1. Amenorrhea

2. Causes : emotions, diet, blood deficiency, and evils invasions such as dampness and coldness. Pathogenesis: blood and qi do not flow through the extra meridians smoothly, so they cannot reach to the uterus and form menses.

3. Deficient: –Deficiency of kidney-qi –Deficiency of kidney essence –Deficiency of spleen and stomach Excess(stasis): –Stagnation of qi and blood –Obstructions in the extra meridians –Excessive heat

4. Kidney deficiency Hyperactive fire due to yin deficiency Poor development of ovaries Emotional and physical stress Chronic (long-term) illness Major bleeding during delivery or miscarriage Long-term breastfeeding Infections of the reproductive organs Postpartum pituitary insufficiency Ovarian problems such as premature ovarian failure (menopause before age 40) Western Diagnosis TCM Syndrome Patterns

5. Kidney deficiency and phlegm obstruction Yin deficiency in the liver and kidneys Stagnation of blood and qi Dysfunction in the heart, spleen and kidneys Polycystic ovarian disease Endocrine disorders such as Cushing Syndrome Pituitary tumor Galactorrhea amenorrhea syndrome Miscarriage or delivery that causes damage to the uterus Anorexia Emotional and physical stress TCM Syndrome Patterns Western Diagnosis

6. Symptoms: –delayed onset of menstruation. –The menses become thin and scanty –weakness, physical immaturity –pale face, dizziness, ear ringing, frequent urination, soreness in the back and knees. Basic prescription: 蓯蓉菟絲子丸

7. Symptoms ： –gradual cessation of menstruation. –weakness and soreness in the back and knees –insomnia, dizziness and ear ringing. –vaginal dryness with little discharge. Basic prescription: 歸腎丸

8. Symptoms ： –gradual cessation of menstruation. –paleness, fatigue, sleepiness, breathless, dizziness –palpitation, insomnia, and dream-disturbed sleep –skin dryness, lusterless hair and brittle nails. Basic prescription: 聖愈湯

9. symptoms: –a sudden cessation of menstruation –pain in the lower abdomen that can be relieved by warmth and sharpened by deep pressure –limb coldness Basic prescription: 溫經湯

10. Symptoms: –irregular menstrual cycle initially then the menstruation eases gradually or suddenly. –pain in the lower abdomen that can be sharpened by deep pressure –depression, irritability, breast tenderness Basic prescription: 血府逐瘀湯

11. Symptoms: –excessive sticky and clear vaginal discharge –nausea, phlegm in the throat –abdominal bloating, fatigue Basic prescription: 蒼附導痰湯