Dysmenorrhea and PMS

Question 1

4 possible tcm etiologies of dysmenorrhea

Answer 1

1. emotional strain
2. cold and dampness
3. overwork or chronic illness
4. excessive sexual activity or childbirth

Question 2

what are the 8 possible tcm pathologies of dysmenorrhea

Answer 2

1. Qi stagnation
2. blood stagnation
3. cold stagnation
4. Damp heat
5. liver Qi stagnation turning to fire
6. Qi and blood deficiency
7. yang and blood deficiency
8. kidney and liver yin deficiency

Question 3

Symptoms of Qi stagnation

Answer 3

Pain with deeling of distension of abdomen, pms tension, irritability, depression
T-may be normal or red on sides
P- wiry or choppy

Question 4

Treatment principle of dysmenorrhea due to qi stagnation

Answer 4

Move qi and blood, eliminate stagnation, stop pn

Question 5

Tx point for qi stagnation

Answer 5

Lv3 ( moves qi and blood and stops pn)
Ren6 (moves qi in lower abdomen)
Gb34 ( moves qi in low abdomen)
Sp8 ( regulates blood in the uterus, xicleft- stops pn)
St 29 ( regulates blood in uterus)
Sp10 (moves blood)
Sp4 rt Pc6 left (regulates the chong mai and blood in the uterus)
Sp14 moves qi and blood in low abdomen

Question 6

symptoms of Blood stagnation

(left off on pg 237

Answer 6

intense stabbing pain, relieved by passing dark clots, dark menstruate with clots, or hesitant menses (starts and stops)
T- purple
P-

Question 7

Tx principle for dysmenorrhea due to blood stasis

Answer 7

Invigorate blood, eliminate stasis, stop pn

Question 8

Tx points for blood stasis

Answer 8

Lv3 (moves qi and blood, stops pn)
Ren6 (moves qi in low abdomen)
Gb 34 ( moves qi in low abdomen)
Sp8 ( xi cleft, stop pn)
St29 ( regulates blood in uterus)
Sp10, bl17 ( move blood)
Sp4, pc6 ( regulate chong mai)
Ki14(eliminates stasis fromThe chong mai)

Question 9

Symptoms of Cold stagnation

Answer 9

pn in lower abdomen before or after menses central pn, ameliorated by heat, scanty, frank blood with small dark clots, feeling cold, sore back
T: pale- bluish or bluish purple
P- deep and choppy or deep and wiry

Question 10

Tx principle for dysmenorrhea due to cold stagnation

Answer 10

warm uterus,scatter cold, invigorate blood stop pn

Question 11

TX points for cold stagnation

Answer 11

Lu7, Ki6 (regulate ren mai and strengthen uterus)
ren 4 wi moxa (warm uterus)
ren6 with moxa (warm lower abdomen
st29- (invigorates blood)
sp8, sp6 (invigorate blood and stop pn)
st36 tonify qi and scatter cold)
st28 w/ moxa (expel cold from uterus)

Question 12

Sx of dysmenorrhea due to damp heat

Answer 12

hypogastric pn before menses, sometimes pn at mid cycle. burning sensation extending to sacrum, feeling of heat, red blood with small clots, vaginal discharge, scanty dark urine, thirst, mental restlessness
T: red, sticky yellow coat
P- slippery

Question 13

Tx principle of dysmenorrhea due to damp heat

Answer 13

clear heat, resolve damp, eliminate stasis stop pn

Question 14

tx points for damp heat

Answer 14

sp9, (resolve damp)
sp6 (move blood)
lu7, ki6 (open ren mai regulate uterus)
ren 3, st28 (resolve damp in lower burner)
bl32 (resolve damp in uterus)
bl22 (promote transformation of fluids and resolves damp in lower burner)
LI11- (clear heat)
sp10 (cool blood)

Question 15

Sx for dysmenorrhea due to Stagnant liver qi turning into fire

Answer 15

abdominal pn before and during menses, dark menstruate, heavy bleeding, irritability, propensity to outbursts of anger, thirst, feeling of heat, dry stools
T: red with yellow coat, and reddder sides
P: rapid wirty

Question 16

Tx principle of stagnant liver qi turning to fire

Answer 16

clear heat, pacify the liver, eliminate stagnation, stop pain

Question 17

tx points for stagnant liver qi turning to fire

Answer 17

lv3 (pacifies the liver, eliminates stagnation, harmonizes the chong mai, and stops pn)
lv2 (clears liver fire)
lv14, tw6, gb34 (pacify liver, move qi and eliminate stagnation
li11 (clear heat)
sp10- move blood and stop pn
*the tx should be to eliminate heat by getting rid of stagnation

Question 18

Sx of dysmenorrhea due to Qi and blood deficiency

Answer 18

dull hypogastric pn toward end or after menses. dragging sensation in lower abdomen, relieved by pressure and massage, scanty bleeding, pale complexion, fatigue, dizziness, loose stool,
T: pale
P: choppy

Question 19

Tx principle of dysmenorrhea due to qi and blood deficiency

Answer 19

nourish blood, tonify qi, strengthen spleen, stop pain

Question 20

Tx points for qi and blood deficiency

Answer 20

st36, (tonify qi and strengthen spleen and nourish blood)
bl20 (support spleen qi)
sp6 (nourish blood and stop pn and nourish blood)
sp10 (invigorate blood and stop pn)
sp8 (stop pn)
ren 4 (nourish blood)

Question 21

Sx for blood and yang deficiency

Answer 21

dull abdominal pn after menses, scanty pale blood, abdominal pn, better with pressure and heat, dull ha, blurred vision, feeling cold, depression dizziness,
T: pale and swollen and wet
P: fine and deep
(this is due to def. spleen yang and liver blood)

Question 22

Tx principle for dysmenorrhea due to blood and yang deficiency

Answer 22

warm the yang, nourish blood, stop pain, tonify spleen and liver

Question 23

Tx points for blood and yang deficiency

Answer 23

bl20, ren12, st36, sp6(tonify spleen, nourish blood, and warm yang)
ren 4, lv8 (nourish blood)
lu7, ki6 (regulate ren mai and strengthen uterus)

Question 24

Sx of dysmenorrhea due to Kidney and liver yin deficiency

Answer 24

dull lower abdomen pn toward end or after menses, sore back, dizziness, scanty bleeding, pn relieved by pressure, tinnitus, blurred vision, exhaustion
T: red and peeled
P:floating and empty

Question 25

Tx principle of kidney and liver yin deficiency

Answer 25

nourish yin, benefit the kidneys nourish the liver

Question 26

tx points for kidney and liver def.

Answer 26

bl23, bl18 (tonify kidneys and liver)
ren 4 (nourish yin and tonify kidneys)
sp6, ki3 (nourish kidneys and liver, and regulate blood
st36 (tonify qi and blood)
lu7, ki6- (ren mai)