Main Signs and Symptoms
Menstruation ceased about 10 years previously. She began to have irregular bleeding, and was referred to a gynaecologist for assessment; no abnormalities were detected.
Other signs and symptoms: Pale and dull complexion, tired demeanour, low and soft voice, reluctance to speak, lethargy.
Tongue: Pale with a thin white greasy coat.
Pulse: Deep, thready and a little wiry.
Diagnosis and Treatment
TCM Diagnosis: Abnormal uterine bleeding (beng luo) due to Qi and Blood deficiency with Spleen and Kidney Yang deficiency.
Treatment Principle: Tonify the Qi and nourish the Blood, strengthen the Spleen and Invigorate the Kidney Yang to consolidate the Kidney and stop bleeding.
Treatment: Zhuang Yang Yi Jing Wan (Epimedium & Ginseng Formula) 50 pills, 4 times daily for 2 weeks.
Second consultation (after one week). After 3 days the bleeding had reduced and after 7 days it had stopped. Energy has improved and appetite has returned. Patient was advised to continue the same formula for another 3 weeks and then stop.
Third consultation (after one month): Bleeding has not returned, energy and appetite are good. Advised to take Zhuang Yang Yi Jing Wan (Epimedium & Ginseng Formula) alternating with Ba Ji Yin Yang Wan (Morinda Formula) 50 pills, 4 times daily 4 – 5 days per week.
Fourth consultation (after 3 months): The condition has resolved completely and not returned.
In cases with abnormal uterine bleeding it is important to have a gynaecological examination to exclude common causes, such as uterine fibroids. In terms of TCM, abnormal uterine bleeding (without a detectable medical cause) in postmenopausal women may be due to Kidney Fire or deficiency. In cases with deficiency, the bleeding can be rapidly brought under control by invigorating the Kidney Yang to consolidate the Kidney Qi. In this case, using the formula Zhuang Yang Yi Jing Wan (Epimedium & Ginseng Formula) the patient responded within three days. I have found that this approach works very well and even when there is severe bleeding patients usually respond within a few days.