dysfunctional uterine bleeding after the pill

[Guest guest]

I have a female patient aged 37 who began experiencing breakthrough bleeding a few days post - ovulation after she went off the bc pills 2 years ago. After giving birth last year the problem continued. She is Spleen Qi Vacuous bordering on yang vacuity with other classic signs such as cold, slow pulse (53), fatigue, depression, low energy. I have been giving her a formula which consists of alot of qi tonics, ren shen, huang qi (18 g), bai zhu, and also just added charred ou jie. She has been on a similar tonic (minus the ou jie ,sometimes with some blood tonics), for 8 weeks and still experiences the bleeding (along with intermittent depression). Her pulse is still very slow. Does anyone have any ideas/experience?

Hillary

[Guest guest]

.....i have often used charred ai ye for such cases....have your blood toncs included e jiao?

 

-

acugirlnyc

Thursday, June 21, 2001 11:55 AM

dysfunctional uterine bleeding after the pill

I have a female patient aged 37 who began experiencing breakthrough bleeding a few days post - ovulation after she went off the bc pills 2 years ago. After giving birth last year the problem continued. She is Spleen Qi Vacuous bordering on yang vacuity with other classic signs such as cold, slow pulse (53), fatigue, depression, low energy. I have been giving her a formula which consists of alot of qi tonics, ren shen, huang qi (18 g), bai zhu, and also just added charred ou jie. She has been on a similar tonic (minus the ou jie ,sometimes with some blood tonics), for 8 weeks and still experiences the bleeding (along with intermittent depression). Her pulse is still very slow. Does anyone have any ideas/experience? Hillary Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

[Guest guest]

, acugirlnyc@a... wrote:

I have been giving her a formula which

> consists of alot of qi tonics, ren shen, huang qi (18 g), bai zhu, and also

> just added charred ou jie.

> Does anyone have any ideas/experience?

> Hillary

 

are you using bu zhong yi qi tang as a base with chai hu and sheng ma

to lift spleen qi?

 

[Guest guest]

Irregular Periods from the use of the pill might require treatment of the

Kidneys (activate the Life Gate) or the Liver (Qi Stagnation) and might take

awhile to treat. If there is border Yang deficiency, as you observed, or

even an Essence deficiency with the birth (is the tongue pale/wet?, or is

there a sign of blood vacuity leading to heat - dry pale thin, curled on the

sides tongue and liver qi stagnation with depression as you say?). You might

even have after all this bleeding an overlap of Kidney Yang and Yin

deficiency.

 

For Yang deficiency you might try Yi Shen Fu Yang Tang - Ren Shen 9gr, Shu

Di 9 gr, Shan Yao 9 gr, Shan zhu yu 9gr, Yuan Zhi 9 gr, Zhi Gan Cao 6 gr, Wu

Wei Zi 6 gr, Tu Si Zi 9 gr, Rou Gui 3 gr, Bu Gu Zhi 6 gr, and maybe a pinch

of Fu Zi if the tongue is wet and there is really obvious cold. You need to

tonify the Life Gate and maybe include some essence things like Lu Jiao

Jiao. But if your not sure leave the Fu Zi out because as you mentioned

depression which means possible Liver Qi stagnation and alternating

heat/cold. You might try then something like Ding Jing Tang which is Tu Si

Zi 9 gr, Bai Shao 9 gr, Dang Gui 9 gr, Shu Di 5 gr, Shan yao 5 gr, Fu Ling 3

gr, Jing Jie 2 gr, Chai Hu 2 gr.

 

All this really depends on if by Breakthrough you mean a heavy flow and

something like Flooding and Trickling which means you have to stop the

bleeding first. When it occurs around ovulation you might acutually have a

bit of heat causing the problem from the ascending and descending action of

the Chong and Ren Meridians and the blood will be acting recklessly. I've

used a cooler formula like Imperata 10 from Seven Forests consisting of Bai

Mao Gen, Han Lian, Huai hua, Huang Qin, Xiao Ji, Pu Huang, Sheng Di, Ou Jie

tan, Di Yu Tan, Ce Bai Ye. You will probably need to use hemostatics in

additon to the other formulas mentioned above and I find this formula to

stop and calm the blood, nourish the kidney yin and cools the blood heat. If

indeed you have an indication there is some heat in the blood.

 

If you believe the Qi Def and the Yang def are the important aspects of the

problem (does she have teethmarks?) and some Qi stag. (does she get clots)

Then why don't you vary Gui Pi Tang like Huang Qi 9 gr, Bai Zhu 6gr, Dang

Shen 6 gr, Fu Ling 6, Long yan rou 6, Suan Zao Ren 6, Mu Xiang 6, Dang Gui

9, Yi Mu Cao 4, Sheng Di 6, Bai Shao 6, Xian He Cao 6, Ai Ye 6, Xu Duan 6,

Chi Shao 4, Da Zao 3.

 

Yun nan Bia yao can be an important addition to your treatment. Pay

attention to the colour of the blood ie pale or deep red, the quantity and

any other details to determine an excess or deficient condition.

 

The emotional component, generally panic, because of the Chong Meridian

affecting the Heart might also have to be addressed with the appropriate

additions for calming the heart ie Suan Zao Ren. Does she get palpitations?

 

Rod

 

 

 

>acugirlnyc

>

>

> dysfunctional uterine bleeding after the pill

>Thu, 21 Jun 2001 14:55:10 EDT

>

>I have a female patient aged 37 who began experiencing breakthrough

>bleeding

>a few days post - ovulation after she went off the bc pills 2 years ago.

>After giving birth last year the problem continued. She is Spleen Qi

>Vacuous

>bordering on yang vacuity with other classic signs such as cold, slow pulse

>(53), fatigue, depression, low energy. I have been giving her a formula

>which

>consists of alot of qi tonics, ren shen, huang qi (18 g), bai zhu, and also

>just added charred ou jie. She has been on a similar tonic (minus the ou

>jie

>,sometimes with some blood tonics), for 8 weeks and still experiences the

>bleeding (along with intermittent depression). Her pulse is still very

>slow.

>Does anyone have any ideas/experience?

>Hillary

 

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[Guest guest]

A fe more details about her cold signs might help. Is it cold hands

/feet or whole body cold , I am just thinking that if after 8 weeks

spleen tonics and no major change ,

1. could be something else complicated with the Spleen qi , blood xu ,

cold phlegm or something

2. what doses are you giving....is it in pilll form or granules or raw

.....at common doses eg 9 grams bai zhu etc

 

Heiko

[Guest guest]

Hilary,

 

Is her pulse also thready or weak ie does her pulse relect the vacuity?

 

Assuming that this is the case, I think you need to change the emphasis of your prescription slightly. Stopping the bleeding should be emphasized more and to do this I would add more stop bleeding herbs. Especially the warm ones such as Ai Ye (upto 12 g), Tian Qi (powdered and added straight into the liquid before drinking). I would increase the dose of Ou Jie to 20-25 grams. It is a mild herb to stop bleeding and needs a relatively large dose. You could also add Xian He cao (upto 12g). They dont have to be necessarily charred-they usually still work pretty well.

 

The addition of an astringent such as Duan Mu Li or Hai Piao Xiao would also help.

 

If she is cold (bordering on Yang Xu) then I would also add some warming herbs that also help to stop bleeding such as Gan or Pao Jiang (or even 1-2 grams of Fu Zi- I'm not sure of the legality of this in the USA). Especially as the bleeding occurs post-ovulation, the change to the Yang phase of the menstrual cycle, I would also think about adding some Kidney Yang tonics such as Bu Gu Zhi etc. (but not with Fu Zi)

 

 

As somebody else has remarked, Bu Zhong Yi Qi Tang would make a good starting point for your prescription

 

Regards

 

Derek High

 

[Guest guest]

.........And, oh yes, some blood tonics to replace what is being lost-Dang Gui being warm and able to move Blood in case of any Stagnation would be a good choice.

 

Derek high

 

[Guest guest]

Hi: E jiao should work well fairly quickly. Also, it sounds like

she could be hypothyroid. I usually have people with such slow

pulses evaluated by a physician who works with nonsynthetic thryoid

hormones - Armour thyroid. You can buy glandular extracts without a

prescription, but they are expensive and not as well regulated.

Think of it as a yang tonic. It can often work wonders - wouldn't

solve all her problems, but as someone else wrote, I've found Ai Ye

and E Jiao to work fairly quickly.

 

Diane Kent

 

, " Turiya Hill " <turiya@j...> wrote:

> ....i have often used charred ai ye for such cases....have your

blood toncs included e jiao?

> -

> acugirlnyc@a...

>

> Thursday, June 21, 2001 11:55 AM

> dysfunctional uterine bleeding

after the pill

>

>

> I have a female patient aged 37 who began experiencing

breakthrough bleeding

> a few days post - ovulation after she went off the bc pills 2

years ago.

> After giving birth last year the problem continued. She is Spleen

Qi Vacuous

> bordering on yang vacuity with other classic signs such as cold,

slow pulse

> (53), fatigue, depression, low energy. I have been giving her a

formula which

> consists of alot of qi tonics, ren shen, huang qi (18 g), bai

zhu, and also

> just added charred ou jie. She has been on a similar tonic (minus

the ou jie

> ,sometimes with some blood tonics), for 8 weeks and still

experiences the

> bleeding (along with intermittent depression). Her pulse is still

very slow.

> Does anyone have any ideas/experience?

> Hillary

>