Case Histories - Menstrual Headaches
A 52-year-old woman suffered from headaches occurring after the
period. Her periods were still coming regularly but were rather
scanty. Her hair was falling out and her skin was dry. She had never
been able to conceive although she tried for many years. She also
felt very weary and depressed, especially so after her period. She
also lacked any motivation and "everything was an effort".
She found it difficult to fall asleep and had had a lump in her
left breast for 20 years. Her iron storage level was very low (3).
Her pulse was very Weak and Empty on the deep level but also slightly
Fine and Wiry on the left. Her tongue was Pale on the sides, had
a Heart crack and a rootless coating.
Diagnosis
This is quite a complex condition. The main pattern that emerges
is that of Liver-Blood deficiency manifesting with scanty periods,
hair falling out, dry skin, infertility, insomnia, a Fine pulse
and a Pale tongue on the sides. There are, however, other patterns
that manifest with only a few symptoms. The Wiry quality of the
pulse indicates that there is some stagnation of Liver-Qi from emotional
stress, also evidenced by the Heart crack on the tongue. The stagnation
of Liver-Qi was a contributory factor to the development of the
breast lump, another being Phlegm (as the lump felt soft to the
touch). Yet another pattern is a Kidney-Yin deficiency, again manifesting
with few symptoms and principally the emptiness of the pulse at
the deep level, the rootless tongue coating and the lack of motivation
and exhaustion. The falling hair and dry skin attributed to Liver-Blood
deficiency may also be caused by Kidney-Yin deficiency, or this
may contribute to them. To sum up, there are two Excess conditions
(stagnation of Liver-Qi and Phlegm) and two Deficiency ones (Liver-Blood
and Kidney-Yin deficiency). In addition, this may be classified
as a case of Mind Weakened, i.e. low spirits, depression, lack of
motivation and physical and mental exhaustion.
Treatment
The headaches occurring after the period were her main presenting
symptom and they were due to Liver-Blood deficiency. I therefore
started by treating her with Precious Sea
(a variation of the formula Ba Zhen Tang-Eight Precious Decoction).
After one course (30 days) of this formula, this patient felt a
lot better in herself and her headaches disappeared. Her iron storage
levels also climbed to 13. The patient is still under treatment
and I foresee that she will probably eventually need to change to
a formula to nourish Kidney-Yin and Blood. |
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