TCM Dialectical Treatment of Amenorrhea

Normally developed girls usually have their first menstruation around the age of 14. If they do not have their first menstruation after the age of 18, or if they stop having menstruation for more than 3 months after menstruation but not due to pregnancy, breastfeeding, or menopause, it is called amenorrhea. Modern medicine calls the former primary amenorrhea and the latter secondary amenorrhea. Traditional Chinese medicine believes that there are two types of amenorrhea: deficiency and excess. Deficiency is mostly due to insufficient yin blood, or even exhaustion, with no blood to flow. Excess is mostly due to obstruction of evil, blocked meridians, and menstrual blood flow. Traditional Chinese medicine syndrome differentiation and treatment are effective, and the classification is as follows:

Qi and blood deficiency: delayed menstruation, less menstruation, pale or sallow complexion, fatigue, limb weakness, shortness of breath and laziness. Pale lips and tongue, thin white fur, weak pulse. Treatment should be to replenish qi, blood and regulate menstruation. Bazhen Decoction with added ingredients can be used for treatment.

3g of medicinal ginseng (decoction separately, take with water), 10g of Atractylodes macrocephala, 10g of Angelica sinensis, 10g of Poria cocos, 5g of Chuanxiong, 15g of White Peony Root, 10g of Rehmannia glutinosa, 15g of Roasted Licorice Root, 5g of Aucklandia Root, 5g of Citrus aurantium, 5g of Stir-fried Cyperus rotundus with vinegar, 10g of Achyranthes bidentata, 12g of Scolopendra subspinipes. Decoction, 1 dose per day. For patients with palpitations, add Semen Platycladi, Salvia miltiorrhiza, and Ejiao; for amenorrhea caused by postpartum hemorrhage, in addition to the symptoms of weak Qi and blood, vaginal dryness, decreased libido, and atrophy of reproductive organs are also seen. This is a symptom of deficiency of essence and blood, deficiency of kidney Qi, and weakness of Chong and Ren meridians. Deer antler, antler frost, placenta, and other blood and flesh products can be added.

Liver and kidney deficiency: Over 18 years old without menstruation, or late menarche with less and lighter color, gradually leading to amenorrhea, or dizziness, tinnitus, soreness of waist and knees, pale red tongue with less fur, weak or thready pulse, treatment should be to nourish the kidney, nourish the liver and regulate menstruation, use Danggui Dihuang Decoction with modifications, medicinal angelica 12g, cooked rehmannia 15g, yam 10g, eucommia 10g, Achyranthes bidentata 15g, cornus officinalis 5g, roasted licorice 10g, Millettia reticulata 15g, motherwort 10g. Decoction in water, one dose per day.

The medicinal diet can be yam and potato soup: 30 grams of yam, 30 grams of potato, 30 grams of black bean, 50 grams of Millettia reticulata, 10 grams of Achyranthes bidentata. First, boil Millettia reticulata and Achyranthes bidentata in water for 1 hour, remove the residue, add yam, potato, and black bean and cook until cooked, add brown sugar in appropriate amount and take. You can also use jujube and pigeon soup: 50 grams of jujube (core removed), 1 pigeon (hair and internal organs removed, washed), 30 grams each of roasted turtle shell and roasted tortoise shell, 20 grams of wolfberry, first fry the turtle shell and tortoise shell for 30 minutes, then add wolfberry and fry for another 20 minutes, remove the residue after frying, take the juice and cook jujube and pigeon until cooked, eat the meat and drink the soup.

Yin deficiency and blood dryness: menstrual blood gradually decreases to amenorrhea, five hearts are hot, hot flashes and sweating, the cheeks are flushed, the tongue is red and the coating is scanty, the pulse is stringy or fine, and it is advisable to nourish Yin, clear away heat and regulate menstruation. The prescription is Yi Guan Jian with modifications, 15g of Radix Rehmanniae, 12g of Lycium barbarum, 15g of Angelica sinensis, 10g of Radix Adenophorae, 10g of Radix Ophiopogonis, 12g of Radix Bupleuri, 10g of Cortex Moutan, 20g of Semen Ziziphi Spinosae, 10g of Polygonatum sibiricum, 6g of Salvia miltiorrhiza, 5g of Fructus Aurantii Immaturus. Decoction in water, 1 dose per day.

For those with severe hot flashes due to deficiency, add Artemisia annua and turtle shell; for those with cough and spitting blood, add Schisandra chinensis, Lilium bulbus, Fritillaria cirrhosa, and donkey-hide gelatin; for those with deficiency, insomnia, and palpitations, add Platycodon grandiflorum and Polygonum multiflorum; for those with amenorrhea caused by blood dryness due to real fire burning the yin, add Scrophularia ningpoensis and Phellodendron chinense. The medicinal diet can be stewed with turtle shell and white pigeon: 50 grams of turtle shell and 1 white pigeon. Wash the white pigeon, smash the turtle shell, put it into the belly of the white pigeon, put it in a casserole, add appropriate amount of water, stew it, and season it. Take it once every other day, and take it for 1 week as a course of treatment.

Qi stagnation and blood stasis: amenorrhea, distension and pain in the lower abdomen and flanks, depression or irritability. Dark tongue, or petechiae, deep and stringy pulse. Treatment should be to activate blood circulation and remove blood stasis, regulate qi and dredge menstruation. The prescription is Xuefu Zhuyu Decoction. Medicinal Angelica, 10 grams each of Rehmannia glutinosa, 12 grams of peach kernel, 10 grams of safflower, 6 grams each of Citrus aurantium and red peony root, 3 grams of Bupleurum, 3 grams of Licorice, 5 grams of Platycodon grandiflorum, 5 grams of Chuanxiong, 10 grams of Achyranthes bidentata. Decoction in water, 1 dose per day. Medicinal diet can use mulberry safflower soup: 25 grams of mulberry, 5 grams of safflower, 20 grams of Millettia reticulata, appropriate amount of rice wine, add 2 bowls of water and boil until 1 bowl, take warm twice a day.

Phlegm-dampness blockage: amenorrhea, obesity, chest and flank fullness, nausea and phlegm, or puffy face and swollen feet, or excessive white vaginal discharge, white and greasy tongue coating, and slippery pulse. Treatment should be to dispel phlegm and dampness, regulate qi, activate blood circulation and dredge menstruation. The prescription is Cangfu Daotan Pills with modifications. Medicinal Atractylodes 10g, Tangerine Peel 5g, Prepared Arisaema 5g, Citrus Aurantium (fried with bran) 10g, Pinellia 10g, Ligusticum chuanxiong 5g, Talc 10g, White Poria 12g, Shenqu (fried) 10g, and Citrus Hand 12g. Decoction, 1 dose per day. Medicinal diet can use coix seed and lentil porridge: 30g coix seed, 15g fried lentils, and 15g hawthorn. Put them together in a casserole and add water to cook porridge. Add brown sugar to taste after the porridge is done.