Irregnlar Menstruation
Irregular menstruation refers to any abnormal change in menstrual cycle , in
quantity and color of flow , and other accompanying symptoms . Commonly seen cases
are antedated and postdated menstruation , irregular menstrual cycle .
Menstruation earlier than due time by seven to eight days , or even twice a
month , is regarded as antedated menstruation , while menses later than due time
by eight to nine days or even once every forty to fifty days is considered as
postdated menstruation .
Menopathy is caused by many factors , such as the exogenous pathogenic cold ,
heat and damp , emotional disturbances - worries , depressed rage , indulgence in
sexual life , grand multiparity , etc . , leading to the disharmony between qi and
blood and the injury of the Shong and Ren Meridians .
Etiology and Pathogenesis
Antedated menstruation :
Heat in the blood : It is due to abundance of the internal heat , yin
deficiency and yang excess , or overtake of pungent food , over dosage of the
warm property drugs acting on uterus , or to fire transformed from stagnated
liver qi , etc . All of these lead to the injury of the Chong and Ren
Meridians by excessive heat , bringing about antedated menstruation .
Qi deficiency : This is caused by overexertion , improper diet leading to
weakness of the spleen qi and insufficient qi in the middle jiao , which
fails to control the menstrual flow , resulting in antedated menses . Dr .
Zhang Jingyue pointed out , If the pulse does not reflect excessive
heat internally it means antedated menstruation is caused by qi deficiency
of the heart and spleen that fail to control the blood .
Postdated menstruation :
Blood deficiency : The blood may be marred due to chronic
hemorrhage , debility resulted from chronic diseases and multiparity .
Irregular diet and overexertion may injure the spleen and stomach , causing
insufficiency of blood in the Chong and Ren Meridians . Finally , postdated
menstruation occurs .
Cold in the blood : It is due mostly to constant yang deficiency and
internal growth of cold , or due to overtake of raw and cold food , exposure
to rain and cold during the menstrual periods . Then the pathogenic cold
invades the Chong and Ren Meridians , impeding the free flow of blood , hence
the menstrual cycle delays .
Qi stagnation : It is due to emotional depression , disturbing
the qi activity and resulting in qi stagnation . The stagnated qi impairs the
smooth now of blood which leads to abnormal function of the Chong and Ren
Meridians . The sea of blood cannot be filled up at due time , and postdated
menstruation occurs .
Irregular menstrual cycles :
Qi stagnation in the liver : It is due usually to depressed rage that
hurts the liver and disturbs the storage of blood , which leads to
dysfunction of the blood in the Chong , Ren Meridians and uterus , hence
irregular menstrual cycles .
Kidney deficiency : It is due to marriage at an immature age , indulgence
of sexual life , grand multiparity , etc . , which consume the essence and
blood . The kidney qi fails to conduct its function in storing essence and
adjusting the Chong and Ren Meridians , resulting in irregular menstrual
cycles .
Differentiation
Antedated menstruation :
Heat in blood :
Main manifestations : Shortened cycle , dark red and thick blood flow in
large quantities , restlessness , ftrilness in the chest , brown urine ,
reddened tongue with yellow coating , rapid and forceful pulse .
Analysis : Dark red , thick and profuse menses indicate internal excessive
heat , which impairs the heart and liver , leading to restlessness and
fullness in the chest . When the heat shifts from the heart down to the small
intestine there appears scanty and dark yellow urine . The yellow tongue
coating and the rapid pulse are signs of internal heat .
Qi deficiency :
Main manifestations : Profuse , thin and light red menses in shortened
cycle , lassitude , palpitation , shortness of breath , subjective empty and
heavy sensation in the lower abdomen , pale tongue with thin coating , weak
pulse .
Analysis : The spleen qi dominates the middle jiao and controls blood . Qi
insufficiency fails to check the blood , there occurs disturbance of the
Chong and Ren Meridians , leading to profuse , thin and light red menses in
shortened cycle . Lassitude , shortness of breath and empty heavy sensation
are manifestations of qi deficiency . Palpitation and pale tongue account for
blood deficiency , and the weak pulse is a sign of qi deficiency .
Postdated menstruation :
Blood deficiency :
Main manifestations : Scanty and light red menses in delayed cycle , empty
and painful feeling in the lower abdomen , emaciation , sallow complexion ,
lusterless skin , dizziness and blurred vision , palpitation and insomnia ,
pink tongue with little coating , weak and thready pulse .
Analysis : Owing to a chronic disease , weak body constitution or chronic
hemorrhage , blood cannot form the timely tide in the sea of blood , bringing
about scanty and light red menses in delayed cycle . When the blood fails to
nourish the uterus , there is an emptiness and pain in the lower abdomen .
When the meridians , vessels , muscles and skin are undernourished , there may
appear emaciation , sallow complexion and lusterless skin . When the liver and
heart fail to be nourished by blood , dizziness , blurred vision , palpitation
and insomnia occur . If the tongue is malnourished and the vessels are not
filled up , there present pink tongue and weak thready pulse .
Cold in the blood :
Main manifestations : Scanty and dark - colored menses in delayed cycle ,
colic pain in the lower abdomen , slightly alleviated by warmth , cold limbs ,
thin and white tongue , deep and slow pulse .
Analysis : The invasion of pathogenic cold during menstruation impedes
blood flow , leading to scanty and dark - colored menses in delayed cycle . Cold
in the uterus binders the smooth flow of qi and blood and then there appears
colic pain . Cold , yin by nature , injures yang qi and brings about cold
limbs . Thin and white tongue coating , deep and slow pulse are signs of cold
syndromes .
Qi stagnation :
Main manifestations : Scanty and dark red menses in delayed cycle ,
distending pain in the lower abdomen , mental depression , stuffy chest
alleviated by belching , distension in the hypochondria and breast region ,
thin , white tongue coating and string - taut pulse .
Analysis : Stagnated qi of the liver brings about retarded blood flow and
results in scanty and delayed menses with distending pain in the lower
abdomen . When the qi fails to travel smoothly , mental depression and stuffy
chest present . Since the Liver Meridian runs through the costal and
hypochondriac regions , the stagnated liver qi gives rise to the distension
in the hypochondrium and breast . String - taut pulse is a typical sign of
liver disorder and qi stagnation .
Irregular menstrual cycles :
Qi stagnation in the liver : Main manifestations : Alteration of menstrual
cycles and quantity of blood flow , thick , sticky , and purple colored menses
difficult to flow , distension in the hypochondriac region and breast ,
distending pain in the lower abdomen , mental depression , frequent sighing ,
thin white tongue coating and string - taut pulse .
Analysis ; Depressed rage injuries the function of the liver , leading to
unsmooth flow of qi and blood and disturbance in the sea of blood , and
finally to the alteration of menstrual cycles and quantity of blood flow .
The stagnation of liver qi causes impeded flow of blood , bringing about difficult
menstruation , distension in the hypochondriac region and breast , and
distending pain in the lower abdomen . Frequent sighing may help to relieve
the stagnated qi . String - taut pulse is a typical sign of liver qi
stagnation .
Kidney deficiency :
Main manifestations : Scanty , light red blood flow in altering cycles ,
dizziness and tinnitus , weak and aching of the lower back and knees ,
frequent night urination , loose stools , pale tongue with thin coating , deep
and weak pulse .
Analysis : When there is insufficiency of kidney qi , disharmonized Chong
and Ren Meridians bring on the derangement of the flow and ebb of tide in
the sea of blood , resulting in the alteration of menstrual cycles .
Insufficient kidney qi decreases the essence and blood , leading to scanty ,
thin and light red menses . Since the kidney dominates bones , generates
marrow , and has its opening in the ear , and the Kidney Meridian runs through
the waist , deficiency condition of the kidney causes lack of marrow , impairs
audibility and malnourishes the waist , bringing on dizziness , tinnitus , sore
and weak in knees and the lower back . When the kidney fails to control
urination and defecation there appear frequent urination and loose stools .
Pale tongue with thin coating and deep weak pulse indicate kidney yang
deficiency .
Treatment
Antedated menstruation :
i ) Heat in the blood : Method : Points of the Spleen and Kidney Meridians
are selected as the principal points . Acupuncture with the reducing method
is applied to regulate the Chong and Ren Meridians and , clear ofT heat from
blood .
Prescription : Quchi ( L 1 11 ) , Zhongji ( Ren 3 ) , Xuehai ( Sp 10 ) , Shuiquan
( K 5 ) . Supplementary points : Liver qi transforming into fire : Xingjian ( Liv
2 ) .
Yin deficiency with internal heat : Rangu ( K2 ) .
Explanation : Quchi ( LI 11 ) is the He - Sea Point of the Hand - Yangming
Meridian while Xuehai ( Sp 10 ) is the Jing - River Point of the Foot - Taiyin
Meridian . When they are used together , heat is removed from blood . Zhongji ( Ren
3 ) , the intersecting point of the three yin meridians of foot , works to
regulate the Chong and Ren Meridians and remove internal heat from the lower
jiao . Shuiquan ( K 5 ) , Xi - Cleft Point of the Kidney Meridian , strengthens
yin , reduces heat and regulates menses . All the points used together serve
the purpose of clearing off heat and regulating menstruation . Xingjian ( L 2 )
is added to clear away the heat from the liver in case of stagnated liver qi
transforming into fire . Rangu ( K 2 ) is used to nourish yin , reduce heat and
to regulate menses .
ii ) Qi deficiency :
Method : Select the main points from the Ren , Foot - Taiyin and Foot - Yangming
Meridians to replenish qi so as to restore its function in controlling
blood . Acupuncture is applied with the reinforcing method .
Prescription : Qihai ( Ren 6 ) , Sanyinjiao ( Sp 6 ) , Zhongwan ( Ren 12 ) ,
Zusanii ( S 36 ) . Explanation : Qihai ( Ren 6 ) can regulate qi of the whole
body . Qi is the commander of blood and when it is abundant blood is totally
controlled by it . Sanyinjiao ( Sp 6 ) , Zhongwan ( Ren 12 ) and Zusanii ( S 36 )
are chosen to build up the spleen qi , and strengthen spleen qi , controls
blood . All the points applied together attain the purpose of replenishing qi
and controlling blood .
Postdated menstruation :
i ) Blood deficiency and cold in the blood :
Method : Points of the Ren and Foot - Taiyin Meridians are selected as the
principal points . In case of blood deficiency , acupuncture is applied with
the reinforcing method to replenish qi and nourish blood . Moxibustion is
also advisable . In case of cold in the blood , acupuncture is given with the
even movement . Strong stimulation of moxibustion is used to warm up the
meridians and disperse cold .
Prescription : Guanyuan ( Ren 4 ) , Qihai ( Ren 6 ) , Sanyinjiao ( Sp 6 ) .
Supplementary points : Dizziness and blurred vision : Baihui ( Du 20 ) ,
Palpitation and insomnia : Shenmen ( H 7 ) . Explanation : Guanyuan ( Ren 4 ) ,
an intersecting point of the three yin meridians of foot connects the
uterus . When the reinforcing method is applied to Guanyuan ( Ren 4 ) and
Sanyinjiao ( Sp 6 ) , qi and blood are promoted , the Chong and Ren Meridians
are regulated and then cold is dispelled from them . Qihai ( Ren 6 ) assists to
adjust qi and blood so that the Chong and Ren Meridians are well regulated
and menses comes on time . Baihui ( Du 20 ) helps ascend qi and blood ,
nourishing the head and eliminating dizziness and blurred vision . Shenmen ( H
7 ) pacifies the mind in case of palpitation and insomnia .
ii ) Qi stagnation :
Method : Points of the Foot - Jueyin and Foot - Yangming Meridians are
selected as the principal points . Acupuncture is applied with the reducing
method to activate qi and blood flow .
Prescription : Tianshu ( S 25 ) , Qixue ( K 13 ) , Diji ( S 8 ) , Taichong ( Liv 3 ) .
Supplementary points : Fullness of the chest : Neiguan ( P 4 ) . Distension in
the hypochondriac region and breast : Qimen ( Liv 74 ) .
Analysis : Tianshu ( S 25 ) and Qihai ( Ren 6 ) are located on the Foot - Yangming
Meridian . Qixue ( K 13 ) can promote qi and blood flow and regulate the Chong
and Ren Meridians . Diji ( Sp 8 ) , a qi point of the blood system can adjust
blood arid qi circulation . Taichong ( Liv 3 ) , the Yuan - ( Primary ) Point of the
Liver Meridian can soothe the liver and regulate liver qi . The points are
used together to achieve free flow of qi and blood . Neiguan ( P 6 ) is chosen
to remove fullness from the chest and adjust qi . Qimen ( Liv 14 ) is added to
regulate qi so as to weed out the disterision in the hypochondriac region
and breast .
Irregular menstrual cycles :
i ) Qi stagnation in the liver : Method : Points of the Ren and Jueyin
Meridians are selected as the principal points to ease the liver and
regulate the Chong and Ren Meridians . Acupuncture is given with the even
movement .
Prescription : Qihai ( Ren 6 ) , Siman ( K 14 ) , Jianshi ( P 5 ) , Ligou ( Liv 5 ) .
Supplementary points : Distension in the hypochondriac region and breast :
Tanzhong ( Ren 17 ) , Qimen ( Liv 14 ) .
Mental depression : Shenmen ( H 7 ) , Taichong ( Liv 3 ) .
Explanation : Qihai ( Ren 6 ) and Siman ( K 14 ) can promote the flow of qi
and blood , regulate Chong and Ren Meridians . Located on the Jueyin
Meridians , Jianshi ( P5 ) and Ligou ( Liv 5 ) remove stagnation of the liver qi
and treat disordered menses . The irregular menstrual cycles will be removed
once the liver restores its normal function and the Chong and Ren Meridians
ate harmonized . Tanzhong ( Ren 17 ) and Qimen ( Liv 14 ) are included in the
prescription to soothe the liver and relieve the stagnated qi of the liver
and distending pain in the hypochondriac region and breast . Shenmen ( H 7 )
and Taichong ( Liv 3 ) ease the mind and relieve depression .
ii ) Kidney deficiency : Method : Points on the Ren and Foot - Shaoyin
Meridians are selected as the principal points . Acupuncture is given with
the reinforcing method . Moxibustion is used to replenish the kidney qi and
regulate the Chong and Ren Meridians .
Prescription : Guanyuan ( Ren 4 ) , Shenshu ( B 23 ) , Jiaoxin ( K 8 ) .
Supplementary points : Sore and weak low back and knees : Yaoyan ( Extra ) ,
Yingu ( K 10 ) .
Dizziness and tinnitus : Baihui ( Du 20 ) , Taixi ( K 3 ) .
Explanation : Shenshu ( B 23 ) the Back - Shu point of the kidney , can
strengthen congenital essence when used together with Guanyuan ( Ren 4 ) and
Jiaoxin ( K 8 ) . The irregular menstrual cycles get redressed naturally once
the kidney can carry out well its function in storing essence . Yaoyan
( Extra ) aims at the sore and weak low back and knees , while Yingu ( K 10 )
strengthens the bones through kidney activation . Taixi ( K 3 ) and Baihui ( Du
20 ) are added to promote marrow and nourish the brain by means of tonifying
kidney to treat dizziness and tinnitus .
Remarks
Included in this disorder is the irregular menorrhea resulted from
dysfunction of antehypophysis or from ovarian dysfunction .
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