Irregular menstruation refers to any abnormal change in menstrual
cycle, in quantity and color of flow, and other accompanying
symptoms. Commonly seen cases are antedated and postdated
menstruation, irregular menstrual cycle. Menstruation earlier than
due time by seven to eight days, or even twice a month, is regarded
as antedated menstruation, while menses later than due time by eight
to nine days or even once every forty to fifty days is considered as
Menopathy is caused by many factors, such as the exogenous
pathogenic cold, heat and damp, emotional disturbances - worries,
depressed rage, indulgence in sexual life, grand multiparity, etc.,
leading to the disharmony between qi and blood and the injury of the
Chong and Ren Meridians.
Etiology and Pathogenesis
1.1. Early menstruation
Heat in the blood: It is due to abundance of the internal heat, yin
deficiency and yang excess, or overtake of pungent food, over dosage
of the warm property drugs acting on uterus, or to fire transformed
from stagnated liver qi, etc. All of these lead to the injury of the
Chong and Ren Meridians by excessive heat, bringing about antedated
Qi deficiency: This is caused by overexertion, improper diet leading
to weakness of the spleen qi and insufficient qi in the middle jiao,
which fails to control the menstrual flow, resulting in antedated
menses. Dr. Zhang Jingyue pointed out, "If the pulse does not
reflect excessive heat internally it means antedated menstruation is
caused by qi deficiency of the heart and spleen that fail to control
the blood. "
1.2. Late menstruation
Blood deficiency: The blood may be marred due to chronic hemorrhage,
debility resulted from chronic diseases and multiparity. Irregular
diet and overexertion may injure the spleen and stomach, causing
insufficiency of blood in the Chong and Ren Meridians. Finally,
postdated menstruation occurs.
Cold in the blood: It is due mostly to constant yang deficiency and
internal growth of cold, or due to overtake of raw and cold food,
exposure to rain and cold during the menstrual periods. Then the
pathogenic cold invades the Chong and Ren Meridians, impeding the
free flow of blood, hence the menstrual cycle delays.
Qi stagnation: It is due to emotional depression, disturbing the qi
activity and resulting in qi stagnation. The stagnated qi impairs
the smooth now of blood which leads to abnormal function of the
Chong and Ren Meridians. The sea of blood cannot be filled up at due
time, and postdated menstruation occurs.
1.3. Irregular menstrual cycles
Qi stagnation in the liver: It is due usually to depressed rage that
hurts the liver and disturbs the storage of blood, which leads to
dysfunction of the blood in the Chong, Ren Meridians and uterus,
hence irregular menstrual cycles.
Kidney deficiency: It is due to marriage at an immature age,
indulgence of sexual life, grand multiparity, etc., which consume
the essence and blood. The kidney qi fails to conduct its function
in storing essence and adjusting the Chong and Ren Meridians,
resulting in irregular menstrual cycles.
2.1. Early menstruation
Heat in blood
Main manifestations: Shortened cycle, dark red and thick blood flow
in large quantities, restlessness, ftrilness in the chest, brown
urine, reddened tongue with yellow coating, rapid and forceful
Analysis: Dark red, thick and profuse menses indicate internal
excessive heat, which impairs the heart and liver, leading to
restlessness and fullness in the chest When the heat shifts from
the heart down to the small intestine there appears scanty and dark
yellow urine. The yellow tongue coating and the rapid pulse are
signs of internal heat.
Heat in the blood
Method: Points of the Spleen and Kidney Meridians are selected as
the principal points. Acupuncture with the reducing method is
applied to regulate the Chong and Ren Meridians and, clear ofT heat
Prescription: [LI11 - RN3 - SP10 - KI5].
Explanation: LI 11 is the He - Sea Point of the Hand - Yangming
Meridian while SP10 is the Jing - River Point of the Foot - Taiyin
Meridian. When they are used together, heat is removed from blood.
RN3, the intersecting point of the three yin meridians of foot,
works to regulate the Chong and Ren Meridians and remove internal
heat from the lower jiao. KI5, Xi - Cleft Point of the Kidney
Meridian, strengthens yin, reduces heat and regulates menses. All
the points used together serve the purpose of clearing off heat and
regulating menstruation. LR2 is added to clear away the heat from
the liver in case of stagnated liver qi transforming into fire. KI2
is used to nourish yin, reduce heat and to regulate menses.
Main manifestations: Profuse, thin and light red menses in shortened
cycle, lassitude, palpitation, shortness of breath, subjective empty
and heavy sensation in the lower abdomen, pale tongue with thin
coating, weak pulse.
Analysis: The spleen qi dominates the middle jiao and controls
blood. Qi insufficiency fails to check the blood, there occurs
disturbance of the Chong and Ren Meridians, leading to profuse, thin
and light red menses in shortened cycle. Lassitude, shortness of
breath and empty heavy sensation are manifestations of qi
deficiency. Palpitation and pale tongue account for blood
deficiency, and the weak pulse is a sign of qi deficiency.
Method: Select the main points from the Ren, Foot - Taiyin and Foot
- Yangming Meridians to replenish qi so as to restore its function
in controlling blood. Acupuncture is applied with the reinforcing
Prescription: [RN6 - SP6 - RN12 - ST36].
Explanation: RN6 can regulate qi of the whole body. Qi is the
commander of blood and when it is abundant blood is totally
controlled by it. SP6, RN12 and ST36 are chosen to build up the
spleen qi, and strengthen spleen qi, controls blood. All the points
applied together attain the purpose of replenishing qi and
2.2. Late menstruation
Main manifestations: Scanty and light red menses in delayed cycle,
empty and painful feeling in the lower abdomen, emaciation, sallow
complexion, lusterless skin, dizziness and blurred vision,
palpitation and insomnia, pink tongue with little coating, weak and
Analysis: Owing to a chronic disease, weak body constitution or
chronic hemorrhage, blood cannot form the timely tide in the sea of
blood, bringing about scanty and light red menses in delayed cycle.
When the blood fails to nourish the uterus, there is an emptiness
and pain in the lower abdomen. When the meridians, vessels, muscles
and skin are undernourished, there may appear emaciation, sallow
complexion and lusterless skin. When the liver and heart fail to be
nourished by blood, dizziness, blurred vision, palpitation and
insomnia occur. If the tongue is malnourished and the vessels are
not filled up, there present pink tongue and weak thready pulse.
Cold in the blood
Main manifestations: Scanty and dark - colored menses in delayed
cycle, colic pain in the lower abdomen, slightly alleviated by
warmth, cold limbs, thin and white tongue, deep and slow pulse.
Analysis: The invasion of pathogenic cold during menstruation
impedes blood flow, leading to scanty and dark - colored menses in
delayed cycle. Cold in the uterus binders the smooth flow of qi and
blood and then there appears colic pain. Cold, yin by nature,
injures yang qi and brings about cold limbs. Thin and white tongue
coating, deep and slow pulse are signs of cold syndromes.
Blood deficiency and cold in the blood:
Method: Points of the Ren and Foot - Taiyin Meridians are selected
as the principal points. In case of blood deficiency, acupuncture is
applied with the reinforcing method to replenish qi and nourish
blood. Moxibustion is also advisable. In case of cold in the blood,
acupuncture is given with the even movement. Strong stimulation of
moxibustion is used to warm up the meridians and disperse cold.
Prescription: [RN4 - RN6 - SP6].
and blurred vision: DU20,
and insomnia: HT7.
Explanation: RN4, an intersecting point of the three yin meridians
of foot connects the uterus. When the reinforcing method is applied
to RN4 and SP6, qi and blood are promoted, the Chong and Ren
Meridians are regulated and then cold is dispelled from them. RN6
assists to adjust qi and blood so that the Chong and Ren Meridians
are well regulated and menses comes on time. DU20 helps ascend qi
and blood, nourishing the head and eliminating dizziness and blurred
vision. HT7 pacifies the mind in case of palpitation and insomnia.
Main manifestations: Scanty and dark red menses in delayed cycle,
distending pain in the lower abdomen, mental depression, stuffy
chest alleviated by belching, distension in the hypochondria and
breast region, thin, white tongue coating and string - taut pulse.
Analysis: Stagnated qi of the liver brings about retarded blood flow
and results in scanty and delayed menses with distending pain in the
lower abdomen. When the qi fails to travel smoothly, mental
depression and stuffy chest present. Since the Liver Meridian runs
through the costal and hypochondriac regions, the stagnated liver qi
gives rise to the distension in the hypochondrium and breast. String
- taut pulse is a typical sign of liver disorder and qi stagnation.
Method: Points of the Foot - Jueyin and Foot - Yangming Meridians
are selected as the principal points. Acupuncture is applied with
the reducing method to activate qi and blood flow.
Prescription: [ST25 - KI13 - ST8 - LR3].
Analysis: ST25 and RN6 are located on the Foot - Yangming Meridian.
KI13 can promote qi and blood flow and regulate the Chong and Ren
Meridians. SP8, a qi point of the blood system can adjust blood arid
qi circulation. LR3, the Yuan Point of the Liver Meridian can soothe
the liver and regulate liver qi. The points are used together to
achieve free flow of qi and blood. MH6 is chosen to remove fullness
from the chest and adjust qi. LR14 is added to regulate qi so as to
weed out the disterision in the hypochondriac region and breast.
2.3. Irregular menstrual
Liver Qi Stagnation
Main manifestations: Alteration of menstrual cycles and quantity of
blood flow, thick, sticky, and purple colored menses difficult to
flow, distension in the hypochondriac region and breast, distending
pain in the lower abdomen,
scanty bleeding with some clots,
patient is stressed out, experiences PMS, breast tenderness,
mood swings, depression, frequent sighing, ‘Plum-pit’ syndrome,
psychological feelings of being easily frustrated, a sense of being
held down, digestive complaints, T- may be normal or have slight
purple or red colour on the sides, P- wiry
Analysis ; Depressed rage injuries the function of the liver,
leading to unsmooth flow of qi and blood and disturbance in the sea
of blood, and finally to the alteration of menstrual cycles and
quantity of blood flow. The stagnation of liver qi causes impeded
flow of blood, bringing about difficult menstruation, distension in
the hypochondriac region and breast, and distending pain in the
lower abdomen. Frequent sighing may help to relieve the stagnated qi.
String - taut pulse is a typical sign of liver qi stagnation.
Method: Points of the Ren and Jueyin Meridians are selected as the
principal points to ease the liver and regulate the Chong and Ren
Meridians. Acupuncture is given with the even movement.
- [RN6 - KI14
- MH5 - LR5] or
- [LR3, LR5, LR14, SP6, SP8,
SP10, ST29, SP4R - MH6L, zi gong,
in the hypochondriac region and breast: RN17, LR14.
- hypochondriac pain- GB34, TH6
depression: HT7, LR3.
Explanation: RN6 and KI14 can promote the flow of qi and blood,
regulate Chong and Ren Meridians. Located on the Jueyin Meridians,
MH5 and LR5 remove stagnation of the liver qi and treat disordered
menses. The irregular menstrual cycles will be removed once the
liver restores its normal function and the Chong and Ren Meridians
ate harmonized. RN17 and LR14 are included in the prescription to
soothe the liver and relieve the stagnated qi of the liver and
distending pain in the hypochondriac region and breast. HT7 and LR3
ease the mind and relieve depression.
Main manifestations: Scanty, light red blood flow in altering
cycles, dizziness and tinnitus, weak and aching of the lower back
and knees, frequent night urination, loose stools, pale tongue with
thin coating, deep and weak pulse.
Analysis: When there is insufficiency of kidney qi, disharmonized
Chong and Ren Meridians bring on the derangement of the flow and ebb
of tide in the sea of blood, resulting in the alteration of
menstrual cycles. Insufficient kidney qi decreases the essence and
blood, leading to scanty, thin and light red menses. Since the
kidney dominates bones, generates marrow, and has its opening in the
ear, and the Kidney Meridian runs through the waist, deficiency
condition of the kidney causes lack of marrow, impairs audibility
and malnourishes the waist, bringing on dizziness, tinnitus, sore
and weak in knees and the lower back. When the kidney fails to
control urination and defecation there appear frequent urination and
loose stools. Pale tongue with thin coating and deep weak pulse
indicate kidney yang deficiency.
Method: Points on the Ren and Foot - Shaoyin Meridians are selected
as the principal points. Acupuncture is given with the reinforcing
method. Moxibustion is used to replenish the kidney qi and regulate
the Chong and Ren Meridians.
- Sore and
weak low back and knees: yaoyan, KI10.
and tinnitus: DU20, KI 3.
Explanation: BL23 the Back - Shu point of the kidney, can strengthen
congenital essence when used together with RN4 and KI8. The
irregular menstrual cycles get redressed naturally once the kidney
can carry out well its function in storing essence. Yaoyan
(Extra) aims at the sore and weak low back and knees, while KI10
strengthens the bones through kidney activation. KI3 and DU 20 are
added to promote marrow and nourish the brain by means of tonifying
kidney to treat dizziness and tinnitus.
bleeding, no clots, sore back &/or knees, tinnitus, feel cold,
urinary incontinence or dribbling, copious clear urination, low
libido, edema of the legs, loose stool (at 5am), excess clear
vaginal discharge, T- pale moist, P- deep weak
P/T – warm & tonify
Kidney Yang, regulate Chong and Ren
- Jin Gui Shen Qi Wan, You Gui
Wan, Gu Yin Jian
bright red or dark blood, dizziness, blurred vision, night sweats,
dry mouth and throat, anxiety, irritable, feeling of heat in the
head, hands, and feet in the afternoon, flushed cheeks, sore back,
constipation, dark urine, T- red with no coating, may have cracks,
P- thin rapid
P/T – nourish
Kidney Yin, consolidate Chong and Ren to regulate menses
- Liu Wei Di Huang Wan, Zuo Gui
Included in this disorder is the irregular menorrhea resulted from
dysfunction of antehypophysis or from ovarian dysfunction.
- Auricular- Nei Shen Zhi Qi
(internal reproductive), endocrine, subcortex, LR, SP, KI, Yuan
- scalp- human reproductive