Early+Menstruation+(Early+Period)

Defined as periods that come consistently up to 9 days early so the cycle is less than 28 days long. Definition implies if tis happens more than twice in succession. The amount of bleeding may be normal, excessive or scanty

TCM Etiology and Pathogenesis
-Qi deficiency (Spleen & Kidney) -Blood Heat: excess heat & deficient/empty heat -Blood Stasis -Irregular diet, invasion of external heat -Emotional stress -Chronic illness, overwork, too many children, chronic bleeding

Differentiation of Disease
-Flooding & Trickling (Dysfunctional uterine bleeding) -Intermenstrual bleeding (Happens during ovulation) - tx by tonifying yin

Spleen Qi Deficiency
early period, pale and dilute menstrual blood, heavy or scanty menstrual flow, sallow complexion, listlessness, poor appetiteshortness of breath, loose stools, epigastric fullness/distention, tiredness. Heavy Bleeding: + Long Gu, Mu Li Yang Deficiency: Ai Ye Bia Jiang, or Bu Gu Zhi Blood Stasis: + Qian Cao Gen, Yi Mu Cao, San Qi Period is scanty & there is Kidney deficiency w/ loose stools: + Lu Jiao Shuang, Du Zhong //Three Treasures Remedies:// Tonify Qi & Ease the Muscles, Calm the Spirit
 * Tongue:** pale, thin white coat
 * Pulse:** fine, weak
 * Treatment Principles:** Strengthen the Spleen, tonify and raise Qi, consolidate the Chong Mai, contain blood
 * Acupuncture:** //ST-36, SP-6, BL-20, CV-4, CV-6, SP-10//, CV-12, ST-29,SP-4 (R), PC-6 (L), GV-20. All reinforcing, moxa applicable.
 * Herbal Treatment:** Bu Zhong Yi Qi Tang, Gui Pi Tang, Ju Yuan Jian + E Jaio (9g.), Hai Piao Xiao (6g.)
 * Modifications: (applicable to all three formulas)**

Kidney Qi Not Firm
Early period, pale-dilute menstrual blood, listlessness, lows spirit, lower backache, dizziness, nocturia, feeling cold. Blood & Essence Deficiency (Gui Rong Bu Chong Tang & Shou Tai Wan): + Gou QI Zi, Shan Zhu //Three Treasures Remedies:// Ease the Journey -Yang
 * Tongue:** Pale and swollen; thin white coat
 * Pulse:** Deep & Weak
 * Treatment Principles:** Strengthen the Kidneys, Tonify Qi, Warm Yang, Consolidate the Chong & Ren Mai
 * Acupuncture:** //KI-3, BL-23, CV-6, KI-13 (Addresses KI & Chong)//, CV-4, LU-7(R), KI-6(L), KI-7, GV-20, ST-36, BL-20, SP-10. All reinforcing, moxa is applicable
 * Herbal Treatment:** Gui Shen Wan; Gui Rong Bu Chong Tang & Shou Tai Wan
 * Modifications:**
 * Patents**: An Tai Wan, He Che Da Zao Wan

Blood Heat, Full Heat: Yang Excess
Early period that is heavy w/ bright red or dark-red blood, thick quality, warm feeling when discharged, irritability, mental restlessness, red face & lips, thirst, dark scanty urine, dry stools. Period is very heavy (Qing Jing San): + Di Yu, Huai Hua, Qian Cao Gen //Woman's Treasure Remedies:// Cool the Menses
 * Tongue:** Red w/ Yellow coat
 * Pulse:** Slippery rapid OR Rapid, overflowing, full & wiry in the middle level
 * Treatment Principles:** Clear Heat, Cool Blood, Regulate the periods
 * Acupuncture:** //SP-10, LI-11, LR-2, SP-8, CV-3//, CV-6, SP-4, PC-6, SP-6; LU-7(R) & KI-6(L), BL-17, SP-6, LR-3, KI-2. All reducing or even method.
 * Herbal Treatment:** //Qing Jing San//, Qin Lian Si Wu Tang
 * Modifications:**
 * Patents**: Long Dan Xie Gan Wan

Blood Heat, Full Heat: Stagnant Liver Qi Turning into fire w/ Blood Heat
Early period, dark red or purple red in color that is usually heavy, thick in quality, difficult to discharge, w/ or without clots, anger, irritability, chest/hypochondriac & breast distention, abdominal fullness/pain, bitter taste, dry mouth Periods start & stop and menstrual blood has clots (Empirical Prescription): + Ze Lan, Dan Shen, Yi Mu Cao Abdominal Pain (Empirical Prescription): + Xiang Fu, Wu Yao, Cuan Lian Zi, Yan Hu Suo Heavy Period: - Dang Gui
 * Tongue:** Red w/ redder sides; thin yellow coat
 * Pulse:** Wiry & Rapid
 * Treatment Principles:** Clear & pacify the Liver, Move Qi, Clear Heat, Cool Blood, Regulate the period
 * Acupuncture:** //SP-10, LR-2/3, LI-11, LI-4//, SP-6, SP-8, SP-4, PC-6, LR-14, GB-34; KI-2, CV-4, LR-14. all reducing or even method.
 * Herbal Treatment:** //Dan Zhi Xiao Yao San//, Qing Gan Da Yu Tang, Tang Shi Shu Jie Fang, Empirical Prescription by Dr. Zhang Jian Zhi
 * Modifications:**

Blood Heat, Empty Heat: Liver & Kidney Yin Deficiency w/ Empty Heat
Early period which may be scanty or heavy, dark red color, thick in quality, malar flush, tidal fever, dry mouth/throat, irritability, insomnia,dizziness, tinnitus, 5-palm heat, night sweating Heat prominent (Liang Di Tang): + Huang Bai, Qing Dai //Three Treasures Remedies:// Ease the Journey -Yin //Woman's Treasure Remedies:// Clear Empty Heat and Cool the Menses
 * Tongue:** Red w/out coat
 * Pulse:** Floating-empty OR fine & rapid
 * Treatment Principles:** Nourish Yin, Clear Empty Heat, Regulate the periods
 * Acupuncture:** //KI-2, LR-2, SP-6, CV-4, SP-10//, KI-6(L), LU-7(R), LR-3, KI-3, BL-23, LI-11, SP-8; LR-8. all reinforcing except KI-2 (reducing or even), no moxa.
 * Herbal Treatment:** //Liang Di Tang//, Di Gu Pi Yin, Qing Jing San variation (+ Xuan Shen (6g.), Mai Men Dong (6g.), Zhi Mu (6g.)
 * Modifications:**

Blood Stasis
Early period, scanty & trickling menstrual flow, dark in color, lower abdominal fullness/distention, dislikes pressure, pain relieved by discharge of clots, go general symptoms, or skin bruise
 * Tongue:** Purple w/ ecchyomosis
 * Pulse:** Choppy OR Wiry & Choppy
 * Treatment Principles:** Invigorate Blood, Eliminate Blood Stasis, Regulate periods
 * Acupuncture:** //CV-3, SP-10, ST-29, LR-3, KI-14//, SP-6, BL-32, LI-11
 * Herbal Treatment:** //Tao Hong Si Wu Tang//