Herbs and Other Approaches for Uterine Prolapse
Answered by: Robert Newman, L.Ac.
Question from: Melvina
Posted on: September 08, 2004

[I am] searching madly for alternative to hysterectomy. Over a year ago I told I had prolapse uterus. Surgery was scheduled, with the added anterior repair of my bladder. Scary stuff for me. I am 53 years old, had three children. I came across a Chinese medicinal book which speaks of upward foods and herbs that will help with this type of energy: rhizoma cimicifugae (elevating herb) and radix bupleuri. Can you point me in some positive direction re: these herbs and any other answers to my present dilemma?

The prolapse of any organ is a very difficult problem to treat without surgery. Once the muscles and tissues that normally hold an organ in place have weakened and lost their structural integrity, it is very difficult to get them to return to their normal state. If the prolapse is very mild or minimal, there is a much better chance of reversing the condition. In traditional Chinese medicine (TCM), an important idea to help prevent uterine prolapse from occuring and to also prevent it from getting worse as well as giving a woman the best chance to recover from this condition is for her to avoid excessive overwork or other causes which can make her become fatigued just prior to and during her menses. Causing fatigue at such an important time in a woman’s cycle is felt to be very detrimental, because there is already this loss occuring of blood and Qi (for an explanation and description of the Chinese medicine concept of "Qi," see my answer to the question, "Is There An Herb That Can Help Acid Reflux?" also found on the Chinese Q&A section on Richters website) and the direction of Qi flow, the basic "energy" of the body, is going downward very strongly at this time: the flow of blood during the menses is clearly moving in a downward and outward direction, and in combination with becoming more weak at this time, it will be much harder for the body’s Qi to hold the tissues in place and prevent the dropping down of the uterus. The health of the organs known in TCM as the "Spleen" and the "Kidneys" is critically important for preventing and treating prolapses. Besides the problem of becoming fatigued at the time of the menses, other factors that are felt to be possible causes for Spleen or Kidney Qi deficiency-caused uterine prolapse (see below for more about these causes) include: a generally weak constitution with a deficiency of the Spleen Qi (see next paragraph), bearing down too early during labor, doing excessively heavy work too soon after childbirth, long term constipation, and long term coughing. In TCM, the importance of the combination of these factors in connection with uterine prolapse becomes apparent when one is aware of and remembers that prolapses are generally considered to be due to a severe deficiency or weakness of Qi -- what is known as "Qi Collapse" -- and a subsequent inability of the Qi to hold some tissues of the body up and in place.

A common cause of the above-described weakness or collapse of Qi is from the Spleen Qi becoming very deficient, according to TCM (in TCM, the "Spleen" is not at all similar to the spleen of western physiology; for additional information about the Chinese medicine concept of the Spleen and of "Qi," see my answer to the question, also on the Q&A section on Richters website, "Can You Tell Me About Korean Ginseng and Give Me Some Advice About Weight Loss Herbs?"). The direction of normal Qi movement of the Spleen is said to be upward when it is healthy, and connected to this upward movement of the Spleen’s Qi is its job in holding various tissues of the body upright and in place. But in this type of prolapse problem, a common causative factor is often that the Spleen Qi is believed to be too weak to move upward as it should and hence is unable to fulfill its function of holding the organs and tissues in place -- a downward movement or collapse, a more severe deficiency, of the Spleen Qi has occurred. In addition to the causative factors listed above, poor diet and poor nutrition, lack of sufficient sleep and rest, prolonged and debilitating illnesses, and overworking or driving and pushing one’s self for prolonged periods of time are also important and common contributing influences in developing a prolapsed uterus. Besides uterine prolapse, other possible symptoms of this Spleen Qi collapse can include profuse menstruation, early menses, excessively long menstrual flow, menses which start suddenly with a heavy flow before the normal time and/or menses that continue with a weak, minor flow after the normal time, pale-colored menses which are rather watery, miscarriages, leaking of milk from the breasts, shortness of breath, weak voice, fatigue, weak muscles, desire to lie down/sleep more, spontaneous sweating (sweating during the day without any reason or valid cause), poor appetite, loose stools or very soft stools, gas and/or bloating.

Another possible cause again involves a deficiency or weakness of the Qi, but in this case, it is a deficiency of the Qi of the Kidneys. To reiterate, factors described above such as bearing down too much during childbirth, long term constipation or coughing, overwork, lack of sufficient rest, long term illness, etc. can be significant causes for this weakening of the Kidneys. Additionally, emotional factors can be significant. A strong state of fear can cause the Qi to go down or descend, and strong grief can cause the Qi to scatter and disperse (which is a weakening process). These can both cause the Kidney Qi to become weaker. In addition to uterine prolapse, there may be other signs with this diagnosis including menses (the menarche) that don’t start until after 18 years of age, blocked menses (amenorrhea), irregular menses, dull and pale-colored menses, watery menses, repeated miscarriages, infertility, reduced sex drive, genital atrophy, lumbar pain with weakness in the lower legs, dizziness, low pitched tinnitus (ringing in the ears) which is chronic/constant, dark and dull facial complexion, dark circles under the eyes, dull hair which easily falls out, a lower abdomen which is cold and feels heavy, excessively frequent urination, nighttime urination (has to get out of bed to use the bathroom), loose stools.

There is one other main type of imbalance, according to TCM, which can lead to uterine prolapse. This can be caused by some of the above-mentioned deficiency factors, but also is said to be caused by bearing a large number of children or particularly excessive sexual activity (especially when one is tired, fatigued). The effects of these factors weakens two acupuncture meridians which are believed to travel from the Kidneys, down to the perineum and then up through the reproductive organs (including the uterus), along the abdomen and front of the body, then into the upper body or head; these two channels have a strong connection and relationship with the uterus. These two channels are known as the Ren or Directing Vessel and the Chong or Penetrating Vessel. They both are involved with regulating the activity of the uterus and the menses and nourishing the Blood. Considering that both of these channels originate from the Kidneys, it makes sense that they are both strongly dependent on the Kidneys for their healthy function. Additionally, the Kidneys are believed, through the "Essence" which is stored in them, to be the source of one’s vitality and life force and in control of the reproductive organs, sexual maturation, fertility, conception, etc.; also, the Kidneys are said to be the overall source and root of the body’s Qi -- it is derived from the above-mentioned Essence, a precious core, fundamental substance of the body (although the Chinese "Spleen" is a significant organ involved with the responsibility for Qi being produced in the body, its involvement in this comes from its function of transforming the food and fluids we ingest into a usable, refined material that is made into different types of Qi in the body; it is the Kidneys are where one’s root, foundational Qi -- derived from Essence -- is stored and drawn upon when one is needing to use one’s reserves during times of greater need). Above, I mentioned that a deficiency of the Kidney Qi can also be a cause of uterine prolapse, so through the link between the Kidneys, the uterus and the Directing and Penetrating Vessels, there is a condition that has been observed which is known as "the Directing and Penetrating Vessels not securing or holding." As mentioned above with the Kidney deficiency issue, various factors can weaken the Kidney Qi, and strong fear and/or grief can damage the Qi and also be a cause for the Directing and Penetrating Vessels not being able to secure or hold. Other possible signs of this condition of non-secure Directing and Penetrating Vessels are excessive (profuse) menstrual bleeding, menses which start suddenly with a heavy flow before the normal time and/or menses that continue with a weak, minor flow after the normal time, spotting between periods, early menstruation, too long of a menses, abnormal vaginal discharge, repeated miscarriages, and any of the above-listed signs in connection with Kidney Qi deficiency.

So in TCM, herbs that are going to tonify or strengthen the Spleen Qi, raise or direct the Spleen Qi upward, and also hold in or astringe the Qi to prevent further loss are going to be used for the above-described diagnosis of Spleen Qi deficiency. The following formula is historically a classic formula used for this:

Bu Zhong Yi Qi Wan ("boo johng ee chee wahn"):

* Huang Qi, Radix Astragalus membranaceus, ("hwahng chee," Membranaceus Milkvetch root)

* Ren Shen, Radix Panax ginseng, ("wren shen," Asian Ginseng root)

* Bai Zhu, Radix Atractylodes macrocephala, ("buy joo," Large-headed Atractylodes root)

* Dang Gui, Radix Angelica sinensis, ("dahng gway," Chinese Angelica root)

* Chen Pi, Pericarpium Citrus reticulata, ("chen pee," dried Tangerine peel)

* Sheng Ma, Radix Cimicifuga dahurica, ("shung mah," Dahurian Bugbane root)

* Chai Hu, Radix Bupleurum chinense, ("chigh hoo," Chinese Thorowax root)

* Zhi Gan Cao, Radix Glycyrrhiza uralensis preparata, ("jih gone tsoww," Honey-Fried Ural Licorice root)

For the diagnosis of Kidney deficiency, as well as the diagnosis of the Directing and Penetrating Vessels not holding or securing, the following formula/herbs historically have been used: Da Bu Yuan Jian ("dah boo yoo-en gee-en"):

* Shu Di Huang, Rhizoma Rehmannia glutinosa, ("shoo dee hwahng," Chinese Foxglove rhizome)

* Shan Zhu Yu, Fructus Cornus officinalis, ("shawn joo yoo," Cornelian Cherry tree fruit)

* Shan Yao, Radix Dioscorea opposita, ("shawn yoww," Chinese Yam/Cinnamon vine root)

* Gou Qi Zi, Fructus Lycium barbarum, ("go chee tzih," Chinese Wolfberry/Matrimony vine fruit)

* Ren Shen, Radix Panax ginseng, ("wren shen," Asian Ginseng root)

* Dang Gui, Radix Angelica sinensis, ("dahng gway," Chinese Angelica root)

* Zhi Gan Cao, Radix Glycyrrhiza uralensis preparata, ("jih gone tsoww," Honey-Fried Ural Licorice root)

These herbs have also been considered in such circumstances:

* Qian Shi, Semen Euryales ferox, ("chee-en shih," Euryales seed)

* Lu Jiao Jiao, Cornu Cervus elaphus, ("loo gee-oww gee-oww," Deer antler gelatin)

* Tu Si Zi, Semen Cuscuta chinensis, ("too sih tzih," Chinese Dodder seed)

* Ba Ji Tian, Radix Morinda officinalis, ("bah gee tee-en," Medicinal Morinda root)

* Wu Wei Zi, Fructus Schisandra chinensis, ("woo way tzih," Chinese Magnolia vine fruit)

Another formula for Kidney Qi deficiency with collapse that has been used traditionally is:

Sheng Ti Gu Tuo Jian ("shung tee goo twoh gee-en"):

* Dang Shen, Radix Codonopsis pilosula, ("dawng shen," Asiabell vine root)

* Bai Zhu, Radix Atractylodes macrocephala, ("buy joo," Large-headed Atractylodes root)

* Huang Qi, Radix Astragalus membranaceus, ("hwahng chee," Membranaceus Milkvetch root)

* Huang Jing, Rhizoma Polygonatum sibiricum, ("hwahng jing," Siberian Solomon’s Seal)

* Gui Ban, Plastrum Testudinis (Chinemys), ("gway bawn," Tortoise Shell)

* Ba Ji Tian, Radix Morinda officinalis, ("bah gee tee-en," Medicinal Morinda root)

* Dang Gui, Radix Angelica sinensis, ("dahng gway," Chinese Angelica root)

* Zhi Ke, Fructus Citrus aurantium, ("jih kuh," Bitter/Seville Orange fruit)

* Sheng Ma, Radix Cimicifuga dahurica, ("shung mah," Dahurian Bugbane root)

* Yi Mu Cao, Herba Leonurus heterophyllus/artemisia, ("ee moo tsoww," Chinese Motherwort herb)

* Da Zao, Fructus Ziziphus jujube var. inermis, ("dah tzoww," Chinese Red Date fruit)

Some additional generally useful herbs that have been considered for prolapses:

* Jin Ying Zi, Fructus Rosa laevigata, ("gin ying tzih," Cherokee Rose fruit)

* Xu Duan, Radix Dipsacus asperoides, ("shoo doo-ahn," Himalayan Teasel root)

* Dang Shen, Radix Codonopsis pilosula, ("dawng shen," Asiabell vine root)

* Zhi Shi, Fructus Citrus aurantium immaturus, ("jih shih," Unripe Bitter/Seville Orange fruit)

* Du Zhong, Cortex Eucommia ulmoides, ("doo johng," Eucommia tree bark)

External treatments that have been employed for some patients in the past: steam and immersion bath:

* Dan Shen, Radix Salvia miltiorrhiza, ("dahn shen," Chinese Red Sage root) and

* Wu Bei Zi, Galla Rhus chinensis, ("woo bay tzih," Chinese Rhus gall) and

* He Zi, Fructus Terminalia chebula, ("huh tzih," Terminalia fruit)

or:

* She Chuang Zi, Semen Cnidium monnieri, ("shuh choo-ahng tzih," Cnidium seed) and

* Wu Mei, Fructus Prunus mume, ("woo may," smoked Plum fruit)

You should see a local TCM practitioner for advice specific to your condition. He or she will advise how Chinese herbs should be taken and which herbs or formulas would be best for your constitution and condition.

Richters sells seeds, plants, and dried herbs of some of the above-mentioned herbs if you are interested in growing your own herbs or making your own remedies.

Certain foods which can help to also support the function of the Spleen holding the organs in place are: Daikon radish, kale, and lean beef. This doesn’t mean that you should eat an excessive amount of these foods, but you might want to try eating these foods regularly as part of a healthy choice of a variety of foods.

Also, it could be very useful to go to a qualified and competent TCM practitioner to get acupuncture treatments with the use of moxa, and/or possibly acupressure or tui na (a special type of therapeutic Chinese massage). You might also do well to consider treatment through homeopathic medicine with a qualified and experienced practitioner, before considering any surgery for this condition.

Avoid carrying heavy loads. Additionally, once you have been cured of a prolapse, it is important to not to do any lifting, don’t do too much exercise -- especially running/jogging, don’t overwork and make sure to rest regularly during your work periods to avoid becoming run down. Also, there are special exercises that could be done daily, which include practicing anus-lifting/anus-contracting exercises (contract, lift, relax, then repeat for 10-15 minutes, at least 1X/day). In connection with this idea of doing certain exercises, there was something I found on a website that seems like it could be useful. I have no personal knowledge of anyone who has tried this exercise program, but it sounds like it could be worth investigating. One person who wrote about it had the following to say:

"For the past 6 months I’ve been doing the T-Tapp program....it’s really the most incredible exercise program for women. At any rate, Teresa Tapp, the woman who has developed this program is an exercise physiologist. One of the exercises that she has created is called Organs in Place/Half Frogs. This particular move was especially created for hernia patients and women who suffer from a prolapsed uterus and incontinence problems (Not to mention the fact that it’s a killer stomach exercise... it will give you firmer and flatter abs). A number of women have been able to reverse a prolapsed uterus by doing this exercise -- many of these women had only been given the option of surgery. This is a very powerful little exercise. And you don’t have to pay for it, it’s free: Teresa has put a detailed article with photos on her web site explaining how to do this move:

http://www.t-tapp.com/articles/flatstomach/default.htm

You can also buy a video of Organs in Place/Half Frogs on her web site. Also, if you have any questions, you might want to contact Teresa (there’s a place to do so on her web site). She’s VERY helpful. If you have any additional questions, you can e-mail me at dyfalck@aol.com."

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