gyno Flashcards
causes of irregular period
liver qi stag
heat in blood
qi xu
cold in uterus
yang xu
blood stag
liver qi stag cycle symptoms
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
stress reduced hormone output partially so there is a minimum amount of LH to luteinise a follicle without ovulation occurring
liver qi stag
period that comes sooner than 27 days after last period, either excess or xu
early cycle
early onset period, sudden onset, often with profuse, heavy flow, red with no purple or clotting, other symptoms
heat in the blood
potential causes of early cycle
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
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
(spleen) qi xu
causes blood stag, dark and clotted period, abdomen feeling cold with palpation, tongue pale purple, pulse tight and deep
cold in the uterus
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
yang xu
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
blood stag
has the same time period between each menses, controlled consistent flow, asymptomatic, clear and concise start and stop
regular menses
if the period starts in the evening or overnight, no matter how heavy the flow is, the next day is counted as
day 1
day 1 of menstrual cycle
first day of RED bleeding
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
day 1-5 of menstrual cycle
one of the follicles evolves and starts to produce oestrogen
day 7 of menstrual cycle
high levels of oestrogen stimulates the endometrium to thicken and the cervical mucus glands to produce fertile mucus
day 7-12 of menstrual cycle
continuing high oestrogen acts on pituitary gland to stimulate it to produce a surge of LH which matures the dominant follicle
day 12-13 of menstrual cycle
egg is released from follicle
day 14 of menstrual cycle
corpus luteum forms from the empty follicle and produces progesterone
day 15-25 of the menstrual cycle
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
day 25-28 of the menstrual cycle
regular cycle is considered between
27 and 34 days
the luteal phase should be ____ to be considered fertile
10-16 days long
BBT
basal body temp
kidney yin xu
increasingly common. older women, overwork
kidney yang xu
constitutional, injury by cold, overwork, longterm yin/qi xu or heart/liver stag
jing xu
constitutional, prolonged hormone treatment, prolonged illness
blood stag
prolonged cold, damp heat, kidney xu
liver/heart stag
sudden shock, prolonged anxiety, historical trauma
phlegm damp accumulation
infection, excess rich and sweet diet (obesity), PCOS, often develops secondary to previous symptoms
excessive menstrual flow
menorrhagia or flooding
bleeding outside the expected cycle
metrorrhagia
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
menorrhagia treatment
harmonize blood
treat the root cause
astringe
treat qi
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
xu of menstrual cycle - period that is three days or shorter with extremely light, scanty flow
hypomenorrhea
phase of the menstrual cycle from day 1 to ovulation, driven by estrogen, known as the follicular phase
yin phase
focus on moving blood, chong vessel starts to empty, ren vessel drives blood downwards, stagnant qi is moved, body temp drops
day 1-3
what points for day 1-3 of cycle
sp6, sp10, lv3, li4, st28, st30, r4, kd14
rebuilding the endometrium starts on day
2-3
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
what points for day 5-6
r4, kd3, 4,5,6,8,13, st27,30,36, bl23,32, lv3, pc6, sp4,6,10
what is considered the transition from yin to yang
ovulation
treatment principle to invigorate ovulation
kd4,5,8,13,14, sp 5,6,8,13, pc5,6, ht5,7, gb26
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
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