TCM Syndrome Differentiation and Prescriptions for the Treatment of Amenorrhea

Amenorrhea is the phenomenon of never having menstruation or menstruation cycle has been established and then stopped. People who have not had menstruation for more than 18 years are called primary amenorrhea, and those who have had menstruation but stopped for 6 months or 3 cycles are called secondary amenorrhea. There are two causes of amenorrhea: functional and organic. Amenorrhea caused by dysfunction of the hypothalamus-pituitary-ovarian axis is functional amenorrhea; organic factors include genital dysplasia, tumors, trauma, chronic wasting diseases (such as tuberculosis), etc. According to different anatomical sites, it is divided into uterine amenorrhea, ovarian amenorrhea, pituitary amenorrhea and hypothalamic amenorrhea.

Which types

Anyone who is over 18 years old and has not yet had menstruation is called primary amenorrhea; it is mostly caused by congenital abnormalities, including abnormal development of the ovaries or Müllerian tissue.

After the menstrual cycle is established, the absence of menstruation for more than 6 consecutive months is called secondary amenorrhea, which is mostly caused by secondary diseases.

True amenorrhea refers to the absence of menstruation due to some reasons, such as mental factors, malnutrition, anemia, tuberculosis, excessive curettage, endocrine dysfunction, etc.

Pseudo (or latent) amenorrhea refers to the inability to discharge menstruation due to adhesion and closure of the lower reproductive tract caused by congenital maldevelopment or acquired damage.

Prescription

[Syndrome differentiation] Liver depression and qi stagnation, stomach disharmony and descending disorder, and meridian obstruction.

[Treatment method] Soothe the liver and stomach, promote blood circulation and unblock menstruation.

[Prescription name] Shugan Huoxue Tongjing Decoction.

[Composition] 10 grams of roasted Cyperus rotundus, 6 grams of Evodia rutaecarpa, 6 grams of Ginger Pu'erhense, 15 grams of Salvia miltiorrhiza, 10 grams of Chuanlian fruit, 6 grams of roasted Corydalis yanhusuo, 6 grams of peach kernel, 6 grams of Citrus aurantium, 12 grams of Angelica sinensis, 10 grams of Moutan bark, 10 grams of Pinellia, 6 grams each of red and white paeonia lactiflora, and 6 grams each of the three roasted herbs.

[Usage] Decoction in water, 1 dose per day, 3 times a day.

【Source】Qu Wenlou Fang.

【Syndrome differentiation】Deficiency of both Qi and blood.

【Treatment method】Regulate Qi and blood, strengthen the spleen and benefit the kidneys.

[Prescription name] Jiajian Bazhen Decoction.

[Composition] 12g Codonopsis pilosula, 9g Poria cocos, 9g Atractylodes macrocephala, 9g Angelica sinensis, 9g cinnamon twig, 9g Chuanxiong, 15g Rehmannia glutinosa, 15g Millettia reticulata, 6g processed aconite, 6g dried ginger, and 6g roasted liquorice.

[Usage] Decoction in water, 1 dose per day, 3 times a day.

[Source] Zhu Nansun’s recipe.

【Syndrome differentiation】 Liver depression and qi stagnation

[Treatment method] Soothe the liver and relieve depression, promote qi and regulate menstruation.

[Prescription name] Siwu Xiaoyao Decoction.

[Composition] 9 grams of Bupleurum, 9 grams of Angelica, 9 grams of Chuanxiong, 9 grams of Cyperus, 9 grams of Corydalis, 9 grams of Peach Kernel, 9 grams of Carthamus, 12 grams of Red Peony Root, 12 grams of Rehmannia Glutinosa, and 6 grams of Citrus Aurantifolia.