By Keren Zelicha
A woman above 18 years old that her menstruation stopped for 3 months or more is considered to have amenorrhea. This should be differentiated with pregnancy, breastfeeding mamas, menopause, anatomy causes and other diseases that can cause this phenomenon.
The disease was first mentioned in the NEI JING , (女子不月 ，月事不来) .
The disease can be divided into 2 parts: Deficiency, excess.
Deficiency – is when Jing – blood aren’t sufficient, sea of blood is empty, no blood is going down. In deficient types there are earlier signs of scanty flow water like menstruation which eventually leads to amenorrhea. (Mostly due to liver – kidney xu, qi- blood xu , yin xu + blood dryness ). Treatment principle would be tonify and promote flow, or tonify boost kidney liver, or harmonize nourish qi & blood.
Excess – is more likely to happen by an exterior evil which obstructs the flow of the channels, menstruation can’t flow downwards .In excess types amenorrhea can come suddenly ( mostly due to qi & blood stagnation, damp heat obstructed). Treatment principle should be drain and promote flow, or move blood transform stagnation, or move qi open stagnation, or expel evil harmonize menstruation.
Using herbs remember that: we shouldn’t tonify to much (evil will remain inside); using too much breaking blood stasis will damage the qi; and using too drying and astringent herbs will cause the blood not to come out.
Pathology:
1. 肝肾不足 – Kd-Liv deficiency:
kidney qi isn’t rising, jing qi isn’t full, liver blood is empty, chong ren aren’t nourished and cant transform menstruation. The causes can be due to many labors, abortions, over sex, chronic disease that harmed the kidney…
kidney yang can also affect by causing deficient cold which blocks the movement of blood, and amenorrhea.
Amenorrhea for 3 months, or delayed menstruation scanty amount which turned into amenorrhea, weak constitution, pain weak back/legs, tinnitus, dizziness, Tongue- pale red, thin coating, Pulse- deep weak, thin
This is tian kui deficiency. Kidney qi xu, chong – ren not flowing causing late menstruation- amenorrhea.
Principle: tonify kidney, nourish liver, harmonize menstruation.
Formula: gui shen wan add ji xue teng, he shou wu.
Gui shen wan:
Tu si zi, du zhong, gou qi zi, shan zhu yu, dang gui, shu di, shan yao, fu ling.
2. 气血不足- qi & blood deficiency:
spleen stomach deficient, or over eating that harm the M.J, or tiredness, attacking heart-spleen, ying- blood deficient, or chronic disease that harm qi & blood, bleedings, abortion, over breastfeeding, all can damage blood and lead to chong ren insufficiency of blood, sea of blood is empty, there is no blood to flow downwards .
delayed menstruation, scanty amount, pale color, watery like , that stopped for long time. Dizziness, palpitations, short of breath, tiredness, no appetite, dropping hear, thin pale body.
Pulse- deep slow, or week fast, Tongue- pale, little white coating.
Principle: tonify qi, nourish blood, harmonize blood.
Formula: ren shen yang rong tang.
Ren shen , huang qi, bai zhu, fu ling, yuan zhi, chen pi, wu wei zi, dang gui, bai shao, shu di, gui zhi, zhi gan cao.
3. 阴虚血燥- yin deficiency, blood dryness:
constitutional yin deficiency, or blood deficiency that harm yin, or chronic disease influenced blood deficiency, or spicy hot food that dried up blood, all dried up the sea of blood causing amenorrhea.
Scanty menstruation that prolonged into amenorrhea, 5 palm heat, malar flash, night sweating, heat in the bones, dry cough, Tongue- red thin coating, Pulse- deep thin fast.
Principle: nourish yin, expel heat, harmonize menstruation.
Formula: jia jian yi yi jian. Add huang jing zhi ke, dan shen
Yi yi jian jia jian:
Sheng di, shu di, bai shao, mai dong, zhi mu, di gu pi, zhi gan cao.
Coughing blood add: bai he, chuan bei mu, e jiao, wu wei zi.
Palpitaions insomnia add: bai zi ren , ye jiao teng.
4. 气滞血淤- qi & blood stagnation:
unstable 7 emotions can cause liver qi stagnation & blood stagnation, or in time of menstruation or labor wind cold entered and damaged the free flow of blood, or wind heat congesting blood and yin transforming into blood obstruction. Chong – ren stagnation blocks the flow of menstruation causing amenorrhea.
Amenorrhea, closed feelings, easy to get angry, fullness in hypochondria, fullness of lower sides of the abdomen, pain can be when pressed. Tongue- purple dark, red spots, Pulse- deep wiry, or deep choppy.
Principle: promote qi ,move blood, expel stasis, move menstruation.
Formula: xue fu zhu yu tang:
Tao ren, hong hua, chuan xiong, dang gui, chi shao, sheng di, niu xi, chai hu, zhi ke, gan cao.
Hypochondriac pain add mu xiang, e zhu, qing pi.
Headache due to blood stasis add jiang huang, san leng.
Yellow leucorrhea add huang bai, bai jiang cao, dan pi.
5. 痰湿阻滞- Damp phlegm obstacting:
Obesity, phlegm, obstruct the flow of menstruation, or spleen yang deficient not moving smoothly causing accumulation of water- damp in the body which stagnate in chong- ren, menstruation can’t flow downwards and amenorrhea.
Amenorrhea, obesity, fullness in chest, watery vomiting, fatigue, face or legs edema, leucorrhea ,Tongue- greasy coating, Pulse- slippery.
Principle: transform ,expel damp- phlegm, harmonize qi , move blood, promote menstruation.
Formula: cang fu dao tan wan + dang gui, chuan xiong.
Cang fu dao tan wan:
Ban xia, chen pi, fu ling, gan cao, cang zhu, xiang fu, dan nan xing, zhi ke, shen qu, sheng jiang
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