Heavy Periods

CHAPTER 11 Heavy Periods



AETIOLOGY 231

PATHOLOGY 232

IDENTIFICATION OF PATTERNS AND TREATMENT 232
Qi deficiency 232

Blood-Heat 233

Blood stasis 235

PROGNOSIS AND PREVENTION 237

‘Heavy Periods’ means periods that occur regularly and last the customary 5 days or thereabouts but are heavier than normal. As mentioned in Chapter 2 on physiology, the average blood loss during a menstrual cycle is 30–80 ml. Since the range of blood loss is quite broad, the definition of a ‘heavy’ period can be rather subjective and difficult to gauge. Generally speaking, a period may be called ‘heavy’ if it starts with a gush of blood, catching the woman unaware and necessitating an urgent resort to a tampon or sanitary towel (pad), or if the woman has to make very frequent changes of these protective devices.


As a category of disease-symptom in Chinese medicine, Heavy Periods (called Yue Jing Guo Duo) should be differentiated from Flooding and Trickling (Beng Lou). The former consists of heavy bleeding which occurs at the proper time and within the proper span of the periods (approximately 5 days); the latter consists of very heavy bleeding that may both start before the proper time and continue after it, and may also trickle on for a long time after the period should have ended. The distinction between these two conditions is not too important in terms of pathology and treatment, which are essentially the same, but it matters from a prognostic perspective: in fact, Flooding and Trickling is more difficult to treat than Heavy Periods. Table 11.1 illustrates the main differences between Heavy Periods and Flooding and Trickling; see also Fig. S-4.1 (p. 198).



Table 11.1 Differentiation between heavy periods and flooding and trickling

image


Aetiology




Excessive physical work


Excessive physical work, including exercise or sports, may injure the Spleen, so that deficient Spleen-Qi fails to hold Blood, the Directing and Penetrating Vessels are weakened and the period becomes heavy.



Emotional stress, irregular diet, external heat


Emotional stress leads to Qi stagnation and, if this continues for a long time, stagnant Qi may turn into Fire. Excessive consumption of hot, spicy foods and alcohol may also lead to Heat or Fire, which may derive from external Heat as well. Whatever the cause, if Heat enters the Blood portion and agitates the Blood so that it spills out of the blood vessels, this gives rise to heavy periods.



Emotional stress, surgery, post-partum conditions


Qi stagnation from emotional stress as described above may turn into Blood stasis rather than Fire. Abdominal surgery and post-partum conditions also frequently lead to Blood stasis. Whatever the cause, when Blood stagnates, the Directing and Penetrating Vessels become obstructed, new Blood cannot enter the channels (because they are blocked by stagnant Blood), bleeding occurs and heavy periods may develop.



Pathology


The pathology of Heavy Periods consists of:


• Qi deficiency

• Blood-Heat

• Blood stasis.

In the first pattern, Blood leaks out because deficient Spleen-Qi fails to hold it in the vessels. In the second, it spills over because Heat agitates it and forces it out of the vessels. In the third, it leaks out because the vessels are obstructed by stagnant Blood and newly generated Blood has no place to go to. The pattern of Qi deficiency is therefore primarily related to the Spleen, but the Kidneys also play their part because Kidney-Qi also holds Blood in the vessels (especially the blood vessels of the Uterus). The patterns of Blood-Heat and Blood stasis are mostly related to the Liver.



Identification of patterns and treatment


All the herbal prescriptions in this section are detailed in Appendix 1 on p. 937.



Qi deficiency



Clinical manifestations


Heavy period, pale and dilute blood, pale complexion, tiredness. Spleen-Qi deficiency: loose stools, slight abdominal distension. Kidney-Qi deficiency: frequent urination, backache, dizziness. Tongue: Pale. Pulse: Weak.



Treatment principle


Tonify and raise Qi of Spleen and/or Kidneys, contain Blood, consolidate the Directing and Penetrating Vessels.



Acupuncture


Du-20 Baihui, Ren-12 Zhongwan, Ren-6 Qihai, Ren-4 Guanyuan, ST-36 Zusanli, SP-6 Sanyinjiao, BL-20 Pishu, BL-23 Shenshu. All with reinforcing method; moxa should be used.




Explanation


– Du-20 raises Qi. This point can be stimulated with a moxa stick.

– Ren-12, ST-36, SP-6 and BL-20 tonify Spleen-Qi.

– Ren-6 tonifies and raises Qi. It is very effective with direct moxa cones.

– Ren-4 tonifies the Kidneys and consolidates Directing and Penetrating Vessels.

– BL-23 is used if there is also a Kidney deficiency.


Herbal treatment



a Prescription



– JU YUAN JIAN

– Raising the Original [Qi] Decoction


Explanation

This prescription, already explained, tonifies and raises Spleen-Qi: this will stop the bleeding from deficiency.



b Prescription



– BU ZHONG YI QI TANG

– Tonifying the Centre and Benefiting Qi Decoction


Explanation

This formula, already explained, tonifies and raises Spleen-Qi to stop bleeding. Very similar to the previous one, it is perhaps more suitable to stop bleeding because it contains Dang Gui to enter the Blood portion.



c Prescription



– GUI PI TANG

– Tonifying the Spleen Decoction


Explanation

This formula, already explained, tonifies Spleen-Qi and calms the Mind. It is suitable to stop bleeding because it also contains Dang Gui, which enters the Blood portion, and is particularly appropriate if the patient suffers from anxiety and depression.



Modifications

These modifications apply to all three previous formulae.


– If the period is very heavy, add E Jiao Colla Corii asini, Wu Zei Gu Endoconcha Sepiae and Pao Jiang Rhizoma Zingiberis preparatum (fried).

– If the period is long, add Pu Huang Pollen Typhae and Yi Mu Cao Herba Leonuri.

– If there are symptoms of Kidney-Yang deficiency, add Xu Duan Radix Dipsaci and Ai Ye Folium Artemisiae argyi.


d Prescription



– JIA JIAN SI WU TANG

– Modified Four Substances Decoction


Explanation

This formula, by Fu Qing Zhu, is for chronic conditions of heavy bleeding from Qi deficiency resulting in Blood deficiency as well. Although it may seem strange that heavy bleeding occurs when Blood is deficient, Fu Qing Zhu explains this by saying that, no matter how deficient Blood is, if it does not return to the vessels properly, menstruation will be heavy.1


– Shu Di Huang, Bai Shao, Dang Gui and Chuan Xiong nourish Blood.

– Bai Zhu tonifies Qi which helps to nourish Blood.

– Jing Jie stops bleeding.

– Shan Zhu Yu and Xu Duan tonify the Liver and Kidneys, consolidate the Directing and Penetrating Vessels and stop bleeding.

– Gan Cao harmonizes.


Women’s Treasure remedy



– RESTRAIN THE FLOW

This remedy is specific to stop uterine bleeding from Qi deficiency. The tongue presentation appropriate to this remedy is a Pale body.



Three Treasures remedy



– TONIFY QI AND EASE THE MUSCLES

This remedy is a variation of Bu Zhong Yi Qi Tang Tonifying the Centre and Benefiting Qi Decoction

Related posts:

  1. Vaginal Itching (and Trichomonas and Candida Infections and Genital Eczema)
  2. Prolapse of the Uterus
  3. Acupuncture and Herbal Treatment in Midwifery
  4. Endometriosis

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Jun 6, 2016 | Posted by in GYNECOLOGY | Comments Off on Heavy Periods

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