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Case Histories - Pre-Menstrual Syndrome (1)

A 27-year-old woman had been suffering from pre-menstrual tension for 13 years (more or less ever since her menarche). She had had two children and the pre menstrual tension became worse after each birth. Her main symptoms were abdominal distension, severe irritability, anger, aggressiveness. She had been given a progesterone pill but this had not helped and had only given her headaches. Her periods were regular, lasted 4 days and were heavy; the menstrual blood was bright-red. She also suffered from constipation and, on interrogation, it transpired that she experienced backache and dizziness, she often felt cold, she had cold feet and her urination was frequent and pale. She did not sleep well and occasionally experienced some tingling of her limbs. Her tongue was Pale and slightly Thin with teethmarks. Her pulse was Wiry.

Diagnosis

The main pattern at the root of the pre-menstrual tension is Liver-Qi stagnation manifesting with the typical pre-menstrual symptoms and a Wiry pulse. This occurred against a background of Kidney-Yang deficiency (feeling cold, cold feet, frequent urination, back-ache, dizziness) and some Blood deficiency (insomnia, tingling and a Pale-Thin tongue).

Treatment principle

The main emphasis should be on pacifying the Liver, moving Qi and calming the Mind. However, one should also attend to the Deficiency by tonifying Kidney-Yang and nourishing Blood. She was treated with acupuncture and patent remedies.

Acupuncture

The points used were selected from the following, using even method on the points to pacify the Liver and reinforcing method on those to tonify the Kidneys and nourish Blood:-

L.I.-4 Hegu to calm the Mind and regulate the ascending and descending of Qi. This will help the distension caused by the stagnation of Qi.-
P-6 Neiguan to pacify the Liver, calm the Mind and settle the Ethereal Soul.-
Ren-15 Jiuwei to calm the Mind and free the chest and breasts.-
SP-6 Sanyinjiao to pacify the Liver, move Qi and Blood and calm the Mind. -
LIV-3 Taichong to pacify the Liver, move Qi and settle the Ethereal Soul.-
KI-3 Taixi, with warm needle, to tonify Kidney-Yang.

Herbal treatment

I prescribed the Three Treasures (or East West Treasures) remedies Strengthen the Root to tonify Kidney-Yang (to be taken for about 12 days after the period) and Freeing the Moon to pacify the Liver and move Qi (to be taken for about 12 days before the period).

After 3 months of treatment (with fortnightly acupuncture sessions), her pre menstrual tension was very much reduced. This patient is still under treatment at the time of writing.