Main Signs and Symptoms
Episodes begin about 10 days before menstruation and symptoms reduced but still present soon after bleeding has ceased; localised severe itching with a burning pain and a thick white discharge.
Pulse: Right side is deep, left side is wiry-rapid
Tongue: Red with a thin coat
Diagnosis and Treatment
Liver-Gallbladder Fire with Damp-Heat affecting the lower Jiao
Treatment Principle: Clear the Liver-Gallbladder, drain Damp-Heat
Long Dan Xie Gan Tang (Gentiana Formula) for 7 days.
After one week of treatment all of the symptoms had stopped. She was then prescribed Tao Hong Si Wu Wan (Persica, Carthamus & Dang-gui Combination) for one week, followed by Huo Xiang Zheng Qi Wan (Agastache Formula) for a further week, in order to consolidate the clinical results and prevent recurrence.
The symptoms were most likely due to thrush (i.e. Candida albicans overgrowth), which often occurs in women with declining hormone levels (e.g. due to menopause or other causes). The vaginal pH level is affected and this encourages the yeast overgrowth, giving rise to itching and a thick white discharge. In terms of TCM, this type of vulvovaginitis is common in middle aged and elderly women and responds rapidly to treatment focused on clearing Liver Fire and draining Damp-Heat, using Long Dan Xie Gan Tang. In order to consolidate treatment results Tao Hong Si Wu Wan (Persica, Carthamus & Dang-gui Combination) is used in order to nourish and activate the Blood, as this helps to balance the woman’s hormones in the short term. Huo Xiang Zheng Qi Wan (Agastache Formula) regulates the Qi and dries Damp, and is given to clear the infection and help to balance the vaginal flora.