IEP Newsletter - Summer 1996 (5)

Chinese Medicine for HIV+ Women

from IEP Newsletter:Summer 1996

We are immensely grateful to Misha Cohen for this insightful and educational article. Adapted from The Chinese Way to Healing: Many Paths to Wholeness by Misha R. Cohen and "Chinese Medicine for Women with HIV/AIDS" by Misha Cohen, OMD and Abigail Surasky, L.Ac.

Chinese Medicine is a complete system of medicine with its own forms of diagnosis, treatment, prognosis and therapies, that can treat disharmonies associated with HIV in women. In conjuction with western therapies and the use of acupuncture, herbal remedies, diet, exercise and meditation the body can remain strong.

Sandy Espinoza gives an acupuncture treatment

Chinese Medicine Principles

Chinese medicine's primary goal is to create wholeness and harmony enabling the body to heal itself. Chinese philosophy embraces the concept of the dialectical opposition of the two polar principles of Yin and Yang. The body is considered a microcosm of the world. The correct balance of Yin and Yang will lead to good health as well as a balanced environment. Yin and Yang are not fixed entities but are always in relation to each other. In one situation something may have more Yang qualities while in another, more Yin qualities. Chinese medicine includes the concepts of Qi, Blood, Body Fluids and Organ Systems. Qi (chee) is the energy of the body. Xue (translated as Blood) is the material substance, including the fluid we call blood. Body Fluids include tears, sweat, and other fluids. Each Organ System governs particular body tissues, emotional states and activities. For example, in the Western concept of kidneys, the Kidney System manages fluid metabolism. In Chinese medicine, the Kidney System is also responsible for reproduction, growth and regeneration. The bones, inner ear, marrow, teeth and lumbar area are all part of the Kidney System. Frequent urination, low back pain, and the emotional state of fear may be associated with the Kidney System. Each Organ System has functions that are unique.

Chinese View of Women's Cycles

Women's monthly cycles depend on the harmonious functioning of the Organ Systems and a balanced flow of Qi and Blood. Irregular periods or pain, bloating, mood swings and /or cramps, are a sign that one or more of the governing Organ Systems and Qi and Xue are not in balance. The Kidney System controls the formation and release of the egg from the ovaries. Kidney disharmonies can accompany chronic fearfulness that in turn causes tension, irritability, or depression associated with the monthly cycle. The Liver System promotes the free flow of Qi and triggers the release of Blood and the onset of the period. Menstrual problems such as cramps, mild headaches or depression before or during the onset of period are usually due to the Liver Qi not flowing smoothly. Anger and emotional suppression can damage the Liver. Spleen System disharmonies are associated with digestive disturbances, sugar craving and fluid retention. When Spleen Deficiency leads to Blood Deficiency it is associated with lengthening of the cycle or missed periods and difficulty falling asleep.

Spleen and Stomach Damage in HIV

Understanding the role the Spleen and Stomach System is central to understanding HIV disease. If the Spleen and Stomach System does not function properly, one cannot absorb nutrients and will waste away. HIV infection starts with the attack on the Stomach and Spleen System, with damage to the center of the body. Strengthening of the Spleen/Stomach and the digestion is a main focus of treatment.

The attack on the Spleen Stomach digestive functions results in symptoms like diarrhea or loose stools, bloating, fatigue, loss of appetite and nausea, often early in the HIV process. The Spleen pulse may be soft or slippery and the tongue may be puffy or scalloped, may have a lack of coating in the center, and is often cracked, showing that the Spleen Qi is deficient.

Chinese Medicine In Women with HIV

Although Chinese medicine is powerful at all stages of HIV and AIDS, it can be especially effective if used regularly from the outset and when a woman is still asymptomatic, rather than after the disease has progressed significantly. Just like a tightrope walker, someone who is asymptomatic or mildly symptomatic must work to stay in balance. With each sign of imbalance, like a cold, sinus infection, or yeast infection, Chinese medicine can gently draw the body back to its center, restoring oneŐs health and making it possible to live with HIV as a chronic manageable virus.

Acupuncture and herbs are used to help with pregnancy, and to treat many health problems like chronic diarrhea, fevers and night sweats, PMS, menopausal symptoms, irregular menses, breakthrough bleeding, dysplasia and chronic PID. The more severe the imbalance, such as opportunistic infections, the more Western Medicine might need to be used, at which point Chinese Medicine can help protect the body from the chemical toxicities and side effects of the medications, in addition to treating the organic symptoms.

Manageable side effects of drugs include anemia, digestive disturbances and peripheral neuropathy. There are treatments available for persons with CMV retinitis, MAC and cryptosporidium. Since treatments are in no way totally benign, your practitioner should be state licensed or nationally certified, as well as trained in HIV and AIDS.

We also recognize that there are common Chinese medicine syndromes (Toxic Heat, Spleen/Stomach Deficiency, digestive weakness, among other syndromes) associated with HIV infection for which all persons with HIV must receive treatment.

Toxic Heat: HPV warts (human papilloma virus) and cervical dysplasia are signs of Toxic Heat in women, and can often be treated with high doses of Clear Heat Clean Toxin herbal formulas internally--which have anti-bacterial and anti viral properties--and topical herbal ointments externally applied to the cervix. Genital and oral ulcers, such as herpes and canker sores and PID, are also Heat manifestations that can be treated with Chinese medicine.

Spleen-Stomach Qi Deficiency:The Spleen also governs the Blood in Chinese medicine, so when the Spleen is weak it cannot hold the Xue properly. In women, this can cause anemia and irregularities in the menstrual cycle. Many women with HIV have problems with breakthrough bleeding, a symptom which responds well to acupuncture and moxibustion. If there is hemorrhaging, always see a gynecologists as it may be a sign of a serious condition like cancer or tubal pregnancy requiring immediate medical attention. Amenorrhea, or lack of menses, is also a common problem in HIV+ women. Lack of Blood, called Blood Deficiency, may occur with certain drug therapies, or when the Spleen is too weak to transform food nutrients into Blood, resulting in amenorrhea, fatigue, paleness and a weak pulse. Another cause of amenorrhea could be Blood Stagnation, marked by more distention and emotional stress.

Dampness:One of the most common symptoms in women with HIV is recurring or persistent yeast infections appearing as vaginal yeast infections, oral thrush, or systemic candidiasis. Esophageal candiasis is an AIDS defining diagnosis, and should always be treated with Western antifungals in addition to herbal therapy.

In Chinese medicine, these conditions are problems of Dampness; either Cold Damp, where yeast is white in color, or Damp Heat, where yeast is more yellow and odorous. As strong fungicidal medications are particularly toxic to the liver, herbal therapy is a safer option for many women. Any treatment for candida overgrowth requires attention to diet, such as avoiding sugars, fermented products, dairy (except for yogurt in certain cases) and alcohol. One must emphasize proteins, garlic, greens and other vegetables, as well as increasing good bacteria by eating such foods as miso soup.

Liver Qi Stagnation:This may involve Liver Qi Stagnation brought on by stress, drug abuse, alcoholism, strong medications, and even abdominal surgery, including abortions. For women with Liver Qi Stagnation, one may see aggravated PMS and/or dysmenorrhea. Symptoms such as increased breast distention, swollen abdomen and increased flatulence are all related to Liver Qi Stagnation. Pre-menstrual symptoms are often aggravated in women with HIV. A looming symptom that may be overlooked or over-treated (especially in women) by doctors is depression. Chinese medicine recognizes that the strength of the Spirit is crucial to the health of the whole person. Chinese theory refers to the Liver as the Sea of Emotions. Acupuncture is a very powerful tool in facilitating the healthy flow of Stagnant Liver Qi to help alleviate depression and anxiety. For the many women with HIV who also have Chronic Hepatitis B and/or C to contend with, excellent results can be achieved by using Chinese herbs in combination with acupuncture.

Kidney Qi: Chronic conditions, especially with fatigue, are usually associated with a Deficiency of the Kidneys, which in Chinese medicine store your vital energy or Qi. Symptoms of Kidney Deficiency can include frequent urination, fatigue, low back pain, no ovulation, lack of desire for sex, lack of will power, and dark circles under the eyes. For women, underlying Toxic Heat and Spleen Qi Deficiency are often complicated by a pre-existing Kidney Deficiency, a condition usually caused by stress, coffee, not enough sleep or rest, childbirth or abortions, low self esteem or incest issues and other viral problems like Epstein Barr and Chronic Fatigue.

Health Care Recommendations

Along with complete Western medical care, women with HIV are recommended to try weekly or bi-monthly acupuncture treatments and daily or bi-weekly treatments for acute symptoms or substance withdrawal. Herbs are taken daily. Qi Gong exercise, massage, dietary changes, and meditation are also recommended. Resolution or control of symptoms can be made with Chinese medicine over time, with the best chance of success being at early onset of symptoms or through prevention/maintenance treatments. Every client should be under the care of a physician to ensure early diagnosis of serious symptoms, and so that stubborn or advanced conditions can be appropriately treated with Western medical intervention if necessary, in conjunction with Chinese medicine. Unfortunately, there are no proven herbal replacements for the different prophylaxes that are recommended against MAC, toxoplasmosis, cytomegalovirus (CMV) or PCP, when one's CD4+ counts fall below 200 or lower (depending on the disease).

Comprehensive Approach

Ask your practitioner to help you develop a comprehensive program which includes a focus on strengthening immunity, and creating harmonious cycles as well as a general, preventive healthcare routine. This could include any of the Chinese medicine approaches mentioned above, along with nutritional supplements, natural hormone therapies, and Western gynecological and other exams and treatments as needed. Chinese medicine offers a type of health care that includes the involvement and intuition of the client, which is probably very new to many women who have experienced only institutionalized health care. The degree of benefit derived from Chinese Medicine depends on the client being a participant in her healing process. In this way, she can gradually take charge of her health and discover her own sense of wholeness and wellness.
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