Guest guest Posted May 4, 2005 Report Share Posted May 4, 2005 Hey All, I have some herb/hormone questions for you: 1. My partner, a harried grad-student type, recently went through some un-fun medicalization after a routine gynecological check-up, involving the school clinic doc being SURE that she (my partner) had PCOS, and eventually getting a referral to an endocrinologist, who diagnosed idiopathic galactorrhea. Some history (incomplete, because my partner isn't really my patient): she has a history of galactorrhea (since age 18 or so - she's 32 now) and has always had infrequent, heavy periods (every other months to every three months). No history of pregnancy. Prolactin levels are very high (I don't have the lab values handy, but the endocrinologist said much higher than is normal for PCOS, almost pregnancy-level), MRI did not show any abnormality of the pituitary. In terms of TCM diagnosis, as I said I don't fully trust my perspective as her partner, but I would say she's pretty much a " Xiao Yao Wan " type: a little Spleen deficiency (she is a student, after all) and a little Liver Qi Stagnation. She's generally healthy: sleeps well, eats/digests well, no major historical health issues. No signs of heat, tends more to cold. She wants to try herbs before going on the medication course (I think a dopamine agonist) prescribed by the endocrinologist, who said go ahead, give it three months. The question is, what to try? I have her taking mai ya for now, but could it really be strong enough? Does anyone have any experience with such a thing, or with stopping lactation generally? Do folks think that acupuncture is a better thing to try? 2. While on the subject, I live in an area with a fair number of " visible " transsexuals (I mostly know FTMs, but there are MTFs of course as well). Some of them want to transition with the minimum of synthetic hormone. Does anyone have any good information on regulating hormones to this kind of degree with Chinese herbs? There are lots of factors of course, including whether the person has their ovaries/testes removed, and if they choose to get, say, testosterone shots, what the long-term effects are and whether side effects can be mediated with herbs. Any experience out there? Any known articles on the subject? Thanks for any advice you can give, Nora Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 8, 2005 Report Share Posted May 8, 2005 Hi Nora, You can treat galactorrhea with very high does of Mai Ya- at least 2 ounces ( 20 Liang daily). You wont get results using less. You could incorporate into a xiao yao san scenario. But I think you also want to include herbs that conduct blood down: wang bu liu xing for example. Yi mu cao as well. You don¹t mention \ the quality of her menses. Try the herbs for 2-3 months, then repeat the blood work. I have treated several of these cases, all with success. But to be fair, they all had pituitary tumors, so I don¹t know if that affects the outcome. hope this helps, Cara > Hey All, > > I have some herb/hormone questions for you: > > 1. My partner, a harried grad-student type, recently went through some > un-fun medicalization after a routine gynecological check-up, involving > the school clinic doc being SURE that she (my partner) had PCOS, and > eventually getting a referral to an endocrinologist, who diagnosed > idiopathic galactorrhea. > > Some history (incomplete, because my partner isn't really my patient): > she has a history of galactorrhea (since age 18 or so - she's 32 now) > and has always had infrequent, heavy periods (every other months to > every three months). No history of pregnancy. Prolactin levels are > very high (I don't have the lab values handy, but the endocrinologist > said much higher than is normal for PCOS, almost pregnancy-level), MRI > did not show any abnormality of the pituitary. > > In terms of TCM diagnosis, as I said I don't fully trust my perspective > as her partner, but I would say she's pretty much a " Xiao Yao Wan " type: > a little Spleen deficiency (she is a student, after all) and a little > Liver Qi Stagnation. She's generally healthy: sleeps well, eats/digests > well, no major historical health issues. No signs of heat, tends more > to cold. She wants to try herbs before going on the medication course > (I think a dopamine agonist) prescribed by the endocrinologist, who said > go ahead, give it three months. The question is, what to try? I have > her taking mai ya for now, but could it really be strong enough? Does > anyone have any experience with such a thing, or with stopping lactation > generally? Do folks think that acupuncture is a better thing to try? > > 2. While on the subject, I live in an area with a fair number of > " visible " transsexuals (I mostly know FTMs, but there are MTFs of course > as well). Some of them want to transition with the minimum of synthetic > hormone. Does anyone have any good information on regulating hormones > to this kind of degree with Chinese herbs? There are lots of factors of > course, including whether the person has their ovaries/testes removed, > and if they choose to get, say, testosterone shots, what the long-term > effects are and whether side effects can be mediated with herbs. Any > experience out there? Any known articles on the subject? > > Thanks for any advice you can give, > Nora > Chinese Herbal Medicine offers various professional services, including board > approved continuing education classes, an annual conference and a free > discussion forum in Chinese Herbal Medicine. > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 8, 2005 Report Share Posted May 8, 2005 Hi Nora, Typical diagnostic work-up for patient with galactorrhea, when prolactinoma is ruled out, is: a)history of taking antipsychotic medication (particularly the typical antipsychotics are dopamin antagonists); b)head trauma with a severed pituitary stalk, in which case the plasma level of all other pituitary hormones decrease (TSH,ACTH etc); c)hypothyroidism - hypothalamic TRH stimulates secretion of both prolactin and TSH (could be subclinical). While dealing with a) and b) is self-explanatory, I think the last one might be of some interest for CH treatment approach to galactorrhea (high doses of haizao,kunbu etc). Ed Mizun, soon to grad. Miami,FL Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 9, 2005 Report Share Posted May 9, 2005 Cara (and List), Thank you so much for this information, it was exactly what I could have hoped for. The dosage in particular I was unsure about. I will let the list know what results we get. The quality of her menses is usually light red, heavy (mega-sized tampons plus a pad) for the first day or so with some darker red clots/clumps (dime-to-nickel-sized on average), fairly bad (not completely debilitating) cramps starting with the flow or slightly before, tapering off by the middle of the second day. Usually about 5 to 7 days duration. She has not had one for about 4 months now, which is one of the longest times she has ever gone. Also, I forgot to mention that she does have one health issue that relates, which is oral herpes; she gets very painful cold sores, usually a few times a year, right before or right after her period starts, and usually when she has been under extra stress. Most Chinese herbal info I have seen addresses genital herpes or herpes zoster, and it seems that Liver Fire or Lr/GB DH are the usual diagnoses, and though my partner certainly has some Liver Qi signs, I see no Fire signs; Spleen Damp-Heat, perhaps, but even then, not a lot of Heat (except, obviously, for the swelling and redness of the sore itself). Any internal or topical advice for the lip sores? I have a couple more questions, if you have time: 1. I'm assuming the dosage of mai ya that you give is raw. I will probably give her raw herbs, but have you used granules also with such patients? 2. I always thought of wang bu liu xing as a lactagogue; is it your experience then that it has more of a regulating effect (i.e. will not increase lactation if lactation is already/excessively present?) 3. Do you alter such patients' formulas cyclically, as if they were ovulating; or do you basically hammer them with the mai ya until they start menstruating (or until milk dries up, whichever comes first)? Do you have them take their BBT to see if they are ovulating? 4. Was your course of treatment for these cases only 2-3 months, or longer? I would imagine that tumors would take longer to resolve...did they re-take MRIs as well as labs? Any recurrences of hyperprolactinemia or symptoms? Thank you so much for any additional advice. I would love to see you publish an article on this subject (as would my partner's endocrinologist, I'm sure)! Thanks again, Nora Cara Frank wrote: >Hi Nora, >You can treat galactorrhea with very high does of Mai Ya- at least 2 ounces >( 20 Liang daily). You wont get results using less. You could incorporate >into a xiao yao san scenario. But I think you also want to include herbs >that conduct blood down: wang bu liu xing for example. Yi mu cao as well. >You don¹t mention \ the quality of her menses. >Try the herbs for 2-3 months, then repeat the blood work. I have treated >several of these cases, all with success. But to be fair, they all had >pituitary tumors, so I don¹t know if that affects the outcome. > > hope this helps, >Cara > > > >>Hey All, >> >>I have some herb/hormone questions for you: >> >>1. My partner, a harried grad-student type, recently went through some >>un-fun medicalization after a routine gynecological check-up, involving >>the school clinic doc being SURE that she (my partner) had PCOS, and >>eventually getting a referral to an endocrinologist, who diagnosed >>idiopathic galactorrhea. >> >>Some history (incomplete, because my partner isn't really my patient): >>she has a history of galactorrhea (since age 18 or so - she's 32 now) >>and has always had infrequent, heavy periods (every other months to >>every three months). No history of pregnancy. Prolactin levels are >>very high (I don't have the lab values handy, but the endocrinologist >>said much higher than is normal for PCOS, almost pregnancy-level), MRI >>did not show any abnormality of the pituitary. >> >>In terms of TCM diagnosis, as I said I don't fully trust my perspective >>as her partner, but I would say she's pretty much a " Xiao Yao Wan " type: >>a little Spleen deficiency (she is a student, after all) and a little >>Liver Qi Stagnation. She's generally healthy: sleeps well, eats/digests >>well, no major historical health issues. No signs of heat, tends more >>to cold. She wants to try herbs before going on the medication course >>(I think a dopamine agonist) prescribed by the endocrinologist, who said >>go ahead, give it three months. The question is, what to try? I have >>her taking mai ya for now, but could it really be strong enough? Does >>anyone have any experience with such a thing, or with stopping lactation >>generally? Do folks think that acupuncture is a better thing to try? >> >>2. While on the subject, I live in an area with a fair number of >> " visible " transsexuals (I mostly know FTMs, but there are MTFs of course >>as well). Some of them want to transition with the minimum of synthetic >>hormone. Does anyone have any good information on regulating hormones >>to this kind of degree with Chinese herbs? There are lots of factors of >>course, including whether the person has their ovaries/testes removed, >>and if they choose to get, say, testosterone shots, what the long-term >>effects are and whether side effects can be mediated with herbs. Any >>experience out there? Any known articles on the subject? >> >>Thanks for any advice you can give, >>Nora >> >> >> >> >> >> >> >>Chinese Herbal Medicine offers various professional services, including board >>approved continuing education classes, an annual conference and a free >>discussion forum in Chinese Herbal Medicine. >> >> >> >> >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 10, 2005 Report Share Posted May 10, 2005 Hi Cara I've been reading this discussion on hyperprolactinemia with interest. I'm currently treating a woman with 'idiopathic' hyperprolactinemia. Her levels are very high - over 1400, but she has never lactated. Her pituitary MRI is clear, although I suspect microtumours. Hence my interest in your experience of treating these types. My patient was amenorrheic. I have been treating her for over 6 months. She has established a 32-38 day 'cycle' but is obviously not ovulating as her prolactin levels are unchanged. She is predominantly a Qi stasis with heat type. Her treatment has been mostly herbal, along the lines of regulating Qi and Blood, clearing heat, and have included (big dose)Chao Mai Ya, Wang Bu Liu Xing. I have recently started to tonify blood more as well as include stronger herbs to move blood, soften lumps and disperse phlegm, based on the presumption that previous treatment has not affected the tumours (a more'westernised' approach to diagnosis.) You say you have had results after 3 months treatment of pituitary tumour hyperprolactinemia, so I am interested in any suggestions you might have on my case. Regards, Tanya , Cara Frank <herbbabe@v...> wrote: > Hi Nora, > You can treat galactorrhea with very high does of Mai Ya- at least 2 ounces > ( 20 Liang daily). You wont get results using less. You could incorporate > into a xiao yao san scenario. But I think you also want to include herbs > that conduct blood down: wang bu liu xing for example. Yi mu cao as well. > You don¹t mention \ the quality of her menses. > Try the herbs for 2-3 months, then repeat the blood work. I have treated > several of these cases, all with success. But to be fair, they all had > pituitary tumors, so I don¹t know if that affects the outcome. > > hope this helps, > Cara > > > Hey All, > > > > I have some herb/hormone questions for you: > > > > 1. My partner, a harried grad-student type, recently went through some > > un-fun medicalization after a routine gynecological check-up, involving > > the school clinic doc being SURE that she (my partner) had PCOS, and > > eventually getting a referral to an endocrinologist, who diagnosed > > idiopathic galactorrhea. > > > > Some history (incomplete, because my partner isn't really my patient): > > she has a history of galactorrhea (since age 18 or so - she's 32 now) > > and has always had infrequent, heavy periods (every other months to > > every three months). No history of pregnancy. Prolactin levels are > > very high (I don't have the lab values handy, but the endocrinologist > > said much higher than is normal for PCOS, almost pregnancy- level), MRI > > did not show any abnormality of the pituitary. > > > > In terms of TCM diagnosis, as I said I don't fully trust my perspective > > as her partner, but I would say she's pretty much a " Xiao Yao Wan " type: > > a little Spleen deficiency (she is a student, after all) and a little > > Liver Qi Stagnation. She's generally healthy: sleeps well, eats/digests > > well, no major historical health issues. No signs of heat, tends more > > to cold. She wants to try herbs before going on the medication course > > (I think a dopamine agonist) prescribed by the endocrinologist, who said > > go ahead, give it three months. The question is, what to try? I have > > her taking mai ya for now, but could it really be strong enough? Does > > anyone have any experience with such a thing, or with stopping lactation > > generally? Do folks think that acupuncture is a better thing to try? > > > > 2. While on the subject, I live in an area with a fair number of > > " visible " transsexuals (I mostly know FTMs, but there are MTFs of course > > as well). Some of them want to transition with the minimum of synthetic > > hormone. Does anyone have any good information on regulating hormones > > to this kind of degree with Chinese herbs? There are lots of factors of > > course, including whether the person has their ovaries/testes removed, > > and if they choose to get, say, testosterone shots, what the long- term > > effects are and whether side effects can be mediated with herbs. Any > > experience out there? Any known articles on the subject? > > > > Thanks for any advice you can give, > > Nora > > > > > > > > > > > > > > > > Chinese Herbal Medicine offers various professional services, including board > > approved continuing education classes, an annual conference and a free > > discussion forum in Chinese Herbal Medicine. > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2005 Report Share Posted May 11, 2005 Hi Tanya, havening not seen this woman, ( and no tongue or pulse) it¹s hard to comment. but I will say this: the only research I have read on the tx of hyperprolactinemia is based on Mai Ya alone, used as a single. I have my patients repeat blood work every 2-3 months ( I suggest 2 months. They get around to it by the 3rd). Prolactin levels should be decreasing. I have also had success with a multi-modality approach using a yam/ progesterone cream in combination w/ the herbs. You could also suggest they chart their basal body temp to see if they begin to ovulate. Cara > Hi Cara > I've been reading this discussion on hyperprolactinemia with > interest. I'm currently treating a woman with 'idiopathic' > hyperprolactinemia. Her levels are very high - over 1400, but she has > never lactated. Her pituitary MRI is clear, although I suspect > microtumours. Hence my interest in your experience of treating these > types. My patient was amenorrheic. I have been treating her for over > 6 months. She has established a 32-38 day 'cycle' but is obviously > not ovulating as her prolactin levels are unchanged. > She is predominantly a Qi stasis with heat type. Her treatment has > been mostly herbal, along the lines of regulating Qi and Blood, > clearing heat, and have included (big dose)Chao Mai Ya, Wang Bu Liu > Xing. I have recently started to tonify blood more as well as include > stronger herbs to move blood, soften lumps and disperse phlegm, based > on the presumption that previous treatment has not affected the > tumours (a more'westernised' approach to diagnosis.) > You say you have had results after 3 months treatment of pituitary > tumour hyperprolactinemia, so I am interested in any suggestions you > might have on my case. > Regards, > Tanya > > > , Cara Frank <herbbabe@v...> > wrote: >> > Hi Nora, >> > You can treat galactorrhea with very high does of Mai Ya- at least > 2 ounces >> > ( 20 Liang daily). You wont get results using less. You could > incorporate >> > into a xiao yao san scenario. But I think you also want to include > herbs >> > that conduct blood down: wang bu liu xing for example. Yi mu cao as > well. >> > You don¹t mention \ the quality of her menses. >> > Try the herbs for 2-3 months, then repeat the blood work. I have > treated >> > several of these cases, all with success. But to be fair, they all > had >> > pituitary tumors, so I don¹t know if that affects the outcome. >> > >> > hope this helps, >> > Cara >> > >>> > > Hey All, >>> > > >>> > > I have some herb/hormone questions for you: >>> > > >>> > > 1. My partner, a harried grad-student type, recently went > through some >>> > > un-fun medicalization after a routine gynecological check-up, > involving >>> > > the school clinic doc being SURE that she (my partner) had PCOS, > and >>> > > eventually getting a referral to an endocrinologist, who diagnosed >>> > > idiopathic galactorrhea. >>> > > >>> > > Some history (incomplete, because my partner isn't really my > patient): >>> > > she has a history of galactorrhea (since age 18 or so - she's 32 > now) >>> > > and has always had infrequent, heavy periods (every other months > to >>> > > every three months). No history of pregnancy. Prolactin levels > are >>> > > very high (I don't have the lab values handy, but the > endocrinologist >>> > > said much higher than is normal for PCOS, almost pregnancy- > level), MRI >>> > > did not show any abnormality of the pituitary. >>> > > >>> > > In terms of TCM diagnosis, as I said I don't fully trust my > perspective >>> > > as her partner, but I would say she's pretty much a " Xiao Yao > Wan " type: >>> > > a little Spleen deficiency (she is a student, after all) and a > little >>> > > Liver Qi Stagnation. She's generally healthy: sleeps well, > eats/digests >>> > > well, no major historical health issues. No signs of heat, tends > more >>> > > to cold. She wants to try herbs before going on the medication > course >>> > > (I think a dopamine agonist) prescribed by the endocrinologist, > who said >>> > > go ahead, give it three months. The question is, what to try? I > have >>> > > her taking mai ya for now, but could it really be strong enough? > Does >>> > > anyone have any experience with such a thing, or with stopping > lactation >>> > > generally? Do folks think that acupuncture is a better thing to > try? >>> > > >>> > > 2. While on the subject, I live in an area with a fair number of >>> > > " visible " transsexuals (I mostly know FTMs, but there are MTFs of > course >>> > > as well). Some of them want to transition with the minimum of > synthetic >>> > > hormone. Does anyone have any good information on regulating > hormones >>> > > to this kind of degree with Chinese herbs? There are lots of > factors of >>> > > course, including whether the person has their ovaries/testes > removed, >>> > > and if they choose to get, say, testosterone shots, what the long- > term >>> > > effects are and whether side effects can be mediated with herbs. > Any >>> > > experience out there? Any known articles on the subject? >>> > > >>> > > Thanks for any advice you can give, >>> > > Nora >>> > > >>> > > >>> > > >>> > > >>> > > >>> > > >>> > > >>> > > Chinese Herbal Medicine offers various professional services, > including board >>> > > approved continuing education classes, an annual conference and a > free >>> > > discussion forum in Chinese Herbal Medicine. >>> > > >>> > > >>> > > >>> > > >>> > > >>> > > >>> > > Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.