Case Histories - Menorrhagia (2)
A 37-year-old woman had been suffering from heavy periods: these
were regular, lasted 6 days and the blood was bright red without
clots. She also suffered from backache, tiredness, poor appetite,
loose stools and dizziness. Her tongue was Pale and Swollen but
also very slightly Red on the sides and her pulse was Weak in general,
especially on both Kidney positions.
Diagnosis
There is a clear deficiency of the Spleen (tiredness, poor appetite,
loose stools, Pale tongue) and of Kidney-Yang (backache, dizziness,
Pale tongue). Her condition therefore seemed to be a straightforward
case of Spleen- and Kidney-Qi not holding Blood and causing heavy
periods.
Treatment
I prescribed Restrain the Flow to tonify
Qi and hold Blood to be taken before and during the period, followed
by Unicorn Pearl to be taken after the
period for about 1 week. However, this approach produced no results
after four months. I therefore re-assessed the case and paid more
attention to the redness of the sides of the tongue. This led me
to enquire about any Blood Heat symptoms and, on interrogation,
it turned out that she did feel slightly thirsty and she did feel
hot occasionally. I therefore changed my approach and gave her Cool
the Menses to cool the Blood and reduce bleeding, to be taken
before and during the period, while I still asked her to continue
taking Unicorn Pearl after the period.
This strategy produced immediate results with a marked and gradual
reduction of menstrual bleeding over 3 months.
This case illustrates an important point of diagnosis and treatment
strategy of heavy menstrual bleeding. Although a woman suffering
from heavy menstrual bleeding may present with many Qi-deficiency
symptoms, it does not necessarily follow that that is the cause
of excessive bleeding: it is perfectly possible for a woman to suffer
from Qi deficiency but also some Blood Heat which may be the cause
of heavy menstrual bleeding. Very often, the manifestations of Blood
Heat are very slight but significant nevertheless. To put it differently,
if a woman suffers from heavy menstrual bleeding and displays many
symptoms of Qi deficiency and a Qi-tonifying approach does not yield
results, it is always advisable to re-assess the case and check
whether there is some Blood Heat. |
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