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Author Topic: (196) Menopause Case  (Read 6487 times)

HB KIM

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(196) Menopause Case
« on: October 08, 2007, 10:48:58 AM »

CASE
Tanya (fictitious name), 51 years old, 123 lbs.  Her skin was slightly pale.  According to Korean Four constitutional theory, her physical body type resembles a Tai-Yin constitution (a little fleshy in the abdomen).  However, her personality characteristics correspond with a Shao-Yang constitution (outgoing, broad interests).  Her chief complaint was hot flashes to the face and whole body joint pain including, her pelvic bones, elbows, knees, and ankles.  Her menstrual cycle has been irregular.  Her appetite was good and there were no problems with her stools and urine.  She has an outgoing nature and enjoys different experiences.  Recently, she returned to college.  Her tongue was red with no coating and slightly redder on the tip.  Her pulse was thin, rapid, slightly wiry.


Herbal Formula
For women, at the age of 49, the Ren channel is empty, the Chong channel is depleted, and the dew of Heaven dries up.  Also, according to the Neijing, the Earth Passage (uterus) is not open therefore, weakness and infertility set in.  The best treatment plan for women during this period is to tonify the LV and KD.  This is the basic treatment principle.  Hot flashes are from Yin deficient fire and whole body joint pain is related to the KD which governs the bones and joints.  I prescribed the following formula:

Shu Di 12
Sheng Di 12
Gou Qi Zi 6
Dang Gui 4
Bai Shao 4
Zhi Mu 2
Huang Bai 2

Basic combination for tonification of LV and KD are Shu Di + Sheng Di + Gou Qi Zi.  For Deficient Heat, Zhi Mu + Huang Bai.  If you like, to tonify LV Blood as well, you can add Dang Gui + Bai Shao because Blood nourishes Essence and Essence produces Blood.  Tonifying LV Blood is also an important treatment principle in order to tonify KD Essence/Yin.  If possible,  preparation of Zhi Mu and Huang Bai with salty water is more effective for guiding them to the KD.

If you prefer to use a larger formula, you can also add Tian Men Dong 6, Mai Men Dong 6, Shan Zhu Yu 6, Shan Yao 6, Fu Ling 4, Bai Zhu 4, Mu Dan Pi  3, Ze Xie 3, so you can have Liu Wei Di Huang Wan idea inside. However, I only used the 7 herbs listed above in the formula.


Acupuncture
The above pulse was used to formulate the herbal prescription.  According to Hwa-Chim (Korean Five Element Harmonizing Theory) pulse, she was "Fire Excess and Water Deficiency".  (There are Five different types:  Wood Excess Metal Deficiency, Fire Excess Water Deficiency, Earth Excess Wood Deficiency, Metal Excess Fire Deficiency, and Water Excess Earth Deficiency).  I tonified LV1 and Sedated SP3 which is the basic Zang No.1 treatment for Fire Excess Water Deficiency type.  Her pain instantly improved after Zang No.1.  I then added Zang No.2 (Tonify KD10, Sedate HT8).  Her whole body pain receded from 10(before) to 2(after).  (I normally set 10 as the level of pain before treatment.  These numbers are relative measurements rather than absolute measuments.)

If you prefer to choose point prescriptions according to point indications rather than channel energetics, SP6 is the most important point in this case.  SP6 can nourish LV and KD in addition to clearing deficiency heat.  In the upper body, LI11 can be combined as well.  For exams, LI11 is mainly for excess heat rather than deficiency heat.  However, clinically, LI11 combined with SP6 can regulate menses.  LI11 also treats joint pain and in this case, LI11 cleared hot flashes which appears as an excess manifestation.  If you use Master Tung style acupuncture, you can use Fu Ke (11.24; Women specialty) and Huan Chao (11.12; Return to nest) for this case.  They are basic points for gynecological disorders.


Prognosis
Formula was prescribed for one week (100 capsules, 15 capsules/day).  Acupuncture was given only 2 times.  Her hot flashes and level of pain reduced significantly.  In this case, Acupuncture seemed more effective for addressing the pain, whereas the herbal formula helped more with the hot flashes due to Yin deficient Heat.
« Last Edit: October 08, 2007, 10:50:34 AM by HB Kim »
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