Acupuncture for Irregular Menstruation - Treatment Protocols

Below you will find some of the more common tcm diagnoses and acupuncture treatment protocols for irregular menstruation and other menstrual issues. There are many ways to treat this condition with Eastern Medicine and our presentation is only one of many possible options.

  • Differentiations:
    • Early Menstruation (3 Major Patterns)
    • Hot Blood - related to emotions a/or diet, internally generated heat injuries the Blood leading to early a/or heavy periods.
    • Qi Deficiency - SP Qi holds the Blood in place, weakness can lead to early periods.
    • Congealed Blood - obstructs the Uterus so the Blood cannot move freely, can lead to early a/or heavy periods.
    • Late Menstruation (3 Major Patterns)
    • Blood Deficiency - hemmorhage, loss of blood, emotional involvement (overthinking, excessive worry), can lead to late periods.
    • Cold & Deficient - dietary involvement (too much cold damaging the Yang in the lower warmer), can lead to late periods.
    • Qi Constraint - emotional involvement (anger, depression), smooth flow of Blood and Qi effected leading to late periods.
    • Chaotic Menstruation (3 Major Patterns) - sometimes early, sometimes late
    • SP Deficiency - may be leading towards Blood deficiency w/symptoms that alternate between the two, SP not holding Blood in the vessels which leads to heavy periods.
    • LV & KD Exhausted - excessive sexual activity (relates more for women with multiple child births) depleting the LV & KD.
    • Constrained Qi - strong emotional involvement effecting the LV and the smooth flow of Blood and Qi.
  • Early Periods (3 Major Patterns)
  • Hot Blood - Early
    • Signs & Symptoms:
      • Red face, hot body, red/dry lips, dry mouth, irritability, easily angered, headache, dizziness, constipation, brighter colored blood (as opposed to SP Qi Deficiency which is more pale.)
      • Tongue:  Red w/yellow coat
      • Pulse:  Fast, wiry
    • Treatment Principle:
      • Cool and adjust the Blood
      • Disperse LV Fire
    • Treatment Points:
      • Valaskatagis Point Selection:
      • SP 6
      • SP 10 - w/SP 6 to regulate the Uterus and cool the Blood
      • LV 2 - cools heat in the Blood
      • Xinnong (CAM) Point Selection:
      • CV 3 - excesses in the lower warmer
      • SP 10 - cool the Blood
      • LI 11 - cool heat
      • KD 5 - regulate the CV and the Chong Mai (unusual usage - could use SP 6 as above instead)
      • LV 2 - if LV Qi stagnation is leading to LV Fire
      • KD 2 - if Yin Deficiency is leading to empty heat
      • Giovanni Differentiations:
      • Giovanni has Heat in the Blood, Stagnant LV Qi leading to Heat and Empty-Heat as variations of the general Heat in the Blood pattern described above
      • Blood Heat
      • LU 7 & KD 6 - influence the Ren Mai for heat in the Blood
      • LI 11 - heat in the Blood
      • SP 10 - heat in the Blood
      • UB 17 - hui meeting of the blood, diaphragm back shu
      • LV 2 - cool LV heat
      • LV 3 & KD 2 - together to cool heat in the Blood
      • SP 8 - can adjust the Uterus in cases of heavy bleeding
      • Stagnant LV Qi leading to Heat
      • LI 11 - heat in the Blood
      • SP 10 - heat in the Blood
      • LV 2 - cool LV heat
      • LV 3 & KD 2 - together to cool heat in the Blood
      • SP 8 - can adjust the Uterus in cases of heavy bleeding
      • CV 4 - effect Qi in the lower abdomen
      • LV 14 - LV Mu
      • SP 6 - effect the Uterus
      • Empty Heat
      • LU 7 & KD 6 - influence the Ren Mai for heat in the Blood
      • CV 4 - effect Qi in the lower abdomen
      • KD 3 - tonify KD Yin
      • LV 8 - tonify LV Yin and Blood
      • SP 6 - effect the Uterus
  • Qi Deficiency - Early
    • Signs & Symptoms:
      • Pale, shiny face, tired spirit, palpitations a/or SOB if HT a/or LU are effected, lighter colored Blood, can be excessive.
      • Tongue:  Pale, thin moss
      • Pulse:  Empty
    • Treatment Principle:
      • Tonify Qi
      • Tonify SP
    • Treatment Points:
      • Valaskatagis Point Selection:
      • ST 36 - tonify Qi
      • CV 6 - tonify Qi
      • SP 8 - can regulate the Uterus (more useful with constrained patterns w/pain - SP 6 is a better general point)
      • Xinnong (CAM) Point Selection:
      • ST 36, CV 6 & CV 12 - powerful Qi tonic
      • Giovanni Differentations:
      • Giovanni has SP Qi Deficiency & KD Qi not Firm as variations of the Qi deficiency pattern described above
      • SP Qi Deficiency
      • ST 36 - tonify Qi
      • SP 6 - tonify Qi
      • CV 12 - tonify Qi
      • UB 20 - SP Shu
      • GV 20 - raise the Qi
      • CV 4 & CV 6 - together to effect the uterus
      • Can consider SP 1 - best for stopping the periods in cases of heavy bleeding, especially when due to deficiency
      • KD Qi Not Firm (SP/KD Deficiency leading to early periods)
      • LU 7 & KD 6 - influence the Ren Mai for heat in the Blood
      • CV 4 - effect Qi in the lower abdomen
      • KD 3 - tonify KD Yin
      • KD 7 - tonify KD Yang
      • UB 23 - KD Shu
      • ST 36 - tonify Qi
      • UB 20 - SP Shu
      • KD 13 - secondary point for regulating the Uterus
      • CV 6 - tonify Qi
  • Congealed Blood - Early
    • Signs & Symptoms:
      • Hemorrhage, purplish Blood w/clots, heavy a/or irregular menstruation, lack of smooth blood flow, abdominal distention, abdominal masses, bloating.
      • Tongue:  Dark or purplish
      • Pulse:  Choppy, wiry
    • Treatment Principle:
      • Resolve Blood Stagnation
      • Restore the smooth flow of Blood and Qi
    • Treatment Points:
      • Valaskatagis Point Selection:
      • CV 3 - move and cool the lower abdomen
      • SP 10 - move the Blood
      • SP 7 - SP 8 may be a better choice - SP 8 & SP 10 will transform the Blood
      • If there are signs of congealed Blood you could add SP 6 to SP 8 & SP 10
      • ST 29 - good for moving Blood in the abdomen
  • Late Periods
  • Blood Deficiency - Late
    • Signs & Symptoms:
      • Patient may be thin a/or weak, sallow complexion, dry skin, palpitations, insomnia, pale blood and scanty menstruation.
      • Tongue:  Pale
      • Pulse:  Thin, weak
    • Treatment Principle:
      • Tonify the SP
      • Tonify the Blood
      • Tonify the Yuan Qi
    • Treatment Points:
  • Cold & Deficient (Empty Cold) - Late
    • Signs & Symptoms:
      • Shiny, pale face, aversion to cold, tired spirit, blood is thin & watery.
      • Tongue:  Pale, swollen
      • Pulse:  Weak, possibly slightly slow
    • Treatment Principle:
      • Tonify the Blood
      • Tonify the Yang
    • Treatment Points:
      • Valaskatagis Point Selection:
      • CV 6 - tonify Qi
      • SP 10 - move Blood
      • SP 6 - tonify Qi & Blood
      • UB 17 - hui meeting of the Blood, diaphragm shu
      • ST 29 - can help to start a period
      • GV 4 - tonify Yang
      • CV 4 - tonify Yang & Qi
      • Xinnong (CAM) Point Selection:
      • Differentiated as Blood Deficiency with Cold
      • CV 4 - tonify Qi, dispel cold in the lower warmer
      • CV 6 - tonify Qi, dispel cold in the lower warmer
      • SP 6 - tonify Qi & Blood
      • If dizziness is present (blood def effecting LV), GV 20
      • If palpitations a/or insomnia is present (blood def effecting HT), HT 7
      • Giovanni Differentations:
      • Further differentiates Empty Cold as Full or Empty Cold and KD Yang Deficiency
      • Full or Empty Cold
      • empty, scanty bleeding w/small clots, better w/heat
      • CV 4 - tonify Qi
      • CV 6 - tonify Qi
      • ST 29 - local warming point
      • SP 6 - tonify SP
      • SP 8 - move the Blood, help w/pain
      • ST 36 - tonify Qi, warm the body
      • GV 4 - tonify Yang
      • UB 32 - abdominal pain, usually more for lower back pain
      • ST 25 - move Qi, warm lower abdomen w/moxa
      • KD Yang Deficiency
      • pale, scanty blood, sore back, nighttime urination, dizziness, pale tongue, weak/deep pulse
      • UB 23 - KD Shu
      • GV 4 - tonify Yang
      • CV 4 - tonify Yang
      • KD 3 - tonify KD
      • LU 7 w/KD 6 - yin qiao ren mai, regulate uterus
      • ST 36 - tonify Qi
      • SP 6 - tonify SP
  • Constrained LV Qi - Late
    • Signs & Symptoms:
      • Depression, premenstrual emotional issues (moodiness, etc.), chest/subcostal tension, breast tenderness, abdominal distention prior to menstruation, purplish Blood.
      • Tongue:  Normal or purplish
      • Pulse:  Wiry
    • Treatment Principle:
      • Calm the spirit
      • Resolve Qi stagnation
    • Treatment Points:
      • Valaskatagis Point Selection:
      • PC 6 - calm spirit, ease chest tightness
      • CV 12 - tonify middle warmer, could use CV 6 instead for lower abdomen
      • LV 2 - clear LV heat, could use LV 3 instead
      • SP 6 - tonify SP, effect lower abdomen
      • Xinnong (CAM) Point Selection:
      • ST 25 - distention in the abdomen
      • SP 8 - moves LV Qi & Blood, could use SP 10 to concentrate on the Blood
      • LV 3 - moves Qi in the lower abdomen
      • LV 14 - breast pain
      • KD 14 - move Qi in the abdomen
      • PC 6 - release chest tension, calm spirit
      • Giovanni Point Selection:
      • SP 4 w/PC 6 - yin wei chong mai, moves Qi
      • LV 3 - resolve LV Qi stagnation
      • LV 14 - breast tenderness
      • KD 14 - move Qi in the abdomen
      • SP 6 - reinforce LV 3, tonify SP
      • CV 4 - tonify Qi
      • CV 6 - tonify Qi
      • PC 7 - resolve emotional issues
  • Chaotic - Sometimes Early / Sometimes Late
  • SP Deficiency - Chaotic
    • Signs & Symptoms:
      • Fatigue, sallow complexion, poor appetite w/no desire to eat.
      • Tongue:  Pale w/thin coat
      • Pulse:  Floating, thin
    • Treatment Principle:
      • Tonify SP
      • Tonify Blood
    • Treatment Points:
  • LV & KD Exhausted - Chaotic
    • Signs & Symptoms:
      • Pale or dark complexion, dizziness, weakness in the lower body, pale colored menstrual blood w/varying amounts.
      • Tongue:  Thin, possibly peeled
      • Pulse:  Deep, weak
    • Treatment Principle:
      • Tonify LV
      • Tonify KD
    • Treatment Points:
  • Constrained Qi - Chaotic
    • Signs & Symptoms:
      • Dizziness, chest oppression, abdominal distention prior to menstruation, abdominal pain, purple or dark blood w/uneven menstrual flow.
      • Tongue:  Dark
      • Pulse:  Wiry
    • Treatment Principle:
      • Smooth Qi Flow
    • Treatment Points:
      • Valaskatagis Treatment Points:
      • PC 6 - release chest oppression, calm spirit
      • LV 2 - clear LV heat, could use LV 3 instead
      • CV 12 - tonify SP, CV 6 may be more useful
      • Xinnong (CAM) Treatment Points:
      • CV 6 - tonify Qi
      • KD 14 - effect lower abdomen
      • PC 5 - could use PC 6 instead, calm the spirit, release chest oppression
      • LV 5 - LV Luo, help emotional balance
      • if chest oppression add CV 17 a/or LV 14
      • if depression add LV 3 a/or HT 7
      • Giovanni Treatment Points:
      • LV 3 - tonify LV, smooth Qi flow
      • TH 6 - release heat from the chest
      • PC 6 - release chest tension, calm spirit
      • LV 14 - LV Mu
      • CV 4 - tonify Qi
      • CV 6 - tonify Qi
      • SP 4 - tonify SP Yang
      • SP 6 - tonify Qi

The information on our site is drawn from our own lecture notes and clinical experience. The following lecture notes were consulted within this section:

  • St. John, Meredith: New England School of Acupuncture, Etiology and Pathology Lecture Notes
  • Valaskatgis, Peter: New England School of Acupuncture, Etiology and Pathology Lecture Notes

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