Menstruation is called in Chinese Tian Gui, meaning heavenly water. It is related to Kidney and the extraordinary vessels Ren Mai and Chong Mai.

For diagnostic purposes, we ask the patient about four essential aspects of her menstruation:

• Duration of the cycle: whether it is regular or irregular, how many days it takes to arrive and how many days the bleeding lasts.
• Quantity: the abundance of the bleeding
• Texture: the fluidity or density of the bleeding
• Color of the bleeding

A normal menstruation should arrive every 28 days and last 4 to 5 days.

Early Menstruation

Arrives before 28 days. Causes:

1. Heat
2. Weak Earth, does not contain the Blood.

Due to Heat

1. Very abundant
2. Very red Blood
3. Clots appear (Heat condenses the Blood)

• We treat Yin to subdue Fire: LR-2, SP-6, LR-12

Due to Weak Earth

1. Lasts many days
2. Darker Blood
3. Tiredness
4. Pallor
5. Pale tongue
6. Weak pulse

Fibroids may be present.

• Lack of energy: Moxa CV-4, CV-6, GV-4
• Unblock SP channel: SP-1, SP-6, SP-9

Delayed Menstruation

Takes more than 28 days. It is considered delayed whether the difference is 1 or 2 days or several weeks, the latter being a more severe degree. Causes:

1. Cold (due to Yang deficiency)
2. Blood deficiency (after childbirth, haemorrhage. Poor nutrition does not nourish the Blood...)
3. Qi stagnation: Emotional.

Due to Cold

1. May be painful
2. With clots (Cold freezes)
3. Scanty quantity
4. Cold hands and feet
5. Aversion to cold
6. Pale tongue
7. Slow pulse

• Warm and tonify the Kidneys. Moxa BL-23, GV-4, CV-4, CV-6, SP-6

Due to Blood deficiency

1. Dizziness
2. Blurred Vision

See Blood deficiency

• Tonify Blood and Qi. Tonify Liver: BL-17, BL-18, ST-36

Due to Qi stagnation

1. Premenstrual syndrome
2. Distension in the lower abdomen
3. Pain
4. Wiry pulse

• Drain Liver LR-3 and moxa CV-3 and CV-4 (a weak KI Essence has a greater tendency toward stagnation)

Dysmenorrhea

Painful menstruation.

Dysmenorrhea due to stagnation

Characteristic of before menstruation or the first days. Premenstrual syndrome, cysts, endometriosis... Causes:

• Cold: during menstruation the uterus communicates with the exterior. Formerly it was recommended to avoid cold showers during those days. Cold penetrates and pain appears.
• Emotions: Liver-Qi stagnation
• Diet: cold, raw, sour, astringent foods (concentrating)

Treatment: LR-3; LI-4; CV-4; CV-6; 6, 8 or 10 SP, KI-9

Dysmenorrhea due to Qi-Blood deficiency

Pain appears toward the end of the cycle or after menstruation. Needs to tonify Qi and Blood in general. Moxa BL-18, BL-23; CV-4, ST-36, KI-6...

See further development: Dysmenorrhea

Metrorrhagia

Metrorrhagia is bleeding outside of menstruation.

1. Due to Heat in Blood
2. Due to Empty pattern: bleeding lasting many days, pale, tiredness, anaemia... (cases of fibroids or pre-menopausal period). Affects Chong Mai and Ren Mai. Important points: Moxa GV-20; SP-1; GV-4, CV-4

Amenorrhoea

1. Full pattern: Qi-Blood stagnation: Nervousness, irritability, pain in the hypochondrium, lower abdomen, distension, nausea. LR-1; SP-6, SP-10; CV-3
2. Empty pattern: Blood deficiency or Qi-Blood deficiency. Weakness, tiredness, hair loss... May be due to poor nutrition. We would use Back-Shu points

See further development: Amenorrhoea

Leukorrhea

1. Damp-Heat: yellowish discharge, strong odour and genital itching. LR-5 in tonification; SP-6; SP-9; CV-4 and CV-6
2. Empty pattern: Discharge without itching or odour, fluid and abundant. Weak Kidneys, Spleen and Dai Mai. Can easily become infected because there is excessive dampness. There is a tendency to miscarry. Moxa GB-26