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Ben Lou Syndrome (Menorrhagia and Metrorrhagia)

Some key points of vocabulary:

Menorrhagia is excessive flow during period.
Menostaxis is an excessively long period
Metrorrhagia is bleeding outside the period proper
Metrostaxis is spotting outside the period proper

Key Diagnostic Points:

1. Menstruation comes irregularly with heavy bleeding or metrostaxis (spotting which can last up to the full monthly cycle) or profuse bleeding during menstruation, prolonged menstrual period, early menses.
2. In TCM, Ben means "bursting through", Lou means "leaking"

Differential Diagnosis:

1. Heat in the blood

Sudden abnormal bursts of profuse menstrual bleeding or uterine bleeding prolonged and sustained for many days. Accompanied with restlessness, fever, thirst, lower abdominal pain, dark urine, constipation.

Blood: Bright or deep red, thick and sticky
Tongue: Thin yellow coat
Pulse: Rapid

2. Blood stasis

Abnormal and frequent bursts of menstrual bleeding manifested as menorrhagia or menostaxis. Accompanied by distending pain in the lower abdomen.

Blood: Dark colored with clots
Tongue: Purple with thin white coating
Pulse: Choppy

3. Spleen deficiency

Irregular menstrual cycle, manifested as metrorrhagia or metrostaxis, prolonged menstruation, accompanied with shortness of breath, spiritlessness (dim Shen), pale face, poor appetite.

Blood: Light colored and thin
Tongue: Pale with thin white coat
Pulse: Deep and/or weak

4. Kidney Yang Deficiency

Prolonged bleeding with a trickle for a long time after the period proper. Late periods, cold feelings, sore back, cold limbs, pale complexion, weak knees, pale urine.

Blood: Pale
Tongue: Pale and swollen with thin white coat
Pulse: Deep and weak

5. Kidney Yin Deficiency

Trickling of blood after the period proper. Late cycle, dizziness, tinnitus, weak knees, feelings of heat in the evening, night sweats, hot flashes, malar flush, mental restlessness.

Blood: Fresh red color
Tongue: Red with no coat
Pulse: Thready and rapid

Treatment Principle:

1. Heat in the blood
Clear heat, cool blood, stop bleeding

2. Blood stasis Move blood, eliminate stasis, stop bleeding

3. Spleen deficiency
Tonify Qi, strengthen the Spleen, nourish Blood, stop bleeding

4. Kidney Yang Deficiency
Tonify and warm Kidney Yang, strengthen Chong channel, stop bleeding

5. Kidney Yin Deficiency Nourish Kidney Yin, stop bleeding

Point and Technique Prescription:

Points to control inappropriate bleeding:

Sp 4 and PC 6: A pair of confluent points on the eight extra channels. They open the Chong channel, which is the sea of blood.

St 30 "Qi Chong" Located at the beginning of the Chong channel. It treats disorders associated with the Chong Channel which is known as the Sea of Blood in the body and intimately associated with menses.

Sp 8, Liv 6, Kid 5
All three are Xi cleft points to stop uterine bleeding.

Sp 10 Sea of blood, moves and tonifies the Blood.
Sp 1 A point known through experience to be used for Ben Lou syndrome.
Sp 6 The crossing point of three Yin channel moves and tonifies blood.

For Blood Heat, add:

L.I. 11 Clears heat, cools Blood.

For Blood stasis, add:

SJ 5, SJ 6
San Jiao channel for qi diseases. These points stimulate the free flow of Qi which is the commander of Blood. It is the driving force behind the movement of the Blood and keeps it flowing within the vessels.

Liv 1 Moves Liver Blood and stops bleeding.
Liv 3 Stimulates the free flow of Liver Qi and hence moves Blood.

For Spleen deficiency, add:

Ren 6 Sea of Qi, tonifies Qi and stops bleeding due to Spleen Qi not holding.
Du 20 helps to raise Clear Qi and stop bleeding due to Qi not holding.

UB 20 Spleen Shu
UB 21 Stomach Shu
St 36 He sea point of Stomach channel
All three tonify the Spleen Qi.

For Kidney Yang Deficiency, add:

Ren 6 Tonifies Qi and stops bleeding
St 36 Tonifies postnatal Qi and Blood to assist the prenatal in the Kidneys.

UB 23, Ren 4
These two points are treated with Moxa, they tonify and warm the Kidney Yang

Kidney 7 Mother point on the Kidney channel to tonify the Yang.

For Kidney Yin deficiency, add:

Ren 6 Tonifies Qi and stops bleeding

UB 23, Kid 3
These two points tonify the Kidney Yin

Kid 2 The Ying Spring point of the Kidney channel, clears deficiency heat from the kidneys.
St 36 Tonifies postnatal Qi and Blood to assist the prenatal in the Kidneys.

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