Main Points of Diagnosis

1. The condition in which menstruation occurs 7 or more days or even 10 days or more earlier than usual is referred to as preceded menstrual cycle; while the condition in which menstruation occurs a week or more later, or comes in 40¡ª50 days, is termed delayed menstrual cycle. And if menstruation occurs over 7 days either earlier or later irregularly, it is called irregular menstrual cycle.

2. The condition in which the amount of menstrual blood is obviously more than usual but the cycle is basically normal is termed menorrhagia. If the amount of menstrual blood is obviously less than usual and the cycle is basically normal, this condition is referred to as scanty menstruation. 

Differentiation and Treatment of Common Syndromes     

1. Heat in the Blood

Main Symptoms and Signs: Preceded menstrual cycle or profuse menstruation which is bright or dark red, thick and sticky, accompanied with restlessness and dry mouth, yellowish urine, constipation, redness of the tongue proper with yellow fur, rapid pulse.

Therapeutic Principle: Clearing heat from the blood to regulate menstruation.

Recipe: Modified Powder for Clearing Menstruation-Heat

moutan bark, wolfberry bark, white peony root, dried rehmannia root, sweet wormwood, phellodendron bark, motherwort, raw sanguisorba root.

All the above herbs are to be decocted in water for oral administration.

If before menstruation, there is a feeling of distension and fullness in the breasts, and distending pain in the lower abdomen, fidgets, bitter taste, exclude motherwort and phellodendron bark and add 9 grams of capejasmine fruit, 9grams of bupleurum root and 9 grams of rose. If the menstrual blood is scanty of rose. If the menstrual blood is scanty accompanied with tidal fever, flushing of zygomatic region, feverish sensation in the palms and soles, then subtract sweet wormwood phellodendron and raw sanguisorba root and add 12 grams of scrophularia root, 9 grams of donkey-hide gelatin (tobe melted and mixed in the finished decoction), 9 grams of glossy privet fruit and 9 grams of eclipta.

2. Deficiency of Qi

Main Symptoms and Signs: Advanced menstruation or profuse menstruation, thin blood with light color, lack of vitality, tiredness in the extremities, short of breath and want of speech, pale tongue with white fur, thready and weak pulse.

Therapeutic Principle: Regulating menstruation by invigorating qi and keeping the blood flowing within the vessels.

Recipe: Modified Decoction for Reinforcing the Middle-Warmer and Replenishing qi.

codonopsis root, astragalus root, bighead atractylodes rhizome, prepared licorice root, Chinese angelica root, motherwort, tangerine peel, cimicifuga rhizome, bupleurum root.

All the above herbs are to be decocted in water for oral administration.

If palpitation or severe palpitation is present, 9 grams of poria with hostwood and 15 grams of wile jujuba seed should be added; if accompanied with soreness of waist and loose stool, 9 grams of antler glue which is to be melted and mixed in the finished decoction and 9 grams of eucommia bark should be added.

3. Blood Stasis

Main Symptoms and Signs: Delayed menstrual cycle, scanty menstruation, dark-colored menstrual blood with clots, pain in the lower abdomen, dark-colored tongue or with ecchymoses, taut and unsmooth pulse.

Therapeutic Principle: Promoting blood circulation and removing blood stasis or regulate menstruation.

Recipe: Modified Four-Ingredients Decoction plus Peach Kernel and Safflower.

peach kernel, safflower, motherwort, rubia root, Chinese angelica root, white peony root, ligusticum rhizome, dried rehmannia root, parched cat-tail pollen, parched trogopterus dung.

All the herbs mentioned above are to be decocted in water for oral administration.

If there are symptoms of cold-pain in the lower abdomen which can be relieved by warmth, and intolerance of cold with cold limbs, the following drugs should be added:

baked ginger, bark of Chinese cassia tree, evodia fruit, common fennel fruit.

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