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Menopause TCM patterns and Herbal Formulas

Brian Carter is the founder of the Pulse of Oriental Medicine, medical professor at Pacific College of Oriental Medicine, and author of Powerful Body, Peaceful Mind: How to Heal Yourself with Foods, Herbs, and Acupressure.

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TCM syndromes and Herbal Formulas

An in-depth look at 9 possible OM diagnoses. Including symptoms and herbal solution. This is practitioner level information for reference purposes only.

  1. Heart Qi/Yang Deficiency
  2. Heart Blood and Yin Deficiency
  3. Spleen Qi Deficiency
  4. Spleen Qi Sinking
  5. Spleen Failing to Regulate Blood
  6. Stagnation of Liver Qi
  7. Liver Blood Deficiency
  8. Kidney Yin Deficiency
  9. Kidney Yang Deficiency
Any of the above syndromes with amenorrhea from
  1. Xue Stagnation
  2. Damp Phlegm Stagnation


1. Heart Qi/Yang Deficiency

Symptoms: (shorter, lighter cycle)

  • pale, white complexion, fatigue, spontaneous sweating, difficulty catching one's breath.
  • depression, cardiovascular deterioration, palpitations
  • Pulse: interrupted, weak, fine, slow
  • Tongue: Pale, smooth or white coat
Herbal Formulas:
  • Gings Nutri-Ren Shen Yang Rong T
  • Ginseng and Gecko Powder, Shen Jie San (H, K Lu qi xu)
  • Ginseng & Zizyphus Formula; Tian Wang Bu Xin Dan....with additional Ht yin Xu
  • Ginseng Longan-Gui Pi Tang- add for Sp qi xu
  • Natural Slumber/Jin Bu
  • Yang Xin Tang
Points: Ht5, Pc5,6, St 36, shenmen
2. Heart Blood and Yin Deficiency

Symptoms

  • pale, white complexion
  • poor memory, insomnia, excessive dreaming, emotional disturbance, dizziness and palpitations
  • Pulse: fine, increased rapidity with deficiency
  • Tongue: pale, red in upper third, dry coat

Herbal Formulas

  • Ginseng & Zizyphus Formula: anxiety, insomnia
  • Zizyphus Formula: night sweat, palpitation (An Mien Pien)Suan Zao Ren T-Lvxuexu, Ht xue st
  • Anem-Phello & Rehmannia Formula: night sweat (greater than Zizyphus sweat), hot flash, hot palms & soles, low grade fever (Zhi Bai Di Huang Wan)-Kyin xu
  • Natural Slumber and Melatonin for sleep

Points: Ht5, Pc5,6, St 36, Sp4,9for more heat, UB 17,20,K3

3. Spleen Qi Deficiency

Symptoms (shorter cycle, not so heavy flow)

  • lustlerless complexion, exhaustion, digestive disturbance, gas, swollen abdomen, sweet cravings, blood sugar swings
  • Pulse: soft, soggy
  • Tongue: pale, possibly swollen, lateral edging

Herbal Formulas

  • Four Gentlemen- basic qi xu
  • Ginseng & Atractylodes Formula; Li Zhong Tang -add for more damp and cold
  • Ginseng & Astragalus Formula; Bu Zhong Yi Qi Tang - add for sl sp yang xu
  • Pinellia Magnolia Formula add for damp and Lv qi stag
  • Xiao Yao San-add for less damp but lv qi stag
  • Ginseng & Longan Formula; Gui Pi Tang- add for Ht qi and xue stag

Points: Sp 3, CV6,12, S36, LV 13, LI8

4. Spleen Qi Sinking

Symptoms: (irregular, long or short, breakthrough bleeding)

  • weakness, sagging, abdominal distention after eating; prolapse of muscles - neck, arms, etc.
  • Pulse: soggy
  • Tongue: enlarged

Herbal Formulas

  • Ginseng Astragalus Formula
  • Ginseng Atractylodes Formula- Li Zhong T, for cold and damp
  • Rehmannia supplement for Kidney Yang Deficiency

Points: LV13, CV6,17, SP4, UB20, ST36, DU20, moxa

5. Spleen Failing to Regulate Blood

Symptoms: (short cycle, heavy flow)

  • hemorrhage, menorrhagia, metrorrhagia
  • white/sallow complexion, dizziness, palpitation, shortness of breath especially with exertion
  • Pulse: choppy, thin, weak, sliippery & thin
  • Tongue: pale, bluish, dark color

Herbal Formulas

  • Huang Tu Tang - Fu Long Gan (Tu Xin Tu) ignited yellow earth, bai zhi, atractylodes, fu zi, di huang, e jiao, huang qin, gan cao - for heavy bleeding
  • Ginseng & Tang Kuei 10 Formula - Shi Quan Da Bu Tang - H/Liv/K xu
  • Butiao Formula - Bu Xue Tiao Jing T, Nourish Blood Adjust Period Decoction - cold, xue stag, K yang qi xu
  • Gu Ben Zhi Beng Tang

Points: LV1, UB20m, CV7,4,6, ST36, SP6, SP1, Du20, ear: uter, endo subc tx, ovary

6. Stagnation of Liver Qi

Symptoms: (longer cycle)

  • depression, impatience, exaggerated emotional response
  • Pulse: wiry
  • Tongue: lateral redness, body may be pale, possilbe bluishness

Herbal Formulas

  • Bupleurum & Tang Kuei Formula; Hsiao Yao San - slight xu Sp and xue
  • Pinellia Magnolia - Ban Xia Hou Po T- damp
  • Bupleurum & Peony Formula; Dan Zhi Hsiao Yao San -with heat and Sp xu
  • Bupleurum & Cinnamon; Chai Hu Gui Zhi Tang with pre-existing Sp xu, stagnant Stomach
  • Bupleurum & Dragon Bone Formula; Chai Hu Jia Long Gu Mu Li Tang - Liv yang t, more heat, and emotional disturbance
  • Minor Bupleurum Formula; Xiao Chai Hu tang - muscle tension predominates
  • Ge Xie Zhu Tu T- for increased pain from xue stagnation (Remove Blood Stagnation below the Diaphragm)
  • Tong Yu Jian

Points: LV3,14, K8, SP6

for more pain with cycles: LV2, SP10, CV3,4, Zigong, ear: shen sympath

7. Liver Blood Deficiency

Symptoms: (longer cycle or irregular)

  • dizziness, insomnia, excessive dreaming, blurred vision, lusterless nails, reduced menstrual flow alternated with increased menstrual flow
  • Puls: thin, weak, possibly rapid
  • Tongue: pale, thin, dry coat

Herbal Formulas

  • Tang Kuei Four Formula - Si Wu Tang
  • Rehmannia 6 Formula; Liu Wei Di Huang wan with Kidney Yin Xu
  • Shou Wu Formula - with Jing xu, xue stagnation, LV yin xu
  • Fo Ti Formula

Points: UB17, LV14, SP4, CV6,12, LV4, K8, if irregular: UB20, ST36

8. Kidney Yin Deficiency

Symptoms: (shorter cycle)

  • dizziness, tinnitus, dry mouth, steady fever, low back pain, spontaneous sweating, insomnia
  • more severe symptoms include weight loss
  • Pulse: thin, slightly rapid, wiry
  • Tongue: shiny, dry coat, some redness lateral or root

Herbal Formulas

  • Rehmannia Six
  • Zuo Gui Wan (Replenish the Yin Left)
  • Anem-Phello & Rehmannia; Zhi Bai Di Huang Wan, with blood heat and fire, St yin xu
  • Lycium & Rehmannia Formula; Qi Ju Di Huang Wan, with LV yin xu

Points: K6, CV4,6, HT5, SP6

9. Kidney Yang Deficiency

Symptoms: (longer)

  • nephritis, fatigue, chronic diarrhea, water retention, aversion to cold, cold hands and feet, dizziness, headaches, joint pains, forgetfulness
  • Pulse: weak, thin, softer
  • Tongue: pale, possibly swollen

Herbal Formulas

  • Kidney Yang Supplement - morinda, cistanche, cynomorium, psoralea, cuscuta, lycium, eucommia, cinnamomum
  • Aconite & Cinnamon Eight Pills
  • Nan Bao, Right Restored Pill, You Gui Wan
  • Ginseng & Tang Kuei Ten Formula (HT, LV, SP, xue xu also)

Points: K3, DU4, CV4m, UB23, CV9-edema, DU20, ST36, LV8

Any of Above Syndromes with Amenorrhea from:

Xue Stagnation - Carth Persic Combination - Hong Hua Tiao Ren Jian, points: SP10, LV14

Damp Phlegm Stagnation - Dao Tan Tang - Phlegm Resolving Decoction - zhi nan xing, arisaema, immature bitter orange, pinellia, citurs peel, poria, licorice, points: ST40, LV13

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All information herein provided is for educational use only and not meant to substitute for the advice of appropriate local experts and authorities.
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