Bleeding during ovulation

[Guest guest]

Hi everyone,

 

My first post here... I'm a student at AIMC in Berkeley.

 

What is the significance in TCM of spotting/bleeding during ovulation? The

blood is bright

red and the flow is light. No lower back soreness, night sweats or other

predominant signs

of KI xu, although the KI pulses are a bit weak. Patient is 37 years old and

fairly healthy

except for some qi xu.

 

Could this be part of the qi xu pattern?

 

Thanks,

Chris

[Guest guest]

Hi, Chris

 

I think u r right as there is surely deficiency. However, u will get

confused as u mingle the concept of western medicine in pure tcm

diagnosis.

 

Tcm does not say ovulation ( u need to mark down the body

temperature in trace the ovulation period). TCM talks about

spotting. Spotting is a sign found in gyneocology so u look at the

disease and then u come up with different patterns such as blood

deficiency, blood heat etc. Jin Gui Yao Lue (Sypnosis of the Golden

Chamber) by ZHANG,Zhong-jing devotes THREE chapters taking about

gynecology 1800 years ago.

 

The pathomechanism of spotting may vary from liver kidney Yin

deficiency, spleen and kidney Yang deficiency, to blood stasis etc

and then u rule out the least likely and come up with diagnosis.

 

Apart from the knowledge from the book, u rely on clinical

experiences to enhance your clinical efficacy. Ex., women in this

age may have spotting after sex life due to biological reason

(pretty common). U r not convenient to do body check as a male

practitoner. Taking everything into considerations, u can see the

tree (signs) as well as the forest(disease). U then can easily come

up with an effective formula (apart from using acupuncture).

 

Spotting can be easily treated with tcm herbology once u hit the

right diagnosis. It is just like the case in another thread here

(Julia's lower back pain), u will achieve quicker efficacy once the

formula is added.

 

Since u r a tcm student so i talk a bit more, hope u do not mind.

 

Regards,

SUNG, Yuk-ming Phd(Chengdu)

[Guest guest]

Thanks very much for your reply. Based on her other signs & symptoms, I'd say

that SP &

KI yang deficiency are the more likely diagnosis. There are some signs of yin

deficiency as

well, but they are subtle and not as significant as the yang deficiency signs.

There is no

evidence of blood stagnation.

 

T is normal color, somewhat flabby with scallops on the side and a thin, white

coat. Pulse

is deep, weak and thin.

 

If you could recommend a formula for me to investigate that might be appropriate

for this

condition, I'd appreciate it.

 

Thanks,

Chris

 

Chinese Medicine , " sxm2649 " <sxm2649

wrote:

>

> Hi, Chris

>

> I think u r right as there is surely deficiency. However, u will get

> confused as u mingle the concept of western medicine in pure tcm

> diagnosis.

>

> Tcm does not say ovulation ( u need to mark down the body

> temperature in trace the ovulation period). TCM talks about

> spotting. Spotting is a sign found in gyneocology so u look at the

> disease and then u come up with different patterns such as blood

> deficiency, blood heat etc. Jin Gui Yao Lue (Sypnosis of the Golden

> Chamber) by ZHANG,Zhong-jing devotes THREE chapters taking about

> gynecology 1800 years ago.

>

> The pathomechanism of spotting may vary from liver kidney Yin

> deficiency, spleen and kidney Yang deficiency, to blood stasis etc

> and then u rule out the least likely and come up with diagnosis.

>

> Apart from the knowledge from the book, u rely on clinical

> experiences to enhance your clinical efficacy. Ex., women in this

> age may have spotting after sex life due to biological reason

> (pretty common). U r not convenient to do body check as a male

> practitoner. Taking everything into considerations, u can see the

> tree (signs) as well as the forest(disease). U then can easily come

> up with an effective formula (apart from using acupuncture).

>

> Spotting can be easily treated with tcm herbology once u hit the

> right diagnosis. It is just like the case in another thread here

> (Julia's lower back pain), u will achieve quicker efficacy once the

> formula is added.

>

> Since u r a tcm student so i talk a bit more, hope u do not mind.

>

> Regards,

> SUNG, Yuk-ming Phd(Chengdu)

>

[Guest guest]

Hi,Chris

 

I am glad u r interested in gyn as most of tcm patients are females and

TCM works like magic for most gyn. diseases. I do not mind recommending

a formula to you for discussion purpose but I lack the most basic data

about your patient. How is her period in general? Is this her first

complaint about her condition or it has been around for a few months?

And how it relates to the sexual thing. Every detail is cruical when a

formula is required for an individual. If it is inconvenient to post

here, u can pm me. Thanks.

 

Regards,

SUNG, Yuk-ming

[Guest guest]

Thanks again for your reply. The patient has a regular cycle every 28 days.

She describes

flow as " medium " , lasting on average 4-5 days. Blood is bright red with no

clots. This

condition has been present for the last three months.

 

She exhibits other signs of SP qi/yang deficiency, such as fatigue, loose stool

and a

tendency to feel cold. There may also be heat in the ST or LI/LU: she has

recurring

pimples (mild acne) on her face (on the ST & LI channel), and complains of

itching all over

her body for the past several days.

 

Chris

 

Chinese Medicine , " sxm2649 " <sxm2649

wrote:

>

> Hi,Chris

>

> I am glad u r interested in gyn as most of tcm patients are females and

> TCM works like magic for most gyn. diseases. I do not mind recommending

> a formula to you for discussion purpose but I lack the most basic data

> about your patient. How is her period in general? Is this her first

> complaint about her condition or it has been around for a few months?

> And how it relates to the sexual thing. Every detail is cruical when a

> formula is required for an individual. If it is inconvenient to post

> here, u can pm me. Thanks.

>

> Regards,

> SUNG, Yuk-ming

>

[Guest guest]

Hi, Chris,

 

To summarize your case,

 

Causation: Spleen and Kidney Yang deficiency

Pathomechanism: Spleen deficiency failing to govern the blood, blood

deficiency with stasis

Diagnosis: Advanced menstruation

Methods of treatment: Qi and blood-supplementing, blood-checking

Formula: Si jun zi tang (Four gentlemen Decoction) with modifications

Medicinal:

dang shen, tu si zi, mu li, long gu, bai zhu, mixed-fried gan cao,

huai hua, nan sha shen, pu huang, fu ling, qian cao gan, gu ya, mai

ya, and hua ju hong(sbustitute with chen pi if u don't have that).

Add shan yao if her appetite is not good.

 

Use regular volume. Take 3 decoctions if using raw herbs or six with

grandule form. Daily. It does not matter if u cannot find one or two

ingredients here as the formula will work on the whole.

 

That is for your reference and pl. feel free to modify.

 

SUNG, Yuk-ming

[Guest guest]

Yuk-Ming,

 

I am very grateful for your help! I will study the formula and consider any

modifications

that might be appropriate, but I think this will be helpful for the patient in

question.

 

Thanks again,

Chris

 

Chinese Medicine , " sxm2649 " <sxm2649

wrote:

>

> Hi, Chris,

>

> To summarize your case,

>

> Causation: Spleen and Kidney Yang deficiency

> Pathomechanism: Spleen deficiency failing to govern the blood, blood

> deficiency with stasis

> Diagnosis: Advanced menstruation

> Methods of treatment: Qi and blood-supplementing, blood-checking

> Formula: Si jun zi tang (Four gentlemen Decoction) with modifications

> Medicinal:

> dang shen, tu si zi, mu li, long gu, bai zhu, mixed-fried gan cao,

> huai hua, nan sha shen, pu huang, fu ling, qian cao gan, gu ya, mai

> ya, and hua ju hong(sbustitute with chen pi if u don't have that).

> Add shan yao if her appetite is not good.

>

> Use regular volume. Take 3 decoctions if using raw herbs or six with

> grandule form. Daily. It does not matter if u cannot find one or two

> ingredients here as the formula will work on the whole.

>

> That is for your reference and pl. feel free to modify.

>

> SUNG, Yuk-ming

>