Menorrhagia


 * IBIS:**

Definition:
Also called hypermenorrhea or menostaxis; is excessively prolonged or profuse menses.

Etiology:
This condition falls under a broader category of "abnormal bleeding", (prolonged, excessive, irregular with regard to time of the cycle or time of life). It is important (although seemingly obvious) in the diagnosis to determine if the bleeding is coming from the vagina and not the urethra or the rectum. There are many causes which are so varied that they may be treated as separate conditions. • DUB: "dysfunctional uterine bleeding" describes abnormal uterine bleeding not associated with tumor, inflammation, or pregnancy. Commonly caused by unopposed estrogen stimulation from a tumor or disease condition. This causes the endometrial tissue to hypertrophy and eventually to begin sloughing and bleeding.

Nutrition:
eating principles • ** Green leafy vegetables **: The patient should consume as many green leafy vegetables as possible because of the vitamin K content. (Marz, p. 433, 1997) • ** Decrease consumption of arachidonic acid **: Avoid animal fats. Remember safflower, corn, and sunflower oils may possibly get converted to arachidonic acid in times of stress. It is best to stick with omega 3 EPA. (Marz, p. 433, 1997) • vegan diet

therapeutic foods: • foods rich in Vitamins A, C, K, E, and Iron • foods that raise the Yang and ascend • increase dark green leafy vegetables: beet, radish, mustard, dandelion, collard greens, kale, spinach, chard • increase omega-3 and omega-6 fatty acids: vegetable, nut, seed oils, salmon, herring, mackerel, sardines, walnuts, flaxseed oil, evening primrose oil, black currant oil

specific remedies: • irregular menstruation: boil 3 oz. raw brown sugar, 3 oz. dried dates and 1/2 oz. ginger in l pt. of water until reduced to half. Drink per day (Butt and Bloomfield, p. 148)

avoid: • animal products with the exception of cold water fish

Botanicals
• ** Achillea millefolium **: an astringent tonic useful for passive menorrhagia due to //uterine atony//, not as effective when bleeding is due to tissue destruction or uterine destruction (Felter, p. 117; Mitchell, p. 43) •** Caulophyllum thalictroides ** (toxic) : uterine tonic (Mitchell, p. 108; Nissim, p. 41) • ** Cinnamomum camphora **: essential oil and tincture are antiseptic, antispasmodic and hemostatic; indicated for passive, atonic uterine bleeding due to //fibroids or polyps// or when organ is //empty and flaccid// such as postpartum (Nissim, p. 41; Felter, pp. 306-307; Mitchell, p. 43) • ** Citrus limon ** (essential oil): hemostatic properties (Nissim, p. 41) •** Claviceps purpurea ** (toxic) (ergot): //active hemorrhages//, uterine inertia and congestion; acts more powerfully on the //gravid uterus// than non-gravid, excellent for subinvolution; use only after the infant or retained uterine material has been passed or uterine rupture is possible risk. See contraindications (Felter, p. 356) • ** Equisetum hyemale **: hematuria, menorrhagia (Nissim, p. 41) • ** Erigeron canadensis **: for //capillary or passive hemorrhage//, most indicated for gastrointestinal bleeding, but of some use in uterine meno- and metrorrhagia (Mitchell, p. 43; Felter, pp. 360-361) • ** Eugenia caryophyllus **: infusion as a stimulating uterine tonic (Nissim, p. 43) • ** Hydrastis canadensis **: helps control passive uterine hemorrhage (Felter, p. 417) •** Senecio aureus ** (toxic) : passive menorrhagia due to //uterine atony// with sense of weight and engorgement in pelvis (Felter, pp. 625-625; Priest and Priest, pp. 106-107; Mitchell, p. 78) • ** Viburnum prunifolium **: //passive and menopausal// menorrhagia (Priest and Priest, pp. 106-107)

Chinese Formulae
• Yun Nan Bai Yao (patent): to control bleeding. (Zhu, p. 243) • ** Du Shen Tang **: Qi Exhaustion due to acute, severe blood loss: //extremely pale complexion, lethargic state, cold extremities, excessive sweating, faint or thin pulse.// (Bensky and Barolet, p. 229). • ** Tang Kuei and Gelatin C. (Jiao Ai Tang); Ren Shen Lu Rong Wan ** (patent): Chong Mo Cold and Xu (Deficiency) with Xue Xu (Blood Deficiency): //abdominal pain with uterine bleeding, excessive menstruation or menstruation with constant spotting, pale thin blood without clots, weakness and soreness of lower back, dull complexion, pale tongue, thin pulse// (for concurrent Spleen Qi Xu (Deficiency) take with Ginseng and Longan C. (Gui Pi Tang) (Tang Kuei: Hsu, 1980, p. 576; Yeung, p. 137; Bensky and Barolet, p. 345; Ren Shen Lu: Zhu, p. 292) • ** Gu Chong Tang **: Chong Mo Xu (Deficiency) with Spleen Qi Xu (Deficiency): //uterine bleeding or profuse menstrual bleeding with pale thin blood, either gushing or continuously trickling out, pale tongue, deficient and big or thin and frail pulse// (Bensky and Barolet, p. 366) • ** Tang Kuei and Evodia C. (Wen Jing Tang) **: Chong Mo Cold and Xu (Deficient) with Xue Yu (Blood Stasis): //weak and cold patient, dry Upper Warmer, mild persistent uterine bleeding, extended or continuous menstrual flow, pain in lower abdomen, infertility// (Hsu, 1980, p. 588; Yeung, p. 242; Dharmananda, 1986, p. 323; Bensky and Barolet, p. 324) • ** Tang Kuei and Ginseng Eight (Ba Zhen Tang) plus artemesia (ai ye) and gelatin (e jiao) **: Spleen Qi Xu (Deficiency) with Xue Xu (Blood Deficiency): //sallow or pallid complexion, anxiety, easily-fatigued extremities, vertigo// (Hsu, 1980, p. 248; Yeung, p. 33; Dharmananda, 1986, p. 107; Bensky and Barolet, p. 259) • ** Ginseng and Longan C. (Gui Pi Tang) ** (available as patent), **Fu Ke Ba Zhen Wan** (patent): Spleen Qi Xu (Deficiency) with Heart Xue Xu (Blood Deficiency): //forgetfulness, palpitations, dream-disturbed sleep, reduced appetite, pallid complexion, pale tongue, early periods with copious pale blood or prolonged, almost continuous periods with little flow// (Ginseng and Longan: Hsu, 1980, p. 425; Yeung, p. 112; Dharmananda, 1986, p. 244; Bensky and Barolet, p. 255; patent: Zhu, p. 274; Fu Ke Ba Zhen Wan: Zhu, p. 277) • Shi Chuang Da Bu Wan (patent): Qi Xu (Deficiency) with Xue Xu (Blood Deficiency): //may be used acutely// (Zhu, p. 263) •** Hei Xiao Yao San **: Liver Qi Stagnation with Spleen Qi Xu (Deficiency): //irritability, short temper, red eyes, increased menstrual flow or uterine bleeding, wiry deficient or wiry rapid pulse// (Hsu, 1980, p. 87; Yeung, p. 72; Bensky and Barolet, p. 149) • Tang Kuei Four C. (Si Wu Tang): Liver Xue Xu (Blood Deficiency): // dizziness, blurry vision, lusterless complexion and nails, generalized muscle tension // (Hsu, 1980, p. 433; Yeung, p. 220; Dharmananda, 1986, p. 327; Bensky and Barolet, p. 248) • Bu Xue Tiao Jing Pian (Butiao Tablets) (patent): Xue Xu (Blood Deficiency) (Zhu, p. 254; Fratkin, p. 177) • ** Qing Jing Zhi Xue Tang **: Liver Xue (Blood) Heat: //abrupt onset bleeding, irritability, thirst, red tongue, large quantity of bright-red blood// (Bensky and Barolet, p. 342) • ** Gu Jing Wan **: Xue (Blood) Heat, often arising from Yin Xu (Deficiency): //continuous menstruation or uterine bleeding that alternates between trickling and gushing of blood, very red blood which may contain purple clots, dark urine, red tongue, rapid wiry pulse// (Yeung, p. 107; Bensky and Barolet, p. 367) • ** Decoction of Shortened Cycle; Yung Sheng He Ah Chiao (Famous Ass Glue) ** (patent); **Nuphar 14** (patent): Xue (Blood) Heat (Decoction: Dharmananda, p. 322; Yung Sheng: Fratkin, p. 186; Nuphar 14: Dharmananda, 1990, p. 87)

Acupuncture
after assessing the person and palpating, consider these patterns: Lack of Xue (Blood) retention in Ren Mai (Conception Vessel) and Chong Mai (Penetrating Vessel); Shi (Excess) of the Ren Mai (Conception Vessel); Chong Mai (Penetrating Vessel) Cold and Xu (Deficiency); Qi Stagnation with Xue Yu (Blood Stasis); Spleen Qi Xu (Deficiency); Heart and/or Liver Xue Xu (Blood Deficiency); Yin Xu (Deficiency) producing Xue (Blood) Heat » __note__: see also "metrorrhagia" for "irregular menstruation" » __illustrative combinations__: • Lv-1 and Sp-1 (d. D both): treat // hypermenorrhea //(Finkelstein, p. 72) • Lv-1 and Sp-6 (+): stop bleeding and capture blood back into the channels (Finkelstein, p. 72) • CV-4 and Sp-1: stop uterine bleeding (Finkelstein, p. 86) • CV-6, Lv-1, Kd-10, CV-4, Lv-3, Kd-2, Sp-6, CV-3, Sp-2, St-12, St-10, Ht-1, PC-3 and UB-54/40 for // menorrhagia // (Lee and Cheung, p. 333) • Sp-1, Lv-3 and Ht-5; CV-6, UB-55 and St-18; Ht-1, UB-54/40 and Sp-2 for// menorrhagia // (Mann, p. 147) • UB-17, UB-18, UB-23, GV-4, CV-6, CV-3, PC-5, Sp-10, Kd-7 and Lv-2 for // menorrhagia with continuous hemorrhaging // (Lee and Cheung, p. 333) • Lv-3 and Sp-6 for // continuous uterine bleeding //(Shanghai, p. 293) • CV-17, PC-6, GB-34, Lv-3, Sp-6, CV-4 and St-36 for // menorrhagia // due to Stagnant Liver Qi with Blood (Xue) Stagnancy, and Xue (Blood) and Qi Xu (Deficiency) (Jirui and Wang, p. 253) • GB-26 and GB-27: capture and control Dai Mai (Girdle Vessel) and treat excessive // leukorrhea // and //menses// (Finkelstein, p. 67) • zi gong, CV-5, CV-3 and UB-23: treat // persistent uterine bleeding //(Ellis, et al, 1988, p. 404) • Sp-1, Sp-6, St-36, Sp-10, CV-4 and CV-6 for // uterine hemorrhage; //also consider Sp-1 ( D ) and CV-4 ( D ) (Liu, p. 390) • Sp-8 and Sp-10: regulate menses (Ellis, et al, 1988, p. 154) • CV-7, Sp-6, UB-20, UB-18 and Sp-1 for // uterine bleeding //; with Qi Xu (Deficiency), also consider GV-4 ( D ) and CV-4 ( D ); likewise also consider GV-20 ( D ) for excess bleeding; can also prick and bleed Sp-10 and Lv-1 for Heat in the Xue (Blood) (Lee and Cheung, p. 332) • CV-6, Sp-6, Sp-1 for // uterine bleeding // of Shi (Excess) type; add Sp-10 and Kd-5 if due to Heat in the Xue (Blood); add Lv-3, Lv-1 and TW-6 if due to Accumulation of Heat; add CV-3 and Sp-9 if due to Damp-Heat (Qiu and Su, p. 10) • CV-4, Sp-6, UB-23 and Kd-8 for // uterine bleeding // of Xu (Deficiency) type; add CV-6, UB-20, UB-17 and St-36 if due to Spleen Qi Xu (Deficiency); add CV-6, GV-4 and Kd-7 if due to Kidney Yang Xu (Deficiency); add Kd-2 and Kd-10 if due to Kidney Yin Xu (Deficiency) (Qiu and Su, p. 12) • CV-4, CV-6, Lv-1, Kd-10, Lv-3, Kd-2, Sp-6, CV-3, Sp-2, St-12, St-10, Ht-1, PC-3 and UB-54/40 for// abnormal uterine bleeding //(Shanghai, p. 673) • UB-62, shi qi zhui xia and Sp-6 for // functional uterine bleeding // (Shanghai, p. 210) • UB-31, UB-32, UB-33, UB-34, St-36, Sp-6, Sp-10, zi gong, CV-6 and CV-4 for // functional uterine bleeding // (Shanghai, p. 217) • CV-4, Sp-1, Sp-10, St-36 for // functional uterine bleeding // (Shanghai, p. 185); • zi gong and CV-3 treat // infertility, uterine bleeding, and vaginal discharge //(Ellis, et al, 1988, p. 404) • Lv-3 (-) and Kd-2 (+): promote Liver function and eliminate Heat in Xue (Blood) • St-28 and St-29 (+/-): regulate menstruation; facilitate the Lower Warmer • GB-34 and Lv-3 (+/-:) soothe Liver; resolve Xue Yu (Blood Stasis ) and Qi Stagnation • Sp-4 and PC-6: open the Chong Mai (Penetrating Vessel) for which menorrhagia is often a symptom of Shi (Excess), although it can also result from Cold and Xu (Deficiency) effecting the Chong Mai (Penetrating Vessel); menstrual disorders are a general symptom of Shi (Excess) and reproductive disorders are a general symptom of dysfunction for the Chong Mai (Penetrating Vessel) • Lu-7 and Kd-6: open the Ren Mai (Conception Vessel) which nourishes the Uterus and regulates menstruation; usually indicated by head and neck pain, abdominal distension, vaginal discharge and other symptoms of congestion; menstrual disorders are usually a part of Shi (Excess) effecting the Ren Mai (Conception Vessel) • UB-62 and SI-3: open the Yang Qiao Mai (Yang Motility Vessel) which transports Yang and for which gynecological problems are a Xu (Deficiency) symptom • Kd-6 and Lu-7: open the Yin Qiao Mai (Yin Motility Vessel) which transports Yin and for which gynecological problems are a Shi (Excess) symptom • CV-3 and Sp-6: regulate the Qi function of the Lower Warmer and the function of the genital organs - Sp-6 sends Qi up; CV-3 sends it deep (Finkelstein, p. 84) • CV-15, CV-16, CV-19, Kd-13, Sp-6, Kd-11, UB-47/52, GB-37, GB-5, UB-60 and CV-10: influence the pituitary (Worsley, 1975, p. B-20; McWilliams, et al, Lesson 31, p. 258) • Kd-13, UB-67, Kd-7, GB-37, Sp-6, Kd-2, GV-4 and Lv-3: influence the ovaries (Worsley, 1975, p. B-20; McWilliams, et al, Lesson 31, p. 258) • UB-31, Sp-6 and GB-3: has strong hormonal action on women (Finkelstein, p. 46)

Homeopathy
• ** Aconitum napellus: ** gushing bright red with overwhelming fear of death • ** Aletris farinosa **: profuse and premature due to atonic uterus; debility from loss of fluids, sterility; large clots; disgust for food, nausea and indigestion • ** Ambra grisea: ** bleeding on slightest strain in nervous women; too early and too profuse; seven days early with itching, soreness and swelling of genitals • ** Ammonium carbonicum **: too soon, blackish, often clots; colic before menses; bleeding from rectum • ** Belladonna **: premature and profuse menses with sensation everything will fall out; foul smelling coagulated blood; throbbing headache • ** Calcarea carbonica **: large clots mixed with bright red flow which is copious; mental shock starts flow • ** Carbo vegetabilis **: too early, long and copious; prostration with every menstrual flow; burning in vagina • ** Cinchona: ** excessive bleeding of long duration; weak, debilitated; dark clots and abdominal distention • ** Ferrum metallicum **: too early, too profuse, too long, causing debility • ** Folliculinum **: history of birth control pills and/or estrogen replacement therapy, esp. bad reaction, i.e., estrogen poisoning; tendency to put others' needs before her own, and then become resentful later; woman has lost touch with her own inner rhythms and her reference has become external rather than internal; often best used in a single dose, or repeated every two weeks, possibly at new and full moons • ** Ignatia **: every two weeks of long duration with cramps and hardness of abdomen; hysteria; nausea with fainting; intolerance of light; vision blurred • ** Ipecacuanha **: bright red blood with prostration, does not coagulate easily; pale, nausea •** Kreosotum **: bleeding brought on by lifting, overexertion, following coitus; constant dull aching in back; terrible left-sided headache a day after flow; flows only when lying down, ceases on sitting or walking • ** Lachesis **: excessive flow with dark clots and severe pains, > as soon as flow starts,< heat, warm weather, > cold; profuse unpleasant perspiration • ** Mitchella repens **: bleeding with frequent urination, not very free or satisfactory; bright red blood with painful urination • ** Phosphorus **: bleeding with uncontrolled thirst for cold water • ** Platina **: 4-6 days early and very profuse •** Ratanhia **: bleeding with pains in abdomen and loins, bearing down towards genital organs, followed by leukorrhea • ** Sabina **: bleeding with bearing down sensation; at times may not stop before next menses starts • ** Secale cornutum: ** profuse bleeding of black color with icy cold extremities; woman wants to uncover and to be cool; blood thin and fetid • ** Stramonium: ** profuse black, coagulated blood; drawing pains in abdomen, thighs, limbs; talkative • ** Thlaspi bursa pastoris **: starts slowly then abundant and woman becomes very weak; slow to regain strength and next flow starts •** Trillium pendulum **: bright red and profuse with faint feeling at epigastrium, pain in back; cold extremities; prostration with rapid feeble pulse • ** Ustilago maydis **: bright red, partly thin and partly clotted; uterus soft and spongy • ** Viscum album: ** profuse bleeding following cold foot bath

Subtle Support
• __ notes __: A, A#, B, C, C#, D, E, F, G, G# • __ chords __: A minor, C minor, D minor, D# minor, tonic (Gimbel, p. 116)

Mind/Body
• Female problems represent a rejection of the feminine principle; denial of the self; rejecting femininity; guilt; fear; belief that genitals are sinful or dirty. (Hay, 1984, p. 165, 174) • Many beliefs, attitudes, and conflicts can affect the individual woman's menses. Some may be due to anxiety and role conflict related to feminine sexual identity. The culprits for one woman may bear no resemblance to the problematic issues for another woman. We cannot generalize findings about one woman to fit all women. (Mehl, p. 173)

Chinese psychophysiology: • ** Liver ~ Gan ** is the home of the Hun (Ethereal Soul); it relates to decisiveness, control, and the principle of emergence; **stores and cleanses the Xue (Blood); maintains smooth flow of Qi and Xue (Blood)**; **has an intimate relationship with the genitals and Lower Warmer**; and reflects emotional harmony and movement. » Healthy expressions are » Liver Xu (Deficiency) signs include **frigidity**; **pain in thighs, pelvic region, and throat**; **ready tendency to "the blahs"** (Seem, p. 28); **timidity**; **depression**; **irritability; vertigo**; pruritus; **dry eyes, skin, and/or tendons**; asthma; **aching at the waist**; **hernia**; and difficulty raising head up and down. Liver Xue Xu (Blood Deficiency) predisposes to Xue Yu (Blood Stasis) and Xue (Blood) Heat. » Liver Qi Stagnation reflects and accentuates emotional constraint as the Liver's function of facilitating **smooth flow in the body is constricted**. Stagnation is **associated with frustration, irritability, tension, and feeling stuck**. With time this pattern tends to produce a gloomy emotional state of constant resentment, repressed anger or depression, along with tightness in the chest, frequent sighing, **abdominal tension or distension**, and/or a feeling of a lump in the throat with difficulty in swallowing. (Maciocia, p. 216) Xue Yu (Blood Stasis) often begins with Qi Stagnation.
 * kindness, spontaneity, and ease of movement.**

• ** Heart ~ Xin **houses the Shen (Spirit) and reveals itself through the brightness in the eyes; **governs Fire and Heat; rules the Xue (Blood) and its vessels and directs the circulation**; and relates to the integration of the organs and the personality. » Healthy expressions are » » The Heart is the Emperor of the bodily realm so that when the Heart is disturbed all the other organs will be disrupted.
 * warmth, vitality, excitement, inner peace, love, and joy.**
 * Heart Xu (Deficiency)** signs include **sadness; absence of laughter; depression; fear; anxiety; shortness of breath** (Seem, p. 28); cold feeling in the chest and limbs; **palpitations**; cold sweat; inability to speak; memory failure; and **restless sleep**. Yin Xu (Deficiency) predisposes to Empty Fire, acute and chronic.

• ** Spleen ~ Pi **governs digestion and manifests in the muscle tissues; **transforms food into Qi and Xue (Blood)**; **governs the Xue (Blood) and holds it in the vessels; maintains upbearing**; and relates to the ability to assimilate, stabilize, and feel centered and balanced. Healthy expressions are **fairness, openness, deep thinking, and reminiscence**.

»
 * Spleen Xu (Deficiency)** signs include **slightness (deficient "form")**; abundant elimination; **morning fatigue**; cold, wet feet (Seem, p. 28); **abdomen taut and distended like a drum; craving for sweets; flatulence; nausea; mild edema**; memory failure; **heavy feeling in legs; pale lips**; **loose stools**; muscular weakness; and, indirectly, obesity.
 * The excessive use of the mind** in thinking, studying, concentrating, and memorizing over a long period of time **tends to weaken the Spleen and may lead to Xue Yu (Blood Stasis)**. This also includes **excessive pensiveness and constant brooding**. (Maciocia, p. 241) Likewise, **inadequate physical exercise and excess consumption of sweet and/or Cold foods will also deplete the Spleen**. Environmentally, the Spleen is highly susceptible to attack from external Dampness and Cold.

Integrative Therapies
Menstruation is a healthy process that occurs every 24 to 36 days and lasts for 3 to 7 days, except during pregnancy and lactation. Frequent menstruation or excessive bleeding is most often caused by nutritional deficiencies, endometriosis, ovary dysfunctions, cancer, fibroids, thyroid problems, and stress. Excessive menstrual bleeding could indicate a serious condition, so consult a physician. If you use an IUD, it may need to be removed.

THE FOLLOWING SUPPLEMENTS CAN BE TAKEN UNTIL SYMPTOMS IMPROVE: 1. Vitamin C – 1,000 milligrams per day. 2. Bioflavonoids – 250 milligrams per day. 3. Vitamin E – 200 Units per day. 4. Chlorophyll – 25 milligrams per day. 5. Iron – 30 milligrams, 3 times per day.

REGARDING THE PROPER DIET: • Eliminate or greatly reduce animal products in your diet. This includes meat, liver, eggs, and cheese, milk, sour cream, and other dairy products. Replace protein from animal products with fish, beans, nuts, and seeds. • Eat plenty of leafy green vegetables, including beet greens, kale, collards, turnip tops, amaranth, and dandelion greens. All of these contain vitamin K and iron.

HERBS USED FOR EXCESSIVE MENSTRUATION: • Shepherd's Purse – Use 2 to 3 teaspoons per day of the tincture, which is a liquid herbal extract. Teas made from the dried plant are not very effective. • Angelica tincture can be effective in regulating menstrual bleeding. For best results, it should be taken in combination with Licorice Root tincture. Take 20 drops of each tincture, 3 times a day in a glass of water throughout the month. • Raspberry Leaf tea – 1 cup per day throughout the month. Add boiling water to 1 heaping teaspoon of the dried herb per cup. • An excessive loss of blood during menstruation may lead to anemia. Cinnamon Bark tincture and Geranium tincture both can be useful as an aid in controlling bleeding. Take 30 drops of each 4 times a day during the menses.

HOMEOPATHY: From the following homeopathic medicines choose the one that best matches your symptoms. Dissolve 3 pellets under your tongue, 3 times a day during the menses. • Cinchona 12C: For heavy periods with extreme weakness. • Sabina 12C: For very profuse menses with bright red blood. Note: A wide range of homeopathic medicines can be helpful for individuals with excessive menstruation. Consultation with a health care professional trained in homeopathic prescribing will usually be the best way to select the correct medicine.