Seattle Institute of Oriental Medicine

Translations: Gynecology

Menstrual Block (Amenorrhea)

Disease Etiology and Pathomechanism

This disease is differentiated between two types of patterns, vacuity and repletion. Those caused by precipitating factors such as numerous childbirths, excessive thought and preoccupation, constitutional vacuity, or a weak constitution due to prolonged illness, ultimately result in weak functioning of spleen and stomach engendering transformation. Yin and blood then become extremely depleted and as a result the blood source becomes desiccated leaving no blood below, even resulting in blood desiccation menstrual block. Those patterns caused by the contraction of cold from cold fluid intake and evil qi settling in the uterine gate, or possibly emotional depression and restraint, result in a qi dynamic that is not smooth, static blood becoming congealed and bound, channel obstruction, and ultimately lead to blood stagnation menstrual block.

Pattern Identification

Women who are within the normal years of menstruation, are not pregnant or breastfeeding and in whom the menses have not come, are identified as having menstrual block. This pattern is differentiated into two types, blood desiccation menstrual block and blood stagnation menstrual block.
1. Blood Desiccation Menstrual Block: The menses amount gradually decreases, finally becoming blocked and stopping. Signs and symptoms often seen include indigestion, sloppy stool, lips and nails lacking luster, dizzy head and palpitations, lassitude of spirit, a thin and rough pulse, and a pale tongue.
2. Blood Stagnation Menstrual Block: The yin channel collects and becomes obstructed. Signs and symptoms often seen include a feeling of distention in the lower abdomen, possibly with simultaneous aching pain, vexation heat, and chest oppression. Severe signs often present in the abdominal area and may manifest as a lump in the abdomen. Other signs include dry bound stool, rough skin and nails, a dry mouth, a dark red tongue possibly with purple speckles, and a pulse that is deep, stringlike, and rough.

Treatment for Blood Desiccation Menstrual Block

Treatment Method: The primary focus is to select ren mai (conception vessel) channel points and include the spleen and kidney back shu points. Filiform needle acupuncture is used with the supplementing method and simultaneous moxabustion.
Formula: Pi Shu (UB 20), Shen Shu (UB 23), Qi Hai (Ren 6), Zu San Li (ST 36)
Explanation: The action of this formula is to regulate the spleen and stomach, and supplement and boost kidney qi. The spleen and stomach are the root of post-heaven qi and govern digestion and transformation of food into the refined essence of qi and blood. When the blood source is abundant the channel obstruction will freely move, therefore choose Pi Shu (UB 20) and Zu San Li (ST 36) in order to fortify the spleen and stomach. The kidney is the root of pre-heaven qi and when kidney qi is abundant then essence and blood are abundant, therefore choose Shen Shu (UB 23) and Qi Hai (Ren 6) in order to supplement kidney qi.

Treatment for Blood Stagnation Menstrual Block

Treatment Method: The primary focus is to select ren mai (conception vessel) channel points and to harmonize the foot tai yin and foot jue yin channel points. Filiform needle acupuncture is used with the draining method and in general moxa is not used.
Formula: Zhong Ji (Ren 3), He Gu (LI 4), Xue Hai (SP 10), San Yin Jiao (SP 6), Xing Jian (LV 2)
Explanation: This formula has the effect of abating heat and soothing depression, eliminating stasis and engendering the new. Zhong Ji (Ren 3) can rectify the chong and ren and regulate the lower jiao. Xue Hai (SP 10) is the foot tai yin spleen channel transport point, Xing Jian (LV 2) is the foot jue yin liver channel transport point, these two points can achieve the effect of moving and regulating liver and spleen qi. He Gu (LI 4) and San Yin Jiao (SP 6) can attain the goal of sending qi and blood down and freeing the channel.

Acupuncture and Moxibustion (Zhen Jiu Xue)
Nanjing College of Traditional Chinese Medicine People's Medical Press, 1984.

By Mary Beddoe