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Case Histories - Menopausal Syndrome (5)

A 53-year-old woman complained of menopausal problems for the previous 3 years, after her periods stopped. Her main problems were severe hot flushes, night-sweating, depression, anxiety, mood swings, a tingling feeling all over and insomnia. She also complained of severely cold feet and frequent urination. Her tongue was Red with a slightly rootless, yellow and dry coating and her pulse Rapid, Overflowing on both Front positions and Weak and Deep on both Rear positions. Although most of these symptoms started after her periods stopped, she had a history of severe stress in the years leading up to the menopause (husband's redundancy, father's death and daughter's breakdown) and this obviously accounted for the severity of the menopausal symptoms. As explained in the chapter on Aetiology (ch. 4), the kind of menopause a woman experiences depends on her lifestyle in the years preceding it.

Diagnosis

Most of this patient's symptoms are due to deficiency of Kidney-Yin with Empty Heat affecting the Heart and harassing the Mind. The symptoms of Kidney-Yin deficiency are hot flushes, night-sweating, Red tongue with a slightly rootless coating and a Weak and Deep pulse on both Rear positions. The symptoms of Empty Heat affecting the Heart and harassing the Mind are depression, anxiety, mood swings, insomnia and a pulse that is Rapid and Overflowing on both Front positions. As in the previous case history, in this case too there is an overlapping of Kidney-Yin and Kidney-Yang deficiency; although the primary condition is one of Kidney-Yin deficiency, there is also some Kidney-Yang deficiency as evidenced by the cold feet and frequent urination.

Treatment principle

The treatment principle adopted was to nourish Kidney- and Heart-Yin, clear Heart Empty Heat, and calm the Mind; a secondary aim was to tonify Kidney Yang. She was treated with acupuncture and patent remedies.

Acupuncture

The points used were selected from the following:-

LU-7 Lieque and KI-6 Zhaohai to regulate the Directing Vessel, strengthen the Uterus and nourish Kidney-Yin.-
Ren-15 Jiuwei to calm the Mind and clear the Heart.-
Ren-4 Guanyuan to nourish the Kidneys and calm the Mind.-
Du-24 Shenting and G.B.-13 Benshen to calm the Mind.-
Du-20 Baihui to lift depression.-
HE-6 Yinxi and KI-7 Fuliu to stop night-sweating and clear Heart Empty Heat.-
SP-6 Sanyinjiao to nourish Yin, calm the Mind and promote sleep.

Herbal treatment

Initially, I treated this patient only with acupuncture for 2 years (at infrequent intervals, see below); after that I prescribed the Women's Treasure's remedies Ease the Journey - Yin to nourish Kidney-Yin combined with Ease the Journey - Yang: I prescribed 3 tablets of the former to be taken in the evening and only half of the latter to be taken in the morning.

This patient came quite infrequently as she found that one acupuncture treatment controlled her menopausal symptoms for up to 4 months. After 2 years, I prescribed the above remedies to consolidate results: using these remedies, she found that she no longer needed to have acupuncture.