TCM and Menoxenia
TCM and Menoxenia
By Dr. Hong-Yen Hsu
Menoxenia is the general term for abnormalities in menstrual cycle or duration, or in the color, amount, or nature of the menstrual blood. It includes the following disorders: antedated menstruation, delayed menstruation, menorrhagia, hypomenorrhea, and irregular menstruation. Amenorrhea, dysmenorrhea, and menopause syndrome are also associated with menoxenia, but are not discussed here.
Antedated Menstruation
The condition in which menstruation occurs at least 7 days earlier than usual for at least 3 months in a row is referred to as antedated menstruation. Qi deficiency, blood heat due to yin deficiency, or excess heat are the most common causes.
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Qi Deficiency
Manifested as fatigue, lack of vitality, shortness of breath, palpitation, profuse menstruation, light-colored menstrual flow, pale complexion, poor appetite, pale tongue, and thready, weak pulse, Qi deficiency may be treated with either Ginseng and Astragalus Combination or Ginseng and Longan Combination.
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Blood Heat Due to Yin Deficiency
Characterized by scanty, bright red menstruation, tinnitus, dry mouth and throat, tidal fever in the afternoon, flushing of the zygomatic region, feverish sensation in the palms and soles, sore and painful lower back and knees, red and dry tongue, and thready, rapid pulse, blood heat due to yin deficiency may be treated with Rehmannia and Lycium Bark Combination.
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Excess Heat
Marked by profuse, bright red or dark red, thick and sticky, bad-smelling menstrual flow, restlessness, thirst, constipation, red tongue with yellowish coating, and rapid pulse, excess heat may be treated with Phellodendron and Moutan Formula or Tang-kuei Four Combination, to which scute and coptis are commonly added. In addition, leonurus and sanguisorba can also be added to either prescription.
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Liver Qi Stagnancy
Characterized by scanty, but normal-colored menstruation, vertigo, fidgeting, tendency to anger easily, depression, chest and hypochondriac fullness and pressure, distending pain in the lower abdomen, thin, yellowish tongue coating, and tense pulse, liver Qi stagnancy is treated with Bupleurum and Peony Formula or Bupleurum Formula. Cyperus, lycopus, and leonurus can be added to either formula to aid in regulating liver Qi and menstruation.
Delayed Menstruation
The condition in which menstruation occurs a week or more later than usual for at least three consecutive cycles is termed delayed menstruation. Blood cold, blood deficiency, and blood stagnancy are the primary causes.
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Blood Cold
Characterized by scanty, dark or purplish menstrual flow, pain in the lower abdomen, cold limbs, soreness and weakness in the lumbar region and lower extremities, and submerged, tense pulse, blood cold is best treated with Tangkuei and Evodia Combination.
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Blood Deficiency
Marked by scanty, light-colored menstruation, pale complexion, vertigo, dizziness, palpitation, dry skin, and weak, thready pulse, blood deficiency is treated with Ginseng Nutritive Combination or Ginseng and Longan Combination.
Menorrhagia
Menorrhagia is when the amount of menstrual blood is markedly more than usual. It is usually caused by Qi deficiency, blood heat, or blood stagnancy.
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Qi Deficiency
Characterized by profuse, thin, light-colored blood, lack of vitality, fatigue, sallow complexion, shortness of breath, pale tongue, and thready, weak pulse, Qi deficiency may be treated with Ginseng and Longan Combination.
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Blood Heat
Marked by profuse, bright red or purplish menstrual flow, thirst, irritability, flushing, insomnia, yellowish or reddish urine, constipation, red tongue with thin, yellowish coating, and rapid pulse, blood heat is cleared with Rehmannia and Gelatin Combination.
Hypomenorrhea
Hypomenorrhea, or scanty menstruation, is the term used to describe a period in which the amount of menstrual blood is markedly less than usual. The condition is usually caused by blood cold, blood stagnancy, blood deficiency, or kidney deficiency.
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Blood Stagnancy
Marked by scanty, dark purplish menstruation with clots which are difficult to discharge, stabbing pain and tenderness in the lower abdomen, relief of pain after discharge of clots, dark purple tongue or ecchymoses on the tongue, and tense pulse, blood stagnancy-induced hypomenorrhea may be treated with Persica, Carthamus, and Tang-kuei Combination. Leonurus, bulrush, and pteropus may be added to enhance effectiveness.
If there are symptoms of cold pain in the lower abdomen which are relieved by warmth, cinnamon bark, fennel, and evodia should be added.
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Blood Deficiency
Characterized by scanty, light-colored menstrual flow, chronic pain in the lower abdomen, dizziness, fatigue, palpitation, pale complexion and tongue, and thready, weak pulse, blood deficiency-induced hypomenorrhea is treated with Ginseng and Tang-kuei Ten Combination or Ginseng and Longan Combination.
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Kidney Deficiency
Marked by scanty, pink or light-colored menstrual flow, dizziness, tinnitus, soreness and weakness in the lower back and legs, light red tongue, and submerged, thready pulse, kidney deficiency-associated hypomenorrhea is treated with Tang-kuei and Rehmannia Combination.
Other Formulas Commonly Used for the Treatment of Menoxenia
This formula is indicated for menstrual irregularity caused by blood stagnancy and marked by flushed face, abdominal fullness, lower abdominal pain upon pressure, headache, dizziness, cold feet, and tense or submerged and slow pulse.
Menstrual irregularity or difficult menstruation caused by blood deficiency and marked by anemia, fatigue, palpitation, lower abdominal pain, dizziness, tinnitus, pale tongue, and thready, weak pulse can be treated with this formula.
This formula tonifies the blood and stimulates circulation, thereby regulating menstruation. It is used in the treatment of profuse menstrual flow marked by pain in the lower abdomen, weakness in the limbs, deficiency and cold conformation, and anemia.