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Females are characterized by what in anatomy?
- Uterus
- Ovaries
- Fallopian Tubes
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This refers to the monthly bleeding that occurs in women of reproductive age.
Menstruation
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The onset of the first menstrual period.
- Menarche
- Average Age: 12.5
- Premature (Blood Heat): 10 or less years old (may be due to Hyperthyroidism, can have heavier flow)
- Delayed (Blood and / or KI Def): after 16 years old (may be due to Hypothyroidism)
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The menstrual cycle occurs every _____ days; the average is __ days and lasts ___ days, with women losing an average amount of _____ ml.
- cycle: 21-35 days
- average: 28 days
- lasts: 3-7 days
- average amount: 30-80 ml
- *it is important that the number of days between menses stays about the same
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The color of menses is usually ________, lighter in the begining, deep in the middle, and pinkish at the end of the period, __________________.
- color: dark red
- no clots and cramps
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This part of the "Four Phases" is characterized by:
-Sharp fall in estrogen & progesterone levels
-Broken endometrium flows out through vagina
- Period / Menstruation
- 3-7 days
- TCM: Blood moving which relies on the free flow of LR Qi & Blood
- TCM Tx: Move blood if too scanty, stops bleeding if too heavy
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This part of the "Four Phases" is characterized by:
-Follicular growth
-Rise of estrogen levels due to FSH
- After period / Follicular phase
- 7 days
- TCM: Blood & Yin are relatively empty; Chong & CV are depleted
- TCM Tx: Nourish Blood & Yin (LR & KI)
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This part of the "Four Phases" is characterized by:
-Release of egg from ovary
-Corpus Luteum development due to LH
- Mid-cycle / Ovulation Phase
- 7 days
- TCM: Blood & Yin gradually fill up in Chong and CV
- TCM Tx: Nourish Essence
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This part of the "Four Phases" is characterized by:
-Corpus Luteum growth
-Progesterone secretion
- Before Period / Luteal Phase
- 7 Days
- TCM: Yang Qi rises & LR Qi moves in preparation for period
- TCM Tx: Tonify Yang (if deficient), Move LR Qi (if stagnation)
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What are the hormones involved in menstruation?
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This is a structure beyond the uterus itself, including uterus, ovaries, fallopian tubes and cervix.
An extraordinary Fu organ.
Stores essence and blood for menstruation and conceiving fetus, demonstrating the "storage" function of Zang organs.
Discharge menstruation or deliver baby, manifesting the "excretion" function of the Fu organs.
Bao Gong (the female reproductive system)
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A vessel which connects the uterus to the pericardium.
Bao Mai (communication between heart and uterus)
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The network vessels distributed over the Bao Gong which supply and fill the Bao Gong with KI essence.
Bao Luo (communication between uterus and kidneys)
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Menstrual blood, not only blood but ____ ___, which orginates from the KI Yin with the participation of HT, SP, and LR.
Yin Jing, produced by KI. ____ ___is the accumulation of congenital essence.
Sex-stimulating essence of both sexes.
The onset of menstruation both at menarche and monthly is referred as the arrival of ____ ___.
Influences the human growth, development.
Produces a type of Yin essence in the reproductive organ.
Tian Gui
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What is the relationship of the Internal Organs with Menstruation?
- KI essence: foundation of menstrual blood (Tian Gui)
- Minister Fire
- LR: blood to uterus
- LR Qi: moves blood
- HT: governs blood
- HT Blood: goes to uterus (thru Bao Mai)
- HT Yang: goes to uterus and KI, both contribute to Tian Gui formation
- SP: generates blood
- SP Qi: holding function
- LU: governs Qi
- LU Qi: helps to make blood
- ST: connected to uterus thru the Chong vessel
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What is the relationship of the Extaordinary Vessels with Menstruation?
- Chong: provides and moves blood
- Ren: provides Essence and Yin
- Du: provides Yang and Minister Fire
- Dai: restrains LR, SP, KI
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From a TCM perspective, what is required for proper menstruation?
- Internal Organs
- Qi & Blood
- Extraordinary Vessels
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Normally there should be no pain during menstruation, but if there is, what could that be due to?
- Qi Stag (before period)
- Blood Stasis (during period / severe stabbing pain)
- Blood Def (after period)
- Cold Stasis (cramps)
- Sinking of Qi (dragging feeling)
- Damp-Heat (heaviness in lower ab with pain)
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Many women suffer from lower abominal pain in general, depending on location, which vessels / meridians could be affected?
- Central Ab: KI & CV (KI-9)
- Lateral Ab: LR & Chong (SP-4)
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If there is excessive and white vaginal discharge without smell; what is that due to?
SP Def
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If there is profuse, white, dilute, and watery vaginal discharge; what is that due to?
KI Yang Def
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If there is white dilute, and light vaginal discharge; without odor; what is that due to?
KI Yin Def
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If there is white / yellowish and sticky discharge, without odor; what is that due to?
LR Qi Stag
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If there is profuse, yellow / brown, sticky with an odor; what is that due to?
Damp-Heat
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If there is profuse, yellow, blood-stained / five-color discharge; what is that due to?
Heat Toxicity
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If there is vomiting during pregnancy, what is that due to?
Rebellious Qi in the Chong, affects the ST (Def / Heat types)
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If there is Edema during pregnancy, what is that due to?
KI Yang Def
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If there is Edema with hypertension, what is that due to?
KI Def & LR Yang rising
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If there is nausea and heavy bleeding after labor, what is that due to?
exhaustion of Chong
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If there is sweating and fever after labor, what is that due to?
exhaustion of Qi & Blood
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If there is post-natal depression, what is that due to?
LR Blood and HT Blood Def
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If there is post-natal psychosis, what is that due to?
Blood Stasis in the Uterus
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If there is a miscarriage before 3 months, what is that due to?
KI Def
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If there is a miscarriage after 3 months, what is that due to?
- Sinking of SP Qi
- LR Blood Stasis
- Blood Heat
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What are the characteristics of Preceded / Early period?
- Period comes consistenly up to 9 days early
- Cycle less than 28 days, 3 times of more in succession
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What are the characteristics of Delayed Period?
- Cycle longer than 28-30 days
- Cycle 40-50 days for 3 consecutive months
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What are the characteristics of Irregular Period?
Periods can come early or late
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What are the characteristics of mid-cycle bleeding?
- Bleeding occurs consistenly around Mid-cycle
- Bleeding may last 1-2+ days
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What are TCM pathologies of Preceded / Early periods?
- SP Def
- KI Def
- Blood Heat
- LR Fire
- Def Heat
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What are TCM pathologies of Delayed periods?
- LR Qi Stag
- Blood Def
- Cold / Damp
- KI Def
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What are TCM pathologies of Irregular periods (failing to fill uterus)?
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What are TCM pathologies of Mid-cycle bleeding?
- Hyperactive Minister Fire
- Damp-Heat
- Blood Stasis
- SP & KI Yang Def
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What are the characteristics of Heavy Menstruation?
Large volume of flow (80+ ml) and / or long duration of flow (7+ days)
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What are the characteristics of Scanty Menstruation?
Little menstrual flow or short menstrual duration
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What is the term for a women who never goes through puberty, the period has never started.
Primary Amenorrhea
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What is the term for periods start at puberty, then stop?
Secondary Amenorrhea
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When is Amenorrhea considered normal?
- Before puberty
- During pregnancy
- While breast feeding
- After menopause
- *prolonged amenorrhea can cause the problems associated with menopause (osteoporosis, heart and blood vessels disorder)
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What are TCM pathologies of Heavy Periods?
- Weak SP
- Heat
- Blood Stasis
- LR & KI Yin def leading Def Heat
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What are TCM pathologies of Scanty Periods?
- Blood Def
- KI Def
- Blood Stasis
- Damp accumulation
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What are TCM pathologies of Amenorrhea?
- Qi Stag and Blood Stasis / Qi Def and Blood Stasis
- Weak SP
- Weak KI Essence
- Damp-Phlegm
- Deficient LR & KI Yin
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This refers to menstrual pain that occurs before, during or after menstruation. The pain may occur in the lower abdomen or sacral region and sometimes, extends to the legs / thighs. In the severe cases, there may be nausea and vomiting even fainting.
Dysmenorrhea
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The type of dysmenorrhea starts from adolescence and is not associated with any organic disorder.
It is associated with uterine hyper-contractility, during contractions endometrial blood flow is reduced, and there is a correlation between minimal blood flow and maximal cramping pain.
Primary Dysmenorrhea
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This type of dysmenorrhea starts during adulthood and may be associated (although not necessarily) with organic diseases such as endometriosis, pelvic inflammation or myomas.
Secondary Dysmenorrhea
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What are possible causes of Dysmenorrhea?
- Endometriosis
- Pelvic inflammatory disease
- Pelvic congestion syndrome
- Fibriods
- Adenomyosis
- Cervical stenosis
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Pain occurs in the lowest part of the abdomen (pelvis) and may extend to the lower back or legs. The pain is cramping or sharp and comes and goes, but it may be a dull, constant ache. Usually the pain starts 1-3 days before or during menses, peaks afer 24 hours, and subdues after 2-3 days. What are these symptoms of?
Dysmenorrhea
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What are TCM pathologies of Dysmenorrhea?
- Excess:
- LR Qi Stag / LR Blood Stag
- Cold-dampness
- Def:
- Qi & Blood Def
- LR & KI Def
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This is a group of physical and psychologic symptoms that start several days before and usually end a few hours after a menstrual period begin.
- PMS - Premenstrual Syndrome
- *LR Qi Stag is a major cause of PMS
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