June, 2012

Menopausal Syndrome

This patient is 56 years old and her symptoms began around age 50. She suffers from frequent hot flashes that are worse with stress. These wake her up at night 2-3X/night. She will sweat at night slightly with the hot flash. This disturbs her sleep but she also has poor sleep in addition to this. She has been diagnosed with Lichen Sclerosis which she experiences as vaginal dryness and cracking. She was recommended to take prednisone for this but she did not want to.

Her digestion if poor as she easily and almost always feels bloated and her bowels are irregular from constipation to diarrhea. Bloating is in the epigastric area and is worse after eating.

Intake

This patient feels very tired much of the time though she feels this is due to sleep loss.

Sweating, thirst, general temperature regulation, respiration all feel normal

Signs:Tongue: pale and slightly dusky with a thin

yellow mossPulses: middle and upper jiao pulses full.

Lower jiao pulses fall off into deep and thin. Abdomen: Firm and resilient with fullness in

the epigastric area and emptiness in the lower belly with a tension above the pubic bone.

Intake

Hysterectomy ‘96 for fibroids leading to heavy bleeding.

History of dysmenorrhea since ‘77 until hysterectomy

History

Hot flashes = Yang out of right relationship Night sweat = fluid coming out of pores at night Vaginal dryness = dry vaginal area Poor sleep = heart involvement Easy bloating after eating = fullness in the epigastric area Diarrhea = stool coming out loose Constipation = stool not coming out Fatigue = qi not available Tongue:

Pale= deficiency Dusky = Blood stasis Thin yellow moss = heat in the fu

Abdomen: Full epigastric area = full epigastrium Empty below = Kidney deficiency Tight above pubis = Kidney deficiency

Symptom Analysis

Hot flashes = Yang out of right relationship

Night sweat = fluid coming out of pores at night

Vaginal dryness = dry vaginal area Poor sleep = heart involvement Easy bloating after eating = fullness in

the epigastric area Diarrhea = stool coming out loose Constipation = stool not coming out Fatigue = qi not available Tongue:

Pale= deficiency Dusky = Blood stasis Thin yellow moss = heat in the fu

Abdomen: Full epigastric area = full epigastrium Empty below = Kidney deficiency Tight above pubis = Kidney deficiency

Diagnosis

Kidney Qi deficiency with Empty heat and blood stasisExcess in the epigastric area with Yang not descending

Kidney Yang/Qi

Stomach Epigastr

ic

Heart

SEEING

Kidney Qi deficiency with Empty heat and blood stasisExcess in the epigastric area with Yang not descending

Treatment Principle

Supplement the Kidneys in a warm way to root the rising Yang and vitalize bloodOpen the epigastric blockKidney

Yang/Qi

Stomach Epigastr

ic

HeartKidney Qi deficiency with Empty heat and blood stasisExcess in the epigastric area.

Treatment

Gui Zhi Jia Fu Zi TangPlusBan Xia Xie Xin Tang

Supplement the Kidneys in a warm way to root the rising Yang and vitalize bloodOpen the epigastric block

Gui Zhi 9Rou Gui 9Bai Shao 12Sheng Jiang 4Da Zao 6Zhi Gan Cao 5Fu Zi 3Xian Mao 6Huang Lian 3Huang Bai 3Dang Gui 5Chuan Xiong 3Gan Jiang 2Ban Xia 4

Results

At the second visit the patient reported that as soon as she began the herbs, she had no more hot flashes or night sweats. She slept soundly through the night all week. Her digestion also felt comfortable with normal bowel movements. In addition her vaginal tissue was moist and the fissures seemed to be healing.

Gui Zhi 9Rou Gui 9Bai Shao 12Sheng Jiang 4Da Zao 6Zhi Gan Cao 5Fu Zi 3Xian Mao 6Huang Lian 3Huang Bai 3Dang Gui 5Chuan Xiong 3Gan Jiang 2Ban Xia 4

Results

I recommended that she take one more week of this formula and then plan to cut back to every other day and see….

Gui Zhi 9Rou Gui 9Bai Shao 12Sheng Jiang 4Da Zao 6Zhi Gan Cao 5Fu Zi 3Xian Mao 6Huang Lian 3Huang Bai 3Dang Gui 5Chuan Xiong 3Gan Jiang 2Ban Xia 4

Concluding remarksConclusions we might have jumped to:

1. Hot flashes, vaginal dryness and insomnia = Kidney Yin deficiency

2. Alternating diarrhea and constipation with abdominal fullness = Liver invading the Spleen