Herbally Treating the Vagina and Adnexa

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Externally treating the vagina and adnexa (adjacent parts) presents an opportunity for creatively applying herbs. This article presents eight techniques for external herbal application to the vaginal region. I co-developed this material with Dr. Yitian Ni, OMD, LAc, as part of a seminar on abnormal vaginal discharges that she presented in March 1998. I had the great fortune of learning from and closely working with Dr. Ni throughout the 1990s.

THE TECHNIQUES

The eight techniques for externally treating the vagina and adnexa are: steams, vaginal wash, douche, retention douche, retention enema, herbal tampon, herbal salve, and herbal oil. The methods for implementing each of these techniques are as follows:

Vaginal Steam

Steaming can be used for any infections or inflammations that mainly involve the external genitalia. The patient puts the boiling decoction into a bedpan. She then sits on the bedpan for 10 minutes so that the steam rises to the vaginal area. Afterwards, she washes the vagina with a wash cloth or with gauze. Steaming should be performed twice daily.

Vaginal Wash

Washes are useful for any infections or inflammations that mainly involve the vagina. Before performing a vaginal wash, the patient should first wash her hands. She then wets a wash cloth or gauze using a lukewarm decoction of herbs. Like steaming, vaginal washing should be performed twice daily.

Vaginal Douche

Douching can be done for any infections or inflammations that mainly involve the vagina and/or the cervix. To douche, the patient places a lukewarm herbal decoction into a douche bag, or a plastic, small-mouthed bottle, or a needle-less syringe. The decoction is placed within the vagina using the tubing of the douche bag, the mouth of the bottle, or the opening of the syringe. Allow the vagina to drain. Perform twice daily.

Retention Douche

The retention douche is used to treat conditions primarily affecting the cervix. Initially, it is performed like the regular douche, allowing the decoction to drain from the vagina. Then the patient lies supine and places a pillow under her sacrum to tilt the vestibule of the vagina upward. She redouches, but this time retains the decoction for 30 minutes. Both parts of the retention douche should be performed twice daily.

Retention Enema

The retention enema can be used for chronic pelvic inflammatory disease (PID) or for a palpable benign mass. it is performed by inserting the lukewarm herbal decoction into the rectum using a 6 inch catheter from an enema bag with tubing. The decoction is retained 30 minutes. For this technique, it is important that the patient position her body according to the area to be treated. Lying on either side, or resting on her knees with her chest against the bed and her hips elevated (genupectoral position), or semiprone with one knee drawn toward chest (SimsĂ­ position) are possibilities. The retention enema is performed once daily for 10 days.

Herbal Tampon

The herbal tampon is especially useful for cervical conditions. Before using an herbal tampon, the patient first douches with either clear warm water or an herbal decoction. Then she uses one of two methods to prepare the tampon.

The first method is to soak the tampon with the lukewarm herbal decoction while it is still in the applicator. The patient lies supinely after inserting the tampon, then uses a needleless syringe to further irrigate the inserted tampon with additional decoction. She should remain supine for 10 minutes to allow the added decoction to be absorbed.

The second method is to push the tampon one-half inch into the applicator using the little finger. Lightly dampen the end of the tampon while it is still in its applicator, then pour powdered herbs into the depression at the upper end of the tampon applicator, insert the tampon.

For both methods, retain the tampon for up to a half-day or entire night. Seven tampons for either the liquid-type or powder-type are considered one course of treatment.

Herbal Salve and Herbal Oil

The herbal salve is used for atrophic vaginitis and for other conditions that include vaginal dryness and/or itching. Caution: Both salves and oils can worsen conditions involving damp-heat. The patient applies the salve to the vulva and/or vagina and leaves it in place throughout the night. Have her apply nightly for one week. Use a commercially available herbal salve, or create your own (see below).

Herbal oil can be used for the same conditions as herbal salve. Like a salve, oil is applied each night for one week. Use a commercially-available herbal oil, or create your own (see below).

HERBAL PREPARATION

Steaming Vaginal Wash

Use at least double the quantity of raw herbs used for an oral decoction. Presoak the herbs by covering with fresh water for 20 minutes. Add water until the water level is one inch above the herbs. Bring to a boil, then reduce to a simmer for 30 minutes. Cook only once. Strain the decoction into a pan.

Herbal Douche and Retention Douche, Retention Enema, and Liquid-Type Herbal Tampon

Use at least double the quantity of herbs used for an oral decoction. Presoak herbs by covering with fresh water for 20 minutes. Do not add any additional water. Bring to a boil, then reduce to a simmer for 30 minutes. Cook only once. Strain the decoction (about 6 fluid ounces of decoction will exist).

Powder-Type Herbal Tampon

Fill the depression created by the tampon pushed into the applicator with approximately 1-2 grams of powdered herbs (either raw or processed). To prepare an herbal salve, use finely powdered herbs (raw or processed). Mix with vegetable oil or fish liver oil to form a thick paste.

Herbal Oil

An herbal oil is made by cutting raw herbs into small pieces. Cover the herbs with sesame oil for 2-4 weeks. Strain the oil.

EXAMPLE FORMULAS

Inflammation or Infection of the External Genitalia and Vagina

One possible formula could consist of: yin hua teng (Lonicerae japonicaecaulis), da huang (Rhei radix et rhizoma), ku shen (Sophorae flavescentis radix), huang bai (Phellodendri cortex), wei ling xian (Clematidis radix), bei xie Dioscoreae hypoglaucae rhizoma), cang zhu (Atractylodis rhizoma), tu fu ling (Smilacis glabrae rhizoma), and pu gong ying (Taraxaci mongolici herba cum radice).

Candida or Trichomonas

Consider using some or all of these herbs: ku shen (Sophorae flavescentis radix), she chuang zi (Cnidii monnieri fructus), zi hua di ding (Violae yedoensitis herba cum radice), bai xian pi (Dictamni dasycarpi cortex radicis), pu gong ying (Taraxaci mongolici herba cum radice), huang qin (Scutellariae baicalensis radix), hua jiao (Zanthoxyli bungeani pericarpium), ma bian cao (Verbena officinalisherba), tu jing pi (Pseudolarix kaempferi cortex) and wu yao (Linderae strychni foliae radix).

Final Remarks: None of these techniques should be used during menstruation. Also, the patient should refrain from intercourse during treatment. Herbs can be consumed orally along with the external techniques at the discretion of the acupuncturist.

CAAOM.

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By Don Goddard

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