Guest guest Posted May 11, 2002 Report Share Posted May 11, 2002 Group: I just saw my first patient with hirsutism and virilization. While pain is her presenting complaint and I am successfully relieving that with acupuncture, I am at a loss to understand the hirsutism and virilizaion in TCM terms. I suspect this to be a more advanced topic as I'm not finding anything on this subject in any of my TCM text/reference books. Can anyone enlighten me? Michael Buyze Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2002 Report Share Posted May 12, 2002 You really have a learning opportunity here! I hate to ask this question first, but what does her endocrinologist say, other than the diagnostic terms? Is she on any pharmaceuticals, which ones? Where is the pain and what is it like? Where are the atypical places that the hair is growing in? What does the virilization look like? Does she menstruate and what is that like? History--at what age was this first noticed and how old is she now? And of course, tongue, pulse, and what pattern do you see. Frances mbuyze wrote: Group: I just saw my first patient with hirsutism and virilization. While pain is her presenting complaint and I am successfully relieving that with acupuncture, I am at a loss to understand the hirsutism and virilizaion in TCM terms. I suspect this to be a more advanced topic as I'm not finding anything on this subject in any of my TCM text/reference books. Can anyone enlighten me? Michael Buyze 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2002 Report Share Posted May 13, 2002 , Frances Gander <fgander@c...> wrote: > You really have a learning opportunity here! I hate to ask this > question first, but what does her endocrinologist say, other than the > diagnostic terms? Is she on any pharmaceuticals, which ones? Where is > the pain and what is it like? Where are the atypical places that the > hair is growing in? What does the virilization look like? Does she > menstruate and what is that like? History--at what age was this first > noticed and how old is she now? And of course, tongue, pulse, and what > pattern do you see. > > Frances Frances: Thanks for your reply. She has not seen an endo as she is of limited means. She is a 41 y.o. Hispanic female with a documented mass in her left ovary (consitent with ovarian dermoid) and a small area (1 cm) of either calcification or hemorrhagic cyst in the right ovary (ultrasound done by OB/GYN). She has not ovulated or menstuated since age 25, except a couple of drug induced periods. Although she complains of infertility, the OB/GYN is most concerned about her increased risk for cardiovascular disease and endometrial cancer. He felt surgery was indicated, but noted it was not within their means. He further recommended induced menstruation at least 4 times per year, which she tried for two months, but discontinued due to dysmenorrhea. The menses was dark and clotted. That was over a year ago. She is taking no prescription drugs now, she uses OTC acetaminophen or ibuprofen for pain relief (headache and abdominal). She presented with c/o H/A back in March (hx of several years of intermittent) and a single acupuncture treatment brought total relief for 2 weeks, with milder headaches recurring subsequently, but not significant enough to seek further Tx. Her current c/o is pain in the lower left quadrant of her abdomen. It is sensitive to pressure. She states that she can feel a mass, but it is vague to my inexperienced hands, and I would not be able to identify it without her assistance. (She is rather obese, which further complicates palpation.) She states that it is soft, and honestly I cannot tell as I can barely feel it. As for her hirsutism and virilization, I did not examine her entire body, but I did note that her abdominal area, face forearms and legs appeared more consistent with male bodily hair than female. On report from her MD, her external genitalia and vaginal mucosa are normal. Details are somewhat difficult to come by since she does not speak English. Her husband accompanies her and translates, but his English is also limited. From a TCM perspective, she is typically warm, especially her feet (more dorsal than plantar) and has night sweats. She has bad breath in the mornings and a strong appetite. She has gained 20 lbs in the last 6 months. She states that she is irritable and easily stressed (although she states that overall her life is not stressful). She has some nocteral enuresis with 1-2 trips per night. Otherwise she sleeps very well. Her tongue is thin and cyan to purple in color with dark veins underneath. The coat is scant. What is there is thin and white. Her pulses are soft and deep, absent in the cubit position. My diagnosis is yin fire with Liver depression, blood stasis, kidney yin vacuity, and spleen qi vacuity. While my understanding of yin fire is evolving, what I am really looking to understand here is the TCM etiology of her hirsutism & virilization. Michael Buyze Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2002 Report Share Posted May 13, 2002 I'd be interested in any insight into this area as well. I share office space with an esthetician who does waxing. A few of her clients have significantly more hair than most of modern society would feel comfortable with and so they come in every two or three weeks to have it removed. I've always been drawn toward the Chong Mai to explain this, but I haven't really got a handle on it yet. Seems like some sort of Chong/Blood excess, whatever that means. Can you tell us where the extra hair is growing? Is this facial hair? I've seen it show up facial and genital. That says Ren meridian to me, but hair growth has more of a Blood connection when talking about thickness or abundance. I associate Yin's effect on the hair as its luster and/or dryness. -al. mbuyze wrote: > > Group: > > I just saw my first patient with hirsutism and virilization. While > pain is her presenting complaint and I am successfully relieving that > with acupuncture, I am at a loss to understand the hirsutism and > virilizaion in TCM terms. I suspect this to be a more advanced topic > as I'm not finding anything on this subject in any of my TCM > text/reference books. Can anyone enlighten me? > > Michael Buyze -- Al Stone L.Ac. <AlStone http://www.BeyondWellBeing.com Pain is inevitable, suffering is optional. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 14, 2002 Report Share Posted May 14, 2002 In the interest of giving you some ideas that might be outside of TCM, i might remind you that hirsutism and ovarian cysts are often associated with Syndrome X, aka insulin resistance. There is much info on this for the last 10 years, so your reading in that direction might give you some nutritional ideas, as well as additional clues as to how to think of these syndromes from a TCM point of view. ann > Thanks for your reply. She has not seen an endo as she is of limited > means. She is a 41 y.o. Hispanic female with a documented mass in her > left ovary (consitent with ovarian dermoid) and a small area (1 cm) > of either calcification or hemorrhagic cyst in the right ovary > (ultrasound done by OB/GYN). She has not ovulated or menstuated since > age 25, except a couple of drug induced periods. Although she > complains of infertility, the OB/GYN is most concerned about her > increased risk for cardiovascular disease and endometrial cancer. He > felt surgery was indicated, but noted it was not within their means. > He further recommended induced menstruation at least 4 times per > year, which she tried for two months, but discontinued due to > dysmenorrhea. The menses was dark and clotted. That was over a year > ago. She is taking no prescription drugs now, she uses OTC > acetaminophen or ibuprofen for pain relief (headache and abdominal). > > She presented with c/o H/A back in March (hx of several years of > intermittent) and a single acupuncture treatment brought total relief > for 2 weeks, with milder headaches recurring subsequently, but not > significant enough to seek further Tx. Her current c/o is pain in the > lower left quadrant of her abdomen. It is sensitive to pressure. She > states that she can feel a mass, but it is vague to my inexperienced > hands, and I would not be able to identify it without her assistance. > (She is rather obese, which further complicates palpation.) She > states that it is soft, and honestly I cannot tell as I can barely > feel it. > > As for her hirsutism and virilization, I did not examine her entire > body, but I did note that her abdominal area, face forearms and legs > appeared more consistent with male bodily hair than female. On report > from her MD, her external genitalia and vaginal mucosa are normal. > > Details are somewhat difficult to come by since she does not speak > English. Her husband accompanies her and translates, but his English > is also limited. > > From a TCM perspective, she is typically warm, especially her feet > (more dorsal than plantar) and has night sweats. She has bad breath > in the mornings and a strong appetite. She has gained 20 lbs in the > last 6 months. She states that she is irritable and easily stressed > (although she states that overall her life is not stressful). She has > some nocteral enuresis with 1-2 trips per night. Otherwise she sleeps > very well. > > Her tongue is thin and cyan to purple in color with dark veins > underneath. The coat is scant. What is there is thin and white. Her > pulses are soft and deep, absent in the cubit position. > > My diagnosis is yin fire with Liver depression, blood stasis, kidney > yin vacuity, and spleen qi vacuity. > > While my understanding of yin fire is evolving, what I am really > looking to understand here is the TCM etiology of her hirsutism & > virilization. > > Michael Buyze > > > > > > 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. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2002 Report Share Posted June 8, 2002 Hi All, Some time ago, Michael Buyze wrote: > I just saw my first patient with hirsutism and virilization. While > pain is her presenting complaint and I am successfully relieving > that with acupuncture, I am at a loss to understand the hirsutism > and virilizaion in TCM terms. I suspect this to be a more advanced > topic as I'm not finding anything on this subject in any of my TCM > text/reference books. Can anyone enlighten me? Did members answer that query, or did I just miss the answer? I'm a novice at this, but could the TCM pattern be KI Yin Xu, with relative KI Yang Shi? Would the treatment be to Tonify KI Yin with herbs like Hanliancao, Shanyao, Shudihuang, Yinyanghuo Best regards, WORK : Teagasc Staff Development Unit, Sandymount Ave., Dublin 4, Ireland WWW : http://www.research.teagasc.ie/grange/search.htm Email: < Tel : 353-; [in the Republic: 0] HOME : 1 Esker Lawns, Lucan, Dublin, Ireland WWW : http://homepage.eircom.net/~progers/searchap.htm Email: < Tel : 353-; [in the Republic: 0] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2002 Report Share Posted June 10, 2002 , " " < @e...> wrote: > Hi All, > > Some time ago, Michael Buyze wrote: I am at a loss to understand the hirsutism > > and virilizaion in TCM terms. > > Did members answer that query, or did I just miss the answer? > > I'm a novice at this, but could the TCM pattern be KI Yin Xu, with > relative KI Yang Shi? Would the treatment be to Tonify KI Yin with > herbs like Hanliancao, Shanyao, Shudihuang, Yinyanghuo > Phil It COULD be, with could being the operative word here. It certainly conforms to certain notions of excess yang in that male secondary sex characteristics are considered as such. However, this could conceivably be due to ANY cause of excess yang in the body, not just yin vacuity. Also yin yang huo is not a yin tonic, but rather a yang tonic. While some sources indicate its use for yin vacuity patients, I believe this is only in the context of formulas where it is combined with other herbs with yin tonic properties and then only in combined yin and yang vacuity. Quote Link to comment Share on other sites More sharing options...
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