In the TCM diagnosis of missed periods, modern TCM practitioners adopt western methods in combination with syndrome differentiation. That means physicians will make a western-medicine-type diagnosis as reference to assist in first identifying a pathological missed period and then further clarify the presenting syndrome pattern. This syndrome pattern refers to a complex pattern of signs and symptoms that reflects the pathology of a disease at a certain stage, which give clues to physicians to understand the entire course of pathological changes and provide guidelines for clinical treatment. The clinical information for diagnosing a syndrome pattern can only be gathered through particular examination techniques that require years of practical training to attain.
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Traditional TCM consultation |
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Below are the common syndrome patterns for missed periods.
1. Deficiency of kidney-qi
Individuals have usually experienced delayed onset of menstruation during puberty. The menses become thin and scanty, then gradually cease. The accompanying symptoms include general weakness, physical immaturity or under development, pale face, dizziness, ear ringing, frequent urination, soreness in the back and knees. On examination, the tongue is pale; the pulse is deep and weak.
2. Deficiency of kidney essence
Individuals present with gradual cessation of menstruation. The accompanying symptoms include weakness and soreness in the back and knees, lower limb weakness with occasional pain in the heels, insomnia, absent-mindedness, dizziness and ear ringing. There may be vaginal dryness with extremely little discharge. On examination, the tongue is pale; the pulse is deep and weak.
3. Deficiency of blood and qi
Individuals present with gradual cessation of menstruation. The accompanying symptoms are paleness and gauntness, fatigue, sleepiness, breathless, dizziness, palpitation, insomnia, and dream-disturbed sleep. There may even skin dryness, lusterless hair and brittle nails. On examination, the tongue is pale; the pulse is thready and weak.
4. Blood stasis and congealed coldness
Individuals usually have normal menstrual periods, but experience a sudden cessation of menstruation. The associated symptoms include pain in the lower abdomen that can be relieved by warmth and sharpened by deep pressure on the region. There is also limb coldness and excessive thin and clear vaginal discharge. On examination, the tongue is purplish and bleeding spots may be found in the tongue tip; the pulse is deep and hesitant.
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5. Stagnation of blood and qi
Individuals experience an irregular menstrual cycle initially then the menstruation eases gradually or suddenly. The associated symptoms include pain in the lower abdomen that can be sharpened by deep pressure on the region, depression, irritability, breast tenderness and chest constriction. Individuals may also have poor appetite and diarrhea. On examination, the tongue is normal; the pulse is deep and taut.
6. Obstruction of phlegm and dampness
Individuals first experience delayed periods, then menstruation gradually ceases. Other accompanying symptoms include excessive sticky and clear vaginal discharge, nausea, phlegm in the throat, chest constriction, abdominal bloating, fatigue and general weakness. On examination, the tongue is pale and covered by white greasy fur; the pulse is taut and rolling. Individuals are usually obese.
It should be noted that missed periods can be due to different pathologies and may vary from individual to individual, and that the above syndrome patterns can appear alone or in complex form.
Generally speaking, physicians emphasize the individual's overall health in making their diagnosis as a principle guideline for further procedures. Individuals with missed periods are classified into deficient or excess states. Deficient individuals usually show abdominal distention and abdominal pain that sharpened by deep pressure on the region. Excess individuals usually present with a pale complexion, fatigue, headache, and a soft abdomen without pain.
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A pale tongue covered by white greasy fur |
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Cuttlefish bone |
Asiatic cornelian cherry fruit |
Eucommia bark |
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