IRREGULAR MENSTRUATION

GENERAL

Clinical Manifestations	Menstruation is seven days or more early, or seven days or more late for three months consecutively
Treatment Principle
Herb Formulas
Points	PC-6, REN-4, REN-6, SP-4, SP-6, SP-10, ST-25, UB-23 Moxa REN-4 HT-1, KI-2, KI-10, LIV-1, LIV-3, PC-3, REN-3, REN-4, REN-6, SP-2, SP-6, ST-10, ST-12, UB-40 GB-26, KI-6, REN-3, REN-4, REN-6, SP-4, SP-6, ST-25, moxa UB-23 GB-26, SP-10 REN-3, SP-6, Zigong KI-5, ST-25 REN-2, REN-3, SP-6, ST-29, Zigong KI-13, SP-6, SP-8, SP-10 Ear: Ovaries, Kidneys, Endocrine, Uterus With amenorrhea or dysmenorrhea: REN-3, REN-4, SP-6, SP-9, SP-10, ST-36

WIND-COLD WITH INTERNAL COLD

Clinical Manifestations	Fever and chills without sweat Headache Body aches Stiff neck and back Abdominal pain and Cold Diarrhea with borborygmus A sensation of fullness in the chest and abdomen May be Cold in the lower body with Heat in the upper body Aching at the waist Anhidrosis Loose stools Sciatica Nausea Abdominal distention Borborygmus An aversion to food Vomiting Women: Cold-type epigastric and abdominal pain Menstrual irregularity Dysmenorrhea T: Normal C: White and greasy P: Deep and wiry or Superficial and slow
Treatment Principle	Release the Exterior Warm the Interior Smooth the flow of Qi Transform Phlegm Invigorate the Blood Reduce Accumulations Regulate Qi and Blood
Herb Formulas	Wu Ji San
Points

WIND-COLD ACCUMULATION IN THE UTERUS

Clinical Manifestations	Lower abdominal pain Pain alleviated by warmth and pressure Irregular menstruation Dysmenorrhea Infertility or This type of pain during the second or third trimester
Treatment Principle	Warm the uterus Supplement the Blood Calm the fetus if necessary
Herb Formulas	Ai Fu Nuan Gan Wan
Points

WIND-DAMP-HEAT

Clinical Manifestations	Generalized body aches and pains Irritability Heavy sensation in the shoulder and back Discomfort or a constricted sensation in the area of the chest and diaphragm Multiple sores, carbuncles furuncles or abscesses Redness Itching Persistent swelling Chest pain Fever Thirst Aching and painful extremities Aching and painful joints Unbearable swelling and pain of the lower extremities Shoulder stiffness T: Normal C: Greasy and slightly yellow P: Wiry and rapid or Soft and moderate or Soft, superficial and slow or Slippery and rapid or Deep and tight
Treatment Principle	Resolve Dampness Clear Heat Disperse Wind
Herb Formulas	Dang Gui Nian Tong Tang
Points

WIND-DAMP ACCUMULATION WITH LUNG AND SPLEEN QI DEFICIENCY

Clinical Manifestations	Irregular menstruation Sweating with aversion to Wind Heavy sensation in the body Superficial edema Urinary difficulty Knee pain Abdominal bloating Edema in lower legs Fatigue Edema in women with constitutional Deficiency T: Pale C: White or Swollen and moist P: Floating and weak, or soft and thready
Treatment Principle	Augment Qi Strengthen the Spleen Release the exterior Promote urination Reduce edema Regulate water circulation
Herb Formulas	Fang Ji Huang Qi Tang
Points

LUNG AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Calcaneus pain May be bone spur Unproductive cough or Scanty, sticky phlegm or Sometimes blood-streaked sputum Dry mouth Dry throat Low back and knees sore and weak "Steaming Bone" tidal fever Night sweats Malar flush Maybe hoarse voice Maybe pain in shin, foot, and heel Spermatorrhea Irregular menses T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish and Reinforce the Lungs and Kidneys
Herb Formulas	Ba Xian Chang Shou Wan Bai He Gu Jin Tang Da Bu Yin Wan Yang Yin Qing Fei Tang
Points	HT-6, KI-3, KI-6, LU-6, LU-9, UB-13, UB-23

SPLEEN QI DEFICIENCY

Clinical Manifestations	Irregular menstruation, either early or profuse Either heavy volume or Continual dripping The Blood is pink Sallow complexion Fatigue Anorexia Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose stools Shortness of breath Lassitude May be much Blood due to Spleen Not Governing Blood May be little Blood due to Spleen Qi Sinking The Blood is pale-red in color and watery An empty feeling in the lower abdomen Spleen Not Governing Blood: Shortness of breath Dizziness Palpitations Functional Uterine Bleeding Purpura Epistaxis Hemafecia Hematuria Menorrhagia Metrorrhagia Spleen Qi Sinking: Prolapse of one or more organs T: Pale and flabby - may have teethmarks C: White or Sticky and white P: Even, forceless and deficient or Slow and weak If transportation of nutrients is the main defect: Menstruation tends to be late Menses decreased Menses are generally light-colored and thin If control of the Chong and Ren Meridians is the main defect: Menstruation tends to be early or prolonged or Menses are excessive Menses are generally light-colored and thin If both functions are impaired: Menstruation tends to be irregular Menses are generally light-colored and thin
Treatment Principle	Tonify The Spleen Nourish Middle Jiao Qi
Herb Formulas	Ba Zhen Tang Gui Pi Tang Shen Ling Bai Zhu San Bu Zhong Yi Qi Tang With Deficiency Cold: Wen Wei Yin
Points	REN-6, REN-12, SP-6, ST-36, UB-20

SPLEEN NOT GOVERNING THE BLOOD

Clinical Manifestations	Abdominal pain Uterine bleeding (metrorrhagia) Excessive menstruation Menstruation with constant spotting Postpartum bleeding Bleeding during pregnancy The Blood is pale and thin without clots Weakness Sore lower back Post abortion bleeding Dull complexion Weakness and pain of the legs Whole body heavy and lethargic Wants to lie down Poor appetite Palpitations Dry mouth Sallow complexion Loss of taste Light red, unelevated and indistinct eruptions T: Pale C: Thin and white or Whitish and moist P: Thready and weak
Treatment Principle	Nourish and warm the Blood Stop bleeding Regulate menstruation Calm the fetus Prevent miscarriage
Herb Formulas	Jiao Ai Tang Gui Pi Tang Bu Zhong Yi Qi Tang modified Gui Pi Tang + Jiao Ai Tang
Points	SP-1, SP-3, SP-10, UB-17, UB-20, ST-36, other points are selected according to signs and symptoms

SPLEEN AND KIDNEY YANG DEFICIENCY

Clinical Manifestations	Early menstruation Late menstruation Scanty menses Light-colored menses Menses may be mixed with leukorrhea Low back pain that can be severe Soft stools Distention in the lower abdomen A sense of prolapse in the lower abdomen Anorexia Fatigue Light headedness Dizziness Frequent erotic dreams Tinnitus Urinary frequency at night Weakness in the lower limbs Vertigo T: Pale C: Thin P: Deep and frail
Treatment Principle	Enrich and tonify the Kidneys Nourish the Liver Regulate the Chong and Ren channels Regulate menstruation Strengthen the Spleen
Herb Formulas	Gu Yin Jian Dang Gui Shao Yao San
Points

HEART BLOOD AND SPLEEN QI DEFICIENCY

Etiology	Improper diet Over fatigue
Clinical Manifestations	Short menstrual cycle Copious, pale menses Maybe light bleeding or Amenorrhea Palpitations Insomnia Much dreaming Easily startled Poor memory Dyspnea Feels weary Little saliva Four limbs tired and lethargic Loss of appetite Listlessness Distention and fullness of the epigastrium and abdomen Lower abdominal pain and distention Loose stools Sallow complexion Vertigo Soft voice Loss of teeth T: Pale or Pale, flabby and moist C: White P: Thready and weak or Deep and slow
Treatment Principle	Reinforce and Benefit the Heart and Spleen
Herb Formulas	Gui Pi Tang Si Wu Tang Bu Zhong Yi Qi Tang
Points	UB-15, UB-20, ST-36, SP-1, SP-6, REN-4, HT-7 HT-7, LIV-13, REN-6, SP-4, SP-6, UB-15 REN-4, REN-6, SP-6, SP-10 REN-4, REN-6, SP-6, ST-36, UB-20

HEART AND LIVER BLOOD DEFICIENCY

Clinical Manifestations	Irritability Anxiety Palpitations Night sweats Dizziness Vertigo Dry throat and mouth no thirst Fidgeting Insomnia Insomnia due to stress Excessive dreams Lack of energy Weakness and fatigue Weak abdomen Restlessness Sleepiness Light-headedness Impatience T: Pale or Red and dry P: Wiry and rapid or Thready and rapid or Thready and weak or Thready and tight
Treatment Principle	Nourish Liver Blood Nourish the Heart Calm the Shen Clear Heat in Liver and Heart Eliminate irritability
Herb Formulas	Suan Zao Ren Tang Postpartum: Dang Gui Bu Xue Tang
Points	HT-7, LIV-3, REN-4, SP-6, ST-36, UB-15, UB-17, UB-18, UB-20 HT-7, SP-6, Yintang, DU-20, KI-1, KI-16

HEART AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Insomnia with much dreaming Spermatorrhea with erotic dreams Premature ejaculation Irritability Easily startled Palpitations Poor memory Dizziness Tinnitus Low back soreness Legs weak Tidal fever Night sweats Dry mouth Red cheeks Urine short and red T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Reduce Fire Make Heart and Kidney communicate.
Herb Formulas	Ba Xian Chang Shou Wan
Points	HT-7, KI-3, PC-6, PC-7, UB-15, UB-23

LIVER QI STAGNATION

Clinical Manifestations	Irregular menstruation Large or scanty amounts of Blood with a normal color If there is Heat it is darker The flow starts and stops Clots Irregular cycle Premenstrual syndrome Distended abdominal pain until menses, Pre-menstrual breast distention Chest and flank distention Hypochondriac pain Headache Vertigo Bitter taste in the mouth Dizziness Frequent sighing Epigastric pain and distention Flatulence Dry mouth and throat Fatigue Anorexia Alternating chills and fever	Lassitude Insomnia Shoulder and back pain Rib pain Tightness or fullness in the chest Cold extremities Pain in the arms and legs Heaviness of the head Night sweats Bloating and pain at the umbilicus and abdomen Diarrhea alternating with constipation Five sole heat Palpitations Malar flush Depression Irritability Increased desire to sleep Flatulence T: Pink C: Thin white or yellow P: Wiry and Deficient or Wiry, tight and Deficient
Treatment Principle	Soothe the Liver Harmonize Qi and Blood Regulate menstruation
Herb Formulas	Xiao Yao San modified Chai Hu Shu Gan Tang Shu Gan Tang With Heat: Jia Wei Xiao Yao San With more severe Blood Deficiency: Hei Xiao Yao San With Kidney Deficiency: Ding Jing Fang
Points	GB-40, GB-41, LIV-2, LIV-3, LIV-4, LIV-5, LIV-13, LIV-14, PC-6, SJ-6, SP-6, UB-18 REN-3, SP-6, SP-8, UB-17, UB-18 LI-4, LIV-3, REN-6, SP-6 LIV-3, PC-6, REN-4, SP-6

LIVER QI STAGNATION: PHLEGM AND QI STAGNANT AND BLOCKED

Clinical Manifestations	Feeling of obstruction in throat as if a slice of roast meat were stuck there which cannot be coughed up nor swallowed down. This sensation becomes more prominent during emotional upset and subsides when relaxed Distention and pain in the sides or flanks Suffocating sensation in the chest and hypochondrium Tendency to sigh Melancholy Depression Irritability Inappropriate anger Hypochondriac pain Coughing with profuse phlegm Vomiting Difficulty swallowing A delicate constitution A tendency towards fatigue Palpitations Abdominal distention Muscular and skin flaccidity Fear Edema Asthma Insomnia Women: Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Pink C: Thin and white P: Slippery and wiry (slippery due to Phlegm)
Treatment Principle	Spread Qi Resolve Phlegm
Herb Formulas	Ban Xia Hou Po Tang
Points	PC-5, LIV-3, SJ-6, LI-18, SI-17

LIVER QI STAGNATION: LIVER QI INVADES THE STOMACH

Clinical Manifestations	Epigastric pain (worse when emotionally upset) Belching with acid regurgitation Recurrent or chronic nausea , vomiting, sour belching and acid reflux, worse with stress and better when calm Anorexia Indigestion Heartburn Epigastric distention Distention and pain in the sides or flanks Suffocating sensation in the chest Fullness, tightness or discomfort in the chest, epigastrium and hypochondrium Tendency to sigh	Melancholy Depression Irritability Inappropriate anger Frustration anxiety Moodiness Women: Irregular menses Dysmenorrhea Breast distention and pain before and during menses Premenstrual syndrome T: Pink or Darkish with slightly red edges - chronic cases may be pale on the edges C: Thin and white, possibly greasy P: Wiry or Wiry and slippery
Treatment Principle	Soothe the Liver Harmonize the Stomach
Herb Formulas	Chai Hu Shu Gan Tang Xiao Yao San Hei Xiao Yao San
Points	LIV-3, LIV-14, PC-6, REN-12

LIVER QI STAGNATION: LIVER QI INVADES THE SPLEEN

Clinical Manifestations	Abdominal distention and pain Gas Borborygmus Diarrhea Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Women: Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Pink C: White and greasy P: Slippery and wiry
Treatment Principle	Soothe the Liver Invigorate the Spleen
Herb Formulas	Xiao Yao San Hei Xiao Yao San Dang Gui Shao Yao San
Points	LIV-3, LIV-13, SP-6, ST-36, ST-37, ST-25

LIVER QI STAGNATION WITH BLOOD DEFICIENCY

Clinical Manifestations	Hypochondriac pain Headache Vertigo Bitter taste in the mouth Dizziness Frequent sighing Epigastric pain and distention Flatulence Dry mouth and throat Fatigue Anorexia Alternating chills and fever Irregular menstruation Breast distention Lassitude Insomnia Shoulder and back pain Rib pain Various types of menstrual discharges Premenstrual cramps	Excessive menstrual bleeding Tightness or fullness in the chest Cold extremities Pain in the arms and legs Heaviness of the head Night sweats Bloating and pain at the umbilicus and abdomen Diarrhea alternating with constipation Five sole heat Palpitations Malar flush Depression Irritability Increased desire to sleep Flatulence T: Pink C: Thin white or yellow P: Wiry and deficient or Wiry, and rapid
Treatment Principle	Pacify the Liver Spread Liver Qi Strengthen the Spleen Nourish the Blood Harmonize the Liver and Spleen
Herb Formulas	Hei Xiao Yao San Xiao Yao San Si Wu Tang Jian Wei
Points

LIVER QI STAGNATION TRANSFORMS INTO FIRE

Etiology	Emotional depression
Clinical Manifestations	Short menstrual cycle Moderate volume May be a heavy period Dizziness Dysmenorrhea Stuffy chest Acid regurgitation Belching Abdominal pain before or during period Menses with dark red clots Dark menstrual blood Dry stools Dry sore eyes Constipation Increasingly poor appetite Melancholy Reluctant to move Frequent sighing Headache Insomnia Irritability Outbursts of yelling or anger Thirst General feeling of Heat May be acne related to the period T: Red body (redder on sides) C: White or Yellow P: Wiry and rapid
Treatment Principle	Soften the Liver Release constraint Dredge the channels Drain Fire
Herb Formulas	Xuan Yu Tong Jing Tang Jia Wei Xiao Yao San Yi Guan Jian modified For mild Heat signs: Jin Ling Zi San For Liver Fire Attacks the Stomach: Hua Gan Jian
Points	LIV-8, SP-8, LU-7, KI-4 REN-6, REN-7, LIV-1 LIV-3, LIV-5, REn-3, REN-4, SP-8

LIVER QI AND BLOOD STAGNATION

Etiology	Cold invasion and stress lead to Qi and Blood stagnation
Clinical Manifestations	No period Chronic stabbing pain in the chest Pain in the hypochondrium Chronic, stubborn headache with a fixed, piercing quality Palpitations Chronic incessant hiccups Five sole Heat Choking sensation when drinking Dry heaves Depression or low spirits with a sensation of warmth in the chest Chest distention Dry, scaly skin Dark rings under the eyes Spider naevi on the cheeks, nose, trunk, inner knee and ankle Dizziness Chronic tinnitus Chronic gum disease with dark, purplish, patchy or dark, red atrophic gums Loose teeth Painful receding gums Lower abdominal pain with guarding Frequently bleeding gums	Vomiting after intake of water Chest and subcostal distending pain Persistent daytime drowsiness Insomnia (persistent with much dreaming) Restless sleep Forgetfulness Irritability Fidgeting Agitation Irascibility A bad temper Extreme mood swings Evening tidal fever Dark or purplish lips, conjunctiva or nail beds Dark complexion Dark sclera Hair loss on the head and body T: Dark-red with purple spots on the edges or Cyanotic or speckled with purpuric spots P: Choppy or Wiry and tight or Wiry and choppy or Thready or Deep and choppy or Wiry
Treatment Principle	Invigorate the Blood Dispel Blood Stasis Spread Liver Qi Unblock the channels Stop pain Promote menstruation
Herb Formulas	Xue Fu Zhu Yu Tang Jia Wei Xiao Yao San Wen Jing Tang Ge Xia Zhu Yu Tang Shi Xiao San Tao Hong Si Wu Tang
Points	REN-3, REN-4, Zigong For Heat Congestion:REN-3, REN-4, Zigong, SP-6, SP-10, GB-34, LIV-5, LIV-3

LIVER WIND STIRRING INTERNALLY: LIVER BLOOD DEFICIENCY GENERATES WIND

Clinical Manifestations	Pale, lusterless complexion Pale lips Blurred or failing vision Spots before eyes Dizziness Dry eyes Pale nail beds Irritability Frightens easily Insomnia with much dreaming Tinnitus Generalized muscle tension Numbness of limbs Tremor, spasms or involuntary movements (chorea) Involuntary shaking of head Light menses or amenorrhea Late menses Irregular menstruation with little flow Periumbilical pain Lower abdominal pain Vertigo Spotting of pale Blood Postpartum uterine bleeding Tic or tremor of hands and feet Maybe trismus T: Pale C: Little P: Thready and wiry
Treatment Principle	Nourish Blood Subdue Wind.
Herb Formulas	Si Wu Tang
Points	UB-17, UB-18, UB-20, ST-36, SP-6, REN-4, LIV-3, GB-20, DU-16, DU-20

LIVER BLOOD DEFICIENCY

Clinical Manifestations	Pale complexion Pale lips Blurred or failing vision Spots before eyes Dizziness Dry eyes Pale nail beds Irritability Frightens easily Insomnia with much dreaming Tinnitus Numbness of limbs Light menses or amenorrhea Late menses T: Pale C: Little P: Thready
Treatment Principle	Nourish Liver Blood
Herb Formulas	Si Wu Tang Qi Ju Di Huang Tang Irregular Menstruation #2
Points	Moxa or moxa needle REN-4, ST-36, UB-17, UB-18, UB-20 tonify LIV-3, SP-6, GB-37, LIV-3, ST-36, UB-18, UB-20

LIVER AND KIDNEY DEFICIENCY

Clinical Manifestations	Menstrual pain relieved by pressure and massage Dull hypogastric pain towards end or after period Clear leukorrhea Delayed puberty Irregular menstruation Scanty leukorrhea Sensation of Cold in the lower abdomen Stunted growth Sore back Scanty bleeding Dizziness Pale complexion Tinnitus Blurred vision Exhaustion Increased clear urine Dusky complexion T: Red or Pale C: Little or None P: Weak and fine or Fine and faint or Floating, empty or Deep and thready
Treatment Principle	Nourish Liver and Kidney Yin Regulate menstruation Nourish Kidney Jing Tonifies the Blood Strengthen Kidney Yang
Herb Formulas	Tiao Gan Tang
Points

KIDNEY YIN DFICIENCY WITH FIRE FLARING

Etiology	Yin Deficiency Blood loss and Yin exhaustion due to illness
Clinical Manifestations	Short menstrual cycle Moderate flow Maybe a heavy flow Light colored Blood Night sweats Dry mouth and tongue Lower back and knee pain Urinary difficulty Weakness of the lower back, knees and extremities Steaming bones Light-headedness Vertigo Tinnitus Diminished hearing Five sole heat Chronic dry, sore throat Toothache Wasting and thirsting disorder (Xiao Ke) Dizziness Muscular weakness Irritability Dry skin	Malar flush Blurred vision Heartburn Deafness Spontaneous and nocturnal emissions Tidal fevers Loose teeth Dripping urine Thirst Swollen gums, painful and light red in color Numbness and weakness at the waist and knees Heel pain Urinary incontinence Pain at midline and in lower back Poor memory T: Red C: Little or None P: Thready and rapid (large at the Kidney positions)
Treatment Principle	Nourish Yin Subdue Fire
Herb Formulas	Zhi Bai Di Huang Wan Liang Di Tang Qing Jing San Gu Yin Jian
Points	KI-1, KI-2, KI-3, KI-6, REN-4, SP-6, UB-23 KI-3, REN-6, SP-6, SP-9, UB-23 KI-3, LIV-8, REN-4, SP-6, SP-10

KIDNEY YANG DEFICIENCY

Clinical Manifestations	Pain during or after the period Pressure and warmth helps Scanty menstruation Irregular cycle Dull-dark red blood Mild persistent uterine bleeding Irregular menstruation (either early or late) Prolonged menstruation Amenorrhea Metrorrhagia Extended or continuous menstrual flow Lower abdominal distention Lower abdominal Cold Lower abdominal pain Infertility Pale or dark complexion Leukorrhea Leukorrhea mixed with light, red, thin Blood Tinnitus Vertigo Frequent, copious urination Irritability No desire to drink Distending breast pain Low back coldness and pain Loose stools Cold limbs Aversion to Cold Nocturia T: Pale or Purple with petechiae C: White and moist P: Deep, Deep and thready or Thready and choppy
Treatment Principle	Warm the Chong and Ren channels Warm the uterus Regulate menstruation
Herb Formulas	Wen Jing Tang Ba Zhen Yi Mu Wan
Points	Moxa or moxa needle DU-4, KI-3, REN-6, SP-6, UB-23 DU-4, REN-4, SP-6 KI-3, REN-4, SP-6, UB-23, UB-52

KIDNEY QI DEFICIENCY

Clinical Manifestations	Irregular period May be much Blood due to Inconsolidation of the Chong and Ren channels May be little Blood due to Jing Deficiency The Blood is pale-brown red in color, clear, thin and watery Frequent urination Large amounts of clear thin vaginal discharge Copious amounts of clear urine Incontinence of urine Enuresis Abortion or miscarriage Either a tendency towards being too hot of too cold Shortness of breath Asthma Cold limbs Weak back and knees T: Pale C: White P: Deep, weak possibly tight
Treatment Principle	Tonify Kidney Qi Regulate menstruation Consolidate the Chong and Ren channels
Herb Formulas	Shen Qi Wan You Gui Wan Gui Shen Wan Yi Shen Tong Jing Tang Yu Lin Zhu Er Xian Tang With Liver Qi Stagnation: Jian Quan Huang Ti Tang
Points

KIDNEY AND LIVER YIN DEFICIENCY

Clinical Manifestations	Irregular cycle Scanty, light red flow Dry eyes Diminished visual acuity Photophobia Tearing when exposed to Wind Painful eyes Blurred vision Lower back pain Weakness of the lower back, knees and extremities Spontaneous and nocturnal emissions Light-headedness Vertigo Tinnitus Diminished hearing Five sole heat Chronic dry, sore throat Wasting and thirsting disorder / Xiao Ke	Toothache Decreased libido Dizziness Muscular weakness Dry skin Deafness Steaming bones Tidal fevers Loose teeth Dripping urine Thirst Dry tongue Numbness and weakness at the waist and knees Urinary incontinence Heel pain Knee pain Night sweats T: Red C: Little or None P: Thready and rapid
Treatment Principle	Enrich Yin Nourish the essence of the Liver and Kidneys Enrich Blood
Herb Formulas	Qi Ju Di Huang Wan Zhi Bai Di Huang Wan Qing Jing San Mai Wei Di Huang Wan Liu Wei Di Huang Wan Yi Guan Jian Ming Mu Di Huang Wan
Points	UB-18, UB-23, SP-6, LIV-3, KI-3 KI-2, KI-3, LIV-14, REN-6, SP-6, UB-18, UB-23 KI-3, LIV-3, UB-18, UB-23

KIDNEY, SPLEEN AND HEART DEFICIENCY

Clinical Manifestations	Irregular periods Scanty bleeding Clots in the menstrual Blood Abdominal distention Breast distention Premenstrual tension Depression Sighing Irritability T: Normal or Slightly red on the sides C: Normal P: Wiry
Treatment Principle	Nourish the Blood Invigorate the Blood Regulate menstruation Tonify the Kidneys Benefit the Spleen
Herb Formulas	Ding Jing Tang
Points

QI AND BLOOD STAGNATION

Clinical Manifestations	One or two days before or during first day of menses there is: Lower abdominal distension and pain Pressure makes worse Generally scanty blood flow The flow starts and stops Dark-purple color with clots When the clots pass the pain is relieved (or when menses stop) Premenstrual syndrome Abdominal masses which are visible when lying down Piercing hypochondriac pain Irritability Indigestion Constipation Dysmenorrhea Amenorrhea Chronic diarrhea Daybreak diarrhea Palpable abdominal masses Irregular menstruation Breast distention Abdominal tumors Hypochondriac distention T: Dark and red or Purple with purple spots on the side C: White P: Wiry or Wiry, choppy and tight
Treatment Principle	Regulate Qi Invigorate the Blood Break up Stasis Relieve pain
Herb Formulas	Ge Xia Zhu Yu Tang Wu Yao Tang + Tao Hong Si Wu Tang Shi Xiao San
Points

QI AND BLOOD DEFICIENCY

Clinical Manifestations	Irregular menstruation Abdominal pain Amnesia Palpitations Feverishness Anorexia Emaciation Pale face Insomnia Dyspnea on mild exertion Fatigue Shortness of breath. Weight loss Dry skin Dry mouth Dry throat Dry lips Uterine bleeding Irregular menstruation May suddenly lose consciousness Restless at night Lassitude Tendency toward being frightened easily	Weakness Slack jaw Sallow complexion Dizziness Tremors in the limbs Spontaneous perspiration Fever and severe chills General debility Mental instability Coughing and gasping. Night sweats Amnesia. Diarrhea Turbid urine Nocturnal emission Impotence Constipation Feeble breathing. Tired limbs. T: Pale C:White P: Thready and weak or thready, rapid and weak or Deep and weak
Treatment Principle	Tonify Qi Nourish the Blood Strengthen the Spleen and Lungs Nourish the Heart Calm the Shen
Herb Formulas	Ren Shen Yang Rong Tang Nu Ke Ba Zhen Wan Ba Zhen Tang With Blood Stagnation: Xiong Gui Tiao Xie Tang With abdominal pain: Ba Zhen Yi Mu Wan
Points

QI, BLOOD AND YANG DEFICIENCY

Clinical Manifestations	Fatigue Anorexia Dizziness Pale face Weak voice Reluctance to speak Sweating with little or no exertion Dizziness Palpitations Insomnia Dry skin Dry hair Poor memory Paleness Scanty periods Chills Cold limbs Inability to get warm Loose stools Profuse clear urine Spontaneous sweating Lassitude T: Pale C: White or Thin, white and dry P: Slow, deep and weak or Empty or Thready and rapid or Weak
Treatment Principle	Tonify Qi and Blood Strengthen the Spleen Tonify Yang
Herb Formulas	Ren Shen Dang Shao San Ren Shen Yang Rong Tang Huo Luo Xiao Ling Dan
Points

BLOOD STAGNATION

Clinical Manifestations	Irregular menstruation Palpable masses that may or may not be painful Lower abdominal pain without palpable masses Lower abdominal distention Lower back pain Lower abdominal distention during menstruation Frequent menstruation (3-5 timer per month) Spotting Dark purple menstrual Blood (usually with clots) Abnormal uterine bleeding with abdominal soreness and pain Aversion to Cold Depression Cold extremities White vaginal discharge T: Pale or With purple spots C: White P: Choppy
Treatment Principle	Invigorate the Blood Dispel Stasis Regulate menstruation
Herb Formulas	Shao Fu Zhu Yu Tang Xue Fu Zhu Yu Tang Tao Hong Si Wu Tang modified Gui Zhi Fu Ling Wan Shi Xiao San Zhe Cong Yin Di Dang Tang With Kidney Deficiency: Ding Jing Tang With Qi Deficiency: Xiong Gui Tiao Xue Yin
Points

BLOOD STAGNATION DUE TO COLD

Clinical Manifestations	Fever and chills without sweat Headache Body aches Stiff neck and back Abdominal pain and Cold Diarrhea with borborygmus A sensation of fullness in the chest and abdomen May be Cold in the lower body with Heat in the upper body Aching at the waist Anhidrosis Loose stools Nausea Abdominal distention Borborygmus An aversion to food Vomiting Cold-type epigastric and abdominal pain Menstrual irregularity Dysmenorrhea T: Normal C: White and greasy P: Deep and wiry or Superficial and slow
Treatment Principle	Releases the Exterior Warms the Interior Smooths the flow of Qi Transforms Phlegm Invigorates the Blood Reduces Accumulations Regulates Qi and Blood
Herb Formulas	Wu Ji San
Points

BLOOD STAGNATION DUE TO BLOOD DEFICIENCY

Clinical Manifestations	Irregular menstruation decreased Blood flow Abdominal pain in women Dizziness Blurred vision Pale, lusterless complexion Pale nails Pale lips Generalized muscle tension Irregular menstruation with little flow Amenorrhea Periumbilical pain Lower abdominal pain Vertigo Tinnitus Blurred vision Insomnia Spotting of pale Blood Postpartum uterine bleeding Maybe five sole Heat Delayed menstruation Palpitations Dizziness Dry skin Maybe leukorrhea Maybe fever Firm, painful abdomen Sporadic fever and chills Dysmenorrhea Breast distention and pain before and during menses Menorrhagia Hard abdominal masses with recurrent pain Unstable fetus with bleeding Chills and fever T: Pale C: Normal P: Thready and wiry or Thready and choppy
Treatment Principle	Nourish the Blood Invigorate the Blood Dispel Stasis
Herb Formulas	Tao Hong Si Wu Tang
Points

BLOOD HEAT

Etiology	Hot, spicy food
Clinical Manifestations	Short cycle Heavy bleeding Red, purple or black in color Sticky Blood Sometimes clots Foul odor Breast distention Lower abdominal distention Lower abdominal pain Thirst Red face Like cold drinks Burning sensation in the Heart Lower back and knee pain Dry stool Constipation Yellowish urine Restlessness Easily angered Dry mouth Dizziness Severe: Red eyes Oral ulcers Epistaxis T: Red C: Thin and yellow (if there are purple clots, the coat will not be yellow) P: Wiry and rapid or Slippery and rapid or Deep and slippery or Choppy (if there are purple clots)
Treatment Principle	Clear pathogenic Heat
Herb Formulas	Qing Jing San modified Qin Lian Si Wu Tang modified
Points	KI-3, LIV-2 or LIV-3, REN-6, SP-6 PC-6, REN-3, REN-4, SP-6 LIV-2, REN-4, SP-6, SP-10

BLOOD HEAT DUE TO EXCESS HEAT IN THE CHONG AND REN

Clinical Manifestations	Continuous menstruation or Uterine bleeding that alternates between spotting and gushing The Blood is very red, thick and sticky and may contain dark-purple clots A sensation of Heat and irritability in the chest Menstruation may be delayed Dry mouth Leukorrhea Dysuria Abdominal pain Dark urine Red urine Red face Difficulty defecating T: Red C: Normal or Yellow P: Wiry or Wiry and rapid or Tight and rapid or Slippery and rapid
Treatment Principle	Enrich Yin Clear Heat Clear Deficiency Heat Stop bleeding Stabilize the Menses
Herb Formulas	Gu Jing Wan
Points

BLOOD DEFICIENCY

Clinical Manifestations	Dizziness Blurred vision Pale, lusterless complexion Pale nails Pale lips Generalized muscle tension Irregular menstruation with little flow Amenorrhea Periumbilical pain Lower abdominal pain Vertigo Tinnitus Blurred vision Insomnia Spotting of pale Blood Postpartum uterine bleeding Maybe five sole heat Delayed menstruation Palpitations Dizziness Dry skin Maybe leukorrhea Maybe fever Firm, painful abdomen Sporadic fever and chills Menorrhagia Hard abdominal masses with recurrent pain Unstable fetus with bleeding Chills and fever T: Pale C: Normal P: Thready and wiry or Thready and choppy
Treatment Principle	Nourish the Blood Regulate menstruation
Herb Formulas	Si Wu Tang Ren Shen Zi Xue Tang modified Bai Zi Ren Wan Irregular Menstruation #3 With Heat: Wen Qing Yin
Points

BLOOD DEFICIENCY WITH QI STAGNATION

Clinical Manifestations	Irregular menstruation Late menstruation Scanty menstruation Distension of the lower abdomen Menstruation with purple blood and clots Pain of the abdomen which is worse upon pressure and diminishes with menstruation Pain is worse with pressure Pain decreases with the passage of clots Swelling and edema of the lower extremities A feeling of oppression in the chest and epigastrium Dry mouth Dark, purplish menses with clots or Dark purple edges T: Red or Purple P: Deep and strong or Hesitant or Choppy and rough
Treatment Principle	Invigorate the Blood Nourish the Blood Move Qi
Herb Formulas	Guo Qi Yin
Points

BLOOD AND YIN DEFICIENCY WITH BLOOD STAGNATION

Etiology	There is no source of Blood, so the Sea of Blood is dry.
Clinical Manifestations	Irregular menstruation Soreness of the lower back Abdominal pain Emaciation Achy and uncomfortable flesh and bones of the hands and feet Anxiety Dizziness Light headedness Tidal fever General disquietude Gradually worsening afternoon fevers T: Red C: Scanty P: Thready and rapid
Treatment Principle	Nourish Yin and Blood Clear deficient Heat Regulate menstruation
Herb Formulas	Yi Yin Jian modified Nu Ke Bai Zi Ren Wan Qing Jing San
Points

COLD EXCESS

Clinical Manifestations	Painful menses with clots The menstrual pain will be relieved by warmth and aggravated by cold Mild persistent uterine bleeding Irregular menstruation (either early or late) Scanty purple red blood with large clots Cold pain in lower abdomen Complexion is white/blue Whole body feels cold Prolonged menstruation Skipped period Metrorrhagia Extended or continuous menstrual flow Pain Lower abdominal distention Cold-pain in the lower abdomen that is alleviated by warmth Infertility Dry lips Dry mouth Pale complexion Leukorrhea Amenorrhea Bleeding between periods No desire to drink Distending breast pain Low back coldness and pain Loose stools Cold limbs Aversion to Cold T: Pale or Purple with petechiae C: White P: Tight maybe choppy (stasis)and deep (internal) or Thready and choppy Menstruation becomes delayed and the menses decreased Menses are dark or grayish in color
Treatment Principle	Warm the blood vessels Dispel Cold Invigorate the Blood Regulate menstruation
Herb Formulas	Wen Jing Tang
Points	Moxa REN-4, DU-4, needle UB-17, SP-10, SP-6 Excess, dislikes pressure : ST-25, ST-29 Deficiency, likes pressure : BL 23 Ear: Internal Reproductive, Endocrine, Subcortex, Liver, Spleen, Kidney, Pituitary Scalp: Human reproductive system (electro)

PHLEGM HEAT

Etiology	Obesity
Clinical Manifestations	Short menstrual cycle The volume is either heavy or moderate Typically the woman is obese Puffy yellowish complexion Severe distention of the head Heaviness of the limbs Vertigo Stuffy chest Sensation of a need to expectorate Profuse Phlegm Maybe loose stools Abdominal distention Chronic leukorrhea T: Normal C: White or Slightly yellow P: Slippery and rapid
Treatment Principle	Clear Heat Eliminate Phlegm
Herb Formulas	Irregular Menstruation #1
Points	REN-3, REN-8, REN-12, SP-6, ST-40

LOWER JIAO BLOOD STAGNATION DUE TO HEAT

Clinical Manifestations	Irregular menstruation Purple clots Lower abdominal distension Excruciating abdominal pain Mania Delirious speech from extreme pain Afternoon fever Restlessness Thirst - likes to drink Amenorrhea Dysmenorrhea Irregular menstruation Chills and fever Headache Black stool Neurosis Hard stool Acute pelvic inflammatory disease Retention of lochia Intestinal obstruction T: Red and dry C: Normal, or yellow P: Sinking and choppy or Sinking and forceful
Treatment Principle	Break up stagnant Blood Activate the Blood
Herb Formulas	Tao He Cheng Qi Tang
Points

DEFICIENCY COLD OF THE CHONG AND REN CHANNELS

Clinical Manifestations	Irregular menstruation Habitual miscarriage Afternoon fever Five sole heat Dry mouth Thirst Cold abdominal pain Infertility Dysmenorrhea Uterine bleeding Chronic pelvic inflammation Menopause
Treatment Principle	Warm the vessels Comfort the Womb Nourish and invigorate the Blood
Herb Formulas	Wen Jing Tang Ai Fu Nuan Gong Wan
Points

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