Late (Delayed) Menstruation

General

Clinical Manifestations
Treatment Principle
Herb Formulas	Ding Jing Fangone week before the patients cycle begins
Points	Ear: Internal Reproductive, Endocrine, Subcortex, Liver, Spleen, Kidney, Pituitary Scalp: Human reproductive system (electro)

Spleen And Stomach Deficiency Cold

Clinical Manifestations	Late menstruation Scanty, light red Blood or Heavy non-stop bleeding Dull pain in the lower abdomen Pain alleviated by warmth Lower back pain Pale face Cold limbs Leg pain T: Pale C: Thin and white P: Deep and thready or Deep and weak
Treatment Principle	Warm the channels Disperse Cold Regulate Qi Pacify the Stomach
Herb Formulas	Xiao Jian Zhong Tang Wu Yao Sanmodified Si Wu Tang modified
Points	Moxa or moxa needle REN-6, SP-6, ST-25, ST-29 Moxa or moxa needle DU-12, REN-6, SP-6, SP-10, UIB-43 Moxa or moxa needle REN-4, SP-6, ST-25, ST-36, UB-20 Ear: Internal Reproductive, Endocrine, Subcortex, Liver, Spleen, Kidney, Pituitary Scalp: Human reproductive system (electro)

Spleen And Kidney Yang Deficiency

Clinical Manifestations	Early menstruation Late menstruation Scanty menses Light-colored menses Menses may be mixed with leukorrhea Low back pain that can be severe Soft stools Distention in the lower abdomen A sense of prolapse in the lower abdomen Anorexia Fatigue Light headedness Dizziness Frequent erotic dreams Tinnitus Urinary frequency at night Weakness in the lower limbs Vertigo T: Pale C: Thin P: Deep and frail
Treatment Principle	Enrich and tonify the Kidneys Nourish the Liver Regulate the Chong and Ren channels Regulate menstruation Strengthen the Spleen
Herb Formulas	Gu Yin Jian
Points

Liver Qi Stagnation

Clinical Manifestations	Delayed periods with clots Scanty or normal Blood flow If no Heat the color is normal If there is Heat the color is deep red and thick The flow starts and stops during menses The patient is stressed out The patient experiences PMS Breast tenderness Distended pain in the lower abdomen Hypochondriac pain Headache Vertigo Bitter taste in the mouth Dizziness Frequent sighing Epigastric pain and distention Flatulence Dry mouth and throat Fatigue Anorexia Alternating chills and fever Irregular menstruation Breast distention Lassitude A sense of being held down	Insomnia Shoulder and back pain Rib pain Flank and breast discomfort Tightness or fullness in the chest Cold extremities Pain in the arms and legs Heaviness of the head Night sweats Bloating and pain at the umbilicus and abdomen Diarrhea alternating with constipation Five sole heat Palpitations Malar flush Mood swings Depression Irritability Plum-pit Qi Stagnation Easily frustrated Increased desire to sleep Flatulence Digestive complaints T: Red edges C:Thin white or yellow P: Wiry and Deficient or Wiry, tight and Deficient
Treatment Principle	Regulate Liver Qi Remove Stagnation Regulate menstruation
Herb Formulas	Xiao Yao San Chai Hu Shu Gan Tang  modified Wu Yao Tang Chai Hu Si Wu Tang modified With more severe Blood Deficiency: Hei Xiao Yao San
Points	LIV-3, LIV-5, LIV-14, SP-6, SP-8, SP-10, Zigong, SP-4 on the right, PC-6 on the left LI-4, LIV-3, REN-6, SP-6 Ear: Internal Reproductive, Endocrine, Subcortex, Liver, Spleen, Kidney, Pituitary Scalp: Human reproductive system (electro)

Liver Wind Stirring Internally: Liver Blood Deficiency Generates Wind

Clinical Manifestations	Pale complexion Pale lips Blurred or failing vision Spots before eyes Dizziness Dry eyes Pale nail beds Irritability Frightens easily Insomnia with much dreaming Tinnitus Numbness of limbs Tremor, spasms or involuntary movements (chorea) Involuntary shaking of head Light menses or amenorrhea Late menses Tic or tremor of hands and feet Maybe trismus T: Pale C: Little P: Thready and wiry
Treatment Principle	Nourish the Blood Subdue Wind
Herb Formulas	Si Wu Tang Bu Gan Tang
Points	DU-16, DU-20, GB-20, LIV-3, REN-4, SP-6, ST-36, UB-17, UB-18, UB-20

Liver Yin Deficiency

Clinical Manifestations	Dizziness Blurred vision Impaired vision Dry eyes Night blindness Tinnitus Headache Nervousness Insomnia with much dreaming Dry throat Thirst Five sole Heat Night sweats Light menses or Late menses or Amenorrhea T: Red C: Little P: Thready, wiry and rapid
Treatment Principle	Nourish Yin Nourish the Liver
Herb Formulas	Yi Guan Jian
Points	KI-3, LIV-3, UB-18, UB-23

Liver Yin Deficiency With Liver Yang Rising

Clinical Manifestations	Dizziness Impaired vision Night blindness Tinnitus Irascibility Throbbing headache with distended feeling Flushed face Blurred vision Red, dry eyes with feeling of grit in eye Dry mouth and throat with bitter taste in mouth Palpitations Headache Nervousness Insomnia with much dreaming Dry throat Thirst Five sole Heat (palms, soles and center of chest) Night sweats Light or late menses or Amenorrhea T: Red and dry C: Little or None P: Thready and wiry or Wiry and rapid (when Yang is Rising and Excess, pulse is forceful) or Thready and rapid when Yang is not prominent
Treatment Principle	Nourish Yin Pacify the Liver Subdue Yang
Herb Formulas	Da Bu Yin Wan Jian Ling Tang
Points	DU-20, GB-20, GB-34, GB-43, KI-3, LIV-2, LIV-3, UB-18, UB-23

Liver Blood Deficiency

Clinical Manifestations	Pale complexion Pale lips Blurred or failing vision Spots before the eyes Dizziness Dry eyes Pale nail beds Irritability Frightens easily Insomnia with much dreaming Tinnitus Numbness of the limbs Light menses or Amenorrhea Late menses T: Pale C: Little P: Thready
Treatment Principle	Nourish the Liver Reinforce the Blood
Herb Formulas	Si Wu Tang Bu Gan Tang Hei Xiao Yao San
Points	Moxa or needle LIV-3, REN-4, SP-6, ST-36, UB-17, UB-18, UB-20

Kidney Yin Deficiency

Clinical Manifestations	Scanty dark colored menstrual Blood with small clots Low back, knees and legs painful and weak Foot pain Light-headedness Vertigo Tinnitus Diminished hearing Five sole Heat Chronic dry, sore throat Toothache Wasting and thirsting disorder (Xiao Ke) Dizziness Muscular weakness Dry skin Deafness Steaming bones	Delayed closing or unclosed fontanel in infants Tidal fevers Loose teeth Dripping urine Thirst Dry tongue Numbness and weakness at the waist and knees Heel pain Dry mouth Dry throat Blurred vision Urinary incontinence Spontaneous and nocturnal emissions Night sweats T: Red C: Little or none P: Thready and rapid
Treatment Principle	Tonify the Kidneys Nourish Yin Regulate menstruation
Herb Formulas	Liu Wei Di Huang Wan Zuo Gui Wan Yi Shen Tong Jing Tang Da Bu Yin Wan With Blood dryness: Yi Yin Jian
Points	Ear: Internal Reproductive, Endocrine, Subcortex, Liver, Spleen, Kidney, Pituitary Scalp: Human reproductive system (electro)

Kidney Yang Deficiency

Clinical Manifestations	Cold symptoms Scanty purple pale thin menstrual Blood Dull cold lower abdominal pain Exhaustion from long-term illness Low energy Lethargy Aversion to Cold Coolness of the extremities Aching and weakness of the lower back and knees Infertility Loose stools (sometimes with undigested food) Incontinence of urine Edema of the lower extremities Pale face Spontaneous perspiration Dizziness Enuresis T: pale, swollen and tender C: White P: Deep and thin or Deep, slow and weak
Treatment Principle	Warm the Kidneys Tonify Yang Nourish the Chong and Ren channels
Herb Formulas	You Gui Wan Ji Sheng Shen Qi Wan Ai Fu Nuan Gong Wan Da Ying Jian Gu Yin Jian
Points	Moxa REN-4, DU-4, needle UB-17, BL 23, SP-10, SP-6, ST-25, ST-29 Ear: Internal Reproductive, Endocrine, Subcortex, Liver, Spleen, Kidney, Pituitary Scalp: Human reproductive system (electro)

Qi And Blood Deficiency

Clinical Manifestations	Amnesia Palpitations Feverishness Anorexia Emaciation Pale face Insomnia Dyspnea on mild exertion Fatigue Shortness of breath. Weight loss Dry skin Dry mouth Dry throat Dry lips Uterine bleeding Irregular menstruation May suddenly lose consciousness Slack jaw Restless at night Lassitude Tendency toward being frightened easily	Weakness Sallow complexion Dizziness Tremors in the limbs Spontaneous perspiration Fever and severe chills General debility Mental instability Coughing and gasping. Night sweats Amnesia. Diarrhea Turbid urine Nocturnal emission Impotence Constipation Feeble breathing. Tired limbs. T: Pale C:White P: Thready and weak or thready, rapid and weak or Deep and weak
Treatment Principle	Tonify Qi Nourish the Blood Strengthen the Spleen and Lungs Nourish the Heart Calm the Shen
Herb Formulas	Ren Shen Yang Rong Tang With Cold: Fu Ke Zhong Zi Wan
Points

Qi And Blood Stagnation

Clinical Manifestations	One or two days before or during first day of menses there is: Lower abdominal distension and pain Pressure makes worse Generally scanty blood flow The flow starts and stops Dark-purple color with clots When the clots pass the pain is relieved (or when menses stop) Pre menstrual syndrome Abdominal masses which are visible when lying down Piercing hypochondriac pain Irritability Indigestion Constipation Dysmenorrhea Amenorrhea Chronic diarrhea Daybreak diarrhea Palpable abdominal masses Irregular menstruation Breast distention Abdominal tumors Hypochondriac distention T: Dark and red or Purple with purple spots on the side C: White P: Wiry or Wiry, choppy and tight
Treatment Principle	Regulate Qi Invigorate the Blood Break up Stasis Relieve pain
Herb Formulas	Ge Xia Zhu Yu Tang Wu Yao Tang + Tao Hong Si Wu Tang Guo Qi Yin
Points

Blood Deficiency

Clinical Manifestations	Delayed menstrual period Scanty bleeding that is pale in color and thin in consistency Dull pain in the lower abdomen Dizziness Vertigo Palpitations Sallow complexion Pale dry skin and lips Blurred vision Lusterless face Dream-disturbed sleep Afternoon fever Dry skin Insomnia (trouble getting to sleep) Pale brittle nails Poor memory May have anxiety Stiff tendons Numbness in the limbs Dry stools T: Pale and thin C: White P: thready and weak or Thready and rapid
Treatment Principle	Nourish the Blood Nourish the Chong Regulate menstruation
Herb Formulas	Xiao Ying Jian Gui Pi Tang Ba Zhen Tang Ren Shen Yang Rong Tang Da Bu Yuan Jian Irregular Menstruation #3 Si Wu Tang Bai Zi Ren Tang Ren Shen Zi Xue Tang Bu Gan Tang With Yin Deficiency: Ren Shen Gu Ben Tang
Points	UB-17, UB-18, UB-23, REN-4, KI-6, KI-13, SP-10, SP-6 REN-6, SP-4, SP-6, ST-36, UB- 20 REN-4, SP-6, SP-10, UB-17, UB-20, UB-23 Moxa LIV-3, REN-4, SP-6, ST-36, UB-17, UB-18, UB-20 Ear: Internal Reproductive, Endocrine, Subcortex, Liver, Spleen, Kidney, Pituitary Scalp: Human reproductive system (electro)

Blood Deficiency With Qi Stagnation

Clinical Manifestations	Irregular menstruation Late menstruation Scanty menstruation Distension of the lower abdomen Menstruation with purple blood and clots Pain of the abdomen which is worse upon pressure and diminishes with menstruation Pain is worse with pressure Pain decreases with the passage of clots Swelling and edema of the lower extremities A feeling of oppression in the chest and epigastrium Dry mouth Dark, purplish menses with clots or Dark purple edges T: Red or Purple P: Deep and strong or Hesitant or Choppy and rough
Treatment Principle	Invigorate the Blood Nourish the Blood Move Qi
Herb Formulas	Guo Qi Yin
Points

Blood Deficiency With Blood Stagnation

Clinical Manifestations	Copious bleeding of dark purple blood The blood is sticky during menstruation May or may not have clots Menstrual cycle is shortened (early menstruation) Palpitations Dizziness Blurred vision Pale, lusterless complexion Pale nails Abdominal pain Irregular menstruation with little flow Fixed lower abdominal pain Vertigo Tinnitus Pale lips May be amenorrhea Insomnia Menstruation may also be accompanied by distention and pain T: Pale C: Normal P: Thin and weak or Thin and choppy
Treatment Principle	Tonify and invigorates the Blood Regulate Blood circulation Break up Blood Stagnation Regulate menstruation Alleviate pain
Herb Formulas	Tao Hong Si Wu Tang
Points

Blood Stagnation

Clinical Manifestations	Pain in the lower abdomen and pelvic region Heavy and/or irregular periods Spotting between periods or before periods Infertility Difficulty conceiving Pain during sexual intercourse Abdominal swelling Painful bowel movements, especially during menstruation Bleeding from the rectum during menstruation Lower abdominal pain during menstruation Low back pain Painful urination during menstruation Sometimes no symptoms at all Other symptoms may include: Headaches Low grade fevers Depression Hypoglycemia Anxiety Susceptibility to infections and allergies T: Purple or Purple spots C: Normal P: Choppy
Treatment Principle	Invigorate the Blood Dispel Stasis
Herb Formulas	Jia Jian Niu Xi Tang
Points

Blood Stagnation Due To Cold

Clinical Manifestations	Late menses Painful menses with clots The menstrual pain will be relieved by warmth and aggravated by Cold Mild persistent uterine bleeding Irregular menstruation (either early or late) Scanty purple red blood with large clots Cold pain in lower abdomen Complexion is white/blue Whole body feels cold Cold limbs Prolonged menstruation Skipped period Metrorrhagia Extended or continuous menstrual flow Pain Lower abdominal distention Cold-pain in the lower abdomen that is alleviated by warmth Infertility Dry lips Dry mouth Pale complexion Leukorrhea Amenorrhea Bleeding between periods No desire to drink Distending breast pain Low back coldness and pain Loose stools Cold limbs Aversion to Cold T: Pale or Purple with petechiae or Pale C: White P: Tight maybe choppy (stasis) and deep (internal) or Thready and choppy Menstruation becomes delayed and the menses decreased Menses are dark or grayish in color
Treatment Principle	Warm the channels Expel Cold Invigorate the Blood Remove Stagnation
Herb Formulas	Wen Jing Tang Ai Fu Nuan Gong Wan Da Ying Jian Wu Yao San Jia Wei Si Wu Tang  modified
Points	Moxa REN-4, DU-4, needle UB-17, SP-10, SP-6 Moxa REN-6, SP-6, ST-25, ST-29 Moxa REN-3, REN-4, SP-6, SP-10, SP-6, Moxa REN-4, SP-4, SP-6, ST-36 Moxa REN-4, SP-6, ST-25, SP-6, UB-20 Excess, dislikes pressure : ST-25, ST-29 Deficiency, likes pressure : BL 23 Ear: Internal Reproductive, Endocrine, Subcortex, Liver, Spleen, Kidney, Pituitary Scalp: Human reproductive system (electro)

Phlegm-Dampness

Clinical Manifestations	Menstruation is usually delayed Menses are decreased, light in color and viscid Palpitations of the heart Shortness of breath Epigastric fullness Nausea Increased vaginal discharge T: Pale and plump C: White and greasy P: Slippery
Treatment Principle	Eliminate Phlegm, Dry Dampness Regulate menstruation
Herb Formulas	Cang Fu Dao Tan Tang Xiong Gui Er Chen Tang Er Chen Tang
Points

Phlegm Stagnation

Clinical Manifestations	Menses may be days to months late Light colored Blood Decreased volume Blood mixed with sticky pale colored leukorrhea Continuous leukorrhea Generally overweight Cough with copious, dilute, white frothy or lumpy sputum Profuse Phlegm Chest and epigastric congestion Palpitations Headache Pain and full feeling in chest Dyspnea - worse lying down Asthma Throat rattle Maybe anorexia Lassitude Nausea / vomiting Dizziness / vertigo Shortness of breath Wheezing Acute attack of panting with high pitched sound and rapid exhalation Facial edema Heaviness of the limbs Weak extremities T: Pale or Pink C: Thick, white and greasy or sticky P: Slippery or Soft or Slippery and wiry
Treatment Principle	Transform Phlegm Dry Dampness Promote blood circulation Regulate menstruation
Herb Formulas	Er Chen Tang Xiong Gui Er Chen Tang Xiang Sha Liu Jun Zi Tang Gui Shao Liu Jun Zi Tang
Points	REN-3, REN-12, SP-6, ST-25, ST-40 Ear: Internal Reproductive, Endocrine, Subcortex, Liver, Spleen, Kidney, Pituitary Scalp: Human reproductive system (electro)