Menstrual Disorders - Menorrhagia In Traditional Chinese medicine Perspective

Menorrhagia is defined as a condition of excessive bleeding in the menstruation phase of the menstrual cycle in the reproductive age of a woman leading to heavy blood loss that can interfere with the woman normal activities, as a result of disruption of normal hormonal regulation of periods or disorders of certain reproductive organs. In traditional Chinese medicine, menorrhagia can be caused by combination of Spleen qi deficiency, liver blood deficiency, damp accumulation and treatments include Tonify spleen qi, nourish blood, resolve dampness.
Please note that in TCM, same disease may be treated with different formula and difference diseases may be treated with the same formula depending to the differentiation.

Symptoms
1. Breathlessness
2. Exhaustion Habitual miscarriage; Intermittent fever due to Qi Deficiency;
3. Loose stools
4. Sweating
5. Anemia
6. Pale tongue,
7. Blurred vision;
8. Dizziness; Evening fever;
9. Insomnia;
10. Irritability;
11. Menorrhagia with blood clot
12.. Etc.

Causes
A. Spleen qi deficiency
Menorrhagia may be a result of spleen qi deficiency cause of sinking yang
4. 1. Cool Food diet
Prolonged period of eating raw, cool and may cold food hinders the spleen function in transformation and distribution of spleen function, leading to spleen qi deficiency.

2. Eating habits
People who eat little protein, irregular eating or excessive eat can also cause spleen deficiency.

3. Occupation
Women who works in the damp condition can also cause dampness accumulation leading to spleen deficiency.

4. Stress and worrisomeness
Since spleen control the mind and though, prolonged period of stress and worrisomeness can cause spleen qi deficiency.

5. Stomach disorder
If the stomach is unable to digest food properly, it will affect the spleen function in food essence transformation and distribution as a result of spleen qi deficiency.


B. Live blood deficiency
Liver blood stagnation is normally caused by liver qi stagnation or the liver is no longer function in blood storing and formation.
1. Poor diet
According to TCM, poor diet may affect the function of liver function in blood formation, if it fails to be properly nourished by the qi from the energy source of spleen. Diet with little or no iron also contributes to the blood deficiency.

2. Abnormal liver function
Abnormal function of liver can be caused by raw foods diet as its affects the spleen function in assisting the digestive system function in absorbing vital energy from foods that reduces the liver function in blood storing and formation.

3. Cold foods
Eating too much raw foods for a prolong period of time, may cause yang deficiency that effects the spleen function in transporting qi and disrupts the kidney in fluid distribution, leading to water accumulation in lower part of the body that creates a worse environment for dampness invasion.

3. Liver imbalance
Liver imbalance caused by excess of any pathogen or/and toxins accumulated can also reduce the normal function of blood storing and formation of the liver.

4. Alcohol drinking
Long terms alcohol drinking damages the liver function in blood formation and regulating the spleen function in energy distribution, leading to not enough blood for the circulatory system to supply nutrients and oxygen to the reproductive organs, resulting in symptoms of dysmenorrhrea such as cramps and pain before, during or after menstruation.

5. Anemia
Anemia is a chronic ill, it is caused by either easily broken off red blood cells or abnormal function of liver in blood formation.

6. Etc.

C. Dampness accumulation
1. Weather
Expose yourself in wet environment for the prolong period of time, may cause dampness accumulation , as a result of depletion of yang in controlling the dryness in the body.

2. Raw foods
Eating too much raw foods for a prolong period of time, may cause yang deficiency that effects the spleen function in transporting qi and disrupts the kidney in fluid distribution, leading to water accumulation in lower part of the body that creates a worse environment for dampness invasion.

3. Occupation
Certain occupations require people to work in damp and wet environment that cause long term moister accumulated in the lung, leading to spleen deficiency. While dampness has a tendency moved downward, it affects the heart in blood circulation, causing blood stagnation resulting in abdominal cramps and pain.

4. Spleen deficiency
Spleen deficiency caused by unhealthy diet or irregular diet may interfere with kidney and liver function in fluids and blood distribution, leading to over flow of fluids and blood stagnation in the abdomen. Also spleen deficiency may also interfere the lung function in qi flow.

5. Etc.

Treatments
A. Formula treatment
Gui Pi Tang Modified, the medication has been used to treat menorrhagia by tonifying qi and blood, the spleen, nourishing the heart and calming the mind. Ingredients include
1. Huang Qi (astragalus root)
Main uses; Tonifies Qi, Raises Yang, Strengthens the Defensive-Qi, Expels toxins, resolve dampness.
2. Dang Shen (Red Sage Root)
Main uses; Moves Blood, Eliminates Blood accumulation, Cools Blood, Nourishes Blood, Tonifies Qi.
3. Bai Zhu (Largehead Atractylodes Rhizome)
Main uses; Tonifies Qii, Strengthens the Spleen, Dries Dampness, Stops Sweating.
4. Mu Xiang (costus root)
Main uses: Tomifies Qi, Alleviate Pain, Regulates Stagnated Qi in intestines, Clears Damp Heat.
5. Yuan Zhi (Thinleaf Milkwort Root)
Main uses; Calms the Heart and Mind; Transforms Phlegm, Resolves oedema.
6. Suan Zao Ren (Spina Date Seed)
Main uses; Stops sweating, Nourishes the Heart, Calms the Mind.
7. Long Yan Rou (Longan Aril)
Main uses; Tonifies Heart and Spleen, Benefits Qi and Blood.
8. Fu Ling (Indian Bread)
main uses; Drain Dampness, Strengthens the Spleen
9. Gou Qi Zi (Wolfberry Fruit)
Main uses; Nourishes Liver and Kidneys, Tonifies Liver and Kidneys, Improves vision, Moistens the Lung.
10. Dang Gui (Angelica Root)
Main uses; Tonifies Blood, Moves Blood, Relieves pain.
11. He Shou Wu (Tuber Fleeceflower Root)
Main uses; Tonifies the Jing and Blood, Benefits the Jing and Blood.
12. Sheng Jiang
Main use; Regulates the Spleen, Moves Water, Warm the Middle burner.
13. Da Zao (Jujube Dates)
Main uses; Tonifies the Middle burner, Strengthens Qi, Nourishes Blood.
14. Gan Cao (Licorice Root)
Main uses; Tonifies the Spleen, Benefits Qi; Moistens the Lung.

B. Herbal suggestions
B.1. Spleen qi deficiency
1.Ren shen (Ginseng)
Ren shen is considered as one of most powerful herbs in strengthening the original qi in the body. In spleen, it improves the spleen function in qi absorption, thus reducing the symptoms of distended chest and abdomen cramps and pain.


2. Xi yang shen (American ginseng)
Xi yang shen is yin in nature, besides promoting the lung and spleen qi, it also increases the digestive system in absorbing vital energy and reducing the heat causes of qi stagnation by moistening the all qi transportation channels, especially for qi stagnation caused by deficiency of yin.

3. Dang shen (pilose asiabell root)
Dang shen is a spleen and lung tonic herbs. It improves the lung function in moving qi smoothly through its channels and spleen function in absorbing qi after foods entering the stomach. It also helps to restore the qi which is damaged by heat caused by infection, inflammation or heat generated due to excessive fluids accumulation.

4. Tai zi shen (pseudostellaria root)
Besides helping to increase the spleen and lung qi, it also improve the blood transportation and spleen and stomach in absorbing vital energy for our body cells and generates fluids to prevent the heat causes of qi stagnation.

5. Huang qi (astragalus root)
It is one of the herb that helps to increase the function of liver in generating more blood and liver qi in blood transportation due to excessive blood loss during menstruation.

6. Da Zao (Jujube Dates)
It is a good herb for tonifying spleen qi and short of breath and nourishing blood.

7. Etc.
B.2. Liver blood deficiency
1. He shou wu (fleeceflower root)
He shou wu is a liver tonic herb. It promotes liver function in blood formation and increases the kidney qi in assisting the liver in transporting blood to the heart for circulation, thereby reducing the blood stagnation causes of deficiency. It also improves the kidney in urinary secretion, thus decreasing the risk of blood stagnation caused by fluid retention.
2. Shu Di Huang (Chinese foxglove root)
Shu di huang is a blood tonic herb. Besides improving the liver in blood formation, it also increases the liver's qi by boosting the circulatory system in transporting oxygen and nutrients to the body's cells thus reducing the risks of symptoms of dizziness, pallid complexion, palpitations, and scanty menstruation.
3. E Jiao (Donkey-Hide Glue)
E jiao is an important herb for improving the liver in blood formation and liver qi in regulating the blood circulation in the body thereby reducing the symptoms of dizziness, shallow complexion, and palpitations caused by blood deficiency.
4. Dang gui (Chinese angelica root)
Dang gui is best known for improving the liver's function in blood formation and regulating the function of the reproductive organs. It also harmonizes the production of hormones during the menstrual cycle, leading to reduced cramps and pain caused by blood deficiency and stagnation.
5. Bai shao (white peony root)
Bai shao plays an important role in nourishing the blood and regulating menstrual problems caused by blood deficiency. It also harmonizes the liver and spleen to prevent the rising of blood heat causes of headache and dizziness.
6. Etc.
B.3. Dampness accumulation
1. Fu ling(matsuhodo)
Fu ling is one of most frequent used herb in promoting the kidney in urinary secretion and improving the Spleen in food absorption, thereby releasing the water retention in the body and promoting strong kidney and spleen qi in assisting liver function in blood formation and transport blood to circulation system, resulting in lessening the risk of abnormal function of heart.

2. Zhu ling (polyporus sclerotium)
The herb besides promotes kidney urinary secretion, it also helps to expel the dampness ( fluid retention) from the body tissues.

3. Ze Xie (water plantain root)
Ze xie has been used frequently in TCM to clean phlegm caused by lung congestion as a result of
excessive dampness accumulated in the lung. It also improves the kidney function in secreting urine, thereby reducing the risk of fluid retention in the body tissues.

4. Tong Cao (ricepaper plant pith)
Tong cao promotes the lung and stomach channel. Deficiency of yang as a result of dampness (fluid retention) in the body, it interferes with lung function in moving and circulating structural body substances, leading to fluid accumulated in the under layer of the skin. On the other hand, it also helps to improve the spleen function in food absorption and waste secretion, thereby reducing the dampness through urinary secretion.

5. Bei Xie (dioscorea root )
The main function of bei xie is to improve the stomach function in separates the pure from the turbid when the foods enter the stomach, thereby reducing the extra dampness by expelling them through kidney urinary secretion.

6. Han Fang Ji (stephania root)
Han fang ji is one of Chinese herbs that has been used to treat fluid retention in the under layer in the skin of the lower part of body, including the abdomen.

7. Etc.
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