Gynecology Test #3 Flashcards
Primary dysmenorrhea
Primary dysmenorrhea: lower abdomenal/lower back pain before or during the menstural cycle, primary dysmenorrhea begins since the very first menstrual cycle, also called functional dysmenorrhea
Secondary dysmenorrhea
Secondary dysmenorrhea: lower abdomenal/lower back pain before or during the menstural cycle, secondary dysmenorrhea means the pain starts later in life, usually due to inflammation, endometriosis
Dysmenorrhea pathogenesis
Pathogenesis: Excess (obstruction causing pain - blood stasis, cold, damp heat/inflammation, cold damp, qi stagnation) Deficiency (failure to nourish - qi and blood defiicency, liver and kidney deficiency, deficiency cold)
Dysmenorrhea differentiation
Differentiation: ectopic pregnancy, pregnancy, appendicitis, twisting of the ovaries, burst ovary cyst, miscarriage
Symptoms: Distending pain in the lower abdomen at one or two days before mensturation or during menstruation, dislike pressing, or with distention in the chest, hypochondriac region and breast, or small volume purple dark blood with clots, abdominal pain better after clots discharge and pain relieved after period, purple dark tongue with spots, wiry or wiry and slippery pulse,
QI STAGNATION AND BLOOD STASIS dysmenorrhea
QI STAGNATION AND BLOOD STASIS dysmenorrhea TP
TP: regulate qi, remove blood stasis, relieve pain
QI STAGNATION AND BLOOD STASIS dysmenorrhea formula
Formula: Ge Xia Zhu Yu Tang
Symptoms: cold pain in the lower abdomen before or during menstruatio, prefer warming and dislike pressing, small volume of purple dark blood with clots, aversion to cold and body ache, white greasy coating, deep and tight pulse
COLD AND DAMPNESS dysmenorrhea
COLD AND DAMPNESS dysmenorrhea TP
TP: warm meridian, dispel cold and dampness, remove blood stasis and releive pain
COLD AND DAMPNESS dysmenorrhea formula
Formula: Shao Fu Zhu Yu Tang + Cang Zhu, Fu Ling
Symptoms: cold pain in the lower abdomen during or after menstruation, prefer warmth and pressing, small light or dark blood, weakness in the lower back and legs, profuse urination, deep pulse, white and moist coating
DEFICIENCY COLD dysmenorrhea
DEFICIENCY COLD dysmenorrhea TP
TP: warm meridian and uterus, relieve pain
DEFICIENCY COLD dysmenorrhea formula
Formula: Wen Jing Tang + Fu Zi, Ai Ye, Xiao Hui Xiang
Symptoms: lower abdominal pain with burning sensation before menstruation which dislikes pressure, or with distending pain on the lower back, or freuqent pain on the side of the abdomen but worse during menstruation, thick dark red blood with clots, low fever, yellow thick vaginal discharge, short yellow urine, red tongue with yellow greasy coating, wiry and rapid or floating soft and rapid pulse.
DAMP HEAT POURING DOWN dysmenorrhea
DAMP HEAT POURING DOWN dysmenorrhea TP
TP: clear heat, dispel damp, remove blood stasis, relieve pain
DAMP HEAT POURING DOWN dysmenorrhea Formula
Formula: Qing Re Tiao Xue Tang + Hong Teng, Bai Jiang Cao, Yi Yi Ren
Symptoms: dull pain in the lower abdomen after or during menstruation, bearing down sensation in the lower abdomen, prefer pressing, small volume, light and thin blood
QI AND BLOOD DEFICIENCY dysmenorrhea
QI AND BLOOD DEFICIENCY dysmenorrhea TP
TP: tonify qi, nourish blood, relieve pain
QI AND BLOOD DEFICIENCY dysmenorrhea Formula
Formula: Shen Yu Tang minus Sheng Di Huang + Bai Shao, Xiang Fu, Yan Hu Suo
Symptoms: dull pain in the lower abdomen after menstruation, small light dark blood
LIVER AND KIDNEY DEFICIENCY dysmenorrhea
LIVER AND KIDNEY DEFICIENCY dysmenorrhea TP
TP: Nourish liver and kidney, relieve pain
LIVER AND KIDNEY DEFICIENCY dysmenorrhea formula
Formula: Tiao Gan Tang
Excess dysmenorrhea pain symptoms
Excess: pain before or during period 1-3 days, distending or stabbing or burning or spasm pain, dislikes pressure
Deficiency dysmenorrhea pain symptoms
Deficiency: pain after period of the end of the period, dull pain that likes pressure
Pain in the middle of the abdomen:
blood stasis or cold
Pain in the low back:
SP/KD yang xu cold
Distending pain with gas:
qi stagnation
Sharp, spasm pain:
blood stasis
Primary amenorrhea
Primary amenorrhea: no period at 16 years old
Secondary amenorrhea
Secondary amenorrhea: no period for 3 cycles
Amenorrhea pathogenesis
- Obstruction due to qi and blood stagnation: can be from emotions, stress, or an organic problem such as hormone disruption, deficiency, or excess
- Obstruction of phlegm and damp: PCOS
- Deficiency of liver and kidney: lack of hormones
- Qi and blood deficiency: can be from loss of blood from labor, causes Sheehan’s syndrome
- Yin deficiency and blood dryness
How is dysmenorrhea diagnoses different from amenorrhea?
Amenorrhea ( also has damp heat, cold and damp, deficiency cold). Amenorrhea also has phlegm damp and yin deficiency with blood dryness.
Symptoms: non appearance of menstruation by the age of 16 years old, slight amount of bleeding and delayed menstruation developing slowly to amenorrhea, weakness and soreness in the low back and knees, dizziness, tinnitus, weak constitution, grey hair, hair loss, frequent or night urination, FSH is high, estrogen is low, ovaries are small, pale tongue, little coating, deep weak or thready choppy pulse
LIVER AND KIDNEY DEFICIENCY amenorrhea
LIVER AND KIDNEY DEFICIENCY amenorrhea TP
TP: tonify kidney, nourish liver, regulate menstruation
LIVER AND KIDNEY DEFICIENCY amenorrhea formula
Formula: Gui Shen Wan + Ji Xue Teng, He Shou Wu
Symptoms: delayed menstruation with a slight amount of pale and thin blood that gradually develops into amenorrhea, qi and blood deficiency symptoms, mostly secondary amenorrhea, pale complexion, pale
lips, nails, eyelids, pale tongue little coating, palpitations, shorntess of breath, insomnia, lassitude, poor appetite, hair loss, dry hair, early greying of hair, sallow complexion, deep deficient or deficient rapid pulse
QI AND BLOOD DEFICIENCY
QI AND BLOOD DEFICIENCY amenorrhea TP
TP: tonify qi, nourish blood, regulate menstruation
QI AND BLOOD DEFICIENCY amenorrhea formula
Formula: Ren Shen Yang Rong Tang
Symptoms of severe blood loss amenorrhea
If heavy blood loss, dry vagina, decreased libido or atrophy of reproductive organs (Sheehan syndrome) add Lu Rong, Lu Jiao Shuang, Zi He Che, Blood loss is unable to nourish the pituitary so hormone production is low
If patient has Sheehan’s syndrome, what formula and added herbs do you use
Ren Shen Yang Rong Tang + Lu Rong, Lu Jiao Shuang, Zi He Che
Symptoms: scanty menstruation gradually becoming amenorrhea, yin and blood deficiency symptoms, night sweating, steaming bone, malar flush, cough with blood, red tongue, little coating, thready rapid pulse
YIN DEFICIENCY AND DRY BLOOD amenorrhea
YIN DEFICIENCY AND DRY BLOOD amenorrhea TP
TP: nourish yin, clear heat, regulate menstruation
YIN DEFICIENCY AND DRY BLOOD amenorrhea formula
Formula: Jia Jian Yi Yin Jian + Huang Jing, Dan Shen, Zhi Ke
Symptoms: amenorrhea for several months, qi and blood stagnation symptoms, fullness and distention in the chest and hypochondrium, distending or stabbing pain in the lower abdomen, dislike pressure, purple dark tongue with purple/black spots, deep wiry or deep choppy pulse
QI STAGNATION AND BLOOD STASIS amenorrhea
QI STAGNATION AND BLOOD STASIS amenorrhea TP
TP: regulate qi, remove blood, regulate menstruation
QI STAGNATION AND BLOOD STASIS amenorrhea formula
Formula: Xue Fu Zhu Yu Tang
Symptoms: amenorrhea, phlegm and damp symptoms, feeling of heaviness, tongue with thick greasy coating, slippery pulse, poor digestion, phlegm sound in the throat, overweight, oppression in the chest, nausea, vomiting with phlegm, lassitude, profuse vaginal discharge, edema
PHLEGM AND DAMP OBSTRUCTION amenorrhea
PHLEGM AND DAMP OBSTRUCTION amenorrhea TP
TP: dispel damp and phlegm, regulate qi, remove blood stasis, regulate menstruation
PHLEGM AND DAMP OBSTRUCTION amenorrhea formula
Formula: Cang Fu Dao Tan Wan + Fo Shou San (Dang Gui, Chuan Xiong)
Menopause definition
No period for 1 year
low estrogen
Menopause pathogenesis
Pathogenesis: age/kidney essence deficiency, kidney deficiency constitution, chronic disease, overstrain
Symptoms: dizziness, tinnitus, hot flushes on the head and face, sweating, feverish sensation in the five hearts, soreness and weakness on the lower back and knees, insomnia, irregular menstruation with heavy
or little volume, bright red blood, dry skin, dry mouth, constipation, scanty yellow urine, red tongue with little coating, thready and rapid pulse
KIDNEY YIN DEFICIENCY menopause
KIDNEY YIN DEFICIENCY menopause TP
TP: nourish kidney yin and anchor yang (liver or heart yang hyperactive from deficiency)
KIDNEY YIN DEFICIENCY menopause formula
Formula: Zuo Gui Yin + Zhi Shou Wu, Gui Ban
Symptoms: dark complexion, lassitude, cold sensation and cold extremities, soreness and cold on the lower back and knees, poor appetite, abdominal fullness sensation, diarrhea, heavy menstruation, heavy
uterine bleeding without cycle, light color or dark, edema, frequent urination, heavy and thin leukorrhea, light red tongue with teethmarks, thin and white coating, deep and thready pulse
KIDNEY YANG DEFICIENCY menopause
KIDNEY YANG DEFICIENCY menopause TP
TP: warm kidney yang, tonify spleen yang
KIDNEY YANG DEFICIENCY menopause formula
Formula: You Gui Wan + Li Zhong Wan
if there is both yin and yang deficiency use
Er Xian Tang + Er Zhi Wan
Leukorrhea pathogenesis
- DAMP: damp, damp cold, damp heat, damp toxin (five color discharge - refer out) (damp nature is downward, turbid, sticky) can be internal damp or external damp, yeast/fungal infection, related to the
spleen and kidney - SPLEEN QI/YANG DEFICIENCY
- KIDNEY YANG DEFICIENCY: can be from spleen yang deficiency, profuse watery discharge, lower back pain
- KIDNEY YIN DEFICIENCY: low estrogen, burning sensation, dry itchy, small amount, sticky, yellow, odor
Leukorrhea problem diagnosis
Volume: too heavy or too light
Color: clear, white, green, red, yellow
Quality: watery, sticky
Odor: smelly
Symptoms: whitish or light yellow leukorrhea which is thin, pale or sallow complexion, lassitude, cold extremities, poor appetite, swollen limbs, loose stools, pale tongue with white or greasy coating, weak and
moderate pulse
SPLEEN DEFICIENCY leukorrhea
SPLEEN DEFICIENCY leukorrhea TP
TP: tonify spleen, raise yang, dispel dampness
SPLEEN DEFICIENCY leukorrhea formula
Formula: Wan Dai Tang
Symptoms: profuse clear and thin leukorrhea which is continual discharge, severe soreness on the lower back, cold sensation in the lower abdomen, frequent and profuse clear urination worse at night,
diarrhea, pale tongue, thin white coating, deep and slow pulse, can be from chronic spleen yang deficiency
KIDNEY YANG DEFICIENCY leukorrhea
KIDNEY YANG DEFICIENCY leukorrhea TP
TP: warm kidney yang, stabilize and stop leukorrhea
KIDNEY YANG DEFICIENCY leukorrhea formula
Formula: Nei Bu Wan
Symptoms: yellowish or reddish thick leukorrhea, burning sensation in external genitalia, yin deficiency symptoms
KIDNEY YIN DEFICIENCY leukorrhea
KIDNEY YIN DEFICIENCY leukorrhea TP
TP: nourish kidney yin, clear heat, stop leukorrhea
KIDNEY YIN DEFICIENCY leukorrhea formula
Formula: Zhi Bai Di Huang Tang + Qian Shi, Jin Ying Zi
Symptoms: profuse yellow and thick foul smelling leukorrhea or white thick like bean curd leukorrhea, vaginal itching, damp heat symptoms
DAMP HEAT leukorrhea
DAMP HEAT leukorrhea TP
TP: clear heat and dispel damp
DAMP HEAT leukorrhea formula
Formula: Zhi Dai Fang
Symptoms of uterine bleeding during pregnancy:
bleeding without lower back and abdominal pain
Symptoms of unstable pregnancy:
lower back or abdominal pain with our without bleeding
Uterine bleeding during pregnancy/unstable pregnancy pathogenesis
Pathogenesis: Kidney deficiency (qi, yin, yang, essence), qi and blood deficiency, blood heat, blood stasis, external injury
Symptoms: during pregnancy, small volume bleeding with light dark color, aching on the lower back and bearing down sensation with pain in the lower abdomen, kidney deficiency symptoms, habitual miscarriage, pale tongue with white coating, deep slippery and weak in chi position pulse
*KIDNEY DEFICIENCY uterine bleeding during pregnancy/unstable pregnancy
*KIDNEY DEFICIENCY uterine bleeding during pregnancy/unstable pregnancy TP
TP: tonify kidneys, calm the fetus, tonify qi
*KIDNEY DEFICIENCY uterine bleeding during pregnancy/unstable pregnancy formula
Formula: Shou Tai Wan + Dang Shen, Bai Zhu
Symptoms: slight bleeding during pregnancy which is light red and thin blood, pain on the lower back and abdomen, qi and blood deficiency symptoms
QI AND BLOOD DEFICIENCY uterine bleeding during pregnancy/unstable pregnancy
QI AND BLOOD DEFICIENCY uterine bleeding during pregnancy/unstable pregnancy TP
TP: tonify qi, nourish blood, stabilize kidneys, quiet the fetus
QI AND BLOOD DEFICIENCY uterine bleeding during pregnancy/unstable pregnancy formula
Formula: *Tai Yuan Yin - Dang Gui + Huang Qi, E Jiao
Symptoms: bleeding with bright red blood during pregnancy, pain in the lower back and abdomen, irritability, anxiety, hot sensation, thirsty, dry mouth, dry throat, afternoon fever, short yellow urine, constipation
red tongue with yellow dry coating, wiry or slippery rapid pulse
BLOOD HEAT uterine bleeding during pregnancy/unstable pregnancy
BLOOD HEAT uterine bleeding during pregnancy/unstable pregnancy TP
TP: nourish yin, clear heat, nourish blood, quiet fetus
BLOOD HEAT uterine bleeding during pregnancy/unstable pregnancy formula
Formula: Bao Yin Jian
Symptoms: external injury during pregnancy, aching on the lower back, fullness and bearing down sensation in the lower abdomen, bleeding, slippery and weak pulse
EXTERNAL INJURY DURING PREGNANCY/ BLOOD STASIS uterine bleeding during pregnancy/unstable pregnancy
EXTERNAL INJURY DURING PREGNANCY/ BLOOD STASIS uterine bleeding during pregnancy/unstable pregnancy TP
TP: tonify qi, harmonize blood, quiet the fetus
EXTERNAL INJURY DURING PREGNANCY/ BLOOD STASIS uterine bleeding during pregnancy/unstable pregnancy formula
Formula: Shen Yu Tang + Tu Si Zi, Sang Ji Sheng, Xu Duan
Habitual miscarriage formula
Bu Shen Gu Chong Wan
Symptoms: dull postpartum lower abdominal pain which is alleviated when pressed, scanty light color lochia, dizziness, tinnitus, pale complexion, dry stool, pale tongue, thin coating, deficient thready pulse
Blood deficiency postpartum abdominal pain
Blood deficiency postpartum abdominal pain TP
TP: nourish blood, tonify qi
Blood deficiency postpartum abdominal pain formula
Formula: Chang Ning Tang
Symptoms: postpartum abdominal pain aggravated by pressing and relieved by warming, scanty lochia with dark clots, dark tongue with purple spots, deep tight pulse
BLOOD STASIS postpartum abdominal pain
BLOOD STASIS postpartum abdominal pain TP
TP: remove blood stasis, dispel cold, relieve pain
BLOOD STASIS postpartum abdominal pain formula
Formula: Sheng Hua Tang + Yi Mu Cao
Symptoms: heavy deep red and thick lochia with foul smelling lochia and blood heat, red cheeks, dry mouth, thirsty, red tongue, deep thready and rapid pulse
BLOOD HEAT postpartum lochiorrhea
BLOOD HEAT postpartum lochiorrhea TP
TP: nourish yin, clear heat, stop bleeding
BLOOD HEAT postpartum lochiorrhea formula
Formula: Bao Yin Jian + E Jiao, Han Lian Cao, Wu Zei Gu
Symptoms: heavy or continuous small volume lochia which is light red and thin, no clots, no smell, bearing down sensation in lower abdomen, lassitude, pale complexion, dizziness, pale tongue, moderate
weak pulse
QI DEFICIENCY postpartum lochiorrhea
QI DEFICIENCY postpartum lochiorrhea TP
TP: tonify qi, stabilize blood
QI DEFICIENCY postpartum lochiorrhea formula
Formula: Bu Zhong Yi Qi Tang + Lu Jiao Jiao, Ai Ye Tan
Symptoms: scanty dark lochia with clots, dark purple color, scanty amount, abdominal pain that dislikes pressure, dark purple tongue with spots, wiry and choppy pulse, or deep and forceful pulse
BLOOD STASIS postpartum lochiorrhea
BLOOD STASIS postpartum lochiorrhea TP
TP: remove blood stasis
BLOOD STASIS postpartum lochiorrhea formula
Formula: Sheng Hua Tang + Yi Mu Cao, Chao Pu Huang
Spleen and stomach deficiency morning sickness formula
Xiang Sha Liu Jun ZI Tang
LV/ST disharmony morning sickness formula
Su Ye Huang Lian Tang
