Chinese herb treatment of perimenopausal syndrome
The approach of perimenopausal treatment in Chinese medicine
a. Popular traditional herb formula
• Nourish Kidney Yin: Er Zhi Wan; Liu Wei Di Huang Wan; Zuo Gui Yin; Zuo Gui Wan.
• Nourish Kidney yin and clear deficient heat: Zhi Bai Di Huang Wan.
• Nourish kidney yin and calm down overactivity of Liver yang: Qi Ju Di huang wan.
• Nourish yin and reduce fire, coordinate between kidney and heart : Huang Lian E Jiao Tang
• Nourish heart yin and calm shen: Tian Wang Bu Xin Dan; Gan Mai Da Zao Tang; Bai Zi Yang Xin Wan; Bai He Di Huang Tang.
• Tonify kidney Qi: Gu Chong Tang, Da Bu Yuan Jian.
• Warm Kidney Yang: Jin Gui Shen Qi Wan; You Gui Yin; You Gui Wan.
• Promote water metabolism: Ling Gui Zhu Gan Tang; Zhen Wu Tang.
• Tonify qi or /and nourish blood: Si Wu Tang, Si Jun Zi Tang; Gui Pi Tang; Bu Zhong Yi Qi Tang; Shen Ling Bai Zhu San.
• Remove qi stagnation: Xiao Yao San; Chai hu Shu Gan San; Yue Ju Wan.
• Regulate liver qi and nourish liver yin: Yi Guan Jian.
• Calm liver and suppressing liver yang: Tian Ma Gou Teng Yin.
b. New herb formula from experts‘s experience
#1 formula of perimenopausal syndrome
ShanYao10g, shanYuRou10g, DanPi10g, FuLing10g, GouTeng15g, ZiBeiChi15g, LianZiXin5g. cook decoction with water. 1 dose a day.
Decoction of nourishing kidney and clear heat in the heart
GouTeng, DanPi, KuDingCha, ZiBeiChi, ZhiGuiBan, LianZiXin, ShanYao, HuangLian.
Decoction of nourish kidney and Liver with clear heat in the heart
TuSiZi20g, HanLianCao15g, NuZhenZi15g, FuLing15g, DanShen15g, ShanYuRou9g, SuanZaoRen9g, WuWeiZi9g, MaiDong12g, ZhiGanCao4g. cook with water. 1 dose a day.
Formula of nourishing Yin for menopause
HeShouWu, ShiHu, YinYangHuo, TuSiZi, ZhiMu, HuangBai, BaiShao, ZhenZhuMu, BaiHe, SuanZaoRen, XiangFu.
Formula for health menopause
ShengDiHuang, ZhiMu, HuangBai, GuiBan, BaiShao, GouQiZi, TuSiZi, RouCongRong, YinYangHuo, BaJiTian, FuLing, HuangLian. Cook decoction.
Decoction of nourishing Yin and clear heat
ShengShiGao15g, ShouDiHuang15g, MaiDong15g, ShaShen15g, DangGui10g, NuXi10g, TaiZiShen30g, XiaoMai30g, ShanZha20g.
ShouDiHuang25g, BaiShao20g, TuSiZi20g, HanLianCao20g, GouQiZi30g, NuZhenZi15g, GuiBan15g, ZhiMu15g, HuangBai15g, FuLing15g, LongGu15g, XianMao15g, YinYangHuo15g, HuangLian10g. cook decoction.
Formula for menopause
HuangJing20g, FuShen20g, CaoZaoRen20g, DangShen20g, ZhuRu20g, DiGuPi20g, ZhiMu20g, CangPu15g, YuJin12g, YuanZhi15g, MuDanPi15g, ZhiZiTan12g, ZhenZhuMu30g, BaiWei10g, GanCao10
Formula from famous doctor_Ha Li Tian(for mood change of perimenopause)
BaiShao10g, NuZhenZi 9g, HanLianCao 9g, DuZhong 9g, SangJiSheng 9g, BaiWei 10g, FuXiaoMai 24g, ShengMuLi 30g, WuWeiZi 3g, FuLing 9g, YuanZhi 6g, GanCao 6g.
Formula from famous doctor_Luo Yuan Kai
Kidney yin deficiency: ShengDi 10g, GouQiZi 10g, NuZhenZi 15g, ShanYao 20g, ZhenZhu Mu 20g, ShanYu Rou 12g, YinYangHuo 9g, JiXueTeng 30g, ZhiHeShouWu 30g.
Both Yin and Yang deficiency of Kidney: ShouDi 15g, GouQiZi 15g, BuGuZhi 15g, JiXueTeng 30g, ZhiShouWu 30g, ZhenZhuMu 20g, ShanYao 20g, YinYangHuo 12g, ShanYuRou 12g.
Formula from famous dictor_Zhu Nan Sun
NuZhenZi12g, HanLianCao12g, SangShenZi12g, BaJiTian12g, RouCongRong12g, ZiCao 30g, YuanShen12g, ShouWuTeng 15g, HeHuanPi 12g, HuaiXiaoMai 30g, ZhiGanCao 6g.
c. Treatment according to the differentiated syndrome
1. Deficient heat due to Yin deficiency
Manifestation: low back and knees ache and weak, dizziness, tinnitus, hot flush and perspiration, reddish tongue with less coating, thread and rapid pulse.
Treatment: liu Wei Di Huang Wan, or Zhi Bai Di Huang Wan modification.
2. Essence and blood deficiency
Manifestation: bone and joint sore, dizziness, poor memory, hair lose, teeth lose, light tongue, thread and weak pulse.
Treatment: Zuo Gui Wan modification
3. Hyperactivity of liver yang due to yin deficiency
Manifestation: dizziness, or headache, irritability, hot flush, eyes dryness, red tongue and less coating, thread and wary pulse.
Treatment: Qi Ju Di Huang Wan modification
4. Kidney Deficiency with Liver Qi Stagnation:
Manifestation: hot flush, dizziness, headache, low back soreness, depression, distension of breast, deep wary pulse
Treatment: Xiao Yao San + Zuo Gui Yin Modification
5. Heart and kidney disharmony
Manifestation: palpitation, restlessness, insomnia, dreaminess sleep, red tongue, thread and rapid pulse.
1.Liu Wei Di Huang Wan + Huang Lian E Jiao Tang modification
2. Tian Wang Bu Xin Dan modification
6. Deficiency of heart and spleen
Manifestation: palpitation and shortness of breath, amnesia and insomnia, sallow complexion, epigastric and abdominal distension, anorexia and loose stool, light red tongue with whitish thin coating, thin and weak pulse.
Treatment: Gui Pi Tang modification
7. Kidney yang deficiency
Manifestation: low back ache with cold sensation, aversion to cold, frequent night urination, light red tongue, deep thread and weak pulse.
Treatment: You Gui Wan modification
8. Yang deficiency of kidney and spleen
Manifestation: Heavy uterine bleed, back coldness and pain, aversion to cold, cold limbs, fatigue, poor appetite, loose stools, puffy face and edema of ankles, pale tongue and deep, slow pulse.
Treatment: You Gui Wan + Li Zhong Wan modification
9. Both deficiency of kidney yin and kidney yang
Manifestation: dizziness, tinnitus, poor memory, hot flush around face and low back ache with cold sensation, light red tongue, deep and weak pulse.
Treatment: Er Xian Tang + Er Zhi Wan modification.
Author ‘s experience _ Treatment of perimenopausal syndrome according chief complain
Menorrhgia or menometrorrhgia
1. Kidney yin deficiency
Manifestation: bright red color bleeding, hot flush, insomnia, palpitation, low back soreness, red tongue, thread and rapid pulse
Treatment: Zuo Gui Wan + Er Zhi Wan modification(add XianHeCao, EJiao)
2. Liver Qi stagnation with heat
Manifestation: deep bright red color bleeding, flush face, dizziness or headache, irritable, reddish tongue, slippery and rapid pulse.
Treatment: Dan Zhi Xiao Yao San modification
3. Spleen Qi deficiency
Manifestation: light red color bleeding, pale complexion, fatigue, poor appetite, bigger tongue with teeth mark, thread pulse
Treatment: Gu Chong Tang.(add PuHuangTan, YiMuCao, ZhiKe)
4. Yang deficiency of spleen and kidney
Manifestation: light red color bleeding, low back ache, low temperature of low abdomen, puffy face, loose stool, edema, light swollen tongue, deep weak pulse.
Treatment: You Gui Wan modification(add HuangQi, AiYe)
1. kidney yin deficiency
Manifestation: hot flush, dry throat, insomnia, thinner body shape, flush cheek, red tongue and smaller size, thread pulse
Treatment: Zuo Gui Yin, Er Zhi Wan, +HeShouWu
2. Both deficiency of kidney yin and kidney yang
Manifestation: hot flush, sweating, aversion to cold, fatigue, slightly over weight, normal tongue color or pale tongue color.
Treatment: Er Xian Tang, Er Zhi Wan +HeShouWu
3. Blood heat
Manifestation: hot flush, irritable, thirsty, yellow color urination, constipation, red tongue, rapid pulse
Treatment: Qing jing San, add BieJia, QinJiu
1.Heart yin deficiency and disharmony of heart and kidney
Manifestation: difficult to fall sleep, or dreaminess sleep, hot flush, palpitation, anxiety, canker sore, red tongue, thread pulse
Treatment: Tian Wang Bu Xin Dan, Bai He Di Huang Tang, Jiao Tai Wan
2. Deficiency of heart and spleen
Manifestation: difficult to fall sleep, stressful, over thinking, anxiety, poor memory, bigger tongue with teeth mark, thread pulse
Treatment: Gui Pi Wan
3. Liver Qi stagnation with heat
Manifestation: wake up in midnight and difficult to fall sleep again, depression, chest pain, headache or dizziness, purplish tongue and reddish color on the tip of tongue, wary pulse
Treatment: Chai Hu Long Gu Mu Li Tang + Suan Zao Ren Tang + YuJin, HeHuanPi
4. Hyperactivity of liver yang due to yin deficiency of liver and kidney
Manifestation: dreaminess sleep and restlessness, dizziness, or headache, irritability, hypertension, red tongue, superficial and strong pulse
Treatment: Tian Ma Gou Teng Yin + ZhenZhuMu.
1. heart and lung deficiency
Manifestation: sadness, often cry, feel empty, unsettle, difficult to concentration, weak pulse
Treatment: Gan Mai Da Zao Tang + Shen Mai Yin + YuanZhi
2. Liver Qi Stagnation
Manifestation: unhappy, depression, paranoid, isolation, or antisocial personality disorder, breast distension, bloating of abdomen, normal tongue, wary pulse
Treatment: Xiao Yao San + XiangFu, YuJin, HeHuanPi.
3. Heart and kidney deficiency
Manifestation: anxiety, panic attack, phobia, palpitation, insomnia, frequency urination, weak pulse
Treatment: Da Bu Yuan Jian + YuanZhi, WuWeiZi.