Hypomenorrhea, Scanty Menstruation, Oligomenorrhea

Lung And Kidney Yin Deficiency

Clinical Manifestations	Hypomenorrhea Calcaneus pain May be bone spur Unproductive cough or Scanty, sticky phlegm or Sometimes blood-streaked sputum Dry mouth Dry throat Low back and knees sore and weak "Steaming Bone" tidal fever Night sweats Malar flush Maybe hoarse voice Maybe pain in shin, foot, and heel Spermatorrhea Irregular menses T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish and Reinforce the Lungs and Kidneys
Herb Formulas	Ba Xian Chang Shou Wan
Points	HT-6, KI-3, KI-6, LU-6, LU-9, UB-13, UB-23

Spleen Qi Deficiency

Clinical Manifestations	Aversion to Cold Bleeding Borborygmus Bloating Catches cold easily Chronic low grade fever Clouded vision Cold extremities Constipation Deafness Depression Desire for warm beverages Diarrhea or dysentery, may be chronic Dizziness Drooping upper eyelids Dry itching nose Dry lungs Dyspnea Dysuria Edema with prolapse Enuresis Epilepsy Eye fatigue after extended use Eye sores Fatigue Fecal incontinence Fever without Cold which alternates between low and high Fever with vexation Frequent bowel movements Frequent urination Fever or Heat in the flesh in cool or cold weather Genital sores Goiter Headache Hemafecia Hematemesis Hematuria Hemorrhoids Hiccup Hoarseness Incessant thirst Intermittent dull abdominal pain, better with warmth and pressure Intermittent fever (worse on exertion) Laconic speech Leukorrhea Limbs may become emaciated Lingering, dull tooth pain Loose and watery stools or diarrhea Loss of voice Maybe chronic weak cough Maybe cloudy urine Maybe cold body Maybe cough Maybe low back pain due to Dampness Maybe scabs on the nasal mucosa Myasthenia gravis	Menstrual flooding or spotting Narrow visual field Nasal congestion Nausea and vomiting Night blindness Night sweats Obstinate sores on the tongue with the opening of the sore falling downward Obstructed urination Oral sores Painful urination Pale complexion Premature ejaculation Prolapse of any organ Prolonged runny nose may be malodorous Protracted, soft, tender, numb tongue Runny nose with clear, watery discharge may be precipitated by Cold or allergen Sagging and distention of the lower abdomen Sallow complexion Seizures Sensitivity of back to Cold and Wind Shiny, pale complexion Shortness of breath Slight thirst with desire for warm drinks Soft voice Somnolence Spontaneous perspiration Suppuration Susceptibility to Wind and Cold Tendency to curl up Terminal dribbling Thirst with a desire for warm drinks Tidal fever which is worse on exertion Tinnitus Urinary obstruction Urinary incontinence Vaginal itching Vertigo Visual disturbances Warmness of the body Waxy, pale complexion Weak eyelids Weakness of the extremities T: Pale, swollen with tooth marks, maybe tender or Slightly Red C: White P: Rootless at right - middle position or Weak and forceless or Big or Large and Surging or Weak, thready, Deficiency and moderate or Deficient and soggy or Deficient and large or Slow and weak
Treatment Principle	Tonify Middle Jiao Qi Benefit Qi Regulate Qi
Herb Formulas	Bu Zhong Yi Qi Tang
Points

Heart And Kidney Yin Deficiency

Clinical Manifestations	Insomnia with much dreaming Spermatorrhea with erotic dreams Premature ejaculation Irritability Easily startled Palpitations Poor memory Dizziness Tinnitus Low back soreness Legs weak Tidal fever Night sweats Dry mouth Red cheeks Urine short and red T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Reduce Fire Make Heart and Kidney communicate.
Herb Formulas	Ba Xian Chang Shou Wan
Points	HT-7, KI-3, PC-6, PC-7, UB-15, UB-23

Heart Blood And Spleen Qi Deficiecny

Clinical Manifestations	Palpitations Insomnia Much dreaming Easily startled Poor memory Four limbs tired and lethargic Loss of appetite Distention and fullness of the epigastrium and abdomen Loose stools Sallow complexion Copious, pale menses Uterine bleeding or Light menstrual flow or Amenorrhea T: Pale C: White P: Thready and weak
Treatment Principle	Reinforce and Benefit the Heart and Spleen
Herb Formulas	Gui Pi Tang
Points	UB-15, UB-20, ST-36, SP-1, SP-6, REN-4, HT-7

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	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

Liver And Kidney Yin Deficiency

Clinical Manifestations	Facial complexion pale and sallow Both cheeks slightly red Dizziness Dry eyes Blurred vision Spots before the eyes Numbness of limbs Flaccid paralysis (Wei syndrome) Weakness Tinnitus Deafness Forgetfulness Five sole heat Low-grade fever Night sweats Insomnia Stools difficult to pass Constipation Dry mouth and tongue Lower back and knee pain Urinary difficulty Weakness of the lower back, knees and extremities Steaming bones Light-headedness Vertigo Chronic dry, sore throat	Toothache Wasting and thirsting disorder (Xiao Ke) Muscular weakness Irritability Dry skin Spontaneous and nocturnal emissions Tidal fevers Loose teeth Dripping urine Thirst Swollen gums, painful and light red in color Numbness and weakness at the waist and knees Heel pain Urinary incontinence Pain at midline and in lower back Irregular menses or Scanty menses or Amenorrhea Vaginal discharge T: Red C: Little or None P: Thready and rapid (large at the Kidney positions)
Treatment Principle	Enriches Yin Nourish the Essence of the Liver and Kidneys Reduce Deficiency Fire
Herb Formulas	Zhi Bai Di Huang Wan Mai Wei Di Huang Wan Liu Wei Di Huang Wan Gui Shen Wan
Points	KI-3, LIV-3, SP-6, UB-18, UB-23 UB-18, UB-23, SP-6, LIV-3, KI-3

KIDNEY Qi DEFICIENCY

Clinical Manifestations	Scanty and late menarche or Gradually becomes scanty Menstruation may be delayed Blood is pale and thin
	For Yin Deficiency predominant: Light-headedness Vertigo Tinnitus Soreness and weakness in low back and legs Spontaneous and nocturnal emissions Night sweats Dry mouth and throat Thirst with a desire to drink Dizziness Forgetfulness Deafness Rhinitis Dizziness Dribbling of urine Malar flush Five sole heat Insomnia Hair loss Loss of teeth Infertility Amenorrhea Uterine bleeding Spontaneous perspiration Spermatorrhea Poor vision T: Red and shiny C: Little or None P: Thready and rapid	For Yang Deficiency predominant: Aversion to Cold Watery stools with undigested food Lower back pain Weakness of the lower extremities A cold sensation in the lower half of the body Tenseness in the lower abdomen Pain and cramps in the lower abdomen Panting and irritability to the point of having difficulty lying down Will breathe most comfortably while leaning against something Nocturia May be numbness in the lower abdomen Urinary difficulty with edema or Spasmodic pain in the lower abdomen Excessive urination If severe, may be incontinence of urine May have persistent diarrhea Dysuria May have flushed face (Yang floating upward) Thirst with frequent, copious urination (Xiao Ke) Fatigue (severe) May have severe perspiration (Yang floating upward) Constipation Lassitude Pale face Edema of the face and feet Severe edema of the legs (may prevent walking) Maybe cough Maybe asthma T: Pale, may be swollen C: Thin, white and moist P: Deep or Deep and thready or Weak and slow
Treatment Principle	Tonify Kidney Qi Nourish Jing
Herb Formulas	Zuo Gui Wan Shen Qi Wan Dang Gui Di Huang Yin Yi Shen Tong Jing Tang Yu Lin Zhu Gui Shen Wan
Points	Moxa REN-4, KI-3 (no Moxa if Yin Deficient), needle UB-23, UB-62, DU-3, DU-4 KI-3, LIV-8, REN-4, SP-6, UB-23 With night sweats: + HT-6, KI-7

Kidney, Spleen And Heart Deficiency

Clinical Manifestations	Irregular periods Scanty bleeding Clots in the menstrual Blood Abdominal distention Breast distention Premenstrual tension Depression Sighing Irritability T: Normal or Slightly red on the sides C: Normal P: Wiry
Treatment Principle	Nourish the Blood Invigorate the Blood Regulate menstruation Tonify the Kidneys Benefit the Spleen
Herb Formulas	Ding Jing Tang
Points

Qi Stagnation

Clinical Manifestations	Difficult to start full flow Distention in the breasts and abdomen The Blood is dark with clots Premenstrual syndrome 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 Insomnia Shoulder and back pain Rib pain	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 Depression Irritability Increased desire to sleep Flatulence T: Pink with red edges or Purple spots on sides C: Thin white or yellow P: Wiry and Deficient or Wiry, tight and Deficient or Wiry and choppy
Treatment Principle	Regulate Qi Promote Blood circulation
Herb Formulas	Xiao Yao San Xiao Yao San + Si Wu Tang
Points

Qi And Blood Deficiency

Clinical Manifestations	The menses is light-colored and thin A constant ache in the lower abdomen that occurs during or just after menstruation The pain responds favorably to pressure Pale or sallow complexion Dizziness with blurred vision Vertigo Palpitations Shortness of breath, Thirst Listlessness Lethargy Anorexia Weak limbs Withdrawn behavior Restlessness Insomnia Sensation of Heat Lusterless hair and skin Loose stools T: Pale C: Thin white P: Thin and frail or Empty or Deep and even or Deep and retarded Due to severe postpartum hemorrhage: Lack of interest Vaginal dryness Vulvar and axillary hair loss Reduced libido Genital atrophy
Treatment Principle	Tonify Qi and Blood Promote menstruation
Herb Formulas	Nu Ke Ba Zhen Wan
Points	REN-4, REN-6, SP-6, ST-36, KI-3, UB-13, UB-15, UB-17, UB-18, UB-20, UB-23, PC-6, HT-7 Ear Points: Ovary, Kidney, Zigong

Qi , Blood And Yang Deficiency

Clinical Manifestations	Fatigue Anorexia Dizziness Pale face Weak voice Reluctance to speak Sweating with little or no exertion Dizziness Palpitations Insomnia Dry skin Dry hair Poor memory Paleness Scanty periods Chills Cold limbs Inability to get warm Loose stools Profuse clear urine Spontaneous sweating Lassitude T: Pale C: White or Thin, white and dry P: Slow, deep and weak or Empty or Thready and rapid or Weak
Treatment Principle	Tonify Qi and Blood Strengthen the Spleen Tonify Yang
Herb Formulas	Ren Shen Dang Shao San
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 Distention and pain in the lower chest and the breasts 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) Premenstrual syndrome Abdominal masses which are visible when lying down Piercing hypochondriac pain Irritability Stomach distention and upset Indigestion Constipation Dysmenorrhea Amenorrhea Chronic diarrhea Daybreak diarrhea Palpable abdominal masses Irregular menstruation Hypochondriac distention T: Dark and red or Purple with purple spots on the side and possible sublingual vein distention C: White P: Wiry or Choppy or Wiry, choppy and tight or Deep and wiry, or Slippery and wiry or Wiry, choppy and strong
Treatment Principle	Regulate Qi Soothe the Liver Invigorate the Blood Break up Stasis Relieve pain
Herb Formulas	Ge Xia Zhu Yu Tang Xue Fu Zhu Yu Tang Jia Wei Wu Yao Tang modified (three days previous to menstruation till menstrual finish) Tong Yue Jian With Cold: Fu Ke Zhong Zi Wan
Points	REN-3, UB-32, SP-8 LI-4, LIV-3, REN-3, Zigong, SP-6, SP-8 , SP-10 REN-6, LIV-3, SP-6, SP-8, SP-10, KI-13, KI-14, ST-25, ST-29, UB-32, Shiqizhuixia REN-6, LIV-3, SP-6, SP-8, SP-10, ST-29, KI-13, LI-4 SP-6, SP-8, SP-10 KI-14, UB-17, UB-22, SP-6, ST-36 LIV-3, SP-6, SP-10 REN-7, REN-3, SP-6, SP-10 REN-6, KI-13, REN-17, SP-10 REN-3, REN-4, REN-6, Zigong, SP-8 , SP-10, GB-34, LIV-3 Zigong, REN-3, SP-10, ST-36, ST-40, SP-6

Blood Deficiency

Clinical Manifestations	Pale thin Blood Maybe just spotting Period is commonly delayed Pallid or sallow complexion Palpitations with anxiety that may be continuous Reduced appetite Shortness of breath Laconic speech Easily fatigued extremities Light-headedness and/or vertigo Dizziness Anorexia Thirst Course skin Headache Blurred vision Lassitude	Midline pain in women Lower abdominal pain which is better with pressure Lower abdominal distention Severe chills and fever Irregular menstruation Weight loss Abscesses that neither suppurate nor improve Continuous spotting from uterine bleeding Weakness of the limbs Itching Under weight T: Pale C: Thin and white P: Thin and frail or Large and Deficient without strength
Treatment Principle	Tonify Spleen Qi Nourish the Blood
Herb Formulas	Ba Zhen Tang Ren Shen Zi Xue Tang  modified + Si Wu Tang  Si Wu Tang  modified Shi Quan Da Bu Tang
Points	REN-4, SP-6, SP-10, UB-17, UB-20, UB-23 REN-4, REN-6, UB-13, UB-15, UB-17, UB-18, UB-20, UB-23, KI-3, ST-36

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 Stagnation

Clinical Manifestations	Scanty menstruation Irregular menstruation Palpable masses that may or may not be painful Lower abdominal pain without palpable masses which is worse with pressure Lower abdominal distention Lower back pain Lower abdominal distention during menstruation Maybe distention along the flanks Frequent menstruation (3-5 timer per month) Spotting Dark purple menstrual Blood (usually with clots) Abnormal uterine bleeding with abdominal soreness and pain Aversion to Cold Depression Cold extremities White vaginal discharge T: Pale or With purple spots C: White P: Choppy
Treatment Principle	Invigorate the Blood Dispel Stasis Regulate menstruation
Herb Formulas	Shao Fu Zhu Yu Tang Xue Fu Zhu Yu Tang Tao Hong Si Wu Tang Gui Zhi Fu Ling Wan Niu Xi San Niu Xi Yin With Kidney Deficiency: Ding Jing Tang
Points	LIV-2, REN-4, SP-6, SP-10, ST-29

Cold In The Blood

Clinical Manifestations	Cold lower abdominal pain Difficult to start full flow Dark color Clots Menstruation is delayed (late) History of Cold Invasion Mild persistent uterine bleeding Irregular menstruation (either early or late) Prolonged menstruation Skipped period Metrorrhagia Extended or continuous menstrual flow Pain Lower abdominal distention Infertility Dry lips	Dry mouth Pale complexion Leukorrhea Amenorrhea Bleeding between periods Low grade fever at dusk Irritability Five sole Heat No desire to drink Distending breast pain Low back coldness and pain Loose stools Cold limbs Aversion to Cold T: Normal or Pale or Purple with petechiae C: Normal P: Tense or Thready and choppy
Treatment Principle	Warm the channels Disperse Cold
Herb Formulas	Wen Jing Tang Ai Fu Nuan Gong Wan
Points	Moxa REN-3, REN-4, SP-6, SP-8, SP-10, LIV-3 self treat often

Phlegm-Damp Stagnation

Clinical Manifestations	The Blood is sticky and , mixed with sticky fluids Menstruation is delayed (late) Leukorrhea The patient is generally overweight Chest and hypochondriac stuffiness Fatigue Weak lower extremities T: Swollen C: Greasy P: Slippery or Wiry, slippery or Deep and thready
Treatment Principle	Eliminate Phlegm Resolve Dampness Tonify the Spleen Promote circulation
Herb Formulas	Er Chen Tang modified Xiong Gui Er Chen Tang modified Cang Fu Dao Tan Tang
Points	REN-6, REN-12, SP-6, ST-25, ST-40