Premature Ovarian Failure at a Young Age: No Period for Months, Worsening Skin, Irritability, Critically Low AMH... What Effective TCM Remedies Exist?
What Causes Premature Ovarian Failure (POI)?
Dr. Que Poh Yuen Albert, a TCM Gynecology Specialist at Singapore's Gong Fang Tang TCM, states that the trend of younger women experiencing Premature Ovarian Insufficiency (POI) is significant. It results from the compounding effects of multiple factors that "damage essence and consume blood":
Kidney Essence Deficiency, Shaking the Congenital Foundation (Core Pathogenesis)
Chronic Sleep Deprivation from Late Nights: Not sleeping during the Zi hour (11 pm-1 am) severely depletes the true Yin of the kidneys.
Repeated Miscarriages/Medicated Abortions: Damage the Qi and blood of the Chong and Ren vessels, directly exhausting kidney essence.
Excessive Dieting for Weight Loss: Deprives the source of Qi and blood production. Since "essence and blood share the same source", kidney essence inevitably becomes deficient.
Liver Stagnation and Blood Stasis, Blocking the Uterine Pathways
High-Pressure Anxiety: Liver Qi stagnation → Qi stagnation and blood stasis → Insufficient blood supply to the ovaries, hindering follicle development.
History of Pelvic Surgery: Procedures like induced abortion or ovarian cystectomy can cause local adhesions and blood stasis.
Spleen Deficiency with Dampness Accumulation, Failing Acquired Nourishment
Overindulgence in Cold Drinks and Sweet, Greasy Foods: Damages Spleen Yang, leading to internal phlegm-dampness that congests the uterus.
Prolonged Sitting and Lack of Exercise: Weakens the Spleen and Stomach's transportation and transformation functions, preventing Qi and blood from nourishing the ovaries.
"Silent Injury" from Modern Environmental Toxins
Plasticizers, Heavy Metals: Interfere with the endocrine system (estrogen-like effects) via daily products and the food chain.
Ionizing Radiation, Chemical Drugs: Certain chemotherapy drugs, long-term exposure to harmful environments.
How Does TCM Effectively Regulate Premature Ovarian Failure?
Addressing the core pathogenesis of Kidney Essence Deficiency and Chong-Ren Vessel Dysregulation, Dr. Que primarily selects the "Yijing Decoction" (Benefit the Menses Decoction) by Fu Qingzhu, a renowned Qing Dynasty gynecologist, as the foundational formula. This classic formula targets the female reproductive system and is expertly modified for modern female constitutions.
Yijing Decoction consists of: Shu Di Huang (Prepared Rehmannia Root), Bai Zhu (Largehead Atractylodes Rhizome), Shan Yao (Chinese Yam), Dang Gui (Chinese Angelica), Bai Shao (White Peony Root), Sheng Zao Ren (Spine Date Seed), Dan Pi (Tree Peony Bark), Sha Shen (Ladybell Root), Chai Hu (Bupleurum Root), Du Zhong (Eucommia Bark), Ren Shen (Ginseng).
Huang Qi (Astragalus Root) tonifies Qi, Dang Gui (Chinese Angelica) tonifies blood – these two herbs directly supplement Qi and blood.
E Jiao (Donkey-Hide Gelatin), Da Zao (Jujube) assist in supplementing Qi and blood.
Bai Zhu (Largehead Atractylodes Rhizome), Fu Ling (Poria), Gan Cao (Licorice Root), plus Huang Qi (Astragalus Root), Shan Yao (Chinese Yam) fortify the Spleen and supplement Qi, enabling the Spleen and Stomach to continuously generate Qi and blood, improving deficiency from the source.
Dan Pi (Tree Peony Bark), Zao Ren (Date Seed) clear heat and transform stasis, removing deficiency heat and blood stasis, balancing Yin and Yang.
Du Zhong (Eucommia Bark), Shu Di Huang (Prepared Rehmannia Root) tonify the Liver and Kidneys; Chai Hu (Bupleurum Root), Bai Shao (White Peony Root) soothe Liver Qi and nourish Liver blood.
The entire formula balances "tonification, unblocking, and regulation," improving POI symptoms from the inside out.
Modifications for Effective Use:
Prominent Yin Deficiency with Fire Effulgence: Severe hot flashes and night sweats – add Di Gu Pi (Lycium Root Bark) 12g, Zhi Mu (Anemarrhena Rhizome) 10g.
Yang Deficiency with Cold Aversion: Add Ba Ji Tian (Morinda Root) 12g, Tu Si Zi (Dodder Seed) 15g (warm but not drying).
Poor Follicle Development: Add Tu Si Zi (Dodder Seed) 15g, Gou Qi Zi (Goji Berry) 15g, Fu Pen Zi (Raspberry) 12g (tonify Kidney, promote ovulation).
Medical Case
Patient: Ms. Liu, 30 years old.
Chief Complaint: Infrequent menstruation for over 1 year, complete amenorrhea for the past 6 months. Severe hot flashes (>10 times daily), insomnia, vaginal dryness, low mood. Diagnosed with POI at another hospital: FSH 58.6 IU/L, AMH 0.09 ng/mL. Western medicine recommended Hormone Replacement Therapy (HRT) and stated the chance of natural conception was extremely low.
Initial Consultation: Sallow complexion, dark eye circles. Tongue pale-dark with tooth marks, thin white coating. Pulse deep, thin, and choppy.
Pattern Differentiation: Spleen and Kidney Deficiency (primarily Kidney Essence depletion), Liver Stagnation and Blood Stasis, Chong and Ren Vessel exhaustion.
Prescription: Modified Yijing Decoction.
Formula: Shu Di Huang (Prepared Rehmannia) 30g, Chao Bai Zhu (Stir-fried Atractylodes) 30g, Shan Zhu Yu (Asiatic Cornelian Cherry Fruit) 15g, Shan Yao (Chinese Yam) 15g, Dang Gui (Chinese Angelica) 15g, Dan Shen (Salvia Root) 15g, Ji Xue Teng (Spatholobus Stem) 20g, Chai Hu (Bupleurum) 6g, Suan Zao Ren (Sour Jujube Seed) 15g, He Huan Pi (Silktree Albizzia Bark) 12g, Dan Pi (Tree Peony Bark) 9g; Formula adjusted during follow-ups, e.g., adding Tu Si Zi (Dodder Seed) 15g, Gou Qi Zi (Goji Berry) 15g, Zi He Che Fen (Dried Human Placenta Powder) 3g (taken infused).
Lifestyle Advice: Sleep before 22:30; Avoid raw, cold, and chilled foods; Brisk walking 30 minutes daily; Emotional counseling.
Result: By Month 1: Hot flashes reduced to 3-4 times daily, sleep quality significantly improved, mood more stable. By Month 3: Menstruation returned! Scanty flow, dark red color. Re-test: FSH dropped to 32.4 IU/L, AMH rose to 0.21 ng/mL. By Month 5: Menstrual cycle stabilized at 35-40 days, flow increased to moderate. FSH 18.7 IU/L, AMH 0.48 ng/mL. Physical discomfort symptoms mostly disappeared.
