CHIM 2: WK 1-3 - MENSTRUAL DISORDERS

EARLY MENSES, DELAYED MENSES

Smooth Liver qi is common practice in treating ob/gyn but those methods, formulas may cause Yin/blood Deficiency
And in womens disorders important to not damage yin. Acrid, Moving medicinals have dispersing condition and may cause
Yin/Blood Xu. This is why Xiao Yao San is safer than Chai Hu Shu Gan San. Xiao yao san has much less chance of causing blood
deficiency.

EARLY MENSES

1. At least 7 days Earlier

2. Happened at least 3 Months in a Row
Regarded as Bleeding Disorder. Causes of Bleeding: Heat, Stasis, SP Qi Xu, Cold. Herbs for Stop bleeding should be divided into those
subgroups. No herbs that specifically Stop bleeding by Tonify Qi, must use tonify qi herbs.
The 2 MAJOR patterns are due to: 1. Blood Heat, 2. SP Qi Xu

SP Qi
Deficiency
(with Yang
Sinking)

Bu Zhong Yi Qi Tang
or
Ju Yuan Jian
Lifting the Original Decoction
(smaller Bu Zhong Yi Qi Tang)

This is a Bleeding
disorder so want to
Lift.

Must Know
INGREDIENTS in
these formulas.

s/s: Pale, Light Color,

Profuse, Thinner. Fatigue,
Digestion issues, (poor
memory=blood xu), Mild
bloating, spontaneous
sweating, dull pain
associated with Sinking
empty sensation in
Abdomen xiou tong. T:
Pale, Teeth Marks (vs Kd
Yang xu, would be same but
more wet with bluish
color); P: Weak

Blood Heat:

Zhi Bai Di Huang

Wan

Deficiency
Heat (KD Yin

or

Deficiency)

**Da Bu Yin Wan

(better because stronger in this
case. ex: 45/50 yr old Sweating
through Clothing and sheets at
night)

Here want to Tonify

KD Yin rather than
Clear Deficiency Heat
Long process to Tonify
Yin, not over night. If
patient suffering from
heat can clear Xu heat
to affect symptoms
more immediately

s/s: (early) Scanty, Darker,

Thicker (because heat
congeals blood), Palm/Soles
Chest heat, Worse in
Afternoon/evening

or
Liang Di Tang
fu qing zhu formula

HERBS IN FORMULA:
Huang Qi 12-24g (C)
Ren Shen/Dang Shen, Bai Zhu, Zhi Gan
Cao (D) (Fu Ling is not here because it has
downbearing action and instead want to lift)
Dang Gui 6-12g(A) (Tonifies the qi in the
Blood; augments qi by invigorating blood; prevents
damage to yin)

Chen Pi 6-9g (A) (help digest Tonics)

Sheng Ma 3-6g (E), Chai Hu 3-9g (E)
Ju Yuan Jian (More Commonly used)
Huang Qi
Ren Shen/Dang Shen
Bai Zhu
Sheng Ma
Zhi Gan Cao
Tonify Qi, Lift Yang; Difference from BZYQT
is Ju Yuan Jian is used MUCH more commonly
in OB/GYN because the 3 ingredients taken
away are Warm and Pungent which could
more likely damage yin and Blood. Doesnt
mean cant use BZYQT for ob/gyn cases.
Side note: When pure LV Qi Stagnation, Chai
Hu is perfect. If LV Qi stag has already caused
Yang to rise Chai Hu must not be used

SIDE NOTES:
Stop Bleeding by Cooling Blood:
Bai Mao Gen
Di Yu
Ce Bai Ye
Da Ji
Bai Ji
Stop Bleeding by Invigorating Blood:
Pu Huang
San Qi
Stop Bleeding by Warming Channel:
Ai Ye
MODIFICATIONS:
Long Standing Diarrhea (would expect Watery Thin
Stool, undigested food, without Strong odor):
Chi Shi Zhi
Rou Dou Kou
Lian Zi, Shan Yao
maybe: Ge Gen, He Zi
Sleeping Problems, Insomnia due to Qi/Blood xu;
Blood Deficiency related Shen problems (these herbs
calm shen by tonifying deficiency):
Long Yan Rou
Suan Zao Ren
Bai Zi Ren
He Huan Pi, Ye Jiao Teng

Side Note: Post partum Mild Abdominal Pain

formula- (includes goat meat), xiou tong: Dang Gui
Sheng Jiang Yang Rou Tang- dang gui, sheng jiang,
yang rou

HERBS IN FORMULA:
Da Bu Yin Wan
Shu Di
Gui Ban
Huang Bai
Zhi Mu
Zhu Ji Shui- pig spinal cord; essential
ingredient in here, reliable [Not listed on
Box but it IS in there]
Liang Di Tang
Sheng Di, Di Gu Pi, Xuan Shen, Mai Dong,
E jiao, Bai Shao + Er Zhi Wan- Nu Zhen Zi,
Han lian Cao)
E Jiao- Tonify Blood, STOPS BLEEDING
Herbs that clear Xu Heat: Zhi Mu, Huang Bai,
Yin Chai Hu, Hu Huang Lian, Di Gu Pi, Bai Wei
Sidenote: Bai Wei called #1 Single herb in
Ob/gyn because can treat xu heat and
urination problems which is very common in
female disorders.

MODIFICATIONS:

Sidenote: Han Lian Cao also STOPS BLEEDING, and

Tonifys Yin (like E Jiao)
Sidenote: Formulas like Qing hao bie jia tang are more
for clearing deficiency heat AFTER febrile disease,
smoldering heat. (inaccurate translation to say Morning
coldness, evening heat. It is Morning normal, evening
heat)

Blood Heat:
Excess Heat
1. External Heat
Invasion (not
common; possibly
right after child
birth or during
menses when Blood
house is Wide
open)

Shi Hui San

10 Charred- all over bleeding
due to heat

or
Si Sheng Wan
Clearing heat (Difficult to access
these herbs so may not have
option to use this formula)

s/s: Bright Red or Darker,

Thicker, whole body fever,
Red face, Thirst, Dry
stool/constipation, Yellow
urine, Anxiety, or Shen
problems P: surging,
flooding, rapid

or
Qing Jing San
Fu Qing Zhu formula
protect, support yin/blood

Excess Heat
2. Internal Heat
Generation
specifically- LV Qi
Stagnation related
Heat

Dan Zhi Xiao Yao

San/Jia Wei Xiao Yao
San
Fxn: Smooth Liver Qi and
Clear Liver heat
s/s: emotional problems,
irritability, Eye issuesredness, swelling,
oversensitive to Light,
Headaches, dizziness,
tinnitus, bitter taste in
mouth, Red face; almost
always (due to LV Qi Yu)
Mid jiao problems too- ST
pain, Nausea, hiccups, acid
reflux

HERBS IN FORMULA:
Shi Hui San
Da Ji, Xiao Ji, He Ye, Ce Bai Ye, Bai Mao
Gen, Qian Cao Gen, Zhi Zi, Da Huang, Mu
Dan Pi, Zong Lu Pi

MODIFICATIONS:
Thirst (want herbs that clear heat and generate body
fluids)
Lu Gen
Tian Hua Fen

Si Sheng Wan (all Raw/fresh herbs)

Sheng Di Huang
Sheng Ce Bai Ye
Sheng Ai Ye (when this is raw or fresh it
treats bleeding due to HEAT)
Sheng He Ye
Qing Jing San
Mu Dan Pi, Di Gu Pi, Huang Bai, Qing
Hao, Fu Ling, Shu Di, Bai Shao
**Original formula nothing included
specifically to stop bleeding so should add:
Di Yu, Xiao Ji (lower body bleeding)/Da Ji
(upper body bleeding), Qian Cao Gen
(commonly used in ob/gyn bleeding)

Regarding the 4 levels: Blood Level Heat- besides bleeding,

talking about Shen problems- Severe Shen problems, coma,
delirium. But when just have bleeding due to blood heat dont
necessarily have these Severe shen problems, should not use Xi
Jiao Di Huang Tang.

Modern research actually shows that Charring does

not increase ability to stop bleeding. Sometimes
actually the opposite.

Sidenote: Herbs that stop bleeding only by Charring- Jing Jie

Tan, Zhi Zi Tan

HERBS IN FORMULA:
Chai Hu
Dang Gui, Bai Shao
Bai Zhu, Fu Ling, Zhi Gan Cao
Zhi Zi
Mu Dan Pi
Sheng Jiang, Bo He optional (Tantan would
prefer not to use them. Sheng Jiang too warm
and Bo He too pungent)
**Almost always ADD to this:
Chuan Lian Zi

MODIFICATIONS:
Mid Jiao problems; ST pain, hiccups, Acid Reflux
Zuo Jin Wan- Huang lian 5: Wu Zhu Yu 1
Diarrhea d/t LV overacting on SP/ST: painful, better
after diarrhea, explosive
Tong Xie Yao Fang- Bai Zhu, Bai Shao, Chen Pi,
Fang feng (why fang feng? for explosive aspect which is
caused by Intestinal Wind)
If Liver Qi Stagnation is cause of Mid Jiao pain, it is most
likely due to heat rather than cold
Wu Zhu Yu- hot, but great for vomiting, nausea;
combined with big Dose of Huang lian to offset hot
property
Side note: another formula like Zuo Jin Wan where one herbs
temperature/taste offsets the other [Ma Xing Shi Gan Tan] Ma
Huang 1: Shi Gao 4

DELAYED MENSES

1. Delayed 7 days at Least

3. Happens at least 3 months in a row
Can be caused by Deficiency (yin or blood)- patient just does not have enough blood to flow out
or Excess (blockage)- Chong and ren channel has been blocked by coldness, blood stagnation or phlegm

Yin/ Blood
Deficiency

in other books
called: Chong and
Ren Channel
emptiness

Si Wu Tang
Common place to use :
*Ba Zhen Tang because
in order to Tonify Blood,
also want to Tonify Qi
(in clinic we have: Fu Ke Ba
Zhen Tang; Fu ke means
ob/gyn; exactly same formula)

s/s: Scanty amount; if Blood xu more than

yin xu, Color is lighter; if Yin more than Blood
xu, color is darker because heat congeals.
Also Sleeping problems, insomnia, dream
disturbed sleep, heart palpitations, pale
complexion, poor memory/focus, P: Thin,
Weak

Shi Quan Da Bu Tang

+ Huang qi, Rou Gui- Rou Gui
used to Warm ming men to
warm vessels to promote Qi
blood regeneration; person may
or may not show cold signs. Rou
Gui is not necessarily used here
for warming coldness

Can we use Dang Gui Bu Xue Tang for general Blood

deficiency?- No it is never for chronic long standing
blood xu; Originally it was for post partum
conditions. DGBXT is for Acute Blood loss with heat
signs- not Xu Heat, so qi has no place to attach and
qi flows out to cause heat signs; Huang Qi in large
dose to strongly tonify qi to hold it back

MODIFICATIONS:
For more Yin Deficiency, Dryness, vision problems,
hearing problems, dry hair; for these cases its a little
more severe because yin xu is causing a delayed
menses:
Liu Wei Di Huang Wan
Zui Gui Wan
also want to use Animal parts, in tcm called herbs
with passion because they are stronger: Gui Ban,
Bie Jia, Lu Rong, Lu Jiao Jiao (safer than Lu
Rong)
Shen problems: poor focus, insomnia, anxiety etc.
These are herbs that calm shen by TONIFYING
Deficiency
Bai Zi Ren, Suan Zao Ren, Ye Jiao Teng, He
Huan Pi/hua

Kidney
Deficiency
(KD Yang
Deficiency)

Jin Gui Shen Qi Wan

KD Yang Xu delayed
menses S/S: Pale, Scanty,
Thinner very light colordescribed as Watery blood.
Why is it watery? Yang
provides needed
heat/warmth. For blood
regeneration, relays SP/St
nutrition from food and KD
Yang to provide needed
heat/warmth to turn it into
Red blood
Other S/S: Diarrhea, Cold
temperature, Low back
weakness, frequent
urination, Edema

HERBS IN FORMULA:
Liu Wei Di Huang Wan + Rou Gui, Fu Zi
also called Gui Fu Di huang wan
Shan Zhu Yu does tonify Kd Yang

Jin gui shen qi wan came before Liu wei di

huang wan
In order to tonify KD yang, also must tonify
KD yin

HERBS IN FORMULA:

Kidney
Deficiency
(KD Yin
Deficiency)

Liu Wei Di Huang

Wan
or
Gui Shen Wan
S/S: Scanty, Dark red blood
with clots, general dryness
of hair/scalp, 5 palm heat,
thin build, thirst
*

Qi/Blood
Stagnation
Can happen after
emotional
problems/upset

Xue Fu Zhu Yu Tang

- this formula is not only
good for chest/heart
conditions. It can be use for
ANY qi/blood stagnation
anywhere in the body.
(shao fu zhu yu tang is warming
so may not be appropriate here
because qi/blood stag usually
creates heat)

S/S: Pain, distention, sharp,

doesnt like pressure,
irritability, darker color,
painful menses, clotting,
darker and thicker blood,
Choppy pulse

Cold from
External
Invasion

Gui Zhi Fu Ling Wan

originally for blood
stagnation related masses

Wen Jing Tang

(shao fu zhu yu tang ok, but
wen jing tang better at
warming)

MODIFICATIONS:

Gui Shen Wan

Shu di, Shan Yao, Shan Zhu Yu, Fu Ling
Dang Gui, Gou Qi Zi, Du Zhong, Tu Si Zi
Why Dang Gui and Gou Qi Zi? besides
tonifying yin, should tonify blood because
this is a menstrual problem
Tu si zi- warms kidneys but induces
astringency, take this away for problems
with delayed menses

HERBS IN FORMULA:
**Specialty: Xue Fu Zhu Yu Tang is
appropriate formula because it also moves Qi
as well as blood**
Tao Ren
Hong Hua
Chuan Xiong- (txs windcold headaches)
Dang Gui
Chi Shao
Chuan Niu Xi
Sheng Di
Chai Hu
Jie Geng
Zhi Ke
Gan Cao

MODIFICATIONS:

HERBS IN FORMULA:

MODIFICATIONS:
Stop bleeding by warming
Ai Ye
Huang Tu (zao xin tu)
Pao Jiang

Wen Jing Tang helps with 1. Warming

channel 2. Moving blood

or
Can happen after
emotional
problems/upset

MODIFICATIONS:
Water Retention/Edema
Gui Zhi
Hu Lu Ba
Lower Abdominal Coldness or general body coldness
Ai Fu Nuan Gong Wan- ai ye, xiang fu major
ingredients; This formula contains original Si Wu Tang
+ ai ye, xiang fu + huang qi, rou gui + Xu Duan
Warming the Uterus formula- originally used for
Infertility due to KD Yang Deficiency; now used for any
ob/gyn with this pattern. What kind of cold expected?
Dull pain, Warm compress/massage will temporarily
relieve pain

S/S: Sharp pain, palpation or massage makes

it worse, Darker, clot

Side Note: What other formulas treat blood stagnation?:

Tao Hong Si Wu Tang
Gui Zhi Fu ling wan
Shi Xiao San
Shen Tong Zhu Yu Tang
Tong Qiao Huo Xue Tang
The point here is that for all these formulas should each ones
specialty

Irregular Menstruation

Irregular Menstrual cycle most common causes

1. Emotional- LV Qi Stagnation
2. teenager that first gets there menses many times it is irregular when it trying to establish pattern- KD Deficiency

LV Qi
Stagnation

HERBS IN FORMULA:
Chai Hu
Bai Shao
Bai Zhu, Fu Ling, Zhi Gan Cao
Dang Gui

Xiao Yao San

S/S:

Sidenote: 3 major herbs to treat Heat pattern

Vomiting/Nausea- Huang Lian, Zhu Ru, Lu Gen

must know
ingredients

HERBS IN FORMULA:

MODIFICATIONS:
Breast Fibroids
Xia Ku Cao
Qing Pi (not great choice)
Ju He
Pu Gong Ying
Commonly causes Midjiao problems (probably see
heat): borborygmous, acid reflux, burping
add Zuo Jin Wan
MODIFICATIONS:

KD
Deficiency
younger patients:
kidney not strong
enough to establish
menstrual cycle

S/S:

Profuse Bleeding yue jing guo duo from Fu Qing zhu

Same patterns as Early Menses. Also though includes Blood Stagnation

HERBS IN FORMULA:

SP Qi
Deficiency

HERBS IN FORMULA:

MODIFICATIONS:

HERBS IN FORMULA:

MODIFICATIONS:
Herbs that tx 1. heat toxicity, 2. invigorate blood, 3.
discharging pus (Must know these 3 Major Functions)
Bai Jiang Cao
Hong Teng

Blood Heat:
Deficiency
Heat (KD Yin
Deficiency)

Blood Heat:

Jie Du Si Wu Tang

Excess Heat
- Western Med: may
point towards
tumor or cancer

May develop into Heat

Toxicity
s/s: very dark color, sticky,
thick purplish with strong
foul odor, Lower abd. pain,
high fever, chills; pus is
causing foul odor

Major way in China to tx Cervical cancer Clear Heat Tox, Invigorate blood, Discharge
pus:
1. Huang lian jie du tang
2. Si Wu Tang- change Dang gui for Dang
Gui Wei and Bai Shao for Chi Shao
COMBINED TOGETHER=
Jie Du Si Wu Tang + Bai Jiang Cao + Hong
Teng
If there are Masses (Tumor) add: **Know
Yu Jin
San Leng
E Zhu
Dan Shen
Yi Mu Cao
also Chuan Shan Jia but hard to get

other disorder where there may be heat toxicity and

pus= Appendicitis

SCANTY MENSES

Compared to that patients normal amount

Caused by deficiency or Excess. Should be taken seriously because may lead to stoppage of menses: Amenorrhea
Deficiency- means yin or Blood Xu
Excess- talking about blockage/obstruction
1. Qi Stagnation, Blood Stagnation AND Phlegm Accumulation
phlegm, or damp phlegm is a major condition in ob/gyn
HERBS IN FORMULA:

Phlegm
Accumulation

Er Chen Tang
most basic

Cang Fu Dao Tan

Wan
major point here is moving qi to
help move damp phlegm
s/s: overweight, heaviness,
dizziness, unclear thinking,
brownish color with sticky
mucus, digestion problems, gas,
bloating, full sensation in
chest/abdomen, burping,
belching
T: thick, sticky greasy coat
P: Slippery

Cang Fu Dao Tan Wan

Cang Zhu
Xiang Fu- in order to move dampness
must move qi
Chen Pi
Ban Xia
Fu Ling
Gan Cao
Tian Nan Xing
Zhi Ke
Sheng Jiang

MODIFICATIONS:
Vaginal Discharge
Lian Zi, Bai Guo, Qian Shi
Lian Xu, Shan Yao
Burping, gas
Ping Wei San
Liu Jun Zi Tang
Long Standing Diarrhea
Shen Ling Bai Zhu San

Shen Ling Bai Zhu San- originally created for Pediatricsmalnutrition, ground into powder and swallowed with
meat soup. Help to tonify SP/ST, move midjiao qi
stagnation, transform dampness.
- Not only for midjiao qi Diarrhea

PAINFUL MENSES tong jing

Mostly affect Young women. Pain can be very very bad. It can be so bad they have a cold sweat, become pale.
Bu tong ze tong- Blockage leads to Pain or Pain caused by blockage. But is all pain caused by blockage? no.
Bu Rong ze Tong- Deficiency can also lead to Pain
Caused by:
Deficiency or Excess
side note: To treat internal wind, treat blood first; after blood is taken care of, wind should be gone- This applies to Wind due to Yin or blood xu- ex: da ding feng zhu; Usually in clinic,
when see wind usually due to Deficiency
Spasms, TMJ is Wind also!

HERBS IN FORMULA:

(KD) Yin,
Blood
Deficiency

Kd yin xu is much more

common than lv
yin/blood xu

Ba Zhen Tang

use as Base but ADD:

Ji Xue Teng, Mu Gua.

Increase Bai Shao to
15g
s/s: milder pain, worse after
menses. Still can have pain
during menses but worse after
menses.
T:
P:

single herb that helps to tonify deficiency while

stopping pain/spasms= Bai Shao, Mu Gua
Sour herbs that have nothing to do with inducing
astringency: Bai Shao, Mu gua; they both have
strong reliable action to go to liver to Soften LV
meridian.
Also Ji Xue Teng important to relax meridians
along with Bai Shao, Mu Gua in treating pain due to
deficiency
Sidenote: Western Medicine:
Calf Contractions: Trace Mineral deficiency
in TCM- LV blood xu

HERBS IN FORMULA:

Excess:
Qi/Blood
Stagnation

Yan Hu Suo Zhi Tong

Pian (patent)
This is purified Yan Hu Suo.
ONLY for painful menses
from Qi/Blood Stagnation

Ge Xia Zhu Yu Tang

-originally for treating
cirrhosis; Now also good
formula for stopping pain
by moving blood for menses
because includes yan hu
suo, wu ling zhi; also
softens hardness, masses

MODIFICATIONS:
Blood Xu related Dryness
Sang Shen
He Shou Wu

Single Herb that theoretically would be best: Yan

Hu Suo; same plant as opium but NOT addictive
and milder
If taken singley, grind a little and can swallow it
with warm water. within 5-10 min can relieve pain

Shao fu zhu yu tang, Wen Jing Tang not the

best because warm.
s/s: SEVERE stabbing pain; pain is worse prior or at
start of menses; Sometimes a little better after
onset becaseu blood can flow out; breast
tenderness; sometimes pain so bad have vomiting,
nausea. Why N/V? Liver overacts on Sp/St
T:
P:

MODIFICATIONS:
LV overacting on SP/ST= Nausea, Vomiting
add Zuo Jin Wan- Huang Lian, Wu Zhu Yu

Painful Diarrhea, better after moving bowels,

explosive. This is Wood overacting on Earth
Tong Xie Yao Fang (why fang feng? for explosive
aspect which is caused by Intestinal Wind)

KD Yang Xu=

Coldness
1. KD Yang
deficiency

HERBS IN FORMULA:

MODIFICATIONS:
A lot of Leukorrhea, itchy, burning, foul odor, maybe
pink
Ku Shen, Huang Bai, Bai Xian Pi, Hua Jiao (to
kill parasites), Long Dan Cao, Bai Fan

use as Base but ADD:

This is coldness from
Internal generation

s/s: - pain is mild, responds

well to warmth, massage, blood
is thinner, lighter, weakness,
soreness in Low back and Knees
TP: Warm KD Yang
some single Herbs: Fu Zi, Rou
Gui, Gan Jiang, Hu Lu Ba

Coldness contracts and

leads to blood
stagnation: Wen Jing
Tang or Shao Fu Zhu
Yu Tang

External Cold=

Cold can come from

internal generation of
external

s/s: darker, lots of clots, more

painful, sometimes can feel
bumps in lower abdomen

Sheng Hua Tang

-classic indication was
lingering lochia

Long Dan Xie Gan

Tang
can use as base
or

encounter this a lot,

TCM better at treating
this than western

MODIFICATIONS:

Jin Gui Shen Qi Wan

2. External
Cold

Lower Jiao
Damp-Heat
Accumulation

HERBS IN FORMULA:

Qing Re Tiao Xue

Tang
Fu Qing Zhu formula
s/s: pain is burning warm
sensation, low grade fever,
diarrhea, discharge- thick sticky
foul odor, local skin itching
burning sensation; this may
indicate tumor or cancer
T:
P:

Qing Re Tiao Xue Tang

Sheng Di
Dang Gui
Chuan Xiong
Tao Ren
Hong Hua
Huang Lian
Xiang Fu
E Zhu (anti-cancer, esp Cervical CA)
Yan Hu Suo
+ Hong Teng, Bai Jiang Cao, Yi Yi Ren

AMENORRHEA Bi Jing closure of Menses

2 Situations:
1. Primary- has not had period yet
Race related, genetics can create a variety of ages that have there first period
2. Secondary- has had period before and then it has stopped
Excess and Deficiency
HERBS IN FORMULA:

Qi/Blood
Deficiency

Translated into
westerns nutrition
related amenorrhea,
low energy, general
dryness, thin body
build, poor
concentration, nails
are brittle, skin
sensation issues

Ba Zhen Tang
Shi Quan Da Bu Tang
Ren shen yang yin
(rong) tang (take chuan
xiong away, ADD chen Pi,
wu wei zi, Yuan zhi by
tonifying qi to calm shen
wu wei zi is great at holding
heart qi together since the HT
Qi is scattered, shen problems,
poor concentration, poor
memory

Skin sensation problems- decrease skin sensation,

muscle twitch-diabetes is very common disease
with this issue! Feeling of ants everywhere, hurt
themselves since they cannot feel the burning
water (This is due to Ying and Wei disharmony):
Use Gui Zhi and ADD Huang Qi

Huang Qi Gui Zhi Wu Wu Tang

MODIFICATIONS:

HERBS IN FORMULA:

LV/KD Yin
Deficiency
& Blood Xu
primary- never had
period before and
doesnt come (USE ZI
HE CHE)
secondary- had period
before and it stops

Liu Wei Di Huang

Wan

Gui Shen Wan

Shu di, Shan Yao, Shan Zhu Yu, Fu Ling
Dang Gui, Gou Qi Zi, Du Zhong, Tu Si Zi

Gui Shen Wan

= Tonifys Kd Yin

-Can occur with either

Primary or Secondary
Secondary s/s: scanty,
delayed menses prior to
stopping, vision/hearing
problems insomnia, dream
disturbed sleep, 5 center
heat

possible Test Question: Difference between

Gui shen Wan and other yin tonic formulas is
that Gui shen Wan also takes care of blood as
well (via Dang Gui and Gou Qi Zi)

HERBS IN FORMULA:

Qi/Blood
Stagnation

More commonly
Secondary
Amenorrhea

Xue Fu Zhu Yu Tang

what makes this formula
different than other blood
moving formulas: also moves qi
s/s: - usually had irregular
menses for a while, emotional
problems, irritable, digestive
problems- burping, gas,
bloating, hiccups, vomiting,
nausea, breast distention or
breast fibroids

DampPhlegm
Accumulation

- moves qi; also want to

increase the formulas qi
moving ability, combine
with:

+ Fo Shou San

MODIFICATIONS:
Breast Fibroids (LV and ST pass through breasts);
Fibroids in general are more painful before menses, in
TCM to tx this- Smooth LV Qi
Xia Ku Cao, Ju He

sidenote: Pu Gong Ying for breast abscess/mastitis

HERBS IN FORMULA:

Xiang Fu Dao Tan Tang

MODIFICATIONS:

s/s: overweight, always eating fast food, (ex: didnt

have first menses until 17yo), This pattern can
happen in both secondary or primary amenorrhea,
constant Leukorrhea issues, Mucous in Blood,
general digestion appetite, burping, gas, Sweet taste
in mouth because Spleen encumbered by damp

MODIFICATIONS:
Shen problems due to Damp phlegm accumulation;
unclear thinking, shen problems
Shi Chang Pu, Yuan Zhi, Yu Jin
Meng Shi (used as last resort, for strong
patients)
Meng Shi Gun Tan Wan

- Fo Shou, Dang Gui, Chuan

Xiong

IRREGULAR UTERINE BLEEDING Beng Lou

Not menstrual bleeding; happens outside of menstrual cycle

Either profuse or spotty as long as it happens outside of the menstrual cycle
In general- Deficiency is much more than Excess; Heat pattern is much more than cold pattern
Can happen during Menopause
or Young ladies where menstrual cycle hasnt fully established yet
To treat Beng Lou 3 Steps must follow:
1. Stopping Bleeding no matter what (of course this is treating the branch but this is ok)
2. When bleeding under control (not necessarily stopped) treat the patterns, root cause
3. Whenever possible try whatever you can to restore Menstrual Cycle
HERBS IN FORMULA:

1. Stopping
Bleeding

Yunnan Bai Yao

-comes in many different forms;
also in tiny red pill- called
emergency pills- only have to
take this when bleeding is very
bad

MODIFICATIONS:

HERBS IN FORMULA:

HERBS IN FORMULA:

Qi/Blood
Stagnation

More commonly
Secondary
Amenorrhea

Xue Fu Zhu Yu Tang

what makes this formula
different than other blood
moving formulas: also moves qi
s/s: - usually had irregular
menses for a while, emotional
problems, irritable, digestive
problems- burping, gas,
bloating, hiccups, vomiting,
nausea, breast distention or
breast fibroids

Xiang Fu Dao Tan Tang

- moves qi; also want to
increase the formulas qi
moving ability, combine
with:

+ Fo Shou San

MODIFICATIONS:
Breast Fibroids (LV and ST pass through breasts);
Fibroids in general are more painful before menses, in
TCM to tx this- Smooth LV Qi
Xia Ku Cao, Ju He

sidenote: Pu Gong Ying for breast abscess/mastitis

HERBS IN FORMULA:

DampPhlegm
Accumulation

MODIFICATIONS:

s/s: overweight, always eating fast food, (ex: didnt

have first menses until 17yo), This pattern can
happen in both secondary or primary amenorrhea,
constant Leukorrhea issues, Mucous in Blood,
general digestion appetite, burping, gas, Sweet taste
in mouth because Spleen encumbered by damp

MODIFICATIONS:
Shen problems due to Damp phlegm accumulation;
unclear thinking, shen problems
Shi Chang Pu, Yuan Zhi, Yu Jin
Meng Shi (used as last resort, for strong
patients)
Meng Shi Gun Tan Wan

- Fo Shou, Dang Gui, Chuan

Xiong

Move blood to Stop Pain: Ru Xiang, Mo Yao, Wu Ling Zhi, San Qi

Move Qi to stop pain: Mu Xiang, Chuan Lian Zi, Bing Lang
Coldness by warming the interior to stop pain: Wu Zhu Yu, Wu Yao, Ai Ye, Xiao Hui Xiang
Bi Syndrome: Chuan Wu (Tou), Cao Wu (Tou)
Stopping Pain by cooling blood and clearing heat: Mu Dan Pi, Chi Shao
Qi Li San- Powder- Good for Int/Ext pain due to Qi/blood Stagnation due to Injury or Trauma
An gong niu huang wan