Botanicals for female deficiencies Flashcards
What is the definition of secondary amenorrhea?
A. Absence of menstruation for 6 months in a woman of reproductive age, not pregnant.
B. Absence of menstruation for 3 months in a woman of reproductive age, not pregnant.
C. Irregular periods occurring less than three times a year.
D. Complete cessation of menstruation due to menopause.
B. Correct. Secondary amenorrhea is defined as the absence of menstruation for 3 months in women who previously had regular cycles and are not pregnant.
A. Incorrect. While 6 months of amenorrhea can also be considered secondary amenorrhea, the standard definition typically uses 3 months.
C. Incorrect. This describes oligomenorrhea, not secondary amenorrhea.
D. Incorrect. Cessation of menstruation due to menopause is a natural physiological process, not secondary amenorrhea.
Which of the following dietary recommendations is suggested for building body mass to address secondary amenorrhea?
A. Increase fat intake to 50% of daily calories.
B. Consume 0.5 g/kg of protein per day.
C. Consume 1 g/kg of protein per day or use the body-weight-based formula.
D. Avoid protein and focus on adaptogens.
C. Correct. Consuming 1 g/kg of protein daily (or dividing body weight by 2 to estimate in pounds) helps address deficiencies often associated with secondary amenorrhea.
A. Incorrect. Increasing fat intake is not emphasized in this context.
B. Incorrect. 0.5 g/kg of protein is insufficient to build body mass; 1 g/kg is the minimum for rebuilding deficiencies.
D. Incorrect. Protein intake is crucial, and adaptogens are supportive but not standalone solutions.
Which herb is a true endocrine modulator commonly used in cases of secondary amenorrhea?
A. Vitex agnus-castus (Chasteberry)
B. Rumex crispus (Yellow Dock)
C. Withania somnifera (Ashwagandha)
D. Glycyrrhiza glabra (Licorice Root)
A. Correct. Vitex agnus-castus (Chasteberry) is a well-known endocrine modulator that can regulate menstrual cycles and support secondary amenorrhea when endocrine imbalance is suspected.
B. Incorrect. Rumex crispus is an alterative, not an endocrine modulator.
C. Incorrect. While Ashwagandha is an adaptogen and supports overall vitality, it does not specifically modulate endocrine functions in secondary amenorrhea.
D. Incorrect. Licorice root supports adrenal function and acts as an adaptogen, but it is not classified as a primary endocrine modulator.
Which Traditional Chinese Medicine (TCM) diagnosis is most aligned with the case presentation of a pale, fatigued patient with absent menses and loose stools?
A. Liver and Heart Blood deficiency progressing to Yin deficiency
B. Liver Yang Rising with Kidney Yin Deficiency
C. Kidney Yang deficiency with excess heat
D. Spleen Damp-Heat with Stagnation
Correct. The pale complexion, fatigue, dizziness, and digestive symptoms point to Liver and Heart Blood deficiency, while the undigested food and loose stools indicate a progressing Spleen and Kidney Yang deficiency, which may lead to Yin deficiency over time.
B. Incorrect. Liver Yang Rising is not associated with the symptoms described.
C. Incorrect. While Kidney Yang deficiency may be involved, there is no excess heat in this presentation.
D. Incorrect. Spleen damp-heat is associated with heavier symptoms like bloating, heaviness, and yellow tongue coating, which are not present here.
Which adaptogenic herb would be most suitable for a patient presenting with secondary amenorrhea due to stress-related fatigue?
A. Angelica sinensis (Dong quai)
B. Eleutherococcus senticosus (Eleuthero)
C. Paeonia lactiflora (Peony)
D. Actaea racemosa (Black Cohosh)
“B. Correct. Eleutherococcus senticosus (Eleuthero) is an adaptogen that improves stress resilience, making it ideal for secondary amenorrhea linked to stress.”
This is true. Eleuthero is a well-documented adaptogen that supports the hypothalamic-pituitary-adrenal (HPA) axis, helping the body adapt to stress and restore homeostasis. Since stress is a common trigger for secondary amenorrhea, Eleuthero is an excellent choice in such cases.
A. Dong quai: Primarily acts as a blood-builder and supports circulation, making it ideal for Blood deficiency. It is not considered a primary adaptogen for stress-related amenorrhea.
C. Paeonia lactiflora (Peony): Known for its Blood-tonifying properties, Peony is particularly suited for Liver and Heart Blood deficiency but has limited adaptogenic effects.
D. Actaea racemosa (Black Cohosh): Typically used for endocrine modulation in menopause or dysmenorrhea, Black Cohosh is not an adaptogen for stress resilience.
Why is secondary amenorrhea considered a red flag in clinical practice?
A. It always indicates an endocrine tumor.
B. It suggests possible structural damage to the reproductive organs.
C. It requires immediate investigation to rule out serious underlying conditions.
D. It is often due to lifestyle factors and does not require follow-up.
C. Correct. Secondary amenorrhea may signify nutritional deficiencies, endocrine disorders, or other serious conditions, so thorough investigation is crucial.
A. Incorrect. Secondary amenorrhea does not always indicate an endocrine tumor but warrants ruling it out.
B. Incorrect. Structural damage is one possible cause but not the only one.
D. Incorrect. Lifestyle factors can contribute but do not negate the need for proper diagnosis.
What is the most effective approach to treating deficiency amenorrhea?
A. Encourage a diet high in raw, cold foods for increased nutrient absorption.
B. Prescribe strong emmenagogues to restart menstruation immediately.
C. Replenish deficiency by ensuring a balanced intake of macro and micronutrients, alongside warm, well-cooked foods to support digestion.
D. Use diuretics to eliminate excess fluids, as this is the primary cause of deficiency amenorrhea.
C. Correct: Deficiency amenorrhea arises from systemic deficiencies (Blood, Yin, or Yang). Addressing this involves replenishing nutrients with a balanced diet and enhancing digestion with warm, cooked foods to optimize nutrient absorption.
A. Incorrect: Raw, cold foods may impair digestion in deficiency syndromes by weakening the Spleen’s function in TCM.
B. Incorrect: Strong emmenagogues may stimulate menstruation but do not address the underlying deficiency, making this an incomplete and potentially harmful approach.
D. Incorrect: Deficiency amenorrhea is not caused by excess fluid retention, so diuretics are inappropriate.
Which of the following herbs is best suited for hit flashed during menopause?
A. Rehmannia, Black Cohosh, Sage (and possibly Red Sage)
B. Viburnum opulus (Crampbark) and Jamaican Dogwood
C. Curcuma longa (Turmeric) and Zingiber officinalis (Ginger)
D. Valerian and Cannabis indica
A. Correct: These herbs support endocrine balance (Black Cohosh), reduce vasomotor symptoms (Sage), and replenish Yin (Rehmannia), making them ideal for treating hot flashes.
B. Incorrect: Crampbark and Jamaican Dogwood are antispasmodics and analgesics, more suited for menstrual cramps than hot flashes.
C. Incorrect: Turmeric and Ginger have anti-inflammatory and digestive-support actions but do not directly address hot flashes.
D. Incorrect: While Valerian and Cannabis may help with anxiety or pain, they are not specific for menopausal vasomotor symptoms.
A 24-year-old woman with severe menstrual cramps rates her pain 10/10 and relies on high doses of over-the-counter pain medications. Which treatment principle is most appropriate?
A. Only use strong analgesics to manage acute pain.
B. Focus on calming and dispersing the pain while addressing the underlying cause.
C. Prescribe emmenagogues to increase menstrual flow and relieve cramps.
D. Address Liver Yang Rising with cooling herbs.
B. Correct: The principle of calming and dispersing aligns with using antispasmodics (e.g., Crampbark) and analgesics (e.g., Jamaican Dogwood) for acute relief while addressing root causes like Liver Qi stagnation or Blood stasis.
A. Incorrect: While analgesics can reduce pain, relying solely on them without treating the root cause is incomplete.
C. Incorrect: Emmenagogues are not indicated here, as increasing flow does not directly alleviate cramps.
D. Incorrect: Liver Yang Rising typically involves symptoms like headaches or irritability, which are not present in this case.
Which herb combination provides the most appropriate actions for relieving menstrual cramps?
A. Valerian, Corydalis, Crampbark, and Jamaican Dogwood
B. Black Cohosh, Red Sage, and Rehmannia
C. Blue Cohosh, Yellowdock, and Turkey Rhubarb
D. Celery Seed, Red Raspberry, and Red Clover
A. Correct: These herbs provide antispasmodic (Crampbark, Jamaican Dogwood) and analgesic (Valerian, Corydalis) actions, which are ideal for managing menstrual cramps.
B. Incorrect: This combination is more suited for hormonal balancing and treating hot flashes, not acute cramps.
C. Incorrect: These herbs are primarily laxatives and are better suited for treating constipation rather than cramps.
D. Incorrect: While these herbs have diuretic and nutritive effects, they lack strong antispasmodic or analgesic properties.
Which key treatment principle applies to menstrual cramps?
A. Focus exclusively on the symptoms with strong analgesics.
B. Combine dispersing actions with analgesics and address the underlying cause.
C. Treat Liver Qi stagnation without providing symptomatic relief.
D. Use hepatics to address liver dysfunction and resolve cramping.
B. Correct: The dual focus on symptom relief (dispersing and analgesic actions) and addressing the root cause (e.g., stagnation, deficiency) ensures effective short- and long-term management.
A. Incorrect: Focusing solely on symptoms ignores the root cause and may lead to dependence on pain relief.
C. Incorrect: Liver Qi stagnation may contribute to cramps, but treating it alone without symptom relief is insufficient.
D. Incorrect: Hepatics may support overall health but are not the primary treatment for cramps.
What is the common name for Angelica sinensis?
Dong quai
This is an Adaptogen as it contains phytoestrogens and can modulate estrogen metabolism
What is a Phytoestrogen?
A phytoestrogen is a plant-derived compound that mimics or influences estrogen activity in the body. These compounds can bind to estrogen receptors (ERα and ERβ) and have either estrogenic (stimulating) or anti-estrogenic (blocking) effects, depending on various factors like:
The person’s hormonal status (e.g., premenopausal vs. postmenopausal).
The concentration of estrogen in the body (low vs. high).
The specific tissue type (breast, bone, uterus, brain, etc.).
How Can Dong Quai (Angelica sinensis) Modulate Estrogen?
Dong Quai contains compounds like ligustilide and ferulic acid, which don’t act as strong phytoestrogens like soy isoflavones but may still influence estrogen metabolism in the following ways:
Weak Estrogenic Effect – In cases of low estrogen (e.g., menopause), Dong Quai may provide a mild estrogenic boost by interacting with estrogen receptors.
Balancing Effect – Instead of strongly increasing estrogen, it is thought to help the body regulate estrogen levels rather than overwhelming it with a direct estrogenic effect.
Liver Metabolism Support – Some evidence suggests it affects estrogen breakdown in the liver, potentially shifting the balance between stronger estrogens (e.g., estradiol) and weaker estrogens (e.g., estrone and estriol).
Circulatory Effects – It promotes blood flow, which can improve hormonal delivery and function in the reproductive system.
Does Dong Quai Raise Estrogen Levels?
In estrogen-deficient states (e.g., menopause), it may provide mild estrogen-like effects.
In estrogen-dominant conditions (e.g., PCOS, endometriosis), it is not strongly estrogenic, but caution is sometimes advised due to its blood-moving effects.
Angelica sinensis is primarily used for female endocrine modulation and is considered a building and supportive tonic.
What is the primary action of Cimicifuga (Actaea) racemosa?
Emmenagogue, anti-inflammatory, endocrine modulator
Commonly known as Black cohosh, it is used for menopausal relief and other female conditions.
Which botanical is known for improving vaginal dryness and reducing dyspareunia?
Foeniculum vulgare (Fennel)
Fennel may also show moderate benefit in improving hot flashes and may lower cholesterol.
True or False: Ginkgo biloba is effective for treating hot flushes and sleep maintenance insomnia.
False
Ginkgo biloba is effective for cognitive symptoms in later stages of menopause.
What are the primary actions of Glycyrrhiza glabra?
Adaptogen, anti-inflammatory, demulcent, antiviral
Glycyrrhiza glabra, or Licorice root, is particularly useful in cases of deficiency and ongoing stress.
Fill in the blank: Hypericum perforatum is commonly known as _______.
St. John’s Wort
It is known for its uplifting nervine and antiviral properties.
What is the primary action of Salvia officinalis (Sage)?
Potent antimicrobial, diaphoretic, carminative
Salvia officinalis is used for infections of the mouth and throat, as well as for UTI.
Which botanical is cautioned against in individuals with a history of breast cancer?
Trifolium pratense (Red clover)
Red clover is a mild phytoestrogen and shows some benefit in treating hot flashes.
What are the therapeutic uses of Withania somnifera?
Fatigue, nervous exhaustion, chronic inflammatory disease
Known as Ashwagandha, it is also an immune modulator and nootropic.
What is the primary action of Vitex agnus-castus?
Female endocrine modulator, androgen normalizer
Vitex is commonly used for irregular menses and may benefit menopause-related symptoms.
Daily therapeutic dose of Foeniculum vulgare (Fennel) tincture?
3–9 mL (1:5 in 40%)
The infusion or decoction dose is 2–4 g dried seed.
What constituents are found in Ginkgo biloba?
Flavonoid glycosides, terpene lactones
These constituents contribute to its circulatory and cognitive benefits.
What are the indications for Rehmannia glutinosa?
Convalescence, anxiety, insomnia, palpitations
It is considered a nutritive and adaptogen herb.
