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Heavy menstruation is medically considered abnormal. Menorrhagia refers to a significant increase in menstrual volume, which is more than twice the normal amount or exceeds 80 ml, but stops naturally within a certain period of time. If this happens for two or more consecutive cycles, it may cause secondary anemia. Menorrhagia refers to the untimely and continuous flow of menstrual blood. Heavy periods are likely due to menorrhagia or metrorrhagia.

complication

1. Anemia

If you lose too much blood due to metrorrhagia, you will experience a series of anemia symptoms such as pale complexion, pale lips, dizziness, mental fatigue, shortness of breath, palpitations, insomnia, and weak pulse.

2. Collapse

When metrorrhagia occurs, if it is severe, with heavy bleeding and continuous bleeding, it can often cause collapse, with critical symptoms such as coma, pale face, cold limbs, profuse sweating, shortness of breath, and a floating and weak pulse or a deep and invisible pulse. Without timely treatment, it can be life-threatening.

3. Evil and poisonous infection

Symptoms include lower abdominal pain that is resistant to pressure, low back pain, thick and sticky vaginal discharge, yellow color and foul odor, or five colors at the same time, accompanied by irritability, thirst, yellow urine, dry stool, yellow and greasy tongue coating, and a thin and smooth pulse.

▍Treatment based on syndrome differentiation

The key point of diagnosis for metrorrhagia is the non-cyclical vaginal bleeding. In clinical practice, the changes in the amount, color, and quality of bleeding and systemic symptoms are combined to distinguish between cold, heat, deficiency, and excess. Treatment should be based on the severity of the condition, the duration of the disease, and the amount of bleeding, following the principle of "treating the symptoms in an emergency and treating the root cause in a chronic manner", combined with the staged and step-by-step treatment approach of "stopping the flow, clearing the source, and restoring the condition". During the bleeding period, stopping the bleeding is the priority. After the bleeding stops, the specific cause of the metrorrhagia can be targeted, with methods such as tonifying the kidney, strengthening the spleen, clearing away heat, regulating qi, and removing blood stasis, so that the metrorrhagia can be fundamentally treated.

1. Kidney deficiency type

(1) Kidney Yin Deficiency Syndrome: irregular menstrual bleeding, a little or a lot of bleeding, continuous bleeding, bright red blood, thick texture, dizziness, tinnitus, sore waist and weak knees, hot hands and feet, red cheeks and lips, red tongue, little coating, and a thready pulse. Treatment principle: Nourish the kidney and replenish yin, consolidate the Chong and stop bleeding. Main prescription: Zuogui Pills (Jingyue Complete Works) with modifications. Prescription: Zuogui Pills (rehmannia root, yam, wolfberry, cornus officinalis, dodder seed, antler glue, tortoise shell glue, cyathula). Remove the cyathula and add Polygonum multiflorum and stir-fried Sanguisorba officinalis.

If there is heat in yin deficiency, add raw rehmannia, Ophiopogon japonicus and Radix Rehmanniae as appropriate.

(2) Kidney Yang Deficiency Syndrome: Untimely menstrual bleeding, heavy bleeding, continuous bleeding, light color and thin texture, back pain as if broken, chills and cold limbs, clear and long urine, loose and thin stools, dark complexion, pale and dark tongue, thin white fur, and deep and weak pulse. Treatment principle: Warm the kidney and assist yang, consolidate the Chong meridians and stop bleeding. Main formula: Dabuyuan Decoction (Jingyue Complete Works) with modifications. Prescription: Dabuyuan Decoction (ginseng, yam, cooked rehmannia, eucommia bark, angelica, cornus officinalis, wolfberry, roasted licorice) with added psoralea corylifolia, antler glue, mugwort charcoal, etc.

2. Spleen deficiency type

Symptoms: Menstrual blood comes out at irregular times, with heavy flow like metrorrhagia, or continuous dripping, with light color and thin texture, fatigue, shortness of breath and laziness to speak, loss of appetite, cold limbs, or swollen face and limbs, pale yellow complexion, pale and fat tongue, thin white fur, and slow and weak pulse. Treatment principle: Strengthen the spleen and replenish Qi, consolidate the Chong and stop bleeding. Prescription: Gu Chong Tang (Medical Records of Combining Chinese and Western Medicine). Atractylodes macrocephala, Astragalus membranaceus, calcined dragon bone, calcined oyster, Cornus officinalis, white peony root, cuttlebone, madder, palm charcoal, and gallnut.

If the amount of bleeding is heavy, add ginseng and cimicifuga as appropriate; if the bleeding persists for a long time, add lotus root nodes and fried cattail pollen as appropriate. If there is heavy vaginal bleeding accompanied by cold sweats on the limbs, coma and unconsciousness, and a weak pulse, it is a critical sign of Qi loss along with blood. It is urgent to replenish Qi and consolidate the loss. The prescription used is Du Shen Tang (Jing Yue Quan Shu). Or use Shengmai San (from "Discussion on the Differentiation of Internal and External Injuries") (prescription: ginseng, Ophiopogon japonicus, Schisandra chinensis) to replenish qi and produce body fluid, nourish yin and stop sweating to prevent collapse. If the symptoms include cold limbs and profuse cold sweat, it is also a sign of yang loss, and the treatment should be to restore yang and consolidate the body. The prescription used can be Shenfu Decoction (Annotated Prescriptions for Women). Prescription: ginseng, aconite, ginger, and jujube.

3. Blood heat type

Symptoms: Menstrual blood comes out at irregular times, with heavy flow like metrorrhagia, or continuous dripping, dark red blood, thick texture, restlessness, insomnia, thirst and preference for cold drinks, dizziness, red face, red tongue, yellow coating, and slippery and rapid pulse. Treatment principle: Clear away heat, cool blood, consolidate Chong and stop bleeding. Main prescription: Qingre Gujing Decoction (Concise Chinese Medicine Gynecology). Prescription: raw rehmannia, rehmannia root bark, roasted tortoise shell, oyster powder, donkey-hide gelatin, scutellaria baicalensis, lotus root nodes, old palm charcoal, licorice, scorched gardenia, and sanguisorba officinalis.

4. Blood stasis type

Symptoms: Menstrual blood comes at irregular times, with a large or small amount, and is not clean. The blood is dark purple with clots, there is pain in the lower abdomen that is resistant to pressure, the tongue is dark purple or has ecchymosis, and the pulse is sluggish or strong and stringy. Treatment principle: activate blood circulation, remove blood stasis, consolidate Chong and stop bleeding. Main prescription: Zhuyu Zhiben Decoction (Anhui Traditional Chinese Medicine Prescriptions Collection). Prescription: Angelica sinensis, Chuanxiong, Panax notoginseng, myrrh, Aconiti lobata, moutan bark charcoal, stir-fried salvia miltiorrhiza, stir-fried mugwort, donkey-hide gelatin (stir-fried with pollen), dragon bone, oyster, and cuttlefish bone.