What is the TCM diagnosis and treatment of metrorrhagia?

It is common to hear women joking with each other that the other person's menstruation is leaking from the side. Why is there such a joke? The main reason is that some sanitary napkins can easily cause menstrual blood to flow out from the side during use, so people call it side leakage. In medicine, there is a disease with a similar name, which is metrorrhagia. So, what is the TCM diagnosis and treatment of metrorrhagia?

Dialectical treatment

Dialectical points

The key point of diagnosis for metrorrhagia is the non-cyclical vaginal bleeding. In clinical practice, the changes in the amount, color, and quality of bleeding and systemic symptoms are combined to distinguish between cold, heat, deficiency, and excess.

Treatment principles

Treatment should be based on the severity of the disease and the duration of bleeding, adopting the principle of "treating the symptoms in an emergency and treating the root cause in a chronic manner", and flexibly applying the three methods of stopping the flow, clearing the source, and restoring the condition. To stop the flow is to stop the bleeding. To clarify the source is to find the cause and treat the root cause. Restoration means to adjust and deal with the aftermath. After the bleeding stops, the spleen and kidneys should be regulated to improve the condition. In short, blocking the flow, clarifying the source, and restoring the condition are different but also intrinsically related, and must be used flexibly in combination with the specific condition of the disease.

Syndrome and Treatment Classification

1. Kidney Yin Deficiency

Main symptoms: irregular menstrual bleeding, a little or a lot of bleeding, continuous bleeding, bright red blood, thick texture, dizziness, tinnitus, sore waist and weak knees, hot hands and feet, red cheeks and lips, red tongue, little coating, and a thready pulse.

Symptom analysis: Kidney Yin deficiency, internal fiery fire, hidden heat in Chong and Ren meridians, forcing blood to flow abnormally, so menstrual blood comes out at an irregular time, with a small or large amount of bleeding, and continuous dripping; Yin deficiency and internal heat, so the blood is bright red and thick; kidney Yin deficiency, essence and blood are weak and cannot nourish the empty orifices, so there is dizziness and tinnitus; essence and blood are deficient and cannot nourish the external organs, so there is soreness and weakness in the waist and legs; Yin deficiency and internal heat, then the hands and feet are hot; virtual heat floats up, then the cheekbones and lips are red. A red tongue, scant coating, and a thin and rapid pulse are also signs of kidney-yin deficiency.

Treatment principles: Nourish the kidney and replenish yin, consolidate the Chong and stop bleeding.

Representative prescription: Jiajian Cistanche and Cuscuta australis Pills (from Traditional Chinese Medicine Gynecological Therapeutics) with Codonopsis pilosula, Astragalus membranaceus, and donkey-hide gelatin.

Commonly used medicines: Rehmannia root, Cistanche deserticola, Rubus idaeus, Angelica sinensis, Lycium barbarum, Viscum album, Cuscuta australis, and Mugwort.

2. Kidney Yang Deficiency

Main symptoms: irregular menstrual bleeding, heavy bleeding, continuous bleeding, light color and thin texture, back pain as if broken, chills and cold limbs, clear and long urine, loose and thin stools, dull complexion, pale and dull tongue, thin white fur, and deep and weak pulse.

Symptom analysis: Kidney Yang deficiency, Chong and Ren meridians are not solid, blood is not sealed, so menstruation is irregular, the amount of menstrual blood is heavy, and it drips continuously; Kidney Yang is insufficient, menstrual blood fails to be warmed, so it is light in color and thin in texture; Kidney Yang deficiency, the external organs lose their nourishment, so there is low back pain as if broken, fear of cold and cold limbs; the bladder fails to warm, so the urine is clear and long; Kidney Yang deficiency cannot warm the spleen and earth, so the stool is loose and thin. Dull complexion, pale and dark tongue, thin white fur, and weak pulse are also signs of kidney yang deficiency.

Treatment principles: warm the kidney and assist yang, consolidate the Chong and stop bleeding.

Representative prescription: Yougui Pills (Jingyue Complete Works) with Codonopsis pilosula, Astragalus membranaceus and Panax notoginseng.

Commonly used medicines: processed aconite, cinnamon, rehmannia root, yam, cornus fruit, wolfberry, dodder seed, antler glue, angelica, and eucommia.