Gynecology Test #2 Flashcards
Causes of advanced menstruation?
- Qi deficiency
- Blood heat due to excessive yang
- Blood heat due to liver fire
- Deficiency heat
Most common causes of bleeding?
Qi deficiency and blood stasis
Causes of amenorrhea?
Cold, qi stagnation, blood stasis, phelgm damp, blood deficiency
On a young patient, focus mainly on which organ in gynecology?
KD
On a middle aged patient, focus mainly on which organ in gynecology?
LV
On a menopausal patient, focus mainly on which organs in gynecology?
SP, KD
Definition of advanced menstruation?
Between 7-14 days early for more than 2 cycles (at least 3 cycles)
Advanced menstruation symptoms: cycle is more than 7 days early continuously for more than 2 cycles (3 cycles minimum), light red and thin blood without clots, heavy volume, fatigue, spontaneous sweating, pale face, dizziness (clear qi cannot rise to the head), poor appetite, loose stools, bearing down sensation in the lower abdomen, pale, swollen, with teethmarks, thin white coating tongue, thready, weak pulse
Qi deficiency
Qi deficiency advanced menstruation TP
Tonify qi, boost spleen to hold blood
Qi deficiency advanced menstruation formula
Bu Zhong Yi Qi Tang
Bu Zhong Yi Qi Tang ingredients
Huang Qi Ren Shen Bai Zhu Zhi Gan Cao Da Zao Dang Gui Chen Pi Sheng Ma Chai Hu
Which four herbs raise spleen qi?
Sheng Ma, Chai Hu, Ge Gen, Huang Qi
Qi deficiency quality of blood
Light red and thin blood without clots, heavy volume
Advanced menstruation symptoms: advanced menstruation that occurs more than 2 months in a row, more than 7 days early, bright red, thick blood with clots, heavy volume, red face, thirsty, irritability, short yellow urine, constipation, red tongue, yellow coating, rapid pulse
Blood heat - excess yang
Advanced menstruation blood heat - excess yang TP
Clear heat, cool blood, regulate menstruation
Advanced menstruation blood heat - excess yang pathogenesis
Collecting heat from external, goes inside. Heat pathogen, spicy food and alcohol etc., excess external yang penetrates interior
Advanced menstruation blood heat - excess yang formula
Qing Jing San
Qing Jing San
Mu Dan Pi: clear heat, infection, liver fire
Qing Hao: clear heat
Huang Bai: clear lower jiao heat
Sheng Di Huang: clear heat, cool blood, stop bleeding, nourish yin
Di Gu Pi: clear excess and deficiency heat, cool blood, nourish yin, stop bleeding
Bai Shao: soothe the liver, nourish yin, nourish blood, stop bleeding
Fu Ling: promote urination, dispel damp, tonify spleen (removes heat through urination) - remove if there is too much bleeding because urine is a body fluid,
blood and body fluid have the same source
Blood quality for advanced menstruation blood heat - excess yang
Bright red, thick blood with clots, heavy volume
Advanced menstruation symptoms: can be heavy amount of blood or small amount of blood, because the liver regulates the qi, sometimes it’s more on the heat side, sometimes more on the stagnant side, color is purple/red with clots (heat can boil the blood causing blood stasis), hypochondriac pain, headache, red face and eyes, distending pain on the lower side of the lower abdomen, oppression in the chest, distending pain in the breast, irritability, short temper, red tongue with thin yellow coating, wiry, rapid pulse
Blood heat - liver fire
Advanced menstruation blood heat - liver fire TP
Clear liver fire, soothe liver qi, regulate menstruation
Advanced menstruation blood heat - liver fire pathogenesis
Emotions
Advanced menstruation blood heat - liver fire formula
Dan Zhi Xiao Yao San
Dan Zhi Xiao Yao San
Remove Wei Jiang because it’s too warm
Mu Dan Pi, Zhi Zi: clear liver fire, cool blood, stop bleeding
Chai Hu: soothe liver qi
Bai Zhu, Fu Ling: strengthen spleen
Dang Gui, Bai Shao: nourish blood to soften liver
Bo He, Gan Cao: Bo He regulates the liver, Gan Cao harmonizes
Advanced menstruation blood heat - liver fire blood quality
purple/red with clots
Advanced menstruation symptoms: small volume or heavy, thick blood, red color, red cheeks, afternoon fever, five center heat, red tongue, little coating, thready and rapid pulse, common to have spotting for a few, days before period and then period comes, similar to hyperthyroid
Yin deficiency
Advanced menstruation yin deficiency TP
Nourish yin, clear deficiency heat, regulate menstruation
Advanced menstruation yin deficiency formula
Liang Di Tang
Liang Di Tang
Sheng Di Huang: nourish yin, clear heat and cool blood
Di Gu Pi: clear deficiency heat
Xuan Shen, Mai Men Dong: nourish yin
E Jiao, Bai Shao: nourish yin and blood
Delayed menstruation definition
More than 7 days late
Amenorrhea definition
Period delayed more than 3 months
Causes of delayed menstruation
- Qi stagnation
- Blood stasis
- Excess cold
- Damp phlegm
- Blood deficiency
- Yin deficiency
- Deficiency cold
Delayed cycle symptoms: the menses are delayed by more than 7 days for more than two cycles continuously, which is scanty dark blood with clots, cold pain in lower abdomen which is relieved when warmed, cold sensation and cold limbs, white coating, deep tight pulse
Blood cold
Delayed cycle blood cold TP
TP: warm meridians, disperseing cold and regulating menstruation
Delayed cycle blood cold formula
Wen Jing Tang
Wen Jing Tang
Rou Gui: warm meridian and dispel cold
Dang Gui, Chuan Xiong: regulate blood and menstruation, remove blood stasis, warm and acrid herbs
Ren Shen: tonify qi
E Zhu, Dan Pi, Niu Xi: remove blood stasis (E Zhu is good at abdominal mass and blood stasis) (Niu Xi is strong for removing blood stasis and guiding blood downward)
Bai Shao, Gan Cao: relax spasm and relieve pain
Delayed cycle symptoms: Symptoms: the menses are delayed by more than 7 days for days for more than two cycles continuously, small volume thin light red blood without clots, cold or dull pain in the lower abdomen preferring, warmth and pressing, weak and sore on the lowerback, profuse clear urine, loose stool, pale tongue with white coating, deep slow or thready and weak pulse
Deficiency cold
Delayed cycle deficiency cold TP
TP: tonify yang, expel cold, regulate menstruation
Delayed cycle deficiency cold formula
Ai Fu Nuan Gong Wan
Ai Fu Nuan Gong Wan
Si Wu Tang: nourish blood Huang Qi, Rou Gui: tonify qi and yang Ai Ye, Wu Zhu Yu: warm meridians and uterus Xiang Fu: regulate qi Xu Duan: tonify liver and kidney
Delayed cycle blood cold blood quality
Scanty dark blood with clots
Delayed cycle deficiency cold blood quality
Small volume thin light red blood without clots
Delayed cycle symptoms: delayed menstruation with small volume light red blood without clots, dull pain in the lower abdomen, dizziness, pale or sallow complexion, palpitations, insomnia, pale tongue, thready and weak pulse
Blood/kidney deficiency
Delayed cycle blood/kidney deficiency TP
TP: nourish blood, regulate menstruation
Delayed cycle blood/kidney deficiency formula
Da Bu Yuan Jian
Da Bu Yuan Jian
Ren Shen, Shan Yao, Gan Cao: tonify qi
Shu Di Huang, Dang Gui, Gou Qi, Shan Yu Rou/Shan Zhu Yu: tonify liver and kidney, nourish essence and blood
Du Zhong: tonify kidney
This formula takes care of both blood deficiency and KD deficiency
Delayed cycle symptoms: delayed menstruation (or irregular cycle), small volume dark red blood with clots, distending pain in the breast, hypochondrium and side abdomen, wiry pulse, emotional (angry, depressed)
Qi stagnation
Delayed cycle blood/kidney deficiency type of blood
small volume light red blood without clots
Delayed cycle qi stagnation TP
TP: soothe qi, regulate menstruation
Delayed cycle qi stagnation formula
Wu Yao Tang
Wu Yao Tang
Wu Yao, Xiang Fu, Mu Xiang: regulate qi
Dang Gui: nourish blood
Gan Cao: harmonize other herbs
Delayed cycle qi stagnation blood quality
Small volume dark red blood with clots
Irregular menstruation definition
Either earlier than 7 days or delayed more than 7 days for at least 3 cycles
Irregular menstruation pathogenesis
The cycle is regulated by the Liver and Kidney, either the Liver is stagnated/has fire, or the Kidney is deficient, can be a mix of both
Irregular menstruation symptoms: Irregular menstruation cycle that is advanced or delayed by more than 7 days, lasting for three or more cycles, heavy or light menses (or normal), purple red blood with clots, unsmooth menstrual flow, liver qi stagnation signs. Either advanced or delayed because the qi stagnation will cause a delay, but if the qi stagnation creates fire/heat, then it will be advanced/early.
Liver qi stagnation
Irregular menstruation liver qi stagnation TP
TP: soothe the liver, regulate menstruation
Irregular menstruation liver qi stagnation formula
Xiao Yao San
Xiao Yao San
Chai Hu, Bo He: soothe the liver
Dang Gui, Bai Shao: nourish the liver
Bai Zhu, Fu Ling, Gan Cao: strengthen the spleen and harmonize the middle jiao
*Wei Jiang: warm the stomach and harmonize the middle jiao (cooked sheng jiang to protect the stomach from the liver)
With liver fire symptoms (more often advanced than delayed): Dan Zhi Xiao Yao San
Irregular menstruation symptoms: Irregular menstruation with small volume, light dark and thin blood, aching lower back and sacrum, dizziness, tinnitus, pale tongue with thin coating, thready and weak pulse
Kidney deficiency
Irregular menstruation liver qi stagnation blood quality
Heavy or light menses (or normal), purple red blood with clots
Irregular menstruation kidney deficiency TP
TP: tonify the kidneys, regulate menstruation
Irregular menstruation kidney deficiency formula
Gu Yin Jian
Gu Yin Jian
Shu Di Huang, Shan Zhu Yu, Tu Si Zi: tonify kidney and nourish essence (very safe herbs - can even use still while pregnant)
Ren Shen, Shan Yao, Gan Cao: tonify spleen qi
Wu Wei Zi, Yuan Zhi: harmonize heart and kidney
Irregular menstruation kidney deficiency blood quality
Small volume, light dark and thin blood
Profuse menstruation definition
Definition: more than 100ml is a heavy period/profuse menstruation (more than 10 pads), more than 2 cycles (at least 3 cycles)
Profuse menstruation causes
Causes: pathogenic factor in the uterus, IUD, improper diet, fibroid, abdominal msas, ovarian polyp
Profuse menstruation symptoms: Profuse menstruation, light red and thin blood + qi deficiency symptoms, no clots, dizziness, fatigue, shortness of breath, pale lusterless face, pulling down sensation in lower abdomen, palpitations
Qi deficiency
Profuse menstruation qi deficiency TP
TP: tonify qi, control blood
Profuse menstruation qi deficiency formula
Ju Yuan Jian
Ju Yuan Jian
Ren Shen, Huang Qi, Bai Zhu, Gan Cao: tonify spleen qi
Sheng Ma: raise yang and lift prolapsed organs
Similar to Bu Zhong Yi Qi Tang
Profuse menstruation symptoms: Profuse menstruation, bright or deep red/purple red thick blood or with small clots and excess heat, red face and eyes, headache, constipation, irritability, dark urine, insomnia, slippery rapid or wiry rapid pulse, red tongue with yellow coating, thirsty
Blood heat
Profuse menstruation blood heat TP
TP: cool blood, clear heat and stop bleeding
Profuse menstruation blood heat formula
Bao Yin Jian + Di Yu, Huai Hua
Bao Yin Jian
Shu Di Huang, Bai Shao: nourish blood and astringe yin
Sheng Di Huang: clear heat, cool blood, nourish yin
Huang Qin, Huang Bai: clear heat and fire
Xu Duan, Shan Yao: tonify kidneys
Gan Cao: harmonize herbs
Profuse menstruation symptoms: Profuse menstruation, or with prolonged bleeding, purple/brown/black dark blood with clots and blood stasis symptoms, distended and purple sublignual veins, purple tongue body
Blood stasis
Profuse menstruation blood stasis TP
TP: remove blood stasis and stop bleeding
Profuse menstruation blood stasis formula
Shi Xiao San + Xue Yu Tan, Qian Cao, Yi Mu Cao
Shi Xiao San
Pu Huang, Wu Ling Zhi: remove blood stasis and stop bleeding
Scanty menstruation definition
Less than 20ml or less than 2 days, more than 2 cycles (at least 3 cycles)
Scanty menstruation causes
2 reasons, either stagnation or deficiency. Similar to amenorrhea or delayed cycle
Stagnation: qi, blood, phlegm and damp, cold
Deficiency: blood, kidney essence deficiency, kidney yin deficiency
Scanty menstruation symptoms: scanty menstruation or just a few drops of blood, light color without blood clots, blood deficiency symptoms (paleness, numbness in knees, blurred vision, hair loss, sallow complexion)
Blood deficiency (of LV or HT)
Blood deficiency scanty menstruation treatment principle
nourish the blood and regulate menstruation
Scanty menstruation blood deficiency formula
Zi Xue Tang
Zi Xue Tang
Ren Shen, Huang Qi, Shan Yao, Fu Ling: tonify spleen qi to generate blood
Dang Gui, Chuan Xiong, Bai Shao, Shu Di Huang: (Si Wu Tang) nourish blood
Scanty menstruation symptoms: scanty menses with thin light red or dark red blood, kidney deficiency symptoms, small uterus, pain in heel, dizziness, tinnitus, deep weak or deep slow pulse, lassitude
Kidney deficiency
Kidney deficiency scanty menstruation treatment principle
tonify the kidneys, nourish blood, regulate menstruation
Kidney deficiency scanty menstruation formula
*Gui Shen Wan
*Gui Shen Wan
Shu Di Huang, Shan Zhu Yu, Gou Qi Zi: nourish kidney essence
Tu Si Zi, Du Zhong: tonify kidney yang and qi
Shan Yao, Fu Ling: tonify spleen
Dang Gui: nourish blood
Scanty menstruation symptoms: scanty menses with dark purple blood and clots, blood stasis symptoms, pain relieved after clot comes out, dark purple tongue with spots on the side, choppy pulse
Blood stasis
Scanty menstruation blood stasis treatment principle
remove blood stasis and regulate menstruation
Scanty menstruation blood stasis formula
Tao Hong Si Wu Tang
Tao Hong Si Wu Tang
Tao Ren, Hong Hua, Chuan Xiong: remove blood stasis
Dang Gui: nourish blood and remove blood stasis
Bai Shao, Shu Di Huang: nourish blood and relieve pain
Scanty menstruation symptoms: scanty menses with light red and sticky blood, phlegm and damp symptoms, can have clots, could be light brown color, overweight, luekorrhea, soft abdominal mass, thick greasy tongue coating, slippery pulse
Phlegm and Damp
Phlegm and damp scanty menstruation treatment principle
TP: resolve phlegm, dry damp, regulate menstruation
Phlegm and damp scanty menstruation formula
*Cang Fu Dao Tan Wan
*Cang Fu Dao Tan Wan
Chen Pi, Ban Xia, Fu Ling, Gan Cao: dispel phlegm and dry damp
Cang Zhu: dry the damp and strengthen the spleen
Xiang Fu, Zhi Ke: regulate qi
Dan Nan Xing: dry the damp and dispel phlegm
Shen Qu, Sheng Jiang: harmonize the stomach
Bleeding between cycles definition
Definition: 3-5 days of bleeding, light or heavy, more than 2 cycles (at least 3 cycles). The volume is less than the period. Can also have clear vaginal discharge (sign of ovulation), or other signs of ovulation.
Bleeding between cycles pathogenesis
Pathogenesis: drop in estrogen and progesterone causes the inner lining to shed. This type of bleeding is caused by hormone changes. Ovulation is when yin changes to yang (when yang qi is strongest).
Bleeding between cycles diagnoses
- Kidney yin deficiency
- Damp heat
- Blood stasis
Bleeding between cycles symptoms: small volume bleeding in between menstruation, which is red without clots, lower back weak and soreness, insomnia, dry stool, yellow urine, red tongue, thready wiry and rapid pulse
Kidney yin deficiency
Kidney yin deficiency bleeding between cycles treatment principle
TP: nourish yin and stop bleeding
Kidney yin deficiency bleeding between cycles pathogenesis
Pathogenesis: the deficiency heat pushes the blood out of the vessels causing bleeding (because the yang is dominant during ovulation time)
Kidney yin deficiency bleeding between cycles formula
Liang Di Tang + Er Zhi Wan
Liang Di Tang + Er Zhi Wan
Liang Di Tang: Sheng Di Huang: nourish yin, clear heat and cool blood Di Gu Pi: clear deficiency heat Xuan Shen, Mai Men Dong: nourish yin E Jiao, Bai Shao: nourish yin and blood
Er Zhi Wan:
Mo Han Lian
Nu Zhen Zi
Bleeding between cycles symptoms: small or little heavy bleeding in between menstruation, which is red sticky blood without clots or red sticky leukorrhea, lassitude, heavy sensation in the whole body, oppression irritability, poor appetite, short yellow urine, leukorrhea with odor, profuse, yellow or white sticky, red tongue with yellow/white greasy coating (thick at the root), thready wiry pulse (or soggy/slippery), may be distending and burning pain, vagina could be itchy
Damp heat
Damp heat bleeding between cycles treatment principle
TP: clear heat and dispel damp, cool blood, stop bleeding
Damp heat bleeding between cycles pathogenesis
Pathogenesis: inflammation, the heat pushes the blood out of the vessels
Damp heat bleeding between cycles formula
Qing Gan Zhi Lin Tang - E Jiao (too sticky)
+ Xiao Ji, Fu LIng
Dang Gui, Bai Shao, Sheng Di Huang, Hei Dou: tonify kidneys, nourish blood, soften liver
Mu Dan Pi: clear liver fire
Xiang Fu: regulate liver qi
Huang Bai: clear heat and dry damp
Bleeding between cycles symptoms: light or little heavy bleeding in between menstruation, which is purple dark or with clots, stabbing pain, irritability, oppression in the chest, tongue with purple spots
Blood stasis
Blood stasis bleeding between cycles treatment principle
TP: remove blood stasis and stop bleeding
Blood stasis bleeding between cycles formula
Zhu Yu Zhi Xue Tang
Zhu Yu Zhi Xue Tang
Dang Gui Wei, Sheng Di Huang, Chi Shao: nourish blood and remove blood stasis
Tao Ren, Da Huang, Mu Dan Pi: remove blood stasis
Zhi Ke: regulate liver qi
Gui Ban: nourish blood and stop bleeding
PROFUSE BLEEDING AND SPOTTING/UTERINE BLEEDING/BENG LOU treatment principle
TP: treat manifestation in an acute case and treat the root in a chronic case
PROFUSE BLEEDING AND SPOTTING/UTERINE BLEEDING/BENG LOU definition
Definition: heavy bleeding or prolonged small volume bleeding without a cycle, may stop and start, may cause blood deficiency
PROFUSE BLEEDING AND SPOTTING/UTERINE BLEEDING/BENG LOU treatment methods
Treatment methods: stop the blood flow, find the root, restore normality
PROFUSE BLEEDING AND SPOTTING/UTERINE BLEEDING/BENG LOU causes of bleeding
Causes of bleeding: spleen qi deficiency, blood heat (excess or deficiency), blood stasis
Profuse bleeding and spotting symptoms: sudden heavy bleeding or prolonged light bleeding without cycle, which is bright red and thick
Blood heat due to yin deficiency of the zang organs (LU, LV, KD)
Deficiency blood heat profuse bleeding and spotting treatment principle
TP: nourish yin, clear heat, stop bleeding, regulate menstruation
Deficiency blood heat profuse bleeding and spotting formula
Bao Yin Jian + Sha Shen, Mai Men Dong, Wu Wei Zi, E Jiao
Profuse bleeding and spotting symptoms: sudden heavy bleeding or prolonged bleeding without cycle, deep red color and thick blood, fever, feeling of heat, yellow urine, constipation, yellow (greasy) coating, flooding rapid pulse
Blood heat (excess type)
Blood heat excess type profuse bleeding and spotting treatment principle
TP: clear heat, cool blood, stop bleeding, regulate menstruation
Blood heat excess type profuse bleeding and spotting
Qing Re Gu Jing Tang + Sha Shen
Qing Re Gu Jing Tang + Sha Shen
Qing Re Gu Jing Tang + Sha Shen
Huang Qin, Zhi Zi, Di Yu, Ou Jie: clear heat and stop bleeding
E Jiao: nourish blood and stop bleeding
Gui Ban, Mu Li: nourish yin and astringe blood
Sheng Di Huang, Di Gu Pi: nourish yin, clear heat, stop bleeding
Zong Lu Tan: astringe to stop bleeding
Profuse bleeding and spotting symptoms: heavy bleeding or prolonged light bleeding without cycle, light red and thing blood, whole body coldness, cold uterus, cold feet/low back, lassitude, no spirit, pale or dark complexion deep thready or faint thready pulse, pale tongue with white coating
Kidney yang deficiency
Kidney yang deficiency profuse bleeding and spotting treatment principle
TP: warm kidney, stabilize chong vessel, stop bleeding, regulate menstruation
Kidney yang deficiency profuse bleeding and spotting formula
Yuo Gui Wan + Rou Gui, Dang Gui, Huang Qi, Fu Peng Zi, Chi Shi Zhi
Yuo Gui Wan + Rou Gui, Dang Gui, Huang Qi, Fu Peng Zi, Chi Shi Zhi
Yuo Gui Wan + Rou Gui, Dang Gui, Huang Qi, Fu Peng Zi, Chi Shi Zhi
Fu Zi, Rou Gui, Shan Zhu Yu, Gou Qi Zi: nourish kidney essence and blood
Shu Di Huang, Shan Yao, Shan Zhu Yu, Gou Qi Zi: nourish kidney essence and blood
Lu Jiao Jiao: warm kidney yang and nourish essence and blood
Dang Gui: nourish blood
Profuse bleeding and spotting symptoms: prolonged small volume or heavy bright red thick bleeding without cycle
Kidney yin deficiency
Kidney yin deficiency profuse bleeding and spotting treatment prinicple
TP: nourish kidney yin, stop bleding, and regulate menstruation
Kidney yin deficiency profuse bleeding and spotting formula
Zuo Gui Wan - Niu Xi + Er Zhi Wan
Zuo Gui Wan - Niu Xi + Er Zhi Wan
Zuo Gui Wan - Niu Xi + Er Zhi Wan
Shu Di Huang, Shan Yao, Shan Zhu Yu, Gou Qi Zi, Gui Ban Jiao: nourish kidney yin and blood
Tu Si Zi, Lu Jiao Jiao: tonify kidney yang and essence
Niu Xi: remove because it guides blood downward
Profuse bleeding and spotting symptoms: heavy bleeding then prolonged light bleeding without cycle, light red and thin blood
Spleen qi deficiency
Spleen qi deficiency profuse bleeding and spotting treatment principle
TP: tonify spleen qi, control blood, nourish blood regulate menstruation
Spleen qi deficiency profuse bleeding and spotting formula
Gu Ben Zhi Beng Tang - Dang Gui + Shang Ma, Shan Yao, Da Zao, Wu Ze Gu
Gu Ben Zhi Beng Tang - Dang Gui + Shang Ma, Shan Yao, Da Zao, Wu Ze Gu
Gu Ben Zhi Beng Tang - Dang Gui + Shang Ma, Shan Yao, Da Zao, Wu Ze Gu
Ren Shen, Bai Zhu, Huang Qi: tonify qi to control blood
Shu Di Huang: nourish blood and kidney essence
Hei Jiang/Pao Jiang: warm middle jiao and stop bleding
Subtract Dang Gui: nourish blood
Profuse bleeding and spotting symptoms: bleeding without cycle, which is repeated bleeding and stopping, prolonged small volume bleeding, or sudden heavy bleeding then prolonged light bleeding after amenorrhea, purple dark blood with clots
Blood stasis
Blood stasis profuse bleeding and spotting treatment principle
TP: invigorate blood, remove blood stasis, stop bleeding and regulate menstruation
Blood stasis profuse bleeding and spotting formula
Si Wu Tang and Shi Xiao San + San Qi Fen, Qian Cao Tan, Wu Ze Gu
Qing Gan Zhi Lin Tang - E Jiao (too sticky)
+ Xiao Ji, Fu LIng
+ Xiao Ji, Fu LIng
Dang Gui, Bai Shao, Sheng Di Huang, Hei Dou: tonify kidneys, nourish blood, soften liver
Mu Dan Pi: clear liver fire
Xiang Fu: regulate liver qi
Huang Bai: clear heat and dry damp
