Missed Periods Before 40? Periods Only Come with Hormones, Stop Without? Beware Your Ovaries Retiring Early! Are There Any Specific TCM Formulas for Treating Amenorrhea?
What Causes Early Amenorrhea?
Singapore Gong Fang Tang TCM gynecology expert Dr. Que Poh Yuen Albert emphasizes that amenorrhea is never trivial; it’s a "red alarm" signaling imbalance in the internal organs! Against the backdrop of soaring stress and drastic lifestyle changes for modern women, the following five causes are most common:
Kidney Essence Deficiency, Source Drying Up (Root Cause!)
"Source of Life" in Crisis: Congenital insufficiency, multiple miscarriages, chronic late nights (depleting Kidney Essence), excessive dieting → Disruption of the Kidney-Tian Gui-Chong Ren-Uterus axis → Menstruation becomes "water without a source".
Typical Manifestations: Sore and hollow lower back and knees, dizziness, tinnitus, decreased libido, uterine and ovarian atrophy (ultrasound confirmed), low AMH levels.
Liver Qi Stagnation, Uterine Vessel Blockage (Main Cause of Stress-Related Amenorrhea)
Emotions "Blocking" Menstruation: High work pressure, family conflicts, anxiety, depression → Liver Qi Stagnation → Qi stagnation leading to blood stasis → Chong and Ren vessel obstruction, menstrual blood cannot descend.
Female Characteristic: Fast-paced life, intense workplace competition, leading to a sharp increase in Liver Stagnation type amenorrhea.
Dr. Que Poh Yuen Albert Sea of Blood Empty (Excessive Consumption)
"Granary" is Empty: Postpartum hemorrhage, long-term chronic illness, Spleen and Stomach deficiency (poor nutrient absorption), excessive weight loss → Insufficient source for Qi and Blood production → Sea of Blood cannot fill and overflow on time.
Typical Manifestations: Sallow or pale complexion, dizziness, heart palpitations, shortness of breath, fatigue, pale tongue with thin coating.
Phlegm-Damp Obstruction, Fat Membrane Blockage (Obesity-Related Amenorrhea)
"Grease" Clogging the Pipes: Craving rich, sweet, fatty foods, desserts, cold drinks (characteristic of Nanchang diet, beware!) + Sedentary lifestyle → Spleen deficiency generating dampness, dampness accumulating into phlegm → Phlegm-fat obstructing Chong, Ren vessels and Uterus.
Typical Manifestations: Obesity, chest and epigastric fullness, excessive sticky leukorrhea, thick greasy tongue coating.
Cold Congealing Blood Stasis, Uterus Frozen (Consequence of Chilling)
"Cold" Freezing Menstrual Blood: Getting soaked in rain or wading in water during period, craving raw/cold foods (iced milk tea, ice cream), long-term inadequate clothing → Cold pathogen invading the Uterus → Blood congeals with cold → Menstrual blood stagnates and cannot flow.
Typical Manifestations: Cold, painful lower abdomen that resists pressure (relieved by heat), cold limbs, dark menstrual blood with clots (before amenorrhea).
How Can TCM Effectively Treat Amenorrhea?
Facing the complex and diverse patterns of amenorrhea, especially the common type centered on Kidney Essence deficiency, combined with Liver Stagnation, Blood Stasis, or mild Phlegm-Damp (accounting for over 60% of clinical cases), Physician Dr. Que Poh Yuen Albert shares a highly effective formula from a renowned TCM Master – Yi Shen Tong Jing Tang (Kidney-Benefiting and Menstruation-Unblocking Decoction). This formula directly targets the root cause, activating the Uterus!
Core Composition and Ingenious Pairing:
[Sovereign Herbs] Tu Si Zi (Cuscuta Seed) 15g, Fu Pen Zi (Raspberry Fruit) 12g, Gou Qi Zi (Goji Berry) 15g: Strongly tonify Kidney Essence, replenish the "Source of Life", promote follicular development.
[Minister Herbs] Dang Gui (Chinese Angelica Root) 12g, Ji Xue Teng (Spatholobus Stem) 30g, Chai Hu (Bupleurum Root) 9g: Nourish Blood, invigorate Blood, soothe Liver and relieve stagnation, smooth Qi and Blood flow, unblock uterine vessels. Lu Lu Tong (Sweetgum Fruit) 12g, Chuan Niu Xi (Cyathula Root) 12g: Guide Blood downward, unblock collaterals and open orifices, guide herbs into the Uterus.
[Assistant Herbs] Chao Bai Zhu (Stir-fried Atractylodes Rhizome) 15g, Fu Ling (Poria) 15g, Chen Pi (Tangerine Peel) 9g: Strengthen Spleen and boost Qi, resolve Phlegm and dispel Dampness, cut off the source of Phlegm-Damp, aid Qi and Blood production.
[Envoy Herb] Zi Shi Ying (Fluorite/Purple Quartz) 20g (decoct first): Warm Kidneys and warm the Uterus, stimulate uterine vitality, provide a "warm bed" for menstrual blood flow.
Why is it Highly Effective?
Treats Root and Branch Simultaneously: Uses Tu Si Zi, Fu Pen Zi, Gou Qi Zi, etc., to replenish Kidney Essence (the "Root"), while using Dang Gui, Ji Xue Teng, Lu Lu Tong, etc., to unblock uterine vessels (the "Branch").
Tonifies and Attacks Simultaneously: Tonifying Kidneys, replenishing Essence, strengthening Spleen, boosting Qi is "Tonification"; soothing Liver, regulating Qi, invigorating Blood, unblocking collaterals is "Unblocking" (Attack). Tonifies without causing stagnation, unblocks without damaging vital Qi.
Regulates Liver, Spleen, and Kidneys Together: Targets the core (Kidneys) while addressing key factors (Liver, Spleen), aligning with the pathogenesis of most amenorrhea patients.
Channel-Guiding and Messenger Herbs: Chuan Niu Xi guides Blood downward, Lu Lu Tong unblocks the "pipes", Zi Shi Ying warms the Uterus – precisely targeting the affected area.
Modifications & Applications:
Significant Kidney Yang Deficiency (aversion to cold, cold limbs, low libido): Add Yin Yang Huo (Epimedium) 12g, Rou Cong Rong (Cistanche) 15g: Strengthen warming Kidneys and supporting Yang, ignite the "fire of the Life Gate".
Yin Deficiency with Effulgent Fire (hot flashes, night sweats, dry mouth/throat): Add Nu Zhen Zi (Ligustrum Fruit) 15g, Han Lian Cao (Eclipta) 15g: Nourish Kidney Yin, clear and descend deficient fire. Reduce Zi Shi Ying dosage or remove it.
Severe Blood Stasis (purple-dark tongue with stasis spots, abdominal pain resisting pressure): Add Tao Ren (Peach Kernel) 9g, Hong Hua (Safflower) 6g: Enhance Blood-invigorating and stasis-removing power.
Severe Phlegm-Damp Obstruction (obesity, thick greasy coating): Add Cang Zhu (Atractylodes Rhizome) 12g, Zhi Ban Xia (Pinellia Rhizome Prep.) 9g: Strengthen drying Dampness and resolving Phlegm.
Diminished Ovarian Reserve (low AMH, high FSH): Add Zi He Che Fen (Human Placenta Powder) 5g (infused) or Lu Jiao Jiao (Deer Antler Glue) 10g (melted): Flesh and blood tonics, strongly tonify Essence and Blood, improve ovarian reserve.
Medical Case
Patient: Ms. Liu, 38 years old.
History: Amenorrhea for 1.5 years. Menstruation stopped suddenly 1 year ago after intense work pressure and consecutive late nights finishing a project. Previous hospital tests: AMH 0.2 ng/ml, FSH 45 IU/L, ultrasound showed slightly small uterus, thin endometrium (only 4mm). Western diagnosis: "Premature Ovarian Failure", told natural pregnancy chance extremely low. Tried artificial cycle therapy (Progynova + Progesterone), had scant withdrawal bleeding during medication, amenorrhea returned upon stopping. Accompanied by severe hot flashes/night sweats (several times daily), insomnia, forgetfulness, irritability, sore and weak lower back and knees, vaginal dryness.
Initial Consultation: Dull, lusterless complexion, dark circles under eyes. Tongue dark red, scant coating, stasis spots on edges. Pulse deep, thready, taut, and rapid. Anxious and depressed mood.
Pattern Differentiation: Kidney Essence deficiency, Yin Deficiency with Effulgent Fire, combined with Liver Stagnation and Blood Stasis.
Treatment Principle: Nourish Kidneys and replenish Essence, nourish Yin and descend Fire, soothe Liver and invigorate Blood.
Prescription: Modified Yi Shen Tong Jing Tang.
Herbs: Tu Si Zi 18g, Fu Pen Zi 15g, Gou Qi Zi 20g, Nu Zhen Zi 15g, Han Lian Cao 15g, Dang Gui 12g, Ji Xue Teng 30g, Chai Hu 9g, Chao Bai Shao (Stir-fried White Peony) 15g, Lu Lu Tong 12g, Chuan Niu Xi 12g, Dan Shen (Salvia Root) 15g, Sheng Di Huang (Raw Rehmannia) 20g, Suan Zao Ren (Spine Date Seed) 30g (crushed), Zi He Che Fen 5g (infused).
Second Consultation: After taking 15 doses, hot flashes and night sweats basically disappeared, lower back soreness reduced. Removed Han Lian Cao and Nu Zhen Zi (deficient fire subdued), added Zi Shi Ying 15g (decoct first) to warm the Uterus, added Sang Ji Sheng (Mulberry Mistletoe) 15g to strengthen lower back and knees. Continued taking.
Result: After 3 months of medication, menstruation returned! Continued consolidation treatment.
