Managing Endometriosis (Painful Period) by Herbs and Acupuncture

 

Endometriosis is a gynecological medical condition in which cells from the lining of the uterus grow and flourish outside the uterine cavity, most commonly on the ovaries, fallopian tubes and the anterior or posterior cul de sacs of the exterior uterus, sometimes also on the peritoneum of the pelvic wall, the sigmoid colon or bladder, but it can be found as far away as the diaphragm, the lungs or the nose.

Patient who suffers endometriosis usually complains of painful period. Painful period is a major symptom of endometrosis.

The endometrial cells build up blood for pregnancy, which is shed during menstruation. However if this tissue is found outside of the uterine cavity, it can cause bleeding in areas where blood is not supposed to be shed and it can cause major pain and inflammation. The

The real caauses of edometrosis are still unknow but there sevearl theories abut endometriosis:

• Retrograde Menstrution.  Endometriosis results when menstrual blood and tissue go backwards up the fallopian tubes and become seeds of implants in the pelvic cavity.
• Metabolic changes.  pelvic tissues spontaneously convert to dometrial tissue possibly due to irritation or hormonal activity from environmental toxins such as dioxin, which can have estrogen-like activity.
• Autoimmune processes are involved that may include autoimmune responses aimed at hormones and/or at components of the cysts.
• Formation of ectopic endometrium.  Embryonic female genital tissue has never made it to the inside of the uterus during development.

 

The uterine cavity is lined by endometrial cells, which are under the influence of female hormones. Endometriosis is typically seen during the reproductive years; it has been estimated that endometriosis occurs in roughly 5–15% of women. Endometriosis is a common finding in women with infertilty.

Most endometriosis lesions are found on these structures in the pelvic cavity

• Ovaries (the most common site)
• Fallopian tubes
• The back of the uterus and the posterior cul-de-sac
• The front of the uterus and the anterior      cul-de-sac
• Uterine ligaments  such as the broad or round ligament of the uterus
• Pelvic and back wall
• Intestines,  most commonly the rectosigmoid
• Urinary bladder and ureters
• Cervix and vagina

Less commonly lesions can be found on diaphram, lung, CNS

Signs and symptoms:

• Dysmenorrhea– painful, sometimes disabling      cramps during menses; pain may get worse over time, also lower back pains linked to the pelvis
• Irregular menses, spotting between periods or before periods
• Chronic pelvic pain– typically accompanied by sacrum  area pain or lower abdominal pain
• Dyspareunia– painful sexual intercourse
• Urinary urgency, frequency, and sometimes painful voiding
• Throbbing, gnawing, and dragging pain to the legs
• Shooting rectal pain or bleeding – a sense of their insides being pulled down
• Infertility

 

Other Complications

• Adhesions, bleeding during menses in unlikely areas
• Pelvic cysts
• Chocolate cysts which are endometriomas filled with old blood      in ovary
• Ruptured cysts where exit of the eggs from the ovaries is      blocked
• Blocked bowel/bowel      obstruction (constipation, bloating)
• Nauseous, dizziness,      fever during menstruation
• Chronic fatigue

 

Managing Endometriosis by Herbs and Acupuncture

 According to the symptoms, it categorizes into dysmenorrheal or painful period, painful sexual intercourse, infertility, periodic pelvic pain.

1. Qi Stagnation and blood stasis

Symptoms: abdominal tenderness; pressure and pain before or during periods; breast distention before periods; distending pain under the rib cage before periods; aversion to pressure on the abdomen; blood clots with periods; pain relieved after the periods; a dark purple tongue with spots and a thin-white tongue coating; and a wiry-choppy pulse.

Treatment principal: Regulate Qi, invigorating blood, remove blood stasis

Formula: Ge Xia Zhu Yu Tang (Driving Out Blood Stasis below the Diaphragm Decoction), Xue Fu Zhu Yu Tang (blood mansion eliminate stasis decoction)

Acupuncture Treatment: 4 Gate, Sp10, GB26, SP6, SP8,  ST29, ST30, Zi Gong Xue

 

 

2. Qi and blood Deficiency and Blood Stasis

Symptoms: abdominal tenderness; pressure and pain during or after periods; a preference for warmth; feeling better with pressure on the abdomen; a “dropping” sensation of the anus; soft bowel movements; pale complexion; lethargy; periods that are either heavy or scanty, with light-colored, watery menses; thick-pale tongue body with tooth-marks on the sides and a white-thin tongue coating; and a thin-soft-weak pulse.

Treatment principal: Tonify Qi and blood, invigorating blood, remove blood stasis

Formula: Tao Hong Si Wu Tang (Four-Substance Decoction with Safflower and Persica Seed)- more blood defi

Acupuncture Treatment: 4 Gate, GB26, SP6, SP8, ST28, ST29, ST30, Zi Gong Xue. Liv8

 

 

3.      Kidney Deficiency and Blood Stasis

Symptoms: abdominal tenderness; a feeling of pressure and pain during or after periods; soreness of the back, legs, and hips; dizziness; irregular periods, scanty periods or spotting; blood clots with periods; failure to conceive a baby or habitual miscarriage; a pale tongue color, or a tongue with spots and a thin-white tongue coating; and a deep-thin-choppy pulse.

Treatment principal: Tonify KI, invigorating blood, remove blood stasis

Formula: You Gui Wan modified (more KI yang defi)

Acupuncture Treatment: K3, K7, GB26, SP6, SP8, Ren2, Ren6, ST28, ST29,

 

4. Cold Retention and Blood Stasis

Symptoms: abdominal tenderness; pressure and pain before or during periods; a preference for warmth; an aversion to cold; blood clots with periods; pain relieved after the periods; pale complexion; nausea or vomiting with severe menstrual pain; a pale, purplish tongue with spots and a white tongue coating; and a wiry-tight pulse.

Treatment principal: Warm uterus, expel cold, invigorating blood, remove blood stasis

Formula: Shao Fu Zhu Yu Tang (Driving Out Blood Stasis in the Lower Abdomen Decoction) – more excess cold.

Acupuncture Treatment: GB26, SP6, SP8, Ren4, Ren3, Ren 6, K7, St 36

 

4.      Heat Obstruction and Blood Stasis

Symptoms: abdominal tenderness; pressure, pain, and fever before, during, or after periods (the more severe the pain, the higher the fever); a preference for cold temperatures; aversion to pressure on the abdomen; a bitter taste in the mouth; dry throat; anxiety; anger; constipation; painful intercourse; red tongue tip or purple spots on the sides of the tongue, with a thin-yellow tongue coating; and a wiry-rapid pulse.

Treatment principal: Clear heat, eliminate dampness, invigorating blood, remove blood stasis

Formula, Qing Re Tiao Xue Tang (Clear Heat and Regulate Blood Decoction)

Acupuncture Treatment: 4 gate, GB26, SP6, SP8,  Ren3,  L11, Sp9, Sp 10

 

 

MAMAGING AMENORRHEA (NO PERIOD) WITH HERBS AND ACUPUNCTURE

BY YANFANG LIU

Amenorrhea refers to the case of no menstrual onset of a female who should have had menses as she has reached the adult age, excluding those physiological conditions before adolescence, in the period of pregnancy and lactation, and after menopause.

1. Primary amenorrhea — refers to no menses over the age which is suppose to have

2. Secondary amenorrhea—refers to the stoppage of regular menstruation for more than 3 months.

 

ETIOLOGY AND PATHOLOGY OF TCM

1. Kidney Deficiency

Congenital weakness of kidney or over childbirth, or over sexual activity or long-term illness — kidney deficiency–deficiency of the Chong and Ren vessels– the sea of the blood —cannot be filled –amenorrhea.

 

2. Spleen Deficiency

Irregular diet or overwork or over mental –spleen deficiency –fail to make blood – deficiency of the Chong and Ren vessel– the sea of the blood cannot be filled– amenorrhea.

 

3. Blood Deficiency

Congenital blood deficiency or long-term illness or over childbirth or poor diet–
blood deficiency –deficiency of the Chong and Ren vessels – the sea of the blood
cannot be filled — amenorrhea.

4. Qi stagnation and blood stasis

Long-standing emotional stress (anger, irritation,  frustration, resentment, worry or anxiety)– Qi stagnation – blood  stasis — block the Chong and Ren vessels – obstructs the flow of Qi and blood – the sea of blood cannot be filled – amenorrhea

5. Blockage of phlegm and dampness

Congenital obesity with more phlegm and dampness or too  much greasy food or deficiency of spleen fail to transportation and  transformation –
phlegm and dampness –  block the Chong and Ren vessels – obstructs the flow of Qi and blood – the  sea of blood cannot be filled – amenorrhea

 

DIFFERENTIATION OF SYNDROME AND TREATMENT

 

1. Kidney Yang deficiency

Clinical manifestation:

The female has no menses over the age of 18 or delayed  menstrual cycle with scanty menstruation leading gradually to amenorrhea,  accompanied with lassitude in loins and legs, dizziness, tinnitus, frequent  urination at night, loose stool, pale-darkish complexion pale tongue with white  coating, deep and thready pulse.

Herbal treatment:

Formula: You Gui Wan (Restore the Right kidney Pill)

Herbs: Shu Di Huang, Shan Yao, Shan Zhu Yu, Gou Qi Zi, Du Zhong, Tu
Si Zi, Lu Jiao Jiao, Dang Gui, Rou Gui, Zhi Fu Zi

 

2.  Kidney Yin deficiency

Clinical manifestation:

The female has  no menses over the age of 18 or delayed menstrual cycle with scanty  menstruation leading gradually to amenorrhea, accompanied with dizziness, lower  back pain, or heels pain, a feverish sensation in the palms and soles, night  sweating, irritability, insomnia, red tongue with little coating or no coating,  thin and rapid pulse.

Herbal treatment:

Formula: Zuo Gui Wan (Restore the Left Kidney Pill)

Herbs: Shi Di Huang, Shan  Yao, Shan Zhu Yu, Gou Qi Zi, Chuan Niu Xi, Tu Si Zi, Lu Jiao Jiao, Gui Ban Jiao

 

3. Spleen Deficiency

Clinical manifestation:

The menses have  ceased for several months, lack  of vitality, tiredness in the extremities, poor appetite, distention of abdomen, loose stools, pale tongue  with teeth mark, white coating,  moderate and weak pulse.

Herbal treatment:

Formula: Shen Ling Bai Zhu  San  (Ginseng, Poria, and Atractylodes
Macrocephala Powder) plus Dang Gui, Niu Xi

Herbs: Ren shen, bai zhu, Fu Ling, Bai Bian Dou, Gan Cao, Shan Yao, Lian Zi,  Jie Geng, Yi Yi Ren, Sha Ren

 

4. Blood  Deficiency

Clinical manifestation:

Gradual delay of menstruation with  very little blood which is thin and reddish, then leading to amenorrhea,  accompanied with dizziness, blurred vision, palpitation, insomnia, dry skin,  sallow complexion, pale tongue with very little coating, deep and thin pulse.

Herbal treatment:

Formula: Ren Shen Yang Rong  Wan (Ginseng Decoction to Nourish the Nutritive Qi)

Herbs: Ren Shen, Huang Qi, Bai Zhu, Fu Ling, Wu Wei Zi, Dang Gui,
Shu Di, Bai Shao, Rou Gui, Yuan Zhi, Chen Pi, Zhi Gan Cao

 

5. Qi stagnation and blood stasis

Clinical manifestation:

The menses have  ceased for several months, depression, restlessness and irritability,  accompanied by distention over the chest, abdominal pain and tenderness,  purplish dark tongue or purplish spots, a deep and wiry or deep and uneven  pulse.

Herbal treatment:

Formula: Ge Xia Zhu Yu  Tang(Drive out Blood Stasis Below the Diaphragm Decoction)

Herbs: Dang Gui, Chi Shao, Tao  Ren, Hong Hua, Yan Hu Suo, Wu Ling Zhi, Mu Dan Pi, Wu Yao, Xing Fu, Gan Cao

 

6. Blockage of phlegm and dampness

Clinical manifestation:

Amenorrhea,  Obesity, nausea and vomiting with productive sputum, oppressive sensation in  the chest and hypochondria, tired easily, or profuse leukorrhea with white  color and thick, pale and swollen tongue with white, greasy coating, slippery  pulse.

Herbal treatment:

Formula: Cang Fu Dao Tan Wan  (Atractylodis and Cyperi Guide out Phlegm Decoction)

Herbs: Fu  Ling, Bai Xia,Chen Pi, Cang Zhu, Xiang Fu, Dan Nan Xing, Zhi Ke, Sheng Jiang,  Shen Di Huang, Gan Cao, Plus: Dang Gui, Chuan Xiong

 

 

 

Managing  Infertility by Chinese Herbs and Acupuncture

By Yanfang Liu, acupuncture fertility clinic in Houston TX

 

What is infertility? Infertility refers to the inability to produce offspring in a woman who has been trying for two
years, who has a normal sexual life.

•Primary Infertility: the female has never gotten pregnant before.

•Secondary Infertility: the female has had a previous pregnancy irrespective of the final outcome of that pregnancy. It includes miscarriage.

 

WESTERN SCIENCE VIEW:

COMMON CAUSE OF INFERTILITY 

Female factors:

1.Disorders with ovulation: Hypothalamic disorder, pituitary insufficiency, ovarian disorder, Adrenal disorder, thyroid disorder (either hyperthroidism or hypothroidism could cause an interruption in the normal menstrual cycle), nutritional disorders, PCOS, suppression of ovarian function (over exercise and an excessively restricted diet). Ovulation could also be impaired due to the presence of tumors or certain medications.

 2.Blockage or damage of the fallopian tubes, which can be caused by endometriosis, pelvic inflammatory disease, adhesions and scarring after a pelvic surgery.

 3.Previous tubal ligation

 4. A poor ovarian reserve (poor quantity and quality) or ovarian failure caused by aging or other factors; (test including Day 3 FSH and estradiol test, clomiphene challenge test, response of the ovaries to ovarian  timulation with injectable gonadotropins (FSH)

 5. Uterus problems: Uterus polyps, uterus fibroids (Masses or cysts in the uterus which could possibly block the passage of an egg into the uterus or could prevent fertilized egg implantation within the uterus), intrauterus
adhesion, congenital uterus malformation, thin endometrial lining, hostile cervical mucus

 6. A defect in the female anatomy that affects the movement of the egg into the uterus or prevents
implantation.

 7. Edometrosis.  The proliferation of the  endometrium lining of the uterus outside of the uterus.

8. Hormone disorder (Luteal phase defect, hormone imbalance)

 9. Infertility associated with immunological problems

 10. Pelvic Adhesions – scar tissue which has resulted from endometriosis, infection or abdominal surgery. The scar tissue would bind and restrict the reproductive organs from their proper function.

11. Unexplained infertility

  

Male factors:

1.Sperm problems—quantity , quality and /or motility of the sperm. The most common cause of infertility in men are enlarged varicoceles ie. veins in the scrotum which are dilated due to the blood not draining properly from them. These dilated veins allow excessive blood to be present around the scrotum which causes their temperature to be chronically raised. This has an inhibiting effect on the production of sperm. However, the condition of varicoceles can usually be reversed by minor microscopic surgery

2.Delivery of sperm from the penis into the vagina may also be a cause for infertility. These problems include erectile dysfunction, problems with ejaculation or blockage of the ejaculatory ducts (previous tubal ligation and previous vasectomy)

3.Seminal fluid abnormality: This is where the seminal fluid is too thick for the sperm to swim through it to reach the woman’s reproductive tract.

4.Poor diet and malnutrition can also contribute to the cause of infertility in a man, including vitamin C deficiency and zinc deficiency in the diet. Some diseases (e.g., tuberculosis, fevers, anemia, and mumps in adulthood).

 5.Infections of the reproductive system such as epididymitis, orchitis, and prostatitis

6.Some sexually transmitted disease such as chlamydia or gonorrhea damage the sperm ducts which may exacerbate male infertility

7.Some medications including cancer-treating agents (e.g., chemotherapy), anti-fungal medication
(ketoconazole), antidiarrheal drug (sulfasalazine), a drug used to treat ulcerative colitis (azulfidine), anti-hypertensive drug, etc.

8.Testosterone deficiency, trauma or injury to the testes, and structural abnormality

9.Some male infertility causes are also connected with lifestyle, like excessive stress, intensive exercise (may
lower the sperm count by producing higher levels of adrenal steroid hormones, which lower the amount of testosterone in the body), tight underwear or jeans, hot tubs, saunas, or anything that raises the temperature of the scrotum, including overheated vehicles and hot work environments, and exposure to environmental hazards such as pesticides, lead, paint, mercury, benzene, boron, radiation (x-ray), radioactive substances, and heavy metals.

 

ETIOLOGY AND PATHOLOGY OF TCM

  1. Kidney Deficiency

Congenital weakness of kidney or over childbirth, or over sexual activity or long-term illness, which causes kidney deficiency, and then leads to deficiency of the Chong and Ren vessels.

 2. Liver Qi Stagnation

Emotional strain (anger, frustration and resentment) causes liver Qi Stagnation, which  leads to  abnormal of smoothing and regulating, which leads to  disharmony between Qi and blood, then blocks Chong and Ren vessels

 3. Phlegm and dampness

Congenital obesity with more phlegm and dampness or too much greasy food or deficiency of spleen fails to transport and transform, which causes phlegm and dampness, which blocks the Chong and Ren vessels, and then obstructs the flow of Qi and blood leading to infertility

 4. Blood stasis

Undergoing cold during the menstrual or after puerperal period, invades uterus, cold stagnation and blood stasis can obstruct the Chong and Ren vessels leading to inftertility

 5. Blood and Qi deficiency

 

DIFFERENTIATION & TREATMENT

 

Syndrome #1:

Clinical manifestation:

Delayed menstrual cycle, the period could be scanty, backache, dizziness, feeling cold, depression, sexual weakness, pale complexion, weak knees, frequent urine, pale and swollen tongue, with white coating, deep and
weak pulse.

Diagnosis: Kidney yang deficiency

Herbal Formula: Yu Lin Zhu (Fertility Pearl)

Herbs: Ren Shen, Bai Zhu, Fu Ling, Bai Shao, Chuan Xiong, Zhi Gan Cao, Dang Gui, Shu Di Huang, Tu Si
Zi, Lu Jiao Suang, Du Zhong, Chuan Jiao

Acupuncture Formula: Lu 7, Kid6, Kid7, Ren 4, Ren 3

 

Syndrome #2

Clinical manifestation:

Delayed menstrual cycle, the period could be scanty, dizziness, tinnitus, palpitation, lower back pain, weak knees, feeling of heat in the evening, night-sweating, sallow complexion, red tongue without coating or
little coating, thin and rapid pulse or advanced age without of any symptoms.

Diagnosis: Kidney yin deficiency or kidney essence deficiency

 Formula: Yang Jing Zhong Yu Tang (Nourishing the Essence and Growing Jade Decoction) add Niu
Zhen Zi, Han Lian Cao

 Herbs: Shu Di Huang, Dang Gui, Shan Zhu Yu, Bai Shao\

Acupuncture formula: Lu 7, Kid 6, Kid3, Sp6, Ren 3, Ren 4

 

 Syndrome #3

Clinical manifestation:

Irregular periods, pre-menstrual tension, painful period, breast distention, lower abdominal distention, irritability, depression, easily angered, normal or slightly red on the sides with thin coating, wiry pulse.

Diagnosis: Liver Qi stagnation

Formula: Bai Ling Tiao Gan Tang (Bai Ling Regulating Liver Decoction)

Herbs: Dang Gui, Niu Xi, Chi Shao, Tong Cao, Chuan Lian Zi, Gua Lou, Zao Ci, Zhi Shi, Qing Pi, Gan
Cao, Wang Bu Liu Xing

Acupuncture formula: Lu7, Kid6, Li4, Li3, Sp6, Ear liver, Du24

 

Syndrome # 4

Clinical manifestation:

Irregular periods, delayed cycle, mid-cycle pain, dizziness, palpitation, vaginal discharge, long-term infertility, obesity, feeling of heaviness, pale tongue with sticky coating, slippery pulse.

Diagnosis: phlegm and dampness

Formula: Qi Gong Wan (Arousing the Uterus Pill)

Herbs: Ban Xia, Cang Zhu, Xing Fu, Fu Ling, Shen Qu, Chen Pi, Chuan Xiong

Acupuncture formula: Lu7, Kid6, St36, Sp9, Sp6, Ren3, Ren12

 

Syndrome #5

 Clinical manifestation:

Irregular and painful periods, dark blood with clots, irritability, manic behavior, mental restlessness, lower abdominal pain with worse by touch, dark complexion, bluish-purple or reddish-purple tongue, choppy pulse.

Diagnosis: Blood stasis block the channel

 Formula: Shao Fu Zhu Yu Tang (Lower Abdomen Eliminating Stasis Decoction)

 Herbs: Xiao Hui Xing, Gan Jiang, Yan Hu Suo, Mo Yao, Dang Gui, Chuan Xiong, Rou Gui, Chi
Shao, Pu Huang, Wu Ling Zhi

Acupuncture formula: Lu7, Kid6, Sp6, Sp10, 4 gate, Ren 6, Ren 4

 

The treatment will be modified and changed according to Four Phase of the period:

1.Menstrual phase

2.Follicular phase

3.Ovulation

4.Luteal or progesterone phase

 

•Follicular phase:

Treatment principle: tonify the kidneys and nourish blood and Yin

•Ovulation phase:

Treatment principle: Nourish essence and blood, promote ovulation

•Luteal phase:

Treatment principle: tonity kidney yang

•Menstrual phase:

Treatment principle: regulate Qi and blood, stop bleeding if bleeding abnormal

 

Managing Menopausal Syndrome with Chinese Medicine

By Yanfang Liu

Menopause is the transition period in a woman’s life when her ovaries stop producing eggs, and menstruation becomes less frequent, eventually stopping altogether.

This process occurs as a normal part of aging, or from surgical removal of the ovaries (Tierney, et. Al. 1997). Although incorrectly
used, the term menopause is broadly understood to describe the natural transition from a woman’s reproductive to a non-reproductive phase in life due to declining ovarian function. (McKinley, et al., 1998)

 

The age of onset of menopause usually takes place between 45 and 55, with the median age in industrialized
countries being 50. This number correlates with the ancient Chinese text “Simple Questions”, which describes women to have 7-year cycles and menopause to occur at the 7^th cycle, at age 49.

 

There are three phases:

1. Perimenopause  – the gradual climacteric period preceding menopause is called perimenopause. It usually starts in a woman’s 40s and lasts 4 years in  average but can last from a few months up to 10 plus years. Many women experience menopausal symptoms in the last years of perimenopause. Periods  may become irregular, scant or heavy; some may even experience prolonged  bleeding. The ovaries are still functioning and pregnancy is still a  possibility, but ovarian function becomes less consistent, less robust,  and estrogen levels tend to decline. Measuring the follicle-stimulating  hormone (FSH) and luteinizing hormone (LH) level in the blood can indicate  if a woman is experiencing perimenopause.
2. Menopause – the time of no menstruation. Menopause  starts at the time of the last menstruation but can only be confirmed  after a naturally occurring absence of any menstrual period for at least  12 months.
3. Post menopause – the time of a woman’s life  following menopause. During this period, most of the transitional stress
   of menopause has passed while other symptoms such as decreased libido, vaginal dryness, and osteoporosis increase.

 

Symptoms of menopause:

The symptoms of menopause could be varies from very mild symptoms to very severe and complicated symptoms, and
involved with many different aspects. The followings are the most common symptoms:

• Hot  flashes or severe body heat, hot sensation in the palms and soles
• Night  sweats
• Fatigue
• Cravings for sweets or carbohydrates
• Diminished sexual desire, vaginal dryness
• Emotional changes such as irritability, mood swings, depression, and/or anxiety or  even panic attack
• Palpitations  often related to fear/anxiety
• Insomnia  or restless sleep
• Fuzzy  thinking (difficulty concentrating, memory problems)
• Weight  gain, especially around the middle abdomen
• Stiffness  and pain of joints
• Swelling  and puffiness
• Pre-period  migraine, breast swelling and tenderness before periods
• Irregular periods, such as irregular menstrual  cycle length, decreased or increased menstrual flow and timing

 

Complications of menopause:

Cardiovascular disease. Heart disease is the leading cause of death in women as well as in men. When a woman experiences menopause, especial post menopause her estrogen levels decline significant, the risk of cardiovascular disease increases.

 

Osteoporosis. During the first few years of post menopause, woman may lose bone density at a rapid rate, which will
increase the risk of osteoporosis. Osteoporosis causes bones to become brittle and weak, leading to an increased risk of fractures. Postmenopausal women are especially susceptible to fractures of the hip, wrist and spine.

 

Urinary incontinence. Menopausal women may experience a frequent, sudden, strong urge to urinate, followed by an
involuntary loss of urine (urge incontinence), or the loss of urine with coughing, laughing or lifting (stress incontinence) because the tissues of woman’s vagina and urethra lose their elasticity due to decline of female hormone.

 

Weight gain. It is common that women gain weight during the menopausal transition, especially around the belly, and hard to loss weight.

 

 Hormonal changes

Hormone changing directly results menopausal syndrome. During the process of menopause, different hormone will decrease in different time and different speed.

Progesterone levels fall first in perimenopause period before changes in estrogen and testosterone.

Estrogen doesn’t diminish until less than a year before the last period, when the ovarian follicles are greatly reduced, estrogen in the form of estradiol markedly decreased right before the last.

Two to six years prior to menopause, estrogen levels increase or remain stable with the drop in progesterone, which allow groups of follicles to grow and mature during successive menstruation as if trying to get rid of the last remaining follicles. During this time, the amount of ovarian follicle decrease at an accelerated rate until the supply of follicles is depleted.

Finally, the levels of the follicle stimulating hormone (FSH) and LH produced in the pituitary gland become erratic and the ovaries begin to skip ovulations until menopause arrives. Once nearing the arrival of menopause, hormone levels will level out and FSH and LH levels then rise to their highest levels for the remaining years of life.

 

Hormonal Treatment:

A.    Hormone Replacement Therapy (HRT)

Estrogen, progesterone or testosterone with the amount and combination of these depending on the individual need of each patient.

B.  The advantage of HRT

The symptoms related with menopause relieve fast; the general heath improved; mental and physical improved; sexual life improved;  Osteoporosis can be prevented; hair and mood swings improved fast, etc.

C.    Disadvantage of HRT

Risk of uterine cancer and breast cancer, existing fibroid or endometriosis worse, formation of embolus, etc.

 

Understanding of Menopause by Chinese Medicine

Menopause is induced by gradual consumption of kidney-Qi, emptiness of the Ren and Chong channels, exhaustion of Tiangui,
breakdown of yin-yang equilibrium in the body and disorders of Zang-Fu, Qi and blood.

The root of the cause is kidney decline either naturally or damaged by many factors such as over child birth, too many or too
closed child birth in short time or in a young age, over sexual activities or surgery. Kidney dominates birth, development and aging of human being according to Chinese Medicine theory. If kidney is damaged or declined earlier than normal, Yin and Yang will be imbalanced and lost of the harmony between the organs.

 

1.     Kidney Qi decline gradually along aging, plus long term illness or over cold food for over time, or a woman with yang deficiency constitution, all above can lead to kidney yang deficiency, which lead to spleen yang deficiency causing accumulation of phlegm or dampness or related disorders. Spleen yang deficiency can further lead to Qi, blood deficiency.

 

2.     Kidney Yin declines gradually along aging, plus excessive emotional change, or loss of blood, or over childbirth, or too many children, too close together or over sexual activity, or over hot spicy food or yin consumed after febrile disease, all these can lead to kidney yin deficiency. Kidney yin deficiency will lead to disharmony between the kidney and heart or Kidney yin deficiency can’t balance the yang, and yang will rising or hyperactive, at same time the imbalance of Yin and Yang can lead to more disorders.

 

In China, most menopausal women use Traditional Chinese Medicine (TCM), particularly Chinese herbs, instead of HRT, with good result of less side effects. 2005, a study by the Women’s Health Institution urged most postmenopausal women to
stop using hormone replacement therapy (HRT). In this report, the global index statistic supported risks exceeding benefits, prompting the data and safety monitoring board to recommend an early end to the trial after 5.2 years. The data showed among the 16,608 participating women an increased risk of invasive breast cancer, bone fractures, coronary heart disease (CHD), stroke, pulmonary embolism, endometrial, colorectal, and other cancers.[1]

[1] Rossouw, Jacques E. et al “Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women.” Journal of the American Medical Association July 17, 2002; 288(3).

 

Differentiation of Syndrome and Treatment with Chinese Herbs:

Chinese Medicine emphasizes the differentiation of syndromes; even within the same “bio-medical disease”, each stage will require a different type of treatment. In addition, each individual develops symptoms in a unique way to him or her body’s constitution. Chinese medicine treats the entire syndrome of each person with a holistic approach that looks beyond symptoms such as individual constitution, season, geographic difference to determine a more appropriate, and a more effective healing method according to the unique TCM diagnosis.

 

Basic syndrome # 1

Kidney – Yin deficiency with deficient heat

Dizziness, tinnitus, night-sweating, hot flushes or feeling heat, 5 palm heat, lower back weakness or soreness, dry mouth, dry and thinner hair, dry and itching skin, constipation, red tongue without coating and thready-rapid or floating-empty pulse.

Treatment strategy: nourish kidney-yin and clear the deficient heat

Pattern formula: Zuo Gui Wan (Restore Left Pill)

 

Basic syndrome # 2

Kidney- yang deficiency

Hot flushes but cold hands and feet, night-sweating in the early morning or sweat in the limited area of the body, pale face, depression, backache, edema easily, tired or fatigue easily, pale tongue with thin white coating, deep and feeble pulse.

Treatment strategy: strengthen kidney, warm the kidney-yang and  balance kidney yin and kidney yang

Pattern formula: You Gui Wan (Restore Right Pill)

 

Basic syndrome  # 3

Kidney-yin and kidney-yang deficiency

Hot flushes but cold hands and feet, night-sweating, frequent-pale urine, flushed or sweat around the neck, slightly agitated, chilliness, dry throat, dizziness, tinnitus, backache, pale or red tongue with thin white coating, deep and feeble or feeble, weak, rapid pulse.

Treatment strategy: nourish the kidneys, nourish yin, gently tonify yang and balance kidney yin and kidney yang

Pattern formula: Er Xian Tang (Two Immortals Decoction)

 

Alternative syndrome # 1

Liver Qi stagnation

Hot flushes, irritability, anxiety, or depression, nervousness, abdominal distension normal tongue or slightly red on
the sides with thin white coating, wiry pulse.

Treatment strategy: regulate liver Qi, tonify liver blood

Pattern formula: Xiao Yao San (Free and Easy Wandering Powder)

 

Alternative syndrome # 2

Liver yang hyperactivity due to kidney and liver yin deficiency

Hot flushes, irritability, anxiety, dizziness, headache, red face, weakness of lower back, red tongue without of coating, wiry or thin wiry-empty pulse.

Treatment strategy: nourish kidney yin and liver yin, calm the liver yang

Pattern formula: Kun Bao Tang (Female Treasure Decoction)

 

Alternative syndrome # 3

Disharmony between the kidneys and heart

Hot flushes, palpitations, insomnia, night sweating, blurred vision, tinnitus, anxiety, mental restlessness, backache, feeling of heat in the evening, dry mouth, dry throat, poor memory, forgetfulness, red tongue redder tip without coating, thread and rapid pulse.

Treatment strategy: harmonize the kidneys and heart, calm the mind and clear deficient heat

Pattern formula: Tian Wan Bu Xin Dan (Heavenly Emperor’s Tonifying The Heart Pill)

 

Alternative syndrome # 4

Accumulation of phlegm-heat

Obesity, a feeling of oppression of the chest, sputum in the chest, a feeling of fullness of the epigastrium, a feeling of distention of the breasts, irritability, belching, nausea, no appetite, moodiness, depression, swollen and may slightly red sides tongue with sticky –yellowish coating, slippery pulse.

Treatment strategy: resolve phlegm, clear heat

Pattern formula: Zhu Ru Wan Dan Tang (Warm Gallbladder Decoction with Bamboo  Shavings)

 

Alternative syndrome # 5

Blood and Qi stagnation

Hot flushes, mental restlessness, or depression, menopause preceded by a period when menses are very irregular and painful for a long time then starting again, dark-clotted blood, insomnia, abdominal pain, purple tongue with thin white coating, wiry or choppy pulse.

Treatment strategy: regulate qi and remove blood stasis

Pattern formula: Wen Jing Tang (Warm The Menses Decoction)

Alternative syndrome # 6

Liver fire or phlegm in live and gallbladder

Hot flushes, irritability with occasional attacks of palpitations, anger easy, constipation, fullness in the chest, red tongue with thick yellowish coating, wiry and rapid pulse.

Treatment strategy: calm the liver, clear the heat and calm the mind

Pattern formula: Chai Hu Jia Long Gu Mu Li  Tang (Bupleurum Plus Dragon Bone and Oyster Shell Decoction ) variation

Alternative syndrome # 7

Qi and blood deficiency

Mild hot flushes, depression, tired even fatigue, loose or diarrhea, poor appetite, pale face, dizziness, palpitation, poor sleep, wake up easy and difficulty go back to sleep again, pale tongue with thin white coating, weak or feeble pulse.

Treatment strategy: nourish the blood, tonify Qi and promote the health

Pattern formula: Gui Pi Tang (Restore The Spleen Decoction)

 

General variation  according to certain symptoms:

1.     diarrhea or loose bowels

– plus Bai Zhu, Bu Gu Zhi (Psoralea), Rou Dou Kou (Mutmeg)

2.    skin itching

–       plus Chan Tui (Cicada Slough), Bai Xian Pi (Dictamnus Root Bark)

3.     Heavy menses

– plus Bu Gu Zhi (Ipsoralea), Ai Ye Tang (Artemisia Leaf)

4.  Night urination

– plus Yi Zhi Ren (Sharpleaf Glangal Fruit), Sang Piao Xiao (Mantis Egg Case)

5.     Dizziness and headache

– plus Tian Ma (Gastrodia Tuber), Gou Teng (Gamnir Vine Stem)

6.     Fuzzy thinking or difficulty concentrating

– plus Bai He (Lily Bulb), Shu Di Huang  (Rehmannia Root)

7.     Insomnia

– plus Wu Wei Zi  (Schisandra Fruit), Suan Zao Ren (Sour Jujube)

8.   Poor memory

–plus Yi Zhi Ren (Sharpleaf Glangal Fruit),

 

Prevention:

1.     Changing attitudes

2.     Have healthy nutrition and diet

3.     Regular exercise

4.     Strengthening kidney

 

I have being treated menopausal syndrome for more than 20 years with acupuncture and Chinese herbs with excellent  results.

Dang Gui  (Chinese Angelica
Root or Tang-kuei) – A Miracle Chinese Herb for Women ‘s Health

By Yanfang Liu

Dang Gui, Chinese Angelica Root or Tang-kuei in English, is a very commonly used herb for gynecological conditions in Chinese Medicine. Latin Name: Angelica sinensis (Oliv.) Diels. Pharmaceutical Name: Radix Angelicae Sinensis. Chinese Angelica Root has sweet pungent and bitter taste and warm property. It is very effective in treating heart, liver and spleen disorders according to Chinese Medical theory. Dang Gui is called a Women’s herb and is commonly used for female health.

Dang Gui has the functions of tonifying the blood and regulating menses; invigorating and harmonizing the blood and dispersing cold; moistening the intestines and relieving constipation; and reducing swelling, expelling pus, regenerating flesh and alleviating pain. It is commonly used for the following conditions in Chinese Medicine:

 

1.     Blood deficiency syndrome. Common symptoms: fatigue, pale face, dizziness, ringing in the ears. Tongue: pale. Pulse: thin or weak

2.  Menstrual disorders such as irregular menstruation, amenorrhea, dysmenorrhea

• above disorders caused by blood deficiency,  accompanied with the following symptoms: scanty periods, thin and pale blood during the menstruation, fatigue, pale tongue body and weak or thin or thready pulse.
• above disorders caused by blood stasis, accompanied with the following symptoms: dark or purple blood during the menstruation, clots in the blood, dark complexion, and purple tongue body color or tongue body with purple spots, and choppy pulse.

3.     Various kinds of pain due to blood stasis. Examples include abdominal pain that is sharp in character
or stabbing with fixed location, pain due to traumatic injury, chronic joint and muscle pain, or deformation of the joints. All the above conditions may be accompanied by dark complexion, purple tongue and choppy pulse.

4.   Sores, carbuncles and abscesses at any stage

5.     Constipation due to blood deficiency and intestinal dryness, usually for elderly patients or weak patients

 

Dosage and administration:

•  3-15g decocted in water for an oral dose
• Vinegar-frying or wine-frying strengthens its blood-invigorating properties

 

Safety:

Very safe, but caution in cases of diarrhea or abdominal distention or patients with heat signs. Do not used if patient with
fibroids or breast cancer or breast cancer history.

 

Simple Home Remedies:

1.      Anemia: Dang Gui (Chinese Angelica Root) 15g, Huang Qi (Astragalus Root) 12g.

Preparation:
Add 3 cups of clean filtered water and soak the herbs for at least 30 minutes.
Cook the mixture over high heat and bring to a boil. Reduce to low heat and
simmer for 30 minutes. Remove from heat, drain the liquid and set aside. Keep
the cooked herbs in the original pot, add 2 cups of clean water and repeat the
same cooking steps above. Combine the liquids and take in equal amounts 2 times
a day before a meal. 30 to 60 days as a treatment course.

2.     Painful period:
Dang Gui (Chinese Angelica Root) 15g, Chuan Xiong (Cnidium) 10g, Bai Shao (White Peony) 10g, Hong Hua (Safflower) 6g.

Preparation:
Add 3 cups of clean filtered water and soak the herbs for at least 30 minutes. Cook the mixture over high heat and bring to a boil. Reduce to low heat and simmer for 30 minutes. Remove from heat, drain the liquid and set aside. Keep the cooked herbs in the original pot, add 2 cups of clean water and repeat the same cooking steps above. Combine the liquids and take in equal amounts 2 times a day before a meal. Take for 7 days before menstrual period starts. Repeat the formula for at least 3 cycles.

3.     Weakness after childbirth: Dang Gui (Chinese Angelica Root) 15g, Rou Gui (Cinnamon Bark) 10g, Huang Qi (Astragalus Root) 12g, Sheng Jiang (Fresh Ginger) 15g.

Preparation:
Add 3 cups of clean filtered water and soak the herbs for at least 30 minutes. Cook the mixture over high heat and bring to a boil. Reduce to low heat and simmer for 30 minutes. Remove fr om heat, drain the liquid and set aside. Keep the cooked herbs in the original pot, add 2 cups of clean water and repeat the same cooking steps above. Combine the liquids and take in equal amounts 2 times a day before a meal.

A second method of preparation: Wrapped all the herbs with cheese cloth and add into the cooking pot when boiling soup with meat. When the meat is ready to eat, keep the meat and soup, throw away the herbs. 7 days as one treatment course.

4.      Perimenopausal or menopausal women’s health: Grind Dang Gui (Chinese Angelica Root) 240g -360g into fine powder. Take 2-3g two times a day with warm water for 60 days. Can be taken for longer if needed.