingredients, Angelica sinensis (Dong Quai) and Ligusticum chuanxiong (Chuanxiong) are classified as yang herbs, while Rehmannia glutinosa (Sheng Di Huang) and Paeonia lactiflora (Bai Shao) are classified as yin herbs.
If the dosage of Chuanxiong, which invigorates blood and promotes qi, is excessive during menstruation, it may lead to heavy bleeding and result in severe anemia.
Conversely, if the dosage of Bai Shao is too high, due to its astringent properties, menstruation may cease altogether.
This can exacerbate conditions such as endometriosis and uterine fibroids, as the uterus is already congested with blood.
Some individuals may experience diarrhea after consuming Sheng Di Huang due to its laxative effect, so it should be used sparingly, especially in those with gastrointestinal issues.
Generally speaking, if menstruation arrives early, it is considered a "heat syndrome," while a delayed onset indicates a "cold syndrome." Pale blood suggests a "deficiency syndrome," dark brown blood indicates a "full syndrome," and the presence of clots is classified as "stasis syndrome." Some individuals experience excessive menstrual flow, while others have scanty periods, necessitating different treatment approaches.
Therefore, while it is common for people to use Si Wu Tang for nourishment, it may not always be ideal.
If consumed without proper differentiation of syndromes, it could be detrimental to health.
This is respectfully noted by Huang Yi-Cheng, a pharmacist at Hualien Hospital, Department of Health, Executive Yuan.

Reply Date: 2004/01/30

More Info

Menstrual pain, or dysmenorrhea, is a common issue that many women face, and it can significantly impact their quality of life. The discussion around the use of herbal remedies, such as Si Wu Decoction (四物湯), particularly in the context of conditions like endometriosis and chocolate cysts, raises important considerations.

Understanding Si Wu Decoction and Its Implications
Si Wu Decoction is a traditional Chinese herbal formula that is often used to nourish the blood and regulate menstruation. It is composed of four primary herbs: Angelica sinensis (Dong Quai), Rehmannia glutinosa, Paeonia lactiflora (White Peony), and Ligusticum chuanxiong. While this decoction is celebrated for its purported benefits in alleviating menstrual discomfort and improving overall reproductive health, it may not be suitable for all women, especially those with specific conditions like endometriosis.

Why Avoid Si Wu Decoction?
1. Endometriosis and Chocolate Cysts: Women with endometriosis often experience severe menstrual pain due to the presence of endometrial-like tissue outside the uterus. This tissue can become inflamed and bleed during menstruation, leading to pain. Chocolate cysts, or endometriomas, are a type of ovarian cyst formed from endometrial tissue. The concern with using Si Wu Decoction in these cases is that it may promote blood circulation and potentially increase blood flow to the pelvic area. This could exacerbate inflammation and pain associated with endometriosis, leading to a worsening of symptoms.

2. Digestive Symptoms: The anecdotal evidence presented highlights a common symptom among women with endometriosis: gastrointestinal discomfort, including diarrhea during menstruation. Many practitioners of both Western and traditional medicine note that certain herbal formulas can stimulate the digestive system. For women experiencing gastrointestinal symptoms alongside menstrual pain, this could lead to further discomfort.

3. Nutritional Considerations: The idea that "tonifying" herbs can help with menstrual pain is based on the premise that they nourish the body. However, in the case of endometriosis, the focus should be on managing inflammation rather than simply nourishing the body. Herbal remedies that are too "warming" or "tonifying" may not address the underlying issues and could lead to increased pain and discomfort.

Alternative Approaches
For women suffering from menstrual pain, especially those with endometriosis, it is crucial to adopt a holistic approach to treatment. Here are some alternatives that may be beneficial:
1. Pain Management: Over-the-counter pain relievers such as NSAIDs (e.g., ibuprofen) can be effective in managing menstrual pain. For more severe cases, prescription medications may be necessary.

2. Hormonal Treatments: Hormonal therapies, including birth control pills or hormonal IUDs, can help regulate menstrual cycles and reduce the severity of pain associated with endometriosis.

3. Diet and Lifestyle Modifications: A balanced diet rich in anti-inflammatory foods (like fruits, vegetables, whole grains, and omega-3 fatty acids) can help manage symptoms. Regular exercise and stress management techniques, such as yoga or meditation, can also be beneficial.

4. Acupuncture and Physical Therapy: Some women find relief through acupuncture or physical therapy, which can help alleviate pain and improve overall well-being.

5. Consultation with Healthcare Providers: It is essential for women experiencing severe menstrual pain to consult with healthcare providers who can offer tailored advice and treatment options based on their specific conditions.

In conclusion, while Si Wu Decoction may provide relief for some women, those with endometriosis or related conditions should approach its use with caution. It is essential to prioritize treatments that address the underlying causes of pain and inflammation rather than merely seeking symptomatic relief. Always consult with a healthcare professional before starting any new treatment regimen, especially when dealing with complex conditions like endometriosis.

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