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PERIMENOPAUSE SYNDROME

GENERAL

Clinical Manifestations
Treatment Principle
Herb Formulas	With uterine leiomyoma: Shao Yao Gan Cao Tang
Points

TAI YANG - YANG MING

Clinical Manifestations	Fever Sweating Thirst Dysenteric diarrhea Foul-smelling stools A burning sensation around the anus Gasping Ephidrosis Palpitations Tenesmus Maybe red tinged urine Irritability and Heat in the chest and epigastrium Stiffness and spasms at the back of the neck Dry mouth Dyspnea with perspiration Maybe wheezing T: Red C: Yellow (Greasy) P: Rapid
Treatment Principle	Release the Exterior Clear Internal Yang Ming Heat
Herb Formulas	Ge Gen Huang Qin Huang Lian Tang
Points

SHAO YANG FU WITH CONGESTED FLUIDS

Clinical Manifestations	Alternating chills and fever (chills predominate) or Chills without fever Sensation of irritability in the chest Sweating from the head Fatigue Gastrointestinal weakness Heavy head Neuralgia Epigastric distension Lower abdominal pain Tension around pubic bone Periumbilical pain Urinary difficulty T: Moist C: White and slippery P: Superficial and wiry
Treatment Principle	Disperse Clumping Harmonize the Shao Yang Warm the Interior Dispel Cold
Herb Formulas	Chai Hu Gui Zhi Gan Jiang Tang
Points	GB-41, SJ-5, moxa or moxa needle REN-4, REN-6, REN-8, REN-12, SJ-6, ST-25, ST-36

SHAO YIN HEAT

Clinical Manifestations	Urinary difficulty Thirst with a desire to drink Fever Cough Nausea/vomiting Irritability Insomnia Restlessness Diarrhea Anxiety Edema Lower abdominal distention and pain Maybe hematuria Painful urination with Yin Deficiency Urinary dribbling Decreased urination Dry skin Sunken eyes Fever worse at night T: Red or Dark red and dry C: Yellow, thin or none P: Thready and rapid or forceful and rapid
Treatment Principle	Promote urination Clear Heat Nourish Yin
Herb Formulas	Zhu Ling Tang
Points	To Nourish the Kidneys: UB-23, KI-3, KI-6, KI-7, KI-10 To Nourish the Heart: UB-15, HT-7, HT-5 To Nourish Yin: LIV-3, SP-6 To clear Heat: DU-14 HT-7, SP-6, Yintang, DU-20, KI-1, KI-16

LACK OF COMMUNICATION BETWEEN THE HEART AND KIDNEYS

Clinical Manifestations	Urinary difficulty Thirst with a desire to drink Fever Cough Nausea/vomiting Irritability Insomnia Restlessness Diarrhea Anxiety Edema Lower abdominal distention and pain Maybe hematuria Painful urination with Yin Deficiency Urinary dribbling Decreased urination Dry skin Sunken eyes Fever worse at night T: Red or Dark red and dry C: Yellow, thin or none P: Thready and rapid or forceful and rapid
Treatment Principle	Promote urination Clear Heat Nourish Yin
Herb Formulas	Zhu Ling Tang
Points	To Nourish the Kidneys: UB-23, KI-3, KI-6, KI-7, KI-10 To Nourish the Heart: UB-15, HT-7, HT-5 To Nourish Yin: LIV-3, SP-6 To clear Heat: DU-14 HT-7, SP-6, Yintang, DU-20, KI-1, KI-16

LIVER QI STAGNATION

Clinical Manifestations	Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Pink C: Thin and white P: Wiry
Treatment Principle	Soothe the Liver Clear Stagnation
Herb Formulas	Xiao Yao San
Points	GB-40, GB-41, LIV-2, LIV-3, LIV-4, LIV-5, LIV-13, LIV-14, PC-6, SJ-6, SP-6, UB-18

LIVER QI STAGNATION INVADES THE SPLEEN

Clinical Manifestations	Abdominal distention and pain Gas Borborygmus Diarrhea Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Women: Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Pink C: White and greasy P: Slippery and wiry
Treatment Principle	Soothe the Liver Invigorate the Spleen
Herb Formulas	Si Ni San
Points	LIV-3, LIV-13, SP-6, ST-25, ST-36, ST-37

KIDNEY YIN DEFICIENCY WITH EMPTY FIRE RISING

Clinical Manifestations	Dry cough Dizziness Tinnitus or deafness Poor memory Aching, soreness or weakness of low back Spermatorrhea or premature ejaculation Aching in bones Aching in leg and heel Dry mouth Thirst Night sweats Five sole heat Malar flush Low grade fever in the afternoon Dry throat, maybe recurrent sore throat Dry stools and / or constipation Urine short and red Heightened libido T: Red C: Little or None P: Thready and rapid
Treatment Principle	Moisten the Yin Restrain the Fire
Herb Formulas	Zi Yin Jiang Huo Tang
Points	KI-1, KI-2, KI-3, KI-6, KI-9, REN-4, SP-6, UB-23

KIDNEY AND LIVER YIN DEFICIENCY

Clinical Manifestations	Hypochondriac and chest pain Dry, parched mouth and throat Bitter taste in mouth Acid regurgitation Epigastric and abdominal distention T: Red and dry P: Thready and weak or Wiry and Deficient
Treatment Principle	Enriches Kidney and Liver Yin Spreads Liver Qi
Herb Formulas	Yi Guan Jian
Points

KIDNEY YIN AND YANG DEFICIENCY

Clinical Manifestations	Amenorrhea Irregular Menstruation Hot flashes Dizziness Tinnitus Night sweats Perspiration Nervousness Muscular flaccidity Fatigue Cold feet Lassitude Frequent, clear urine Irritability Headache Palpitations Insomnia T: Pale C: Thin and white P: Thready and rapid
Treatment Principle	Replenish Kidney Yin and Yang Purge Fire
Herb Formulas	Er Xian Tang
Points

DISHARMONY BETWEEN THE CHONG AND REN CHANNELS

Clinical Manifestations	Amenorrhea Irregular Menstruation Hot flashes Dizziness Tinnitus Night sweats Perspiration Nervousness Muscular flaccidity Fatigue Cold feet Lassitude Frequent, clear urine Irritability Headache Palpitations Insomnia T: Pale C: Thin and white P: Thready and rapid
Treatment Principle	Replenish Kidney Yin and Yang Purge Fire Regulate the Chong and Ren
Herb Formulas	Er Xian Tang
Points

QI AND PHLEGM STAGNATION

Clinical Manifestations	Depression Irritability Feeling of oppression in the chest Plum-seed Qi Stagnation Enlarged thyroid gland T: Red C: Thin and greasy P: Wiry or Slippery-wiry
Treatment Principle	Resolve phlegm Regulate Qi circulation Soothe the Liver
Herb Formulas	Ban Xia Hou Po Tang
Points

BLOOD STAGNATION

Clinical Manifestations	Pain that is fixed, stabbing and /or severe Pan is worse with pressure Dark complexion Fixed, palpable masses Bleeding with clots Purple lips Purple nails Dry skin Blue, dark or purplish discoloration of skin in small or large areas, Varicose and spider veins Cold hands and feet Tendency to hemorrhage dark blood or clots T: Purple, possible purple or red spots Red purple if there is Heat Blue purple if there is Cold C: White P: Choppy or Wiry and choppy
Treatment Principle	Invigorate the Blood Break up Stagnation
Herb Formulas	Gui Zhi Fu Ling Wan Due to Cold with Deficiency Cold of the Chong and Ren channels: Wen Jing Tang
Points	SP-6, SP-10, ST-36, UB-17, UB-40

LOWER JIAO BLOOD STAGNATION WITH HEAT

Clinical Manifestations	Acute lower abdominal pain Incontinence of urine Night fevers Delirious speech Irritability Restlessness Thirst May be mania (severe) Dysmenorrhea Amenorrhea Hard stool Dark red complexion Headache Vertigo Tinnitus Insomnia Palpitations Constipation Frequent urination Emotional instability Chills in the waist and feet Tremors Excruciating abdominal pain with cold Black stool May be chills and fever Hemoptysis Hematuria Red eyes Pain and distention of the head Toothache Irregular menstruation Lochioschesis Severe wheezing Distention of the chest T: Red and dry C: Yellow P: Deep and forceful or Choppy
Treatment Principle	Drain Heat Break up Blood Stasis
Herb Formulas	Tao He Cheng Qi Tang
Points

BAI HE BING (LILY SYNDROME)

Clinical Manifestations	Mental disorientation Irritability Insomnia Palpitations Depression Restlessness Hopelessness Sudden mood swings Erratic behavior Feels cold then not cold Feels hot then not hot Aversion to life Dry mouth Dry stools Dry throat Fatigue Irregular stools Lethargy Mental instability Obsessions Craves food the hates food Does not like to talk Does not know what he/she wants Dark urine A bitter taste in the mouth Dizziness Muddled thinking T: Red C: Little or None P: Slightly rapid or Weak and rapid or Thready and rapid
Treatment Principle	Moisten the Lungs and Heart Nourish Fluids Nourish Yin Clear Deficiency Heat Cool the Blood
Herb Formulas	Bai He Di Huang Tang Bai He Zhi Mu Tang
Points