Dr Zijing Hu (M.B. M.

Med)

The Therapeutics of Lecturer: Department of

Complementary Medicine

Acupuncture and Moxibustion (Acupuncture)

Faculty of Health Sciences
University of Johannesburg
Dysmenorrhoea

• Definition:
• Dysmenorrhoea refers to abdominal and lumbar pain before, after or during menstruation
in females.

• Primary dysmenorrhoea has no pathological changes in the reproductive organs

• Secondary dysmenorrhoea results from reproductive system disorders, such as
endometriosis, acute or chronic pelvic inflammatory disease, tumor, stenosis and
obstruction of the cervix.
• Aetiology

Depression or anger Liver qi stag.

Qi and blood stag.
Cold environments Cold and damp in
Cold foods the lower abdomen

Dysmenorrhoea
Severe or chronic
illness Qi and bld def.

Liver or kidney def. Essence and bld def.

Weak constitutions
• Syndrome differentiation
• Main symptoms: Lower abdominal pain before, during or after menstruation, lasting for
several hours or two to three days, pale complexion with cold sweats, physical weakness,
nausea, diarrhoea, frequent urination and headache.

• Qi and blood stag.: severe abdominal pain during or before menstruation, lower
abdominal distending pain that is worse with pressure, purplish, red blood clots, slight
alleviation of pain after passing the clots, pain and distension in the chest, hypochondria
and breasts, restlessness, irritability, emotional lability, petechiae on the tongue and a thin
and wiry pulse.

• Cold-damp: cold pain in the lower abdomen that feels better with warmth, nausea,
vomiting, dark purple menses with clots and scanty bleeding, infertility, aversion to cold, a
pale tongue with a white, greasy coating and the pulse is deep and tight.
• Qi and blood def.: Dull abdominal pain primarily after menstruation, scanty menses with
light pale colour, sallow and pale complexion, physical weakness, fatigue, dizziness,
blurred vision, palpitations, infertility, a pale and enlarged tongue with teethmarks and the
pulse is thin and weak.

• Liver and kidney def.: Weakness of the lower back and knees, insomnia, dizziness,
vertigo, tinnitus, blurred vision, a red tongue with less coating and a thready pulse.
• Treatment principles:
• Regulate qi, activate blood, regulate the chong and ren meridians, nourish qi and blood

• Main points: focus on the ren and spleen meridians

• RN4 (guanyuan), SP6 (sanyinjiao), RN6 (qihai), SP8 (diji)

• Needling technique:
• Select 3-4 points at a time, reinforce SP6 (sanyinjiao) and SP8 (diji)
• Qi and blood stag.: add LV3 (taichong), SP10 (xuehai), BL32 (ciliao), EX-B9 (shiqizhui)
• Cold-damp: add moxibustion
• Qi and blood def.: add BL18 (ganshu), Bl20 (pishu), RN6 (qihai), ST36 (zusanli)
• Liver and kidney def.: add BL18 (ganshu), BL23 (shenshu), KI3 (taixi)

• Other treatment approaches:

• Auricular acupuncture: Uterus, sympathetic,subcortex, endocrine, liver, kidney and
shenmen, select 3-4 points, keep for 30 minutes, once a day
• Three-edge needling technique: BL18 (ganshu), BL20 (pishu), BL23 (shenshu), BL32
(ciliao), RN4 (guanyuan), RN3 (Zhongji)
• Skin needling technique: Select points on the ren, kidney, stomach and spleen
meridians on the lower abdomen as well as points on the du and gallbladder meridian on
the lower back.
Amenorrhea
• Definition:
• Amenorrhea is the absence of menarche in women older than 16 and discontinuation of
menstruation for 3 consecutive months in women of reproductive age.

• Physiological states of amenorrhea are seen, most commonly, during pregnancy, lactation
(breastfeeding) and menopause.
• Factors contributing to amenorrhea include deficiency of qi and blood in the Chong and
Ren meridians due to deficiency of the spleen and kidney, blood stasis due to qi
stagnation or cold retention, and phlegm-dampness affecting the uterus.
• Aetiology

Depression or anger Liver qi stag.

Qi and blood stag.
Cold environments Cold and damp in
Cold foods the lower abdomen

Multiple
Qi and bld def.
miscarriages
Amenorrhoea
Kidney qi def. Essence and bld def.

Weak constitutions

Spleen dysfunction Phlegm and damp accum.

• Syndrome differentiation
• Main symptoms: lack of menstruation in women older than 16 or discontinuation of
menstruation for 3 consecutive months in women of reproductive age.

• Blood exhaustion/depletion: No/delayed menstruation, scanty bleeding that gradually

develops into amenorrhoea.

• Liver and kidney def.: Dizziness, tinnitus, aching and weakness of the lower back and
knees, dry mouth, feverish sensations in the palms and soles, tidal fever, sweating, a red
tongue with less coating and the pulse is thin and wiry.

• Qi and blood def.: Dizziness, blurred vision, palpitations, shortness of breath, fatigue,
lassitude, poor appetite, a pale tongue with a thin white coating and a deep and moderate
pulse
• Blood stasis: sudden amenorrhoea and abdominal distension.

• Qi stag.: Mental depression, emotional liability, chest and hypochondriac distension and
fullness, pain in the lower abdomen that is worse with pressure, a deep red tongue with
petechiae and a deep and wiry pulse

• Phlegm-damp obstruction: obesity, chest and hypochondriac distension and fullness,

lassitude, fatigue, profuse leucorrhoea, a white, greasy tongue coating and a slippery pulse

• Cold coagulation: Amenorrhoea, cold pain in the lower abdomen, cold limbs, aversion to
cold, a white tongue coating and a deep, slow pulse
• Treatment principles:
• Deficiency conditions: nourish blood and regulate menstruation
• Excess conditions: invigorate blood and regulate menstruation

• Main appoints:
• Def conditions:
• RN4 (guanyuan), ST36 (zusanli), ST29 (guilai)

• Qi and blood def.: add RN6 (qihai), BL20 (pishu), BL21 (weishu)
• Liver and kidney def.: add BL18 (ganshu), BL23 (shenshu)
• Tidal fever and sweating: add KI3 (taixi)
• Palpitations: add PC6 (neiguan)
• Poor appetite: add RN12 (zhongwan)

• Needling technique:
• Reinforcing method and moxibustion can be used

• Excess conditions:
• RN3 (zhongji), SP6 (sanyinjiao), ST29 (guilai)

• Qi stag. and blood stasis: add LI4 (hegu), SP10 (xuehai), LV3 (taichong)
• Phlegm-damp obstruction: add SP9 (yinlingquan), ST40 (fenglong)
• Cold coagulation: RN4 (mingmen), DU3 (yaoyangguan)
• Chest and hypochondriac fullness and distension: add PC6 (neiguan)
• Needling technique:
• Reducing method, moxibustion can be added for cold coagulation.

• Other treatment approaches:

• Auricular acupuncture technique: Endocrine, internal genitals, liver, kidney, subcortex,
and shenmen, select 3-4 points, keep for 30 minutes, once a day

• Skin needling technique: EX-B2 (jiaji) on the back or lumbo-sacral area or back shu
points, points on the lower abdomen from the ren, kidney, spleen, stomach and belt
meridians.
 Metrorrhagia

• Definition:
• Metrorrhagia is uterine bleeding at irregular intervals, particularly between the expected
menstrual periods. It is a cause of vaginal bleeding. In some women, menstrual spotting
between periods occurs as a normal and harmless part of ovulation.

• Aetiology

Congenital def.

Invasion of exogenous heat

Damage to Chong and ren Intermenstrual bleeding
Excess spicy/pungent foods

Depression Liver qi stag. Fire

• Syndrome differentiation
• Def. conditions:
• Main symptoms: Profuse bleeding or intermenstrual bleeding
• Spleen def.: Light red colour, less menses, sallow complexion, lassitude, shortness of
breath, no desire to speak, poor appetite, loose stools, a pale and enlarged tongue with a
white coating and a deep, thin and forceless pulse.

• Kidney yang def.: Profuse and continuous pale light-red coloured menses, cold
abdominal pain that prefers pressure and warmth, cold body sensation, aversion to cold,
a pale tongue with a thin white coating, and a deep, thin and slow pulse.

• Kidney yin def.: Scanty, red menses, dizziness, tinnitus, restlessness, irritability,
insomnia, pain and weakness of the lower back and knees, the tongue is red with less
coating and a thin and rapid pulse.
• Exc. conditions:
• Main symptoms: Profuse bleeding or intermenstrual bleeding, bright red blood

• Blood-heat: Dark red, sticky menses with a foul odour, dry mouth with thirst, the tongue
is red with a yellow coating and a slipper and rapid pulse.

• Damp-heat: Profuse, red, sticky menses, profuse, yellow leukorrhoea with a foul odour,
vaginal pruritis, a yellow greasy tongue coating and a soggy, rapid pulse.

• Qi stag.: Normal colour menses with blood clots, restlessness, irritability, emotional
lability, feels better with sighing, distention and pain in the lower abdomen, thin white
tongue coating and a wiry pulse.
• Treatment principles:
• Def. conditions: Regulate and reinforce Chong and Ren, nourish the qi to govern the
meridians.
• Exc. conditions: Regulate the chong and ren, dispel pathogens and strengthen the
meridians.

• Main points:
• Def. conditions: Focus on points on the ren, spleen and stomach meridians.
• RN6 (qihai), SP6(sanyinjiao), ST36 (zusanli)

• Spleen qi def.: Add DU20 (baihui), BL20 (pishu), BL21 (weishu)

• Kidney yang def.: Add BL23 (shenshu), DU4 (mingmen)
• Kidney yin def.: Add KI2 (rangu), KI3 (taixi)
• Night sweating: Add HT6 (yinxi)
• Insomnia: Add HT7 (shenmen)

• Needling technique:
• Reinforcing method and moxibustion can be used.

• Exc. conditions: Select points on the ren and spleen meridians.

• RN4 (guanyuan), SP4 (gongsun), SP6 (sanyinjiao), SP1 (yinbai)

• Blood-heat: Add SP10 (xuehai)

• Damp-heat: Add SP9 (yinlingquan)
• Liver qi stagnation: Add LV3 (taichong)

• Needling technique:
• RN4 (guanyuan) is manipulated with even technique, use reducing method on other
points.

• Other treatment approaches:

• Auricular acupuncture: internal genitals, subcortex, endocrine, kidney, liver and spleen
 Dr Zijing Hu (M.B. M.Med)
Lecturer: Department of Complementary Medicine
(Acupuncture)
Room 7106d John Orr Building DFC
Faculty of Health Sciences
University of Johannesburg
Tel: 011 559 6999
E-mail: zhu@uj.ac.za