No period for three
begins at about fourteen in healthy girls. Menstruation thatdoes not
come until 18 or suppression of menstruation for over three months
iscalled amenorrhea. Stop of menses during gestation period and
lactation periodis of normal physiological phenomena. The causative
factors of amenorrhea fallinto deficiency and excess types. The
deficiency type is mostly seen due to deficiencyof blood, and the
excess type is caused by excessive pathogenic factorsobstructing the
passage of menses.
The clinical differentiation and treatment are usually conducted in
the lightof blood stagnation and blood depletion.
Etiology and Pathogenesis
a) Blood stagnation: It is due to the seven emotional disturbances,
stagnation of liver qi, resulting in retardation of both qi and
blood in the uterus and obstruction in the passage of menses.
b) Blood depletion: Improper intake of food or overstrain undermines
the reproducing source of qi and blood, severe or chronic diseases
that consume blood, or by grand multipara or indulgence in sexual
life that exhaust essence and blood, all of which may drain the sea
of blood, deprive the Chong and Ren Meridians of nourishment and
result in amenorrhea.
a) Blood stagnation: Main manifestations: Absence of menses for
months, lower abdominal distending pain aggravated by pressure, hard
mass in lower abdomen, distension and fullness in the chest and
hypochondriac region, dark purple tongue coating with purplish spots
on its borders, deep string - taut pulse.
Analysis: Worry and anger cause qi stagnation and failure of it to
control blood, bringing on blockage of the Chong and Ren Meridians
and amenorrhea. The abnormal function of qi gives rise to lower
abdominal distending pain and fullness in the chest and epigastrium.
Blood stasis retaining in the sea of blood binders menstrual flow,
manifested by the abdominal pain aggravated by pressure and hard
mass in the lower abdomen. Purple tongue coating with purplish spots
on its borders and deep string - taut pulse are signs of stagnation
of qi and blood.
a) Blood stagnation: Method: Points of the Ren, Foot - Taiyang and
Foot - Jueyin Meridians are selected as the principal points.
Acupuncture with the reducing method is used to remove the
stagnation and regulate the circulation ofqi and blood in the
Prescription: [RN3 - ST29 - SP10 - LR3 - LI4 - SP6].
Supplementary points: Pain in the lower abdomen with hard mass
aggravated by pressure: KI14.
Explanation: RN4, an intersecting point of the three foot - yin
meridians, may regulate the Chong and Ren Meridians and dredge the
blockage from the lower jiao. ST29 is chosen as a local point to
remove blood stasis from the uterus. SP10 and LR3 applied together
can regulate the liver qi, and relieve stagnation and stasis. LI4
and SP6 can get qi and blood down to restore the normal
menstruation. KI14 may be added when there is pain and hard mass in
the lower abdomen aggravated on pressure.
Qi and Blood
– Ren 6 & SP 6, LR 2 & SP 10, LR 14 & GB 34 (hypochondriac
b) Blood depletion: Main manifestations: Delayed menstrual cycle,
gradual decrease of menses and amenorrhea, sallow complexion in
prolonged cases, lassitude, vertigo and dizziness, poor appetite,
loose stools, dry skin, pale tongue with white coating, slow weak
pulse, all of which are signs of deficiency of qi and blood:
dizziness and tinnitus, sore and weak low back and knees, dry mouth
and throat, hot sensation in the palms, soles and epigastrium,
afternoon fever and night sweating, pale tongue with little coating,
string - taut and thready pulse, all of which are signs of
deficiency of essence and blood.
Analysis: Blood is transferred from food through the function of
transportation and transformation of the spleen, and dysfunction of
the spleen leads to blood deficiency. Blood deficiency causes
malnutrition of the Chong and Ren Meridians and the void ness in the
sea of blood. Hemorrhage causes exhaustion of blood, and finally
delayed menstrual cycle and the gradual decrease of menses till
amenorrhea. Blood deficiency Fails to nourish the muscles, skin and
head, bringing on sallow complexion, dry skin, vertigo and dizziness
and lassitude. Dysfunction of transportation and transformation of
the spleen gives rise to poor appetite and loose stools. Pale tongue
with white coating and slow, weak pulse are signs of blood
depletion. Since the kidney dominates bone and marrow, while the
brain is the sea of marrow, deficiency in the kidney may lead to
dizziness, tinnitus, sore and weak low back and knees. Yin
deficiency produces internal heat manifested by the dry mouth and
throat, hot sensation in palms, soles and epigastrium, afternoon
fever and the night sweating. Pale tongue and string - taut thready
pulse are signs of deficiency of essence and blood.
b) Blood depletion: Method: Select points of the Ren, Liver, Spleen
and Kidney Meridians. Acupuncture is used with the reinforcing
method. Moxibustion is applied sometimes to tonify blood and restore
Prescription: [RN4 - BL18 - BL20 - BL23 - ST36 - SP6].
Explanation: The spleen, the foundation of the acquired essence,
abstracts nutrient particles from food and transforms them into qi
and blood. When blood supply is abundant the menstrual cycle is
normal. So BL20, ST36 and SP6 are selected to strengthen the
function of the spleen and stomach. The kidney is the foundation of
congenital essence, and ample kidney qi guarantees sufficient qi and
blood. For this reason BL23 and RN4 are chosen to replenish kidney
qi. BL18 is selected to promote the blood in the liver, where blood
is stored. When the spleen, liver and kidney carry out well their
functions of controlling blood, storing blood and essence
respectively, the Chong and Ren Meridians are well nourished and
amenorrhea is cured.
young women do not get menarche until late years, slow development
RN, BL23 & RN4, ST30 & SP6
Qi and Blood
BL20, ST36, SP6, BL17 & RN6
- dizzy, blurred vision, BL18, DU20
post delivery overweight patients
– RN17, ST40, RN6, RN12
- clear vaginal discharge- BL32
– BL15, BL23, KI3, SP6, LR3
- insomnia- HT7, MH6
RN8 with ginger, RN3, RN4, DU4, LR3 & LI4, SP6
Alternative Treatment Methods
endocrine, reproductive organs,
KI LR, SP, HT
T5 to coccyx and Dai Mai (L2 to navel)
Included in this disease is amenorrhea resulted from endocrinal and