Helen came to my clinic seeking treatment for the menstrual headaches she suffered. When I examined her physical features: tongue, skin, hair, nails, eyes, pulse and so on, I discovered a bright red mark encircling her wedding ring finger. I asked Helen if she had just taken her ring off. She replied that she had. “I have to take it off every afternoon around 3 o’clock. I’m fine in the morning, but by the afternoon my hands and fingers swell up; so do my calves and ankles. Lots of my girlfriends experience this! Isn’t it normal?”
I told Helen that no, it certainly was not normal. I explained that the cause was fluid retention, and suggested that it was probably more pronounced before or around her period. Helen responded that it was indeed much worse – to the point where she becomes angry with herself.

Helen shares the problem of fluid retention, or oedema, with many other women. It may affect the face, hands, fingers, lower legs and abdomen and can be extremely uncomfortable.
Oedema is related to physiological imbalance of hormones, emotional stress and excessive physical work. According to Traditional Chinese Medicine (TCM), the main organs that influence water metabolism are the spleen and the kidneys.
There are two types of oedema. The first type is caused by spleen and kidney yang deficiency. In Chinese medicine, spleen and kidneys are two major organs that are in charge of transforming, transporting and excreting water. When the spleen and kidney yang are deficient, they fail in this function. Fluid accumulates in the space between the skin and the muscles, resulting in oedema. This type of fluid retention tends to be permanent and becomes distinctly worse before or during menstruation. Other symptoms such s backache, tiredness, loose bowel movements, heavy menstrual flow and a feeling of cold may manifest. The patient will have a pale, swollen tongue. Patients may be obese, or have gained weight suddenly - perhaps after childbirth or a serious operation or illness.

Treating this type of oedema can take some time. I thoroughly examine the patient’s medical history, then run a number of tests. I check her thyroid function with a medical blood test, her hormonal profile with a saliva test, and bowel toxicity level through hemaview analysis. I also look for nutritional deficiencies such as zinc, magnesium or chromium by taking a case history. Doing all this enables me to design a treatment program specific to the individual case.

The other type of oedema is slightly less severe. Caused by stagnation of qi, or energy, it is related to emotional stress due to anger, frustration, resentment, and depression, which may lead to stagnation of liver energy. Liver energy does not flow freely and fails to promote the transformation of fluid over the body. Chinese medicine calls this type of fluid retention “false oedema” because it is not caused by fluids per se. Unlike the other type of oedema, no depression remains when the skin is pressed with the thumb. So quite often the young ladies cannot work out why rings become so tight on their fingers for they can’t see obvious swelling. Their breasts become hard and tender, their feet are puffy and abdominal swelling may be quite obvious.

Treatment of this type of oedema is considerably easier. Acupuncture alone can achieve excellent results because it is highly effective in moving energy, assisting with blood and qi flow and unblocking any stagnation. Liver and spleen herbs are also effective.

Treatment for fluid retention is a challenge, but not an insurmountable one. The results are excellent when a patient is treated both nutritionally and medically. Diet, lifestyle, emotional factors are all important and need to be taken into account. If the patient co-operates with my treatment and follows my recommendations, she improves very quickly. In Helen’s case, after just two weeks of treatment, her headaches and swelling disappeared.