9.2       Vaginal pain (vulvodynia)

Vagina is a complex organ, it contains several parts. It is often difficult to clearly pin point which part of the vagina is at fault. Most frequently, it is the inflammation of urinary tract like bladder or urethra (UTI) that is the cause of pain. UTI causes severe pain both in urination and intercourse.  

One female patient in her mid 30’s with vaginal pain went to see four doctors and came up with four different diagnosis: hormonal deficiency, infection, dryness, inflammation.  Nothing worked.  I used electro acupuncture  at  points, one each leg, on the inner thigh, mid line, down about  three fingers width from Perineum. 30 minutes interval two times a week. This is an extra acupuncture point on the Liver channel which according to TCM encircles the vaginal area. The problem disappeared within a month. It was a case with minor inflammation of one spot of labiaminora that created a QI stagnation at the whole area. Soon she was pregnant which made her very happy.

This point that I used lies on the liver meridian. In TCM, Liver(Lv) meridian surround genitalia.  Other points on the liver meridian, Lv 3 in particular, is also good choice but not as effective in electro acupuncture because of the electro conduction issues. In electro acupuncture, the electrical current has to travel from one pole to the other. The longer the distance between the points used, the higher the voltage needed to get the same current flow.

9.3       Painful urination

This happens frequently with many women, very painful, hurting like being knifed. One potential problem is the infection in urinary tract which is called UTI in medical terms that involves overgrowth of pathogenic bacteria, mostly E. coli, in and around the urinary tract.  In such situation, antibiotics work well.  Alternative, Chinese patent herbal formula can be used, frequently either Ba Zheng San or Long Dan Xie Gan wan are prescribed.

Frequently, bacterial is not the culprit. “Honeymoon” UTI frequently do not involve bacterial infection.  These problems could come from emotional triggered issues  as well as physiological. Because urinary tract runs next to vagina, any gynecological issues would be affecting the urinary function as well.

In treating these problems, either moving Qi and Blood or smooth Qi will do. Acupuncture sometimes coupled with electric stimulation –electro acupuncture and or moxibustion offers good results.

53 year old female had a painful urination one day after visiting OB/GYN for a routine Pap smear. She went to Urgent care and was diagnosed as having UTI which she had once about 6 months ago.  The urine did not appear to be different from normal but the doctor maintained that it’s positive for white cells. The doctor prescribed her 10 days antibiotics, which gave her dry mouth. Next day, it did seemed to have helped somewhat. Although the urine appeared to be clear light yellow, she was told that it still has some blood and white cells.  Next day, she felt uncomfortable tension in the low abdomen.

The patient had been married for 10 years to the current husband. The husband has no interest in sex so she had not been  intimate  for many years. She appeared to be on the upper range of normal weight.

The patient had many grown up children. The last pregnancy was 15 years ago, delivered with c-section which led to a 6 inches horizontal scar, 3-4 inches below umbilicus. The scar is slightly tender to pressure at the left corner.

Her tongue looks normal light red with thin white coating and the pulse is slightly tight. The patient complained about being tired.

Diagnosis and treatment:

Most likely the patient had no UTI.  As with many patients who went through surgery, her surgical scar did not heal well that caused Qi and Blood stagnation according to TCM, Her low abdomen from time to time gave her trouble because of that. Her current pain was mostly triggered by Gynecological examine.

Treatment: The goal of treatment is to reduce the QI and Blood stagnation at the scar; this is achieved by using electro acupuncture coupled with moxibustion on and around the scars, particularly on the tender area. After the treatment, the pressure disappeared.

9.4       Frequent urination

These days, we are bombarded with commercial about “over active “ bladder. Medically, it is the symptom of frequent urination.  The bladder is not overly active, just a frequent urge to pee. People don’t have “overactive” nose when they are having running nose. It is a neurological event. Anything that irritates the bladder nerve and some surrounding nerves would cause such issues. These include excessive water intake, pregnancy. Infection or inflammation of bladder, vagina and urinary tracts as well as  prostate disorders all can irritate bladder. Look at such list, it is easy to understand why female are more prone to such problem.

Finding out the true cause will help selection of effective treatment. Infection can be handled mostly through antibiotics or through herbs useage. Usage of antibiotics often resulted in yeast infection, therefore, many people would take cranberry juice concurrently or instead of antibiotics.  In TCM, the commonly used herbal formula for such problem is called Long Dan Xie Gan Wan which clears heat toxin through urination or Ba Zheng San which reduces infection in the UTI.

IF no infection is involved, acupuncture would be very effective in treating frequent urination issue because it can smooth the overactive nerve or excess Qi. Ren 2, Ren 3 are very popular choice. My favorite is St 28 with electro acupuncture. Better yet, St 28 and the empirical points on the inner thighs on the Liver meridian. The results are quite good. Most of such patients have lower Jiao Qi deficiency or blood stagnation. So, use warm therapy concurrently is highly desirable.

Many pregnant women have urinary issues such as urge to pee frequently or difficult to urinate. Using St 28 would be difficult, but along the Lv channel in the upper inner thigh can be used.

Prostate problem easily cause frequent urination. Prostate related frequent urination which is not caused by infection( relative rare event for men) is quite unique. It is due to restrict urine flow, which can be resulted from incomplete empty of bladder each peeing. So the urge to go becomes a constant occurrence. 

9.5       Prostate issues

9.5.1    Prostate enlargement-frequent urination and dysuria

The true issue about prostate enlargement is the difficulty in urination and the resulting urgency and frequency of urination. It bothers many elderly men.

It is kind of curious to think that as men ages, everything in the body shrinks, including the bones. One exception is that the many male’s prostate gland grow bigger. It appears even more strange to realize that the only function for prostate is to increase the liquid volume (not sperm) to assist ejaculation. What is the Mother Nature trying to tell us with “enlarged “prostate? Knowing that more and more percentage of sperm are not viable as men ages anyway. Bigger testicles may help. Bigger prostate would not make any difference. It does not make sense. Furthermore, when a man can’t pee, there is no desire nor ability for sex.

I believe the problem is not about the size of the prostate organ that is causing the problem.  Remember, the urethra runs through the center of the prostate gland. Enlargement of prostate has little effect on the urethra.  The true culprit is the stiffness of the musculature of the urethra and the gland.  As with any other muscles in the body, they become stiffer, less elastic with age. Therefore, it becomes more and more difficult to move urine through the duct. The discomfort that is associated with the pressure further stiffens the duct. Therefore, soften these tissues and the urination problem would go away. 

I have a 75 year old patient who has had frequent pain and discomfort at the low abdominal area,  with elevated PSA. His sleep was disturbed because of the need to visit bathroom.  Using the points prescription in above section for frequent urination plus heat lamp over low abdominal area weekly. Everything began to work fine. Slept through the night. Currently, if he skipped the treatment for more than two weeks, the problem would start to creep back.