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Beth Conroy Compendium - Premenstrual Tension - Traditional Chinese Medicine

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Sources: Maciocia,G.(1998).ObstetricsandGynecologyinChineseMedicine BriefOverview Theterm"PremenstrualSyndrome"(PMS)isanoverarchingtermforavarietyofemotionaland physicalsymptomsoccurringbeforeaperiod,ranginginintensityfromverymildtoquite serious.Thesymptomsvaryindurationaswellasinintensity,rangingfrom1dayto2weeks beforetheperiod.AspertheTCMstyle,theetiologyofPMSisemotionalstrain,diet, overwork,and/orexcessivesexualactivity.Inthecaseofemotionalstrain,PMSmanifestsas LRQistagnationduetoanger,frustration,andresentment.Phlegmisproducedduetothe excessiveconsumptionofdairyandgreasyfoodsandcanmixwithfireraisedfrom emotionallybasedLRQistagnation.AsPhlegmfireascends,itcausesbreastdistention,chest oppression,andsometimesseverementalandemotionalchanges.Poordietcanalsoleadto Blooddeficiency,influencingtheLR.PhysicalandsexualoverstrainbothweakenLRandKD Yin. ItisimportanttodeterminewhetherPMSderivesfromaFullorEmptycondition.Itcanbe assumedthatinmostcases,PMShassomeconnectiontoastagnationofLRQi.IfLRQi stagnationstemssolelyfromemotionalstrain,PMSmaybeconsideredapurelyFullcondition, manifestingwithawirypulseLRQistagnationintandemwithphlegmfirerisingmanifesting andPhlegmfireharrassingtheHTisalsoaFullcondition.IfLRQistagnationarisesfroma deeperdeficiency(LRBlood,LRYin,orLR+KDYin),PMSmaybeconsideredanEmpty condition,manifestingwithafine,weakpulse. (ObstetricsandGynecologyinChineseMedicine,pp339340) CategoriesofDisharmony 1.LRQistagnation 2.PhlegmfireharrassingtheHT 3.LRBlooddeficiency 4.LRandKDYindeficiency 5.SPandKDYangdeficiency ClinicalManifestations: Depression,sadness,irritability,anxiety,lethargy,lossofconcentration,aggressiveness, changesinlibido,changesinbowelmovements,skineruptions,foodcravings,crying, propensitytooutbursts,clumsiness,distentionofabdomenandbreasts,insomnia. PatternDifferentiation 1.LRQiStagnation(ObstetricsandGynecologyinChineseMedicine,pp340344) Treatmentprinciples :SootheLiver,moveLiverQi Clinicalmanifestations :

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Beth Conroy Compendium - Premenstrual Tension - Traditional Chinese Medicine

Physical/emotional:Abdominalandbreastdistention,irritability,clumsiness,moodiness, depression,hypochondrialpainanddistention. Tongue:normaltoredbody Pulse:wiry,especiallyon(L)guanposition Pointselection: LV3,GB34,GB41,SP6,TW6,PC6reducingorevenmethod 2.PhlegmfireHarrassingHT(ObstetricsandGynecologyinChineseMedicine,pp345348) Treatmentprinciples:Clearheat,resolvephlegm,calmthemind Clinicalmanifestations: Physical/emotional:Agitation,depression,manicbehavior,aggressiveness,oppression ofthechest,redface,bloodshoteyes Tongue:redbody,stickyyellowcoat Pulse:overflowing,slippery,rapid Pointselection: PC7,ST40,ST8,GV24,LI11,SP9,(R)SP4+(L)PC6reducingorevenmethod CV12,BL20tonifyingmethod 3.LRBlooddeficiency(ObstetricsandGynecologyinChineseMedicine,pp349351) Treatmentprinciples:NourishLiverBlood,moveLiverQi Clinicalmanifestations: Physical/emotional:depressionandweepiness,slightabdominalandbreastdistention, scantyperiods,tiredness,poormemory,poorsleep,slightdizziness,dullpale complexion. Tongue:pale,especiallyonsides Pulse:choppyorfine,possiblywiryin(L)guanposition Pointselection: CV4,(R)LU7+(L)KD6,SP6,ST36,LV8,BL20,BL18tonifyingmethod GB34,PC6,CV6evenmethod 4.LRandKDYindeficiency(ObstetricsandGynecologyinChineseMedicine,pp351353) Treatmentprinciples:NourishLiverandKidneyYin,moveLiverQi Clinicalmanifestations: Physical/emotional:Slightbreastdistention,irritability,sorebackandknees,dizziness, blurredvision,poormemory,insomnia,dryeyesandthroat,5palmheat,nightsweating. Tongue:red,nocoat Pulse:floating,empty Pointselection: LV8,CV4,SP6tonifyingmethod LV3evenmethod 5.SPandKDYangdeficiency(ObstetricsandGynecologyinChineseMedicine,pp353355) Treatmentprinciples:TonifyYang,strengthentheKidneys Clinicalmanifestations: Physical/emotional:Slightpremenstrualtensionwithdepressionandweeping,slight abdominalandbreastdistention,tiredness,soreback,feelingofcoldness,frequentand paleurination,lowsexualdesire. Tongue:pale,swollen Pulse:deep,weak Pointselection: BL23,BL20,CV4,ST36,SP6,KD3,(R)LU7+(L)KD6tonifyingmethod,withmoxa.
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Beth Conroy Compendium - Premenstrual Tension - Traditional Chinese Medicine

PatientEducationandRecommendations: BecausePMSisrootedinemotionalstrain,poordiet,overwork,and/orexcessivesexual activity,patientsshouldbeencouragedtoinvestigatetheirdailylifetodeterminewhatmaybe thesourceofanyoftheseissues.Payingcloseattentiontoone'sdietmaybeanintegralpart oftreatingPMS,especiallyifthereisaphlegmcomponenttotheconditioneliminatingsugar, dairy,and/orgreasyfoodsingeneralbutspecificallyaroundthetimewhenPMStypically comesonmayhelptoalleviatesymptoms.Itis,unfortunately,difficultforpatientstoreduce theirworkload,regardlessofhowmuchitmaydetrimentallyimpacttheirhealthhowever,to preventfurtherKDdeficiency,itmightbesuggestedthattheytakeextratimetorestbeforeand afterwork,aswellastolimitsexualactivityiftheyfindittoberesponsibleforexacerbating symptoms.Patientsmayalsobetaughthowtousemoxaoncertainbeneficialpointssuchas CV4,SP6,and/orKD6throughouttheircycletomaintainthehealthoforganscontributingto patternsofdisharmonyinvolvingPMSsymptoms. Prognosis: AcupuncturehasprovenpowerfullyeffectiveintreatingPremenstrualTension.Casesof PhlegmfireHarrassingtheHTmaytakethelongesttotreathowever,othersmaybe completelyalleviatedwithinuptothreemenstrualcyclesfromtheonsetoftreatment.

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