Early Menstruation and TCM

Early Menstruation

• Condition where menstruation occurs earlier than expected
• It often relates to issues with Spleen Qi, Heat, or Yin Deficiency

Spleen Qi Deficiency

• Cycle is early and duration normal
• There is a profuse or scant amount of period blood
• Color is pale
• Texture is thin
• Other complications can include digestive issues, fatigue, prolapsing, insomnia, palpitations, and Kidney Deficiency
• The tongue is pale with a white coating
• The pulse is thin and weak
• Treatment principle is to tonify Qi, hold blood, and regulate along with gentle Moxa
• Acupuncture points: UB20, SP6, ST36, REN4, REN6, DU20, SP1

Yang Abundant Heat (Excessive Heat)

• Cycle is early and duration normal
• There's a profuse amount of period blood
• The color is red or redder than normal
• The texture is thicker
• Other complications can include restlessness and thirst, scanty urine, and constipation
• The tongue is red with a yellow coating
• The pulse is rapid and forceful
• Treatment principle is to clear heat, cool and stop the bleeding
• Acupuncture points include UB15, UB23, KD3, LI11, SP10, SP1, DU14, and REN3

Stagnated Heat (Liver Qi Stagnation)

• Cycle is early and duration normal
• The amount is profuse or scanty, alternating
• The color of the blood can be dull red
• The texture is thicker
• Other complications can include depression, breast tenderness, lower abdominal distending pain, chest/hypochondriac discomfort, bitter taste, dry mouth, and emotional disorders
• The tongue has red sides or is possibly swollen and wiry
• Rapid pulse
• Treatment principle is to clear heat, soothe the liver, relieve constraint, and regulate the Chong/Ren meridians
• Acupuncture points: SP8, LV2, LI11, GB34, LV1, SP8, KD14, and REN6

Deficient Heat (Kidney Yin)

• Cycle is early and duration normal
• There is a profuse or scant amount of period blood
• The color is red
• Texture is thicker
• Other complications can include dryness, KD Def symptoms, hot flashes, night sweats, malar flush, scant urine, bone steaming, and five-center heat
• The tongue is dry, cracked, and red with little to no coating
• The pulse is thin and rapid
• Treatment principle is to nourish Yin, clear heat, stop bleeding, and regulate with emphasis on Kidney issues
• Acupuncture and herbal remedies: SP6, LU7, KD6, KD2, REN7, REN4, KD5, Bo He, Mei Gui Hua, Chamomile tea, REN12, PC6

Late Menstruation

• Menstruation that occurs later than the expected time frame

Blood Deficiency

• The cycle is late and duration is normal
• There is a scanty amount of period blood
• The color is pale
• The texture is thinner
• Diagnose blood deficiency by observing paleness in complexion, nails, tongue, and inside of eyelids
• The tongue is pale
• The pulse is thin and weak
• Treatment principle is to nourish by tonifying qi and regulating menstruation via REN6, REN4, SP6, SP10, and UB17

Deficient Cold

• The cycle is late and duration is normal
• There is a lesser amount of period blood
• The color is dull and pale
• The texture is thinner
• Distinguish by nature, severity, and preference for warmth or pressure/ If kidney system cold, knees and low back will be affected and Urine will be profuse, clear, and frequent at night
• The tongue is pale
• The pulse is weak, slow, and deep
• Treatment principle involves warming and tonifying kidney yang via strong moxa
• Acupuncture points: DU4, UB23, UB32, UB31-34, UB20, KD3, REN6, REN4, REN8, KD13, ST25

Blood Cold (Excessive Cold)

• The cycle is late and duration is normal
• There is less amount of period blood
• The color is dull
• The texture contains clots
• The tongue is pale
• The pulse is tight and deep
• Treatment involves warming meridians, resolving cold, and regulating the process.
• Acupuncture points: ST29, SP8, REN6, UB32, REN8 + Rou gui

Qi Stagnation

• The cycle is late and duration is normal
• There is less amount of period blood
• The color is dull
• The texture contains clots
• It is related to pain, bloating, distention, discomfort, and emotions
• The tongue is normal
• The pulse is wiry
• Treatment principle involves regulating qi
• Acupuncture points: SP4, PC6, LV14, REN3, LI4, LV3

Irregular Menstruation

• Menstruation that is not consistent in its cycle length

Liver Stagnation

• Cycle is irregular and duration normal
• There is more or less of period blood
• The texture contains clots
• Related pain and emotional disorders
• The tongue is normal
• The pulse is wiry
• Treatment is to soothe liver and relieve and regulate the flow.
• Acupuncture points: LV14, UB18, REN17, LV3, REN3, KD14, ST18

Kidney Deficiency

• Cycle is irregular and duration normal
• Scanty amount of blood
• Color is dull pale
• Texture is thinner
• Energy problems
• Bowel movement issues
• Pale tongue and weak pulse
• Treatment tonify and regulate flow.
• Acupuncture points: UB23, UB52, KD3, KD6, KD7, REN4, REN6, SP6

Profuse Menstruation

• Heavy menstrual bleeding

Qi Deficiency

• With a normal cycle and duration
• Profuse in amount
• Lighter in color
• Thinner texture
• Symptoms of general deficiency, impaired T&T function
• Pale Tongue and thin weak pulse.
• Treatment to tonify and regulate the flow.
• Key points: UB20, UB21SP/ST, DU20, REN4, REN6, SP1

Blood Heat (Excessive Heat)

• With a normal cycle and duration
• Profuse in amount
• Fresh red or deep red in color
• Thicker smaller clots for texture
• Mental Restlessness
• Thirsty
• Yellow scanty Urine
• Dry and hard BM
• Red Tongue, Yellow/Thick pulse
• Treatment to clear heat, cool blood, stop bleeding, and regulate flow.
• Key points: SP1, LV1, SP8, LI11, SP10, REN3, SP4, PC6

Blood Stasis

• With a normal cycle and duration
• Profuse in amount
• Dark in color
• Clotted texture
• Location/Nature of Pain
• Choppy/Wiry/Tight/Thin pulse
• Move blood
• Resolve stasis
• Stop bleeding
• Regulate flow
• Key points: SP4, PC6, REN3, KD14, ST29, SP10, SP6, UB17, SP8, LI4

Scanty Menstruation

• Abnormally light or infrequent menstrual periods.

Blood Deficiency

• Cycle is normal with normal or shorter duration
• Scanty amount of blood
• Pale color
• Thinner texture
• Paleness, insomnia, dizziness, etc
• Pale Tongue with thin pulse
• Treatment aimed at nourishing the blood
• Key acupuncture points: ST36, SP6, UB20, REN4, SP10, UB17

Kidney Deficiency

• Cycle is normal or shorter duration
• Scanty amount of blood
• Dull pale color
• Thinner texture
• Problems could be Empty/Cold (Yang Def) or Empty/Heat (Yin Def)
• Look to Coating of Tongue, use points that Tonify
• UB23, UB18
• KD-
  • REN4
  • REN6
  • KD13
  • REN8/DU4

Blood Stasis

• Pain (Stabbing)
• Location (Fixed)
• Worsened with pressure
• Red tongue, with purple on tongue body
• "Choppy" pulse
• Treatment to break and regulate Stasis
• SP4, PC6 - open Chong Mai
• ST29
• REN 3

Phlegm Damp

• Stool/Urine with "Profuse/Sticky Whitish Discharge"
• Look to Liver area of the tongue
• Reduce by "reducing" the Liver-Chi to
• • dry liver/ reduce "Heat"
• UB-23
• Tonify KD

Prolonged Menstruation

• Menstruation that lasts for an extended period of time.

Blood Stasis

• Normal cycle
• Longer duration
• Less amount
• Dark in color
• Clotted texture
• Pain
• Purple tongue and choppy pulse
• Treatment to move blood, resolve stasis, stop bleeding, and regulate the cycle.
• SP4, PC6
• LI4

Yin Deficiency Empty Heat

• Normal cycle
• Prolonged menstruation
• Less amount of flow
• Patient may have a red color for blood (Blood deficiency and Yin Deficiency have very slight, though critical differences)
• Thin and rapid pulse.
• Aim to "nourish yin," clear heat, and stop the prolonged flow.
• LU7-LUNG 7 and KD-6 KIDNEY 6
• REN4
• REN 6

Dysmenorrhea (Tong Jing)

• Painful Menstruation

Qi Stagnation Blood Stasis

• Nature of Pain is Distending Sharp
• Time is before and during
• Aversion/preference: worse with pressure, prefers movement
• Treatment Principle: Move and Resolve Stasis, Stop Pain
• Key acupuncture points
  • SP6
  • SP10
  • SP8
  • LV3
  • LI4

Cold Deficient Cold / Cold Damp Accumulation

• Pain is cold in nature.
• Time is later/post/pre/during early
• Aversion/preference: prefers heat, pressure makes it worse (Excessive)
• Treat by warming and resolving Cold, Damp or Blood Stasis
• Must stop blood loss
• The governing principle is to Tonify the Def and Reduce the Excessive
• UB32

Damp Heat Accumulation

• Burning nature of the pain.
• Before and During period.
• Is often a red sticky menstruation, with possible intermittent bleeding .
• Can be some underlying bacterial infection, refer for further tests.
• Treatment: Clear Heat, resolve Damp.
• Key points --SP9 --SP6 --REN 3

Qi & Blood Deficiency

• Nature: Achy, soreness.
• Time: during and / after Period.
• Aversion /Preference. Likes Rest. Desires Warmth
• Treat by Nourishing and Tonifying
• REN4

Liver vs Kidney Deficiency

• Essence
• Blood
• Nature- Achy/Soreness
• -Time= during/after
• --Tonify for Kidney/ Liver - Nourishing

Intermenstrual Bleeding

• Bleeding between periods

Kidney Yin Deficiency

• Yin def and Hot
• Not Clotted
• Treatment to nourish and clear heat, use LV7/KD6
• Stop bleeding

Damp-Heat (Excessive)

• More or less blood present
• Red coloring with a greasy texture, related to pain
• Fatigue poor appetite etc
• Joint soreness
• Chest restlessness Treatment
• To relieve damp and clear heat, must regulate the system
• Liver pain- chest pain

Blood Stasis

• Either the sides of the L-lower abdomen or the
• In the chest the Pt feels trapped
• The "Pulse - is "Choppy"

Amenorrhea (Bi Jing)

• The state of not menstruating

Liver and Kidney Deficiency

• "Essence-blood- Late: Scanty Color.
• Color more in the Pale/dul Texture: Less/thinner .
• Key Notes: Constitution
• Ach/Sore Dizzy. Tinnitus"
• Pale Tongue "Pulse":
• "Deep Weak/Thin".

Qi & Blood Deficiency

• Qi and Blood are deficient with " Paleness & Color as Scant/Less; Then texture as. "Thinner

Phlegm / Damp

• Scanty amount of everything ""Key is Dry mouth, which signals def"
• ""Tongue "Is what separates it" Body & Coating of both the " Tongue is DRY with Scanty
• Pulse 100% slippery (Damp system indicator)
• "To help resolve : Treat upper , Medial Jiao with special notes as above (re-examine)"