David Lee
Saint Johns Street, Port Moody, British Columbia, Canada
20 years exp

Total years in practice: 20

Publish Date
September 06, 2018
23 Years, Female, White
Medical Condition
Menstrual Bleeding (Heavy)
Medical History


Chief Complaint: very heavy & painful period for 2 yrs (since she broke up w/ high school sweet heart)

Periods: heavy (she has to change protection every 2 hours at cannot sleep well at night during the 1st 3 days because she’s always worried about leakage). Her blood is dark w/very dark clots; during periods, she suffered from strong lower abdominal cramping that is better with a hot-water bottle. The cycle is regular & menarche was at 14yrs of age. PMS: moody, breast distension, stabbing headaches, and very bloated.

Other Symptoms: Cold hands & feet most of the time. She drink a lot of teas and doesn’t like cold drinks. She has tendency to constipation especially a week before her period. She also works as a librarian and has been diagnosed with Carpal tunnel syndrome. Her constant pain is worse at night and better with warmth.

  • T: bluish in centre & purple at sides

  • P: Wiry-choppy (left middle position), and tight-thin (right middle position).

Case Management

Diagnosis: LV Blood stasis (with underlying LV Qi stagnation) & internal cold.


Treatment principles: Move Blood & Qi, warm the meridian & scatter cold.

  • Cause: Emotions (broke up with high school sweetheart).

  • Differentiation of symptoms:

  • – Blood stasis: dark blood with clots, strong cramps, stabbing headaches, carpal tunnel syndrome worse at night, purple sides of the tongue, wiry choppy pulse.

  • – Internal Cold: period cramps better on warmth, carpal tunnel syndrome pain better with heat, bluish tongue, tight pulse.

  • – LV Qi stagnation: Cold hands and feet, PMS (breasts tenderness, moody, bloated, constipation).

  • – The thin pulse is starting to show a blood deficiency, due to the heavy bleeding.

  • Diet recommendation: no processed foods or too much salty foods, no alcohol! Adding apple cider vinegar daily, turmeric, lemon, and sauerkraut to the diet. And starting SEED Cycling (which helps balance & regulate hormones).

Acupuncture Points: weekly treatment

  • SP 4 (R), PC 6 (L): to address blood stasis and balance the Chong vessel (The sea of blood).

  • Sp 10 & Sp 8: to relieve period pain & slow down the bleeding.

  • Sp 1: to slow down the bleeding needled only during the first 2 days of the period.

  • Sp 6 to balance Lv, Kd & Sp.

  • St 29 with Moxa to warm the uterus and scatter cold.

  • LV 3 & Li 4 to move blood (LI 4 was omitted during the period week).

  • PC 7: Ghost point to help heal from a broken heart.

  • Herbal formula: Tao Hong Si Wu Tang w/modification

  • Tao Hong Si Wu Tang: Moves blood & nourish blood.

  • Whu Zhu Yu, and Gui Zhi: to warm uterus & scatter cold.

  • Pu Huang & Wu Ling Zhi: stop pain by moving blood.

  • San Qi and E Jiao: stop bleeding.

Outcome of treatment

After 1 month: her hands and feet were no longer cold, she had formed BM, experienced less PMS and the period pain was almost non-existent. So the herbal formula was stopped. But acupuncture continued weekly.

After 2 more months: most her symptoms were history: her period had normal flow (she changed protection every 4 hrs the first 2 days, and the last 3, only 2/day). They were no clots and no pain!

Western Approach to Heavy Periods

Causes: postpartum, menopause, fibroids, polyps, drugs (like blood thinners), cancer.

Tests: the doctor may do a physical exam, perform a PAP, need to order Blood tests (for thyroid issues & low Ferritin & red blood cell…), also a Endometrial biopsy or Ultrasound may be required to rule out any major issues.

Treatment options: Hormonal IUD, Birth Control Pill, NSAIDs, D & C, endometrial ablation, uterine artery embolization, hysterectomy.

Basic TCM Treatment Protocols for Heavy Periods

Definition: Heavier than average consisting of the woman changing protection very often (every hour!). Heavy menstrual bleeding is defined as losing 80 ml or more in each period, having periods that last longer than 7 days, or both.

Causes: Over work (physical or mental), emotional stress, irregular diet, internal heat, toxic heat, postpartum, menopause, masses.

Tx options: Ear (Shen Men, LV, SP, KD).

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