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Menopausal Syndrome

Menstruation usually stops at about the age of 50. It is a physiological phenomenon due to deficiency of kidney-qi, exhaustion of Tiankui and debility of the Chong, Ren and Bao meridians. During this period, most of women do not have marked clinical symptoms, but some show manifestations such as irritability, listlessness, fatigue, mental depression, emotional upsets, dizziness, tinnitus, palpitations, insomnia, lumbago, feverish sensation over palms and soles, paroxysmal sweating and flushed face, edema, loose stool, etc., which are known as menopausal syndrome.

Etiology and Pathogenesis

The dysfunction of the Zhang-fu organs resulting from the deficiency of kidney-qi, the insufficiency of essence and blood is the main cause of menopausal syndrome. Deficiency of the kidneys is the basic pathological change, which is classified clinically into deficiency of kidney-yin, deficiency of kidney-yang and imbalance between heart-yang and kidney-yin.

Diagnosis and Differential Diagnosis

A. Diagnostic evidence

a) Irregular menstruation with varying amounts of menstrual flow.

(b) Occurrence of symptoms such as dizziness, tinnitus, irritability, insomnia, sweating, feverish sensation over the chest, palms and soles, emotional upsets, edema, loose stool, lumbago, osteodynia, fatigue, etc.

(c) A female of 45 to 52 years of age.

(d) No organic disease observed.

B. Differential diagnosis

Menopausal syndrome should be distinguished from irregular menstruation and some internal diseases which are manifested by symptoms such as dizziness, palpitations and edema.

Syndrome Differentiation and Treatment

A. Deficiency of liver-yin and kidney-yin

Manifestations: Dizziness, headache, tinnitus, soreness and weakness of lumbus and knees, irritability, sweating accompanied by palpitations, sleeplessness, poor memory, feverish sensation over the chest, palms and soles, dryness of eyes, absent-mindedness, mental disorder and fear, irregular menstruation with small amount of purplish-red and dripping menstrual flow, red tongue with little coating, thready and rapid pulse, or itching, formication or numbness of the skin and even convulsions.

Therapeutic principles: Nourish kidney-yin, and suppress liver-yang.

Prescription:

Radix Rehmanniae 15 g
Radix Rehmanniae Praeparata 15 g
Fructus Lycii 15 g
Radix Polygoni Multiflori Praeparata 20 g
Fructus Mori 15 g
Fructus Ligustri Lucidi 10 g
Colla Plastri Testudinis 10 g
Radix Paeoniae Alba 15 g
Os Draconis (decocted) 30 g
Concha Ostreae (decocted) 30 g

Remarks: For cases with hypertension and convulsion due to liver-wind stirring inside the body resulting from hyperactivity of liver-yang, add Pulvis Cornu Saigae Tataricae (3 g, taken by mixing with the decoction), Ramulus Uncariae cum Uncis (10 g) and Rhizoma Gastrodiae (10 g) to calm the liver and wind. For cases with skin itching and formication due to blood deficiency and endogenous wind, add Radix Angelicae Sinensis (10 g), Radix Salviae Miltiorrhizae (15 g), Flos Campsis (10 g) and Pulvis Scorpio (1.5 g, taken by mixing with the decoction). For cases with stagnation of liver-qi manifested by distending over the chest and hypochondria and frequent belching, the therapies for tonifying the kidneys and calming the liver, regulating the stomach and keeping adverse qi downwards may be employed. The following prescription applies:

Magnetitum (decocted) 15 g
Haematitum (decocted) 15 g
Fructus Mori 15 g
Radix Angelicae Sinensis 10 g
Rhizoma Pinelliae 10 g
Semen Canavaliae 10 g
Radix Paeoniae Alba 15 g
Flos Inulae 10 g

B. Deficiency of kidney-yang

Manifestations: Hypomenorrhea with light-colored and thin menses, delayed menstrual cycles, soreness and weakness of lumbus and knees, tight sensation of the chest, coldness of the back, bearing-down sensation of pudenda, listlessness, apathy, pale tongue and deep and weak pulse.

Therapeutic principles: Warm and tonify kidney-yang.

Prescription:

Rhizoma Curculiginis 10 g
Herba Ephedrae 15 g
Radix Morindae Officinalis 10 g
Radix Codonopsis Pilosulae 15 g
Cornu Cervi Degelatinatum 12 g
Pericarpium Lagenariae 15 g
Semen Cuscutae 20 g

Remarks: For cases accompanied by deficiency of kidney-yin and manifested as hectic fever, chilliness, irritability, sleeplessness, dizziness and tinnitus, omit Curculiginis and Ephedrae and add Herba Cistanchis (15 g), Radix Polygoni Multiflori Praeparata (20 g), Os Draconis (30 g, decocted first) and Concha Ostreae (30 g). For cases accompanied by deficiency of spleen-yang and manifested as edema and loose stool, omit Herba Cistanchis and add Rhizoma Atractylodis Macrocephalae (15 g) and Fructus Psoraleae (15 g).

C. Imbalance of heart-yang and kidney-yin

Manifestations: Dizziness, palpitations, tinnitus, insomnia, dreaminess, irritability, sweating, soreness and weakness of lumbus and knees, absent-mindedness, poor memory, emotional upsets and fainting, crimson tongue and thready-weak and rapid pulse.

Therapeutic principles: Tonify kidney-yin, nourish heart, and calm the mind.

Prescription: Radix Rehmanniae 15 g
Radix Rehmanniae Praeparata 15 g
Fructus Lycii 15 g
Fructus Ligustri Lucidi 10 g
Fructus Corni 10 g
Radix Asparagi 10 g
Radix Ophiopogonis 10 g
Bulbus Lilii 15 g
Rhizoma Acori Graminei 10 g
Lignum Pini Poriaferum (prepared with Cinnabaris) 10 g
Plumula Nelumbinis 10 g
Radix Polygalae 6 g
Concha Mauritiae 30 g

Remarks: For cases with deficiency of heart-blood and spleen-blood and stagnation of liver-qi manifested as frequent yawning, red tongue with thin coating and thready and rapid pulse, the therapy should be nourishing yin and regulating the heart and spleen, and the Modified Powder for Restoring Pulse Beat and Decoction of Glycyrrhizae, Triticu Levis and Jujubae should be employed as follows:

Radix Glycyrrhizae Praeparata 6 g
Radix Rehmanniae 15 g
Radix Rehmanniae Praeparata 15 g
Radix Ophiopogonis 10 g
Fructus Jujubae 5 pcs
Fructus Tritici Levis 30 g
Bulbus Lilii 15 g
Cortex Albizziae 10 g
Plumula Nelumbinis 6 g

In addition, King of Heaven Tonic Pill for Mental Discomfort should be used to nourish the heart and kidneys; it is composed of Semen Biotae, Radix Ophiopogonis, Radix Asparagi, Radix Scrophulariae, Radix Salviae Miltiorrhizae, Fructus Schisandrae, Radix Rehmanniae, Radix Angelicae Sinensis, Poria, Radix Polygalae, Radix Platycodi, Semen Ziziphi Spinosae and Radix Codonopsis Pilosulae.

Copyright 1995 Hopkins Technology

 


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