Light menstrual flow – Dark purple flow or thick flow – Thick menstrual flow – Thin flow – Early menstruation – Late menstruation – Amenorrhea (lack of period) – Metrorrhagia (heavy flow) – Irregular menstrual cycle – Fever during menstruation
Light menstrual flow
qi and blood deficiency
Clinical Manifestations- Light flow, delayed cycle,
- abdominal aching, fatigue, dizziness
- T: Pale
- P: Thready
- Anemia
- Heavy flow possible in the case of qi deficiency with no blood deficiency.
- Ba Zhen Tang (Eight Treasure Decoction)
Accumulation of phlegm damp
Clinical Manifestations- Light flow, obese patient, irregular cycles,
- heavy sensation in body
- T: Swollen tongue body with greasy coat
- P: Soft and slippery
- Jia Wei Er Chen Tang (Modified Two Aged Decoction)
Dark Purple Flow or Thick Flow
Qi and blood stagnation
Clinical Manifestations- Dark purple flow with clots, sever abdominal pain, sever PMS symptoms
- T: Purple
- P: Choppy
- Tao He Cheng Qi Tang (Peach Pit Decoction to Order the Qi)
Heat and blood stagnation
Clinical Manifestations- Thick dark clotty flow
- Severe abdominal pain, fever, mental symptoms
- Tao Hong Si Wu Tang (Four-Substance Decoction with Safflower and Peach)
Cold stagnation leading to blood stagnation
Clinical Manifestations- Thick dark clotty flow
- Severe abdominal pain, fever, mental symptoms
- Lower back cold, patient prefers warmth
- T: White coat
- P: Deep and tense
- Wen Jing Tang (Warm the Menses Decoction)
Thick Menstrual Flow
Qi and blood stagnation
Clinical Manifestations- Dark purple flow with clots, sever abdominal pain, sever PMS symptoms
- T: Purple
- P: Choppy
- Tao He Cheng Qi Tang (Peach Pit Decoction to Order the Qi)
Heat and blood stagnation
Clinical Manifestations- Thick dark clotty flow
- Severe abdominal pain, fever, mental symptoms
- Tao Hong Si Wu Tang (Four-Substance Decoction with Safflower and Peach)
Cold stagnation leading to blood stagnation
Clinical Manifestations- Thick dark clotty flow
- Severe abdominal pain, fever, mental symptoms
- Lower back cold, patient prefers warmth
- T: White coat
- P: Deep and tense
- Wen Jing Tang (Warm the Menses Decoction)
Damp Heat accumulation
Clinical Manifestations- Dark thick flow, strange oder, burning and itching in the vaginal region.
- Phlegm accumulation
- Clinical Manifestations
- Thick, though not dark flow. Congestion, dizziness, leukorrhea
- T: Greasy coat
- P: Slippery
Thin flow (the quality of the blood, see “light”
flow).
Early menstruation (early in the month, not early in life)
Blood heat
Clinical Manifestations- Bright red, copious flow. Could lead eventually to very dark red if the heat goes
untreated.
- Bright red, copious flow. Could lead eventually to very dark red if the heat goes
yin deficiency heat in the blood
Clinical Manifestations- scanty quality, red.
blood stagnation leading to heat in the blood.
Clinical Manifestations- Clots, abdominal pain
- Early or late period, heavy or light amount, spotting,
qi deficiency
Clinical Manifestations- Light and thin flow.
- Abdominal pulling or bearing down sensation, fatigue
- P: Weak
Late menstruation (In the month, not in life)
Cold and blood stagnation
Clinical Manifestations- Abdominal pain, patient desires warmth, flow with clots.
- T: Purple
- P: Deep, slow, possibly choppy.
phlegm/damp accumulation
Clinical Manifestations- Delayed, or lack of menses
- Pale red thick flow
- Obesity, indigestion
- T: Greasy coat
- P: Soft
deficiency of qi and blood
Amenorrhea (Lack of period)
Kidney qi deficiency
Clinical Manifestations- Congenital Kidney qi deficiency (Primary amenorrhea)
- No period as of the 15th birthday
- Emaciation, Lower back pain, fatigue,
- slow development
- P: Weak
- T: Pale
- Tonify Kidney
Qi and blood deficiency
Clinical Manifestations- Usually found after an illness or post partum
- No pain, no period
- Palpitations
- Fatigue, weakness
- P: Weak
- Tonify qi and blood
- Ba Zhen Tang (Eight Treasure Decoction)
Qi and blood stagnation
Clinical Manifestations- Amenorrhea following traumatic injury or stress.
- Lots of distention and pain
- fatigue, depression, anger
- T: Varies
- P: Deep and wiry
Damp and phlegm accumulation
Clinical Manifestations- Menopausal symptoms
- Delayed cycle, quantity of flow is light.
- Amenorrhea, weight gain, water retention
- T: Pale with white greasy coat
- P: Soft and slippery
Metrorrhagia (heavy flow)
Qi and blood deficiency
Clinical Manifestations- Heavy quantity, thin quality and light color.
Heat in blood
Clinical Manifestations- Dark Red flow
- blood stagnation
- Clinical Manifestations
- Irregular flow, spotting, dark purple color clots, pain in abdomen, which gets better
after the onset of the flow. - T: Purple
- P: Deep and choppy, or wiry and slippery
Irregular Menstrual cycle
Liver qi stagnation (accounts for 95% of cases)
Formula- Xiao Yao San (Rambling Powder)
Kidney qi deficiency
Fever during menstruation
Liver qi stagnation with Liver fire (most common)
Clinical Manifestations- Fever alternating with chills, more often before period, sometimes during.
- Early or irregular cycle, irritation, dizziness
- Thirst, dry mouth
- T: Red with yellow coat
- P: Wiry and Rapid
- Jia Wei Xiao Yao San (Modified Rambling Powder) (aka Dan Zhi Xiao Yao San)
Formula
Yin deficiency Fever
Clinical Manifestations- Fever following illness of post partum.
- This fever tends to happen before or during the period.
- Emaciation, irritability, dry mouth, thirst.
- T: Red and thin
- P: Thready and rapid
- Zhi Bai Di Huang Wan (Anemarrhena, Phellodendron, and Rehmannia Pill)
Formula
Wind cold
Clinical Manifestations- Chong and Ren channels are weak just prior to menses
- Tai yang syndrome
- Gui Pi Tang (Bolster the Spleen Decoction) even if there’s no sweating.
- Xiao Chai Hu Tang if fever is also associated with chills.
blood stagnation before or during period
Clinical Manifestations- Abdominal pain, dark complexion
- Flow is purple with clots.
- Xue Fu Zhu Yu Tang (Drive Out Stasis in the Mansion of Blood Decoction)
Qi deficiency or qi and blood deficiency fever
Clinical Manifestations- Fever before or during the period
- Light color and thin quality, scanty quantity
- T: Pale
- P: Weak
- Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction)
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