gyno Flashcards
(244 cards)
1
Q
causes of irregular period
A
liver qi stag
heat in blood
qi xu
cold in uterus
yang xu
blood stag
2
Q
liver qi stag cycle symptoms
A
period 7 or more days before or after expected period, breast distension, abdominal and hypochondriac distension, irritability, frequent sighing, belching. Pulse wiry, tongue red sides
3
Q
stress reduced hormone output partially so there is a minimum amount of LH to luteinise a follicle without ovulation occurring
A
liver qi stag
4
Q
period that comes sooner than 27 days after last period, either excess or xu
A
early cycle
5
Q
early onset period, sudden onset, often with profuse, heavy flow, red with no purple or clotting, other symptoms
A
heat in the blood
6
Q
potential causes of early cycle
A
excess internal hear (anxiety, infection)
yin xu with yang excess (false heat)
overconsumption of warm or pungent foods
overuse of warming herbs acting on the uterus
liver qi stag transformed into fire
7
Q
unable to lift yang and contain blood, thin, light and watery consistency, early onset, sooner than 27 days with no force.may e accompanied by brown spotting almost immediately
A
(spleen) qi xu
8
Q
causes blood stag, dark and clotted period, abdomen feeling cold with palpation, tongue pale purple, pulse tight and deep
A
cold in the uterus
9
Q
impedes menstrual flow, BBT needs to rise due to progesterone, if progesterone is xu, yang will not rise, it will take longer for the cycle to function, will feel more fatigued than cold, but prefers warmth and pressure
A
yang xu
10
Q
develops as a long term consequence of retained cold, retained damp heat or kidney xu, sea of blood will not be filled or empty completely, negatively impacts the function of the heart, since it controls blood circulation, pulse tight and thready, tongue dark purple, history of clotted and/or painful periods
A
blood stag
11
Q
has the same time period between each menses, controlled consistent flow, asymptomatic, clear and concise start and stop
A
regular menses
12
Q
if the period starts in the evening or overnight, no matter how heavy the flow is, the next day is counted as
A
day 1
13
Q
day 1 of menstrual cycle
A
first day of RED bleeding
14
Q
both oestrogen and progesterone are low to enable the uterine lining to shed, pituitary gland starts to produce FSH and LH to stimulate new follicles growth
A
day 1-5 of menstrual cycle
15
Q
one of the follicles evolves and starts to produce oestrogen
A
day 7 of menstrual cycle
16
Q
high levels of oestrogen stimulates the endometrium to thicken and the cervical mucus glands to produce fertile mucus
A
day 7-12 of menstrual cycle
17
Q
continuing high oestrogen acts on pituitary gland to stimulate it to produce a surge of LH which matures the dominant follicle
A
day 12-13 of menstrual cycle
18
Q
egg is released from follicle
A
day 14 of menstrual cycle
19
Q
corpus luteum forms from the empty follicle and produces progesterone
A
day 15-25 of the menstrual cycle
20
Q
corpus luteum dies causing progesterone and oestrogen levels to drop, causing endometrium to disintegrate and period to start, pituitary gland is stimulated to produce FSH and LH to start the next batch of follicles
A
day 25-28 of the menstrual cycle
21
Q
regular cycle is considered between
A
27 and 34 days
22
Q
the luteal phase should be ____ to be considered fertile
A
10-16 days long
23
Q
BBT
A
basal body temp
24
Q
kidney yin xu
A
increasingly common. older women, overwork
25
kidney yang xu
constitutional, injury by cold, overwork, longterm yin/qi xu or heart/liver stag
26
jing xu
constitutional, prolonged hormone treatment, prolonged illness
27
blood stag
prolonged cold, damp heat, kidney xu
28
liver/heart stag
sudden shock, prolonged anxiety, historical trauma
29
phlegm damp accumulation
infection, excess rich and sweet diet (obesity), PCOS, often develops secondary to previous symptoms
30
excessive menstrual flow
menorrhagia or flooding
31
bleeding outside the expected cycle
metrorrhagia
32
factors causing menorrhagia
blood heat - profuse, bright red
blood empty heat - less heavy, prolonged spotting at end, red colour
qi xi - spleen yang, kidney yin/yang. flooding at beginning or prolonged spotting, pale red
blood stasis - excess loss during period, possibly loss before the period. dark and clotted
33
menorrhagia treatment
harmonize blood
treat the root cause
astringe
treat qi
34
how to harmonize blood
stop bleeding - sp8 w moxa, r6, du20
eliminate stasis - sp10, stm36, lv8, r4, r6
calm blood - lv2, kd2, sp6, li11
nourish blood - st36, r6, st30, sp6, lv8
35
sudden flooding, trickling red flow for long after, bright red colour, thirst, red face, agitation, feeling of heat, dark urine, constipation, tongue red with yellow coating, pulse rapid and overflowing
blood heat
36
treatment principle for blood heat
clear heat, stop bleeding, cool blood
sp4 and pc6 open sea of blood to control all blood
li11, sp10 to cool blood and stop bleeding
sp8 stops uterine bleeding
kd5 cools uterine blood
sp6 moves and cools blood
37
sudden flooding outside of expected dates, trickling for many days after expected end, fresh red colour, watery texture, mental restlessness, evening heat, malar flush, scanty dark urine, dry stool, tongue red no coating, pulse floating and empty
blood empty heat
38
treatment principle for empty blood heat
clear empty heat, stop bleeding, cool blood, nourish yin
kd2, lv3 cool blood, clear false heat
li11, sp10 cool blood and stop bleeding
sp8 stops uterine bleeding
kd5 coold blood in uterus
sp6 cools and moves blood
r4 nourishes yin
39
hesitant start and intermittent flow, when it starts again after stopping it floods, trickling flow for a long time after end, premenstrual pain, dark colour and clotted, abdominal distension, dark complexion, tongue purple/red, pulse choppy
blood stasis
40
treatment principle for blood stasis
move blood, eliminate stasis, stop bleeding
lv3 free flow of qi to move blood
lv1 moves liver blood, stops bleeding
sp8 stops uterine bleeding
sp4 and pc6 moves blood and subdue rebellious qi
sp6 cools and moves blood
sp10 moves blod, stops bleeding
st30, sp 12 are penetrating vessel, moves blood
41
menstrual bleeding either scanty or abundant, mid cycle bleeding, sticky blood mixed with significant amounts of mucus, yellow brown discharge premenstrually, no clots, heavy, dragging sensation in lower abdomen, chest oppression, scanty dark urine, burning urination, significant vaginal discharge, coating sticky yellow, pulse slippery
damp heat in uterus
42
treatment principle for damp heat in uterus
clear heat, resolve damp, cool blood, stop bleeding
li11 sp10 cool blood, stop bleeding
sp8 stops uterine bleedings
sp4, pc6 open the penetrating vessel to move blood and subdue rebellious qi
sp6 cools and moves blood
sp1 empirical point to stop uterine bleeding
sp9, r3, resolve damp heat in lower jiao
bl22, bl32 promote transformation of fluids, resolve lower jiao damp heat
43
period comes with a flood, turns to trickle for long time after initial flood, pale colour, watery consistency, pale face, tiredness, slight dizziness, no appetite, loose stool, tongue pale with teethmarks, pulse weak
spleen not holding blood
44
treatment principle spleen not holding blood
tonify qi, strengthen spleen, nourish blood to stop bleeding
r6t tonifies qi, stops bleeding by stopping qi sinking
sp6, st36, r12, bl20, bl21 tonify spleen qi
du20 raises qi, stops bleeding from sinking qi
45
prolonged bleeding, trickle for a long time after proper period, late onset period, late onset period, pale colour, felling cold, sore back, cold limbs, pale complexion, weak knees, pale urine, tongue pale and swollen, pulse deep and weak
kidney yang xu
46
treatment principle for kidney yang xu
tonify and warm kidneys, consolidate chong, stop bleeding
r6 tonifies qi, stops bleeding
bl23, r4 (moxa) tonify and warm kidney yang, nourish chong
st30 (moxa) tonifies chong
kd7 tonifies kidney yang
st36, sp6 tonify qi and blood
47
trickling after regular flow, late onset cycle, fresh red and watery consistency, dizziness, tinnnitus, weak knees, evening heat, night sweats, hot flash, malar flush, mental restlessness, tongue red, no coating, pulse floating and empty
kidney yin xu
48
treatment principle kidney yin xu
nourish yin, strengthen kidneys, stop bleeding
r6 tonifies qi, stops bleeding
bl23, r4 (no moxa) tonify and warm kidney yang, nourish chong
kd3 tonifies kidney
kd2 clears empty heat from kidney
st36, sp6 tonify qi and blood
49
xu of menstrual cycle - period that is three days or shorter with extremely light, scanty flow
hypomenorrhea
50
phase of the menstrual cycle from day 1 to ovulation, driven by estrogen, known as the follicular phase
yin phase
51
focus on moving blood, chong vessel starts to empty, ren vessel drives blood downwards, stagnant qi is moved, body temp drops
day 1-3
52
what points for day 1-3 of cycle
sp6, sp10, lv3, li4, st28, st30, r4, kd14
53
rebuilding the endometrium starts on day
2-3
54
day when we switch the treatment focus from moving stagnation and invigorating blood flow, endometrium should be 1-2mm thick and remodelling is complete
day 5-6
55
what points for day 5-6
r4, kd3, 4,5,6,8,13, st27,30,36, bl23,32, lv3, pc6, sp4,6,10
56
what is considered the transition from yin to yang
ovulation
57
treatment principle to invigorate ovulation
kd4,5,8,13,14, sp 5,6,8,13, pc5,6, ht5,7, gb26
58
from ovulation to end of cycle/pregnancy, known as luteal phase because it is driven by the corpus luteum, progesterone elevates BBT and therefore considered yang natured, tonify yang to support progesterone, warm uterus to nourish blood flow, lift and support yang
yang phase
59
emotional stress at the time of ovulation can inhibit egg release, period 7 or more days either before or after expected date, breast distension, abdominal and hypochondriac distension, irritability, frequent sighing, belching, pulse wiry, tongue red on sides
liver qi stagnation
60
defined as a period that comes sooner than 27 days after the last period, typically has two diagnostic patterns, excess or xu, the actual condition of the period will also enable diagnosis along with general health, tongue and pulse
early cycle
61
most common cause of amenorrhea
kidney yin xu
62
infrequent or no periods, no fertile mucus, dizziness, low back pain, 5 palm sweats, night sweats, red tongue, no coating
kidney yin xu
63
prolonged yin xu will lead to
yang collapse
64
treatment principle for kidney yin xu
reinforce yin and nourish blood
r4,7, kd3,4,5,6,8,13, st27,30,36, bl23,32, lv3, sp4, pc6, sp6,10, kd12
65
points for kidney yang xu
bl20,23,32, r2,3,4,6,12, st25,36, sp6, kd3
66
pale complexion, dizziness, fatigue, poor diet, overwork, restless, dreamful sleep, anxiety, cold extremities, abdominal bloating, poor appetite, pale tongue, thready pulse
blood xu
67
blood xu treatment principle
nourish blood, nourish spleen qi, support kidneys
r12, st36, bl20, sp6, kd13, st30, ht7
68
life events causing stopped period
heart qi stag affecting hormones via pituitary
69
amenorrhea, insomnia, dreamful sleep, palpations, anxiety, fear, restlessness, history of trauma, pulse choppy and rapid, tongue red tip
heart qi stag
70
heart qi stag treatment principle
p5, 6, ht7, kd3, sp 6, kd19, r4,14
71
long term breastfeeding can cause
liver qi stag
72
if liver fire rises and invades the stomach channel it may force menstrual blood
upwards and appear as (bloody) milk secretion from the nips
73
irritability, headaches, milk secretions, chest oppression, anorexia, long term use of medication, breast distension, tongue red sides, pulse wiry
liver qi stag
74
liver qi stag treatment principle
lv2,8, pc5,7, lv14, st18, sp4
75
post pill amenorrhea treatment principle
lv1,5,8, 11, r3, st30, r1
76
defined as pain before, during or after menstruation , may be located in abdomen or lumbrosacral region
dysmenorrhea
76
menostaxis
prolonged, excessive bleeding outside of the usual cycle, or amenorrhea
76
causes of dysmenorrhea
emotional strain, anger, frustration, resentment, hatred leads to liver qi stag
cold and damp exposure during puberty, exposure of low abdomen/back or ankles, most likely to get cold path after the period
overwork and chronic illness leads to qi and blood xu, specifically affects spleen and stomach, general blood xu results in chong and ren vessels empty, blood xu leads to blood stasis and pain
excess sexual activity/childbirth, both deplete liver and kidney qi
76
most dominant factor of dysmenorrhea
stagnation of qi and/or blood
blood/liver and kidney xu causing blood stag
77
front menstrual pain is
liver
78
things to consider when diagnosing
time of onset, pressure, heat/cold, location of pain, cycle, character of pain
79
time of pain onset
before or during - full condition
after - empty condition
80
cycle blood type
prolonged with dark clotted blood - blood stasis
red blood with small dark clots - cold in uterus
short cycle, heavy flow, bright red - blood heat
81
character of pain
better after passing clots - blood stasis
pronounced feeling of distension - qi stag
burning pain - blood heat
cramping pain - cold in uterus
stabbing pain - blood stasis
pulling pain - blood stasis
bearing down before the start - blood stasis
bearing down after the period - kidney xu
82
lower abdomen pain either during or a couple days before period, improved by passing clots, breast and abdomen distension, period hesitant to start or typically late, dark flow with clots, premenstrual tension and irritability, tongue purple pulse choppy or wiry
qi and blood stagnation
83
qi and blood stagnation treatment principle
move blood and qi eliminate stasis and stop pain
lv3, r6, gb34, sp8, st29, sp10,6, lg7 and kd6, pc6 and sp4
84
lower abdomen pain before or after the period, pain more central location, relieved by application of heat, menstrual flow scanty, bright red with dark clots, feeling cold, sore low back, tongue pale blue or blue purple, pulse deep, choppy or wiry
stagnation of cold
85
stagnation of cold treatment principle
warm uterus, expel cold, move blood
r4,6 with moxa, st29, sp8,6, st36
86
hypogastric pain before the period and sometimes mid cycle, burning sensation extending through the abdomen to sacrum, general feeling of heat, menstrual flow with red small clots, significant vaginal discharge, yellow colour, scanty dark urine, tongue red, coating sticky and yellow, pulse slippery
damp heat
87
damp heat treatment principle
clear heat, resolve dampness, eliminate stasis
sp6 and sp9, lg7 and kd6, r3, st28, bl32,22
88
dull hypogastric pain towards or at end of menses, dragging sensation in lower abdomen, pain relieved by pressure and massage, scanty menstrual flow, pale complexion, chronic tiredness but worse after menses, slight dizziness, loose stool
qi and blood xu
89
qi and blood xu treatment principle
tonify qi, stregthen spleen, nourish blood
r4,6, st36 and sp6, sp8, bl20,17
90
dull hypogastric pain towards or and end of period, sore lower back, dizziness, worse after period, scanty bleeding, pain relieved by pressure or massage, tinnitus, blurred vision, exhaustion, tongue red, coating peeled, pulse floating, empty
kidney and liver yin xu
91
kidney and liver yin xu treatment principle
nourish yin, tonify kidneys, nourish liver
bl23,18, R4, sp6 and kd3 st36
92
three possible causes of leukorrhea
spleen xu, kidney xu, damp heat
93
excess mucous vaginal discharge
leukorrhea
94
leukorrhea treatment principle
tonify spleen, warm middle jiao, remove damp, regulate ren and dai
r6, bl26,30, sp9, st36, tonify all, moxa applicable
95
profuse and continuous discharge, mucus thin and opaque or transparent, severe lumbar soreness, frequent and excessive urine, loose stool, severe fatigue, cold sensation in lower abdomen, tongue pale, coating thin, pulse deep
kidney xu leukorrhea
96
kidney xu leukorrhea treatment principles
tonify kidney yang, stabilize and contain ren and dai, resolve leukorrhea
bl23, r4, kd12, bl26
97
infertility phase one - menses
open the uterus, encourage smooth and strong downward flow p6, sp4, p5
move blood and regulate chong kd14
cool blood if yin xu heat is evident sp10
remove obstructing blood flow sp8
regulate and move qi in uterus/lower jiao bl25,30,32
moderate descending action r6
98
infertility phase two - kidney yin and blood
this is the most crucial phase to building a fertile cycle
treatments must be as precise as possible to influence production of a new endometrium and allow the egg to mature to its fullest potential
the endometrium should be min 8mm thick at the end of this phase
also determines how well an embryo can implant
start building yin and blood at day 4
if menses is short start at day 3
assessing cervical secretions is the most reliable way to measure yin
address kidney jing xu
99
infertility patterns in phase 1 and 2
kidney yin xu
kidney yang xu
kidney jing xu
heart and liver qi stag
blood stag
phlegm damp obstruction
100
nourish kidney jing points
kd12 and st27
101
balance ren and chong vessels
r7, kd5,8,13
102
lower back pain accompanied by abdomen pain and
cant feel pulse, labour starting within 12-24 hrs
103
development of fetal meridians
week 1-4 liver
week 4-8 gall bladder
week 8-12 pericardium
week 12-16 san jiao
week 16-20 spleen
week 20-24 stomach
week 24-28 lung
week 28-32 large intestine
week 32-36 kidney
week 36-40 bladder
can needle if needed, avoid for general pregnancy treatment
104
avoid strong stimulation during pregnancy (especially first trimester) unless
inducing labour
threatened miscarriage from spleen qi sinking
104
points to avoid
li4 and sp6 used to induce labour
gb21 strong downward action, makes qi sink (for induction)
bl32,bl32 used to induce labour
bl67 only needle to induce labour - moxa daily to turn breech baby
abdominal points
104
3 organs most commonly affected by change in qi circulation
spleen, liver, kidney
104
questions for morning sickness
time of day
any pain or dull ache
how does eating affect
how does activity affect
presentation of morning sickness
what is content of vomit
any thirst
any taste in the mouth
105
stimulate chong vessel
sp4, st30
106
emphasize kidney yin development
kd3,5,6, sp6, bl23, r4
106
encourage blood production
st36, lv3, sp10
106
resolve phlegm damp
r9, sp9, sp5, gb26
107
move liver qi stag
lv3,5
107
harmonize the shen
ht5,7, pc6
108
infertility phase three - ovulation
at the end of phase two begin to build yang (when yin grows it will consume yang)
ovulation is the transition from yin to yang
to ensure ovulation is successful we must boost yang quickly and effectively for ~4-5 days
if yang is very xu you should begin to nourish during the follicular phase while also nourishing kidney yin
when yin foundation is strong we can switch the focus to drastically move qi and blood
it is crucial that heart and liver remain clear and calm, choose points to maintain flow
109
cool heart/liver fire if necessary
ht5,8, pc7, lv2
110
mid cycle bleeding
can be caused by dramatic peaks and falls of estrogen
most likely to occur is endometrium structure and quality has not been firmly established in follicular phase
tcm-chong vessel not fortified due to yin and blood xu
may also signify heat in the blood - pc4
111
infertility phase four - post ovulation
implantation depends on the embryo quality, so nourishing kidney jing to enhance gamete quality should always be done
by the time of phase 4 nothing can be done to change the quality of the embryo
now we focus on the environment for the embryo to finish
maintain kidney yang
inadequate progesterone - kd yang xu
112
methods to boost yang
boost kidney yang by tonifying kidney yin
boost kidney yang by promoting qi
boost kidney yang by nourishing blood
113
boost kidney yang by tonifying kidney yin
reinforce and invigorate kidney yin and yang r2,4, kd3,6, bl23
regulate qi in uterus r5
regulate activity of chong and ren r7
calm the mind r15
114
boost kidney yang by promoting qi
invigorate spleen and stomach qi r12,6, st36,25, bl20, sp6
support development of kidney yang r4, kd3, bl23
regulate qi in ren channel r5
115
boost kidney yang by nourishing blood
directly influence blood formation bl17, sp10
enhance blood formation though kidney yang kd5, st36, r12, sp6
support kidney yin and yang r4
invigorate qi and blood of all zang bl17, r17, lv8
115
heart liver qi stag treatment
regulate liver qi lv3,5,11,13,14, gb34
regulate liver fire (anger) lv2
nourish liver blood (to temper qi stag) lv8
regulate qi in uterus lv5,8,11, kd5, ht7
resolve emotional tension lv5
calm the mind and shen pc5,6,7, ht5,7
regulate qi in ren and liver channels r3
116
blood stasis treatment goals
regulate qi and blood st28,29
assist embryo passage down fallopian tubes r6, st36
resolve blood stasis to assist implantation sp10, lv3
regulate blood in uterus lv5,8, kd14, sp6,8, r3
regulate kidney and ren channels kd5,9
117
phlegm damp accumulation treatment goals
transform and distribute fluids r9
resolve damp by increasing kidney yang r3,6
resolve phlegm from fallopian tubes gb26,27,28
regulate fluids in lower jiao bl22,28,32
support spleen action of transforming fluids sp9,6
118
IUI
inter uterine insemination - used as an aid to natural conception, sperm is collected, washed, and treated with a protein drink and inseminated during natural ovulation cycle
118
IVF short protocol
exactly the same as long protocol but without 3 weeks downregulating meds
does not consume yin in the same way as long term
not used as often
118
ART
assisted reproductive techniques
includes medications, interventions, and donor gametes
118
blood heat miscarriage
bright red, profuse bleeding, sudden onset, accompanied with febrile symptoms if due to infection, anxiety is a big trigger - causes heat in the heart which disturbs the uterus via the bao mai vessel, extreme anger - liver fire, restless and agitated, thirst, dark urine, constipation, pulse rapid
118
kidney qi xu miscarriage
spotting, low back pain, ache or soreness, sore legs, fatigue, frequent urination, low progesterone, tongue pale, pulse weak and soft
kidney pulse should be firm, solid and slightly slippery in a healthy pregnancy
118
IVF - long protocol
woman is given downregulating drugs to switch off her natural hormone cycle, putting her into 'false menopause'
symptoms can vary in severity but are all yin xu symptoms
IVF affects kd, ht, lv, st yin, create ht and lv blood xu, LQS and shen disturbance
118
ICSI
intracytoplasmic sperm injection - if sperm are unable to fertilize egg effectively or at all, during IVF the sperm will be chosen and directly injected into the egg
119
post miscarriage treatment
move qi and blood, sink qi
if possible treat while the person is actively bleeding
119
threatened miscarriage
presents with pink, red or brown spotting following positive pregnancy test
lower back ache, lower abdominal cramps, heavy PMS pain
bleeding may be functional, indicating new growth phase
119
blood xu miscarriage
scanty, watery bleeding, fatigue, palpitations, small fetus for dates, anemia, pale complexion, tongue pale
119
causes of miscarriage
embryo DNA failure
multiple fertilizations of 1 egg
kidney jing and yin xu (age)
difficult implantation due to endometrial abnorm
excess phlegm/damp obstructing implantation
cold womb - yang xu - typically low progesterone
blood and yin xu- thin dry uterine lining
119
causes of blood heat miscarriage
yin xu heat
prolonged IVF patients whose yin has been consumed by meds
infection of the endometrium, a UTI or flu
treat with low dose Tylenol
119
spleen qi sinking miscarriage
abdominal distension and heaviness, bearing down or sagging sensation, spotting, fatigue, nausea worse for exertion, cervix may be slightly open, pulse weak
120
blood stasis miscarriage
IVF procedures cause stasis, should be addressed after embryo transfer so not interfering with implantation, fibroids and endometriosis, physical traumas, terminations, previous miscarriages, traumatic births, blood clotting disorders, sharp, stabbing or cramping abdominal pain, dark bleeding with clots, tongue purple, pulse choppy
121
inevitable miscarriage
if the fetus has stoped growing and deceased in the first trimester TCM can be used to expel the products of pregnancy, instead of surgical intervention D&C
122
post miscarriage
invigorate blood without causing haemorrhaging, sp10, lv1, r6, sp8 can regulate blood and qi to stop excessive bleeding, post miscarriage is it vital to recover qi and blood and strengthen kidney, spleen and heart yang
st36, sp3,6, lv13, r12, bl20, r6, kd3,6, lg7, pc6&sp4, sp10
123
spleen and stomach xu morning sickness
pre existing xu allows qi and blood to accumulate in chong and counterflow upward - nausea
spleen xu - inability to T&T food to produce enough blood to meet the increased demand from fetus
spleen and stomach disharmony nausea, vomiting, poor appetite, abdominal distension and fatigue
spleen and stomach xu - weakness, lethargy, slow movements, feeling better after eating and resting, sickness worse in the morning, tongue pale, coating white, pulse loose and slippery
124
liver and stomach disharmony
LQS is partly necessary to prevent energy from moving freely and negatively affecting the fetus, liver stores blood, governs smooth flow of qi of all meridians, liver qi helps spleen transform food and qi of all meridians, liver qi helps spleen transform food and qi and ascend, helps stomach digest food and descend
125
liver and gallbladder disharmony
presents similarly to liver and stomach disharmony, with more pronounced nausea and bile regurge, may present as depression, irritability, fullness or heaviness in chest of hypochondruim
126
points review
p6 relaxes chest and diaphragm, moves qi stag in upper and middle jiao, relieves nausea
st36 helps treat xu patterns and rebellious stomach qi works with p6 and r12
r10 food retention in stomach p6
r12 calms rebellious qi, xu based nausea
r14 helps qi descend
st19,20 moves epigastric fullness, helps nausea better for vomiting
st21 combined with st44 for stomach heat
st34 used for excess conditions, p6
st40 pairs with p6 to resolve phlegm
kd21 pairs with st19 and r12 for patient cant stop vomiting emergency
sp4 and p6 strong treatment so only use if patient has persistent condition that isint responding to other points
127
PRIMARY CAUSE OF PCOS
dampness
128
endocrine imbalance
spleen qi xu
129
hirituism is
disharmony between chong, qi and blood, blood xu in uterus leads to excessive chong at skin level leading to facial hair
130
ovarian cysts
abdominal masses as a result of damp phlegm accumulating
131
PCOS patterns
there is always damp phlegm
there is always kidney xu, typically kidney yang xu
may be blood stasis, blood xu or damp heat in liver (based on symptoms)
132
treatment of PCOS
use extraordinary vessels to clear damp phlegm from uterus and tonify kidneys
SJ to balance the flow of water passages with sj4
harmonize water with st28, r9, du26
clear fluids from ren r17, r9, r5
gb 26
ren mai - lg7 (left) and kd6 (right)
chong mai - pc6 (left) and sp4 (right)
du mai - si3 (right) and bl62(left)
133
spleen and kidney yang xu PCOS
kidney yang fails to warm spleen yang- unable to transport fluids - damp
scanty or no periods (spleen not producing .blood)
irregular bleeding (spleen not containing blood)
underdeveloped breasts (kidney essence xu)
cold back ache (kidney yang xu)
tiredness (spleen yang not producing daily energy)
dizziness (spleen not making blood to nourish marrow)
poor appetite ( spleen unable to process food) tongue ale, wet, pulse weak, axc.
134
excess patterns of PCOSq
damp phlegm obstructing uterus
accumulation of damp/heat
blood stasis
liver fire with damp heat
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xu patterns of PCOS
spleen and kidney yang xu
blood xu
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damp phlegm obstructing uterus PCOS
scanty or no periods (clogged uterus lining)
obesity (damp phlegm)
excessive hair (phlegm obstructing uterus disturbs hormone balance)
chest oppression (damp interferes with lung dispersing fluid)
abdominal masses (phlegm accumulation)
excessive vaginal discharge (damp in lower jiao)
tongue swollen, coating sticky, pulse slippery
137
damp heat
abdominal heaviness and fullness (spleen not able to transport fluids from middle jiao)
overweight (spleen not able to transform food into qi and transport it around the body)
acne (accumulation of damp when yellow pus indicates heat)
excessive yellow or odoured vaginal discharge (damp heat in lower jiao)
mid cycle pain and heaviness (damp obstructing ovulation)
pulse slippery, rapid, coating sticky, yellow
138
liver fire and damp heat PCOS
the least frequent pattern of PCOS
amenorrhea or irregular bleeding liver (fire consuming blood)
excessive hair growth hormonal imbalance = liver not freely moving qi
large red spots on buttocks yellow pus filled (damp heat)
headaches on top of head as liver fire rises or distending, muxxy pressure with damp
breast distension (liver not freely moving qi)
yellow vaginal discharge (damp heat in lower jiao)
tongue red sides, coating sticky, yellow, pulse wiry, rapid
138
blood stasis PCOS
imbalanced chong, ren and uterus, phlegm obstructs blood circulation
painful, dark, clotted periods (blood not flowing smoothly)
irregular periods (blood not fulling chong regularly)
abdominal pain (sharp, stabbing nature a blood stagnated)
tongue purple all over or at sides, pulse wiry, choppy
139
spleen and kidney yang xu PCOS
kidney fails to warm spleen yang - spleen yang unable to transport fluids = damp - spleen unable to transform food into qi
scanty or no periods (spleen not producing blood)
irregular bleeding (spleen not containing blood in vessels)
underdeveloped breasts (kidney essence xu)
cold backache (kidney yang xu)
tiredness (spleen yang not producing daily energy)
dizziness (spleen not making blood to nourish marrow)
poor appetite (spleen unable to process food)
tongue pale, wet, pulse weak, deep
140
endometriosis symptoms
dysmenorrhea, pelvic pain, lower back pain radiating down anterior thigh, heavy periods, irregular bleeding, pain on deification, rectal pressure, tender ovaries, infertility, painful intercourse
141
triggers for blood stasis in uterus (endometriosis)
cold invading uterus, tampons, emotional stress, damp accumulation, intercourse during puberty
emotional stress causes liver qi to stagnate which prevents blood from flowing smoothly
142
xu endometriosis patterns
spleen qi xu, kidney yin xu, kidney yang xu, blood xu
if spleen is too weak to make blood liver will also become xu - spleen qi xu will lead to kidney yang xu
143
non consensual sexual activity results in
liver qi stag
144
the root of endometriosis is
always kidney xu - typically yang but may be yin or yang
145
patterns of endometriosis
liver blood stasis
cold stag
damp accumulation
damp phlegm in the uterus
kidney yang xu
kidney yin xu
blood xu
spleen qi xu
146
general treatment endometriosis
phase one - invigorate blood
phase two - tonify kidney, nourish blood and yin
phase three (ovulation) - tonify kidney and spleen, resolve dampness
phase four - invigorate blood, tonify yang to expel cold, resolve damp
147
liver blood stasis endo
intense stabbing pain before or during period (liver unable to regulate smooth flow when fullest)
pain is relieved for passing clots (excess blood stasis)
dark blood with large clots (qi not circulating blood)
irritability (liver not governing smooth flow)
mental restlessness (liver not governing smooth flow, not controlling blood to fill heart volume)
tongue purple, pulse wiry or choppy
148
cold accumulation endo
painful period better for heat (cold contracts qi and blood flow)
pain is central lower abdomen (uterus location)
scanty red menstrual flow with small dark flecks of clots (cold obstructing blood flow to endometrium)
feeling cold, especially during period (internal cold retnetion)
tongue pale blue/purple, pulse deep, tight
149
kidney yun xu menopause
dizziness, low pitch tinnitus, hot flashes, night sweats, 5 palm sweats, lower back ache, dry mouth, skin, hair, constipaiton, tongue red if empty heat - not necessarily, coating peeled, pulse fine and rapid
150
damp accumulation endo
hypogastric pain before period and mid cycle (damp obstructing blood flow around ovaries and uterus)
menstrual flow red with small clots and clear mucus (stagnation not caused by blood stasis)
vaginal discharge (damp in lower jiao)
scanty dark urine (damp obstructing flow of water passages)
abdominal fullness and heaviness (spleen not transporting fluids)
tongue swollen, coating sticky, pulse slippery
may be combined with heat = burning pain though sacrum, heat thirst tongue red
151
kidney yang xu
hot flushes with cold hands and feet, night sweats in early morning when yang begins to rise, pale face, depression, chilliness, backache, ankle oedema, tongue pale, pulse weak, deep
152
kidney yin and yang xu
hot flushes with cold extremities, night sweats, frequent pale urination, flushed around neck when talking, mild agitation, chilliness, dry throat, dizziness, tinnitus, lower back ache, pounding, throbbing, top of head headache, tongue peeled, red with false heat, pulse wiry on middle right
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