Irregular Periods

CHAPTER 10 Irregular Periods



AETIOLOGY 225

PATHOLOGY 226

IDENTIFICATION OF PATTERNS AND TREATMENT 226
Liver-Qi stagnation 226

Kidney-Yang deficiency 227

Kidney-Yin deficiency 228

Ancient acupuncture prescriptions for Irregular Periods 230

PROGNOSIS AND PREVENTION 230

The term ‘Irregular Periods’ refers to periods that come with an irregular cycle, sometimes early, sometimes late. It is important to note that if the periods come consistently early or consistently late, they fall under the categories of Early Periods or Late Periods respectively: thus, it is only when they are sometimes late and sometimes early in an unpredictable manner that they constitute Irregular Periods. An irregularity of the cycle in the time preceding the menopause is normal; similarly for some months after the menarche.


When questioning a woman patient, it is important to make sure that her particular problem does indeed fall into this category; many women refer to their periods as being ‘irregular’ when they are in fact consistently early or consistently late.


Irregular Periods are called Yue Jing Xian Hou Wu Ding Qi which means ‘an irregular cycle with periods that come early or late’. In the old literature the condition was also called Jing Luan which means ‘chaotic periods’.


An irregularity of the cycle is always related to the Liver and Kidneys (and especially the latter) because it is the rhythmic ebb and flow of Blood and Essence that give rise to the periods. Thus, these two organs are responsible for the internal, biological clock that determines the menstrual cycle. In fact, Fu Qing Zhu says in Fu Qing Zhu’s Gynaecology:



The menstrual flow originates from the Kidneys, the Liver is the Child of the Kidneys, when the Liver stagnates the Kidneys also stagnate. When the Kidneys stagnate their Qi does not diffuse, early periods, late periods, stoppage or continuation of the periods all relate to Kidney-Qi being free or obstructed . . . Whether Liver-Qi is free or obstructed affects whether Kidney-Qi goes or stays.1


This statement clearly stresses that the regularity of the menstrual cycle depends first and foremost on Liver and Kidneys: this is because the Liver stores Blood and the Kidneys are the origin of the Heavenly Gui. An interesting aspect of the above statement is Fu Qing Zhu’s reference to Kidney-Qi stagnation, a condition that is not usually mentioned as one of the patterns of disharmony but that does, nonetheless, exist.



Aetiology



Emotional stress


Emotional stress such as anger, frustration or resentment may cause Liver-Qi to become stagnant and the Directing and Penetrating Vessels (Ren and Chong Mai) to become obstructed. When Qi stagnates for some time, Blood also stagnates so that the Sea of Blood (of the Penetrating Vessel) cannot fill the Uterus and the periods become irregular.


The Complete Works of Jing Yue (1624) attributes great importance to emotional problems as a cause of irregular periods. It says:



Unfulfilled longing and deep pensiveness cause the Qi of Heart and Spleen to stagnate, this injures the source of the Directing and Penetrating vessels, and Kidney-Qi declines: in mild cases the periods become irregular, in severe cases they may stop altogether.2



Overwork, too many children too close together


Overwork or having too many children too close together lead to a Kidney deficiency: when the Kidneys are deficient, the Directing and Penetrating Vessels become depleted, the Sea of Blood of the Penetrating Vessel cannot fill the Uterus and the periods become irregular.



Pathology


The pathology of Irregular Periods may be due to:


• Liver-Qi stagnation

• Kidney deficiency (Yang or Yin).

The Liver and Kidneys are therefore the two organs at the root of this problem. This is understandable because it is these two organs that are most responsible for the cyclical recurrence of the periods. In fact, the Liver stores Blood and is closely related to the Penetrating Vessel and the Kidneys are the origin of the Heavenly Gui that crystallizes into menstrual blood. Irregular Periods from Kidney deficiency tend to occur in older women.



Identification of patterns and treatment



Liver-Qi stagnation



Clinical manifestations


Irregular periods usually with scanty bleeding with some clots, abdominal and breast distension, pre-menstrual tension, depression, sighing, irritability. Tongue: normal coloured or, if the stagnation is longstanding, slightly Red sides. Pulse: Wiry.



Treatment principle


Pacify the Liver, move Qi, eliminate stagnation, regulate the periods.



Acupuncture


LIV-3 Taichong, T.B.-6 Zhigou, P-6 Neiguan, LIV-14 Qimen, Ren-4 Guanyuan, Ren-6 Qihai, SP-4 Gongsun (on the right) and P-6 Neiguan (on the left). All with reducing or even method.




Explanation


– LIV-3, T.B.-6, and LIV-14 pacify the Liver, move Qi and eliminate stagnation.

– P-6, related to the Liver channel through the Terminal Yin, moves Liver-Qi, calms the Mind and settles the Ethereal Soul.

– Ren-4 and Ren-6 move Qi in the Lower Burner and strengthen the Uterus.

– SP-4 and P-6 regulate the Penetrating Vessel and subdue rebellious Qi. They are selected if there are clear symptoms of rebellious Qi of this vessel such as a feeling of distension of the abdomen that seems to transmit upwards to the chest, a feeling of oppression or tightness of the chest with sighing and a vague feeling of anxiety.


Prescription from the Great Compendium of Acupuncture (1601)3



– Ren-6 Qihai, Ren-3 Zhongji, G.B.-26 Daimai, BL-23 Shenshu and SP-6 Sanyinjiao.


Herbal treatment



a Prescription



– XIAO YAO SAN

– Free and Easy Wanderer Powder


Explanation

This formula, which has already been explained, pacifies the Liver, moves Qi, eliminates stagnation, nourishes Liver-Blood and tonifies Spleen-Qi.



Modifications


• If there is abdominal pain, add Xiang Fu Rhizoma Cyperi and Yan Hu Suo Rhizoma Corydalis.

• If stagnant Liver-Qi turns into Fire, add Mu Dan Pi Cortex Moutan and Shan Zhi Zi Fructus Gardeniae.


b Prescription



– DING JING TANG

– Settling the Menses Decoction


Explanation

This formula, by Fu Qing Zhu, pacifies the Liver and tonifies the Kidneys. Since an underlying deficiency of the Kidneys nearly always accompanies Liver-Qi stagnation when the periods are irregular, this formula is well adapted to treat the type of patients we see. About irregular periods, Fu Qing Zhu says:



When the child is ill the mother attends to it. When the Liver stagnates the Kidneys have compassion; opening or blockage of Liver-Qi implies going or staying of Kidney-Qi . . . One must pacify the Liver and open the stagnation of Kidney-Qi.4



– Tu Si Zi, Shu Di Huang and Shan Yao tonify the Kidneys.

– Bai Shao and Dang Gui nourish Liver-Blood and pacify the Liver.

– Fu Ling resolves Dampness.

– Jing Jie stops bleeding.

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  2. Abdominal Pain after Childbirth
  3. Habitual Miscarriage
  4. Endometriosis

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

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